Question 11150 — health professions

Summary

Mr. Jean-Yves Bony draws the attention of the Minister of Solidarity and Health to the attribution of part of the acts of care contained in the decree on the act and exercise of masseurs-physiotherapists, to chiropractors, by an order published in the Official Journal on February 13, 2018. It is clear that this order, which defines the training of chiropractors and contains a framework of activities and skills, mentions in its appendices of teaching in chiropractic schools multiple care techniques which go well beyond simple joint manipulation and encroach very widely on the field of functional rehabilitation. This decision is all the more surprising as this decree increases the skills of chiropractic even though it is today considered “an unconventional care practice” (PSNC). That risks further complicating the patient's care pathway, since from now on, the distinction between what is the responsibility of the physiotherapist and what is the responsibility of the chiropractor can only be made with regard to the functional state of the patient, even though no relevant indication in the text allows us to place the limit of intervention of one professional in relation to the other. This also risks creating a de facto double regime of access to the same care. Indeed, for the same pathology, the patient will be able to access the chiropractor unconditionally or access the physiotherapist on condition of obtaining a prescription from their doctor. Physiotherapists fear that this new deregulation will ultimately lead to a dereimbursement of their services since those of chiropractors are not covered by health insurance. Regarding the recognition of their course of study, physiotherapists follow a long process which is not validated at its fair value. Thus, the first year common to health studies (PACES) delivering 60 ECTS is still not added to the other 240 ECTS delivered during the four additional years of institute training. It would therefore be logical for them to obtain 300 ECTS. He would like to know how the Government intends respond to the concerns raised by this order and the risks it entails. Furthermore, he asks them if they intend to recognize their diploma as a master 2 degree as already exists in other European and Anglo-Saxon countries.

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