Changing Landscapes: The Advanced Generalist; Improving career structure for rural physiotherapists

Kelly  Thurlow1

1University Of Newcastle Department Of Rural Health , Taree, Australia

The scope of physiotherapy practice in rural and remote areas has potential for workforce change. Rural and remote physiotherapists are seen as specialist generalist, required to work across a wide variety of conditions and lifespan. However, there is often a lack of career advancement for the rural physiotherapist.

There is strong evidence that advanced practice physiotherapy roles in the Emergency Department (ED) can improve service performance, decrease waiting times and improve overall patient and staff satisfaction.  Advanced practice roles for physiotherapists in rural areas could enhance both service delivery and provide a training pathway for career advancement.

An advanced practice physiotherapy role employed under the University of Newcastle Department of Rural Health, provided a service to the ED at a Rural Referral Hospital.

Data was collected over a 6 month period from the physiotherapy service looking at the number of patients in triage Category 3-5, seen as a primary contact role meeting the national four hour timeframe.

Results:  The following percentage of patients where seen and discharged within 4 hours

  • Category 3 patients 62%
  • Category 4 patients, 87%
  • Category 5 patients, 92%

Over all advanced practice, roles within physiotherapy can improve outcomes for a Rural Referral Hospital.  Additionally the benefits for the physiotherapist is to improvement in role recognition, increase in workplace satisfaction.  Enhancement of skill base is an important factor in development of a career.


Kelly has worked in rural facilities in Far North Queensland, and on large state-wide projects such as the HP redesign for Queensland Health as the rural and remote representative, as well as previously being on the APA Rural issues Committee. Kelly currently works with the University Of Newcastle Department Of Rural Health. Her role involves clinical supervision for undergraduate student in the Emergency Department. Her interests remain around advocacy for rural and remote health and the advanced practice models of workforce re design, development and application of advanced scope roles across the physiotherapy and formalized and Australia wide training pathways.

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