Physiotherapy in

Physiotherapy in Greece Interna<onal Perspec<ves in Physiotherapy Professor: Staes Filip Student: Piperakis Spyridon 18/5/2015 Overview ü  Greece in numbers ü  Physiotherapy Educa<on in Greece •  Public •  Private •  Effect of crisis •  Conclusion ü  Status of profession ü  Effect of crisis ü  Physiotherapy Profession in Greece •  Public •  Private •  Effect of crisis ü  Abbrevia<ons ü  References Greece in numbers • 
Language: Greek • 
Loca7on: southeastern of Europe • 
Capital: Athens (3.827.624 Inhabitants) • 
Popula7on: 10.816.286 (2014) • 
Popula7on density of: 81,96/km2 (2014) • 
13 regions • 
Surface: 41.543km2 (0.8669 % water) Has the longest coastline on the Mediterranean Basin and the 11th longest coastline in the world at 13,676 km (8,498 mi) has in length, featuring a vast number of islands (2.000, 227 are inhabited) • 
Mountains: 8%, Olympus is the highest peak at 2.917 m (9,570 X) • 
Religion: Orthodox-­‐Chris<an • 
Currency: Euro Physiotherapy educa<on in Greece Public Sector •  Faculty of Health and Caring professions Department of Physiotherapy 4 Technological Educa<onal Ins<tu<ons (T.E.I) equivalent to universi<es 1. 
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Athens Thessaloniki Lamia Patras (Aigio) Physiotherapy educa<on in Greece Public Sector •  Admission Requirements ü  Cer<ficate of Upper Secondary Educa<on (Lyceum) ü  Pan-­‐Hellenic entrance examina<ons (Final Exams) Entrance grades 2014 TEI Athens = 16,29/20 TEI Thessaloniki = 16,02/20 TEI Lamia = 14,93/20 TEI Patra (Aigio) = 14,77/20 Physiotherapy educa<on in Greece Public Sector Ø  Curriculum In total 4 years (8 semesters) à 240 ECTS 7 semesters : Theore<cal classes, prac<cal classes, laboratories, clinical exercises in hospitals from the 3rd semester, wri<ng research assignments and seminars. 8th semester : ü  Supervised clinical placement 6 months (26 weeks, 1040 hours) in Public hospitals, Health ins<tu<ons ü  Disserta<on Ø  The studies covers Pathological disorders and dysfunc<ons of: 1. 
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Orthopedic Rheuma<c Sports associated Neurological (adults and children) Respiratory Cardiovascular Physiotherapy educa<on in Greece Post graduate Studies q  Master of Science in Advanced Physiotherapy (since 2014) / Dura<on : 2 years on TEI Lamias / Tui<on fees 6.000 € q  Seminars in Manual Therapy (18 months) approved by IFOMPT From: Hellas OMT / A.M.P.G (Associa<on of Manipula<ve Physiotherapists of Greece) Η-­‐OMT-­‐D (Hellenic Orthopaedic Manipula<ve Therapy Diploma, since 2014) Theore<cal & laboratory courses: 264 -­‐ 340 h Clinical placement: 180 -­‐ 522 h Fees: 4.000 -­‐ 8000 € q  Specializa<on in paediatric physiotherapy T.E.I Thessaloniki – Paediatric clinic “Hippocrates University Hospital” Dura<on : 210 hours / part <me Tui<on fees : 1.200 € Licensed physiotherapist can follow further specific Master programs at: ü  Public universi<es of Health Sciences and Health Care (Medicine School) ü  Public universi<es of Sports Sciences Physiotherapy educa<on in Greece Post graduate seminars from Panhellenic Associa<on of Physiotherapists (PAP) R  Previously exis<ng sec<ons of PAP: •  Sec<on of Cardiovascular and Respiratory Physiotherapy – Rehabilita<on •  Sec<on of Sports Physiotherapy •  Sec<on of Hellenic Orthopaedic Manipula<ve Therapy R  New / under construc<on sec<ons of PAP: • 
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Physiotherapy in Geriatrics Physiotherapy and Psychological Health Physiotherapy in women Physiotherapy in children Physiotherapy educa<on in Greece Private Sector 1)  Bsc in Physiotherapy : Metropolitan College (Athens, Thessaloniki) collabora<on with Queen Margaret University (UK) , 4 years Ö 480 credits 2)  Bsc in Physiotherapy : IST college (Athens) collabora<on with University of Herlordshire (UK) Ö 3 years 3)  Bsc in Physical Therapy : Amco College (Athens)/ University of Plymouth (UK) Ö 3 years Requirements High School degree English Tui<on fees : 5.000 – 7.000 € / year Physiotherapy educa<on in Greece Studies Assistant of Physiotherapy IEK (public or private Ins<tute of Voca<onal Training) Public IEK of Athens , Thessaloniki, Patra, Ioannina, Lamia Private •  IEK KSINI •  IEK SVIE •  IEK DELTA •  IEK AKMI (Athens – Thessaloniki) •  IEK OMIROS Total Dura<on : 2 years Alumni of that kind of educa<on are prohibited to open a private prac<ce, to work in a hospital or to provide a treatment in a pa<ent (only assistants) BUT they can work in hotels or Spa centers Physiotherapy educa<on in Greece Effect of crisis •  Ministry of educa<on ¼ number of those admioed in Physiotherapy & small increase in capital and 2nd biggest city TEI Athens TEI Thessaloniki TEI Lamia TEI Patra(Aigio) 2014-­‐2015 100 100 150 125 2015-­‐2016 105 110 110 120 Physiotherapy educa<on in Greece Conclusion Q  Lack of specialized Master programs integrated in the facul<es of public educa<on Q  No interna<onal programs Q  Teaching language in public universi<es is only Greek Q  No ac<ve collabora<on of T.E.Is in scien<fic research and publica<ons Q  Private educa<on requires high tui<on fees and diploma recogni<on & professional rights are doublul in Greece Course taught in Universi<es TEI (Technologica
l Educa<onal Ins<tu<ons) Admission -­‐ Pre selec<on Dura<on 5 years 4 years Internship 8 months 6 months Status of profession u 
Greece has established a code of ethics for physiotherapists based on WCPT Ethical Principles. The Ministry of Health is the na<onal authority which is responsible for the physiotherapy profession in Greece. The rules of professional conduct are determined directly by the state through na<onal legisla<on. u 
The physiotherapist must be stay registered on Panhellenic associa<on of Physiotherapy (PAP) and obtain a license to prac<ce. Without membership to PAP no PT can acquire a license to legally perform their profession. u 
T h e 7 t l e a n d t h e p r o f e s s i o n a l a c < v i t y i n m y c o u n t r y c a l l e d “Physiotherapist” (physiotherapeWis) and it is protected by the state. Status of profession Effect of crisis
According to the Code of Deontology in Greece u 
PT can provide free services or with less amount of money to needy people or economically weak pa<ents without adver<se himself or to compete in a fraudulent way his colleagues. Every person who has insurance coverage is not considered needy against Physiotherapist Physiotherapy profession in Greece Number of PTs / countries Country N of inhabitants N of PTs Inhabitants per PT % of Members of unemployment the na7onal associa7on Austria 8.174.762 6.000 1.362 0 4.200 Belgium 10.348.276 18.000 575 NA 3.000 Denmark 5.336.394 9.408 567 3.5 9.408 Germany 82.797.408 75.000 1.103 6 31.682 Spain 40.280.780 22.000 1.831 7 6.223 United Kingdom 60.270.708 35.952 1.676 0 32.000 Greece 10.601.527 5.000 2.120 10 4.000 From European Region of the world Confedera<on for Physical Therapy, 2005 Physiotherapy profession in Greece Public Sector •  Public Hospitals : 107 hospitals (General, Psychiatric and Peadiatric) & 15 Military ones !  In Amki, 236 PTs in 11 hospitals 1 PT per 49 hospital beds (study 2000) !  In 16 hospitals in the periphery 1 PT per 91 hospital beds (study 2000) •  Centers of Health •  Free Clinics •  Centers of open protec<on of elderly (KAPI in Greek) •  Secondary and higher educa<on (academic career) •  Centers of Medicine and Rehabilita<on (KEFIAP in Greek) •  Insurance providers Physiotherapy profession in Greece Field of employment Number of PTs Hospitals 600 Centers of open protec<on of elderly 200 Insurance providers 100 Home treatments / employees 500 Private prac<ce owners 2500 Unemployed / Working in other fields 1600 Total 5500 From PAP 2008 Physiotherapy profession in Greece Public Sector -­‐ Effect of crisis 1. 
None staff recruitment of PTs for the Public sector since 2010 where the crisis began 2. 
Remarkable lack of PTs in public hospitals 3. 
600 are employed BUT 600 are s<ll needed Centers are under-­‐subsidized & underfunded § 
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15 -­‐ 20 Centers of Medicine and Rehabilita<on (KEFIAP) DO NOT func<on at all, even though they are full equipped. TOTAL: 69 private rehabilita<on centers in Greece!! EOPYY owes money to the centers. Funds are used to pay off the commissions towards private prac<ces and/or rehabilita<on centers Last years the best Public Rehabilita<on Center used to have a wai<ng list (6-­‐8 months) BUT now any pa<ent can immediately find a place Physiotherapy profession in Greece Private Sector / Independent Prac<<oners Obligatory facili<es in a private physiotherapy lab: •  A wai<ng room •  An office •  Fully equipped treatment rooms, each room with separate physiotherapy and hydrotherapy space •  Toilet Specific equipment to obtain the license to have yours private prac<ce: ü  Hydrotherapy tank ü  Whirlpool bath ü  Different kinds of chairs and pillows ü  Shortwave medical diathermy ü  Ultrasound therapy unit ü  Transcutaneous nerve s<mulator ü  Paraffin wax bath ü  Hot/ freeze packs Physiotherapy profession in Greece Private Sector 1. 
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Dura<on of treatment Time of a session varies : condi<on, coopera<on & number of treatments are needed Ranges from 30 -­‐60 min. some<mes can exceed 90 min. Number of sessions : 5 -­‐10 visits but depends on the condi<on Special cases : Ø  Stroke & Severe motor disabili<es (e.g paraplegia, quadriplegia, etc.): 10 sessions / month for 6 months (re-­‐evalua<on) Ø  Severe reversible orthopedic problems (e.g. severe fractures): 12 sessions / month for 6 months Physiotherapy profession in Greece Private Sector Payment, sessions & insurance Customer has insurance (public / private) . Depending on the Insurance, the fund may be fully or par<ally covered At the referral, the number of sessions and the necessary physiotherapeu<c procedures per session are indicated by the doctor. Public insurance Only 10 sessions of two (2) <mes / year is jus<fied from the Greek Health Care System. Fees = 15 € / session home visits = 12 € , 12 sessions / month up to 6 months Pa<ents can be self refer to physical therapists in private prac<ce OR they have private insurance = PT define the fee / session Physiotherapy profession in Greece Private Sector – Effect of crisis Ø  Due to specific laws which defined by the government in order to eliminate the country’s debt. 1.  EOPYY (Na<onal Health Care Insurance Organiza<on) have been withhold from PTs four months of 2014 (May-­‐June & November-­‐December) + 10% of 2014 = 35 million € 2.  EOPYY refuses to pay the amounts dues to PTs = 70 million € 3.  Each month the debts EOPYY to contracted physiotherapists Ý by 5.5 million € 4.  PTs from 27/11/2014 un<l now have been paid only for a month from EOPYY 5.  PTs -­‐ due to delays of EOPYY -­‐ can not pay taxes, pension funds, banks and suppliers º endangered to close 2100 private prac<ces = loss of at least 5.000 jobs For that reason PTs stop the collabora7on with the EOPYY = pa7ent has to pay individual the whole amount of money = ¼ people visit PT Abbrevia<ons v  WCPT : World Confedera<on of Physical Therapists v  PAP : Panhellenic Associa<on of Physiotherapists v  PTs : Physiotherapists v  TEI : Technological Educa<onal Ins<tute v  KAPI in Greek : Centers of open protec<on of elderly v  KEFIAP in Greek : Centers of Medicine and Rehabilita<on References Ø 
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hop://en.wikipedia.org/wiki/Greece hop://www.physio-­‐europe.org/download.php?memberprofile=27 hop://www.neolaia.gr/wp-­‐content/uploads/2014/07/sxoles-­‐eisakteoi.pdf Code of ethics of physiotherapists adopted by decision of the Ministry of Health (Αριθμ. Υ7γ/ΓΠ/οικ. 107359) European Region Website: www.physio-­‐europe.org hop://www.psf.org.gr/ Regula<on of Physiotherapy Prac<ce Report, 1st WHPCR The Role and Future of Health Professions, Regula<on Margaret Grant © November 2008,pg 4 hop://www.psf.org.gr/ hop://www.tkafa.gr hop://ekapreli.wix.com/sportsphysio hop://www.homtd.gr hop://www.psf.org.gr/news_details.php?id=2638 hop://www.phys.teilam.gr/misc_files/odigos_epagg_physikotherapeuth.pdf hop://www.physio-­‐europe.org/download.php?document=69&downloadarea=18 hop://www.moh.gov.gr/ar<cles/ci<zen/xrhsima-­‐thlefwna-­‐amp-­‐dieythynseis/75-­‐nosokomeia-­‐ana-­‐
ygeionomikh-­‐perifereia hop://www.iatropedia.gr/index/informa<on/11 hop://www.iatropedia.gr/ar<cles/read/9837 hop://www.tovima.gr/society/ar<cle/?aid=635099 hop://www.tovima.gr/society/ar<cle/?aid=659155 hop://www.tovima.gr/society/ar<cle/?aid=684779 hop://www.neolaia.gr/wp-­‐content/uploads/2015/04/%CE%A0%CE%AF%CE%BD%CE%B1%CE%BA%CE%B1%CF%82-­‐%CE
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ώ Πολύ !
Thank you !