Regulation of the physiotherapy workforce in the private sector: from quotas to accessibility, instruments that empower administrations

The demographic regulation of physiotherapists in the private sector changed significantly in 2017, with the introduction of restrictions on public contracting in areas considered to be over-supplied. This regulation is based on a new instrument, Potential Localised Accessibility, which analyses the distribution of practitioners by modelling their accessibility. This poses the question of how the instrument deals with demographic issues, and the power relationships that arise when it is used. On the one hand, the question of accessibility by territory marks a change in the formulation of demographic problems, historically linked to the overall number of practitioners. On the other hand, the instrument used to evaluate distribution is reused to regulate it by serving as an indicator for choosing areas where the number of physiotherapists should be limited. By framing both the way of thinking about the demographic issue and the right density to accept in a given area, this instrument for public action makes it possible to tilt the balance of power in favour of health administrations to the detriment of representatives of physiotherapists.