THERAPY Magazin
Physiotherapy: the underestimated key to a healthier society
New studies show: Physiotherapy must shift from late-stage treatment to prevention, direct access, and digital innovation. Why systemic change is essential.
Why the healthcare profession needs external impetus – insights from two current studies
Physiotherapy in Germany is at a crossroads: it could be one of the cornerstones of a modern healthcare system, yet instead it struggles with outdated structures, lack of political recognition and a system that still views prevention as a secondary concern.
The figures speak for themselves: 35.8 million physiotherapy services were provided in 2022, 254 million individual treatments took place.[1] This, however, is not because the system is functioning well, but because it intervenes far too late. Instead of preventing discomfort, physiotherapy is only prescribed when patients are already struggling with pain and no longer know when and where their problems started. This is not a future-proof approach.
The PhysioStudie 2025-2035 study and additional survey of doctors and patients by the opta data Zukunfts-Stiftung foundation show where the problems lie – and what urgently needs to change. Both studies were initiated and conducted by the opta data Zukunfts-Stiftung foundation in cooperation with the Institute for Future Psychology and Future Management at the Sigmund Freud Private University Vienna. The PhysioStudie 2025-2035 study is based on a mixed-method approach which combines qualitative interviews with over 60 experts and a quantitative survey of around 1,900 physiotherapists. The opta data Zukunfts-Stiftung study is an online survey in which a total of 116 individuals (doctors and patients) participated and which complements the PhysioStudie.
The PhysioStudie 2025-2035 study and additional survey of doctors and patients by the opta data Zukunfts-Stiftung foundation show where the problems lie – and what urgently needs to change. Both studies were initiated and conducted by the opta data Zukunfts-Stiftung foundation in cooperation with the Institute for Future Psychology and Future Management at the Sigmund Freud Private University Vienna. The PhysioStudie 2025-2035 study is based on a mixed-method approach which combines qualitative interviews with over 60 experts and a quantitative survey of around 1,900 physiotherapists. The opta data Zukunfts-Stiftung study is an online survey in which a total of 116 individuals (doctors and patients) participated and which complements the PhysioStudie.
Patients want direct access but are blocked by the system
97.17% of the patients surveyed demand direct access to physiotherapy services as a health insurance benefit without the need for a doctor’s prescription. This means that they want to take responsibility for their health, but the system does not allow them to do so. The hurdles are enormous:
55.26% of patients report that they had difficulties getting a prescription at all.
35.96% couldn’t find a suitable practice or had to wait so long for an appointment that their condition worsened.
62.79% of the patients surveyed waited more than three weeks for their first treatment – during which time pain can become chronic.
67.39% of the physiotherapists surveyed feel that patients are assessed far too late in view of disease progression.
64.84% also believe that early physiotherapy could have avoided surgery.
In countries such as the Netherlands, Sweden or Great Britain, direct access to physiotherapy has long been a reality – with positive effects on patient care, treatment duration and costs to the healthcare system. Why is Germany clinging to outdated structures?
85.06% of the physiotherapists surveyed who participated in the online survey consider themselves professionally capable of making an adequate diagnosis. The knowledge acquired during training should be properly utilised and valued within the system. A forward-looking healthcare system should enable direct access, so that patients can be treated early, rather than suffering unnecessarily, having to resort to medication-based solutions or, in the worst case, developing chronic conditions or multimorbidity.
97.17% of the patients surveyed demand direct access to physiotherapy services as a health insurance benefit without the need for a doctor’s prescription. This means that they want to take responsibility for their health, but the system does not allow them to do so. The hurdles are enormous:
55.26% of patients report that they had difficulties getting a prescription at all.
35.96% couldn’t find a suitable practice or had to wait so long for an appointment that their condition worsened.
62.79% of the patients surveyed waited more than three weeks for their first treatment – during which time pain can become chronic.
67.39% of the physiotherapists surveyed feel that patients are assessed far too late in view of disease progression.
64.84% also believe that early physiotherapy could have avoided surgery.
In countries such as the Netherlands, Sweden or Great Britain, direct access to physiotherapy has long been a reality – with positive effects on patient care, treatment duration and costs to the healthcare system. Why is Germany clinging to outdated structures?
85.06% of the physiotherapists surveyed who participated in the online survey consider themselves professionally capable of making an adequate diagnosis. The knowledge acquired during training should be properly utilised and valued within the system. A forward-looking healthcare system should enable direct access, so that patients can be treated early, rather than suffering unnecessarily, having to resort to medication-based solutions or, in the worst case, developing chronic conditions or multimorbidity.
Prevention remains an unused potential
Another key finding of the studies is the lack of use of preventative physiotherapy measures. While physiotherapy is predominantly used for rehabilitation, disease prevention remains a marginal phenomenon – despite patient willingness to engage in preventative measures. Insurance companies and public health policy should provide incentives within this field.
Another key finding of the studies is the lack of use of preventative physiotherapy measures. While physiotherapy is predominantly used for rehabilitation, disease prevention remains a marginal phenomenon – despite patient willingness to engage in preventative measures. Insurance companies and public health policy should provide incentives within this field.
97.17% of the patients surveyed demand direct access to physiotherapy services as a health insurance benefit without the need for a doctor’s prescription.
86.36% of the patients surveyed stated that they would like to use preventative physiotherapy, even if they have no acute pain.
67.21% of the physiotherapists indicated that they perceive a lack of health literacy in society and that there are no social incentives to engage in prevention (59.01%).
52.45% believe that the healthcare system focuses on illness rather than on maintaining health.
65.57% see the professional mission in the role of a patient educator.
The economic advantages of preventative measures, for example in the area of back health, are substantial. According to an analysis by the German Institute of Medical Documentation and Information (DIMDI), significant savings can be achieved through workplace health management and preventative interventions. The Health Technology Assessment (HTA) 144 by DIMDI emphasises that preventative measures not only promote the health of employees, but can also increase productivity and reduce sickness absence.[2]
In addition, the report Zukunftsmarkt Prävention (Future Market Prevention) by FutureManagementGroup AG stresses the impor-tance of preventative approaches in the healthcare system. There can be significant long-term cost savings and the efficiency of the healthcare system can be improved through the use of early interventions and health promotion.[3] More precise figures cannot be determined due to the complexity of the system.
67.21% of the physiotherapists indicated that they perceive a lack of health literacy in society and that there are no social incentives to engage in prevention (59.01%).
52.45% believe that the healthcare system focuses on illness rather than on maintaining health.
65.57% see the professional mission in the role of a patient educator.
The economic advantages of preventative measures, for example in the area of back health, are substantial. According to an analysis by the German Institute of Medical Documentation and Information (DIMDI), significant savings can be achieved through workplace health management and preventative interventions. The Health Technology Assessment (HTA) 144 by DIMDI emphasises that preventative measures not only promote the health of employees, but can also increase productivity and reduce sickness absence.[2]
In addition, the report Zukunftsmarkt Prävention (Future Market Prevention) by FutureManagementGroup AG stresses the impor-tance of preventative approaches in the healthcare system. There can be significant long-term cost savings and the efficiency of the healthcare system can be improved through the use of early interventions and health promotion.[3] More precise figures cannot be determined due to the complexity of the system.
35.8 million physiotherapy services were provided in 2022, 254 million individual treatments took place.
Too many interfaces are connected to physiotherapy and the underlying health issues involved in a person’s recovery. However, what is certain is that a shift towards a more preventative approach could not only improve patients’ quality of life, but also reduce the burden on the healthcare system in the long term.
Digitalisation: desire for innovation
The digitalisation of physiotherapy offers great opportunities, but many patients are still reluctant to embrace it. The PhysioStudie 2025–2035 study shows that 88.52% of physiotherapists see AI-supported treatment as a valuable addition to traditional face-to-face therapy, primarily for monitoring and intensification purposes. Modern wearables that analyse movement patterns and provide real-time feedback can personalise and optimise therapy plans. Despite these technological advances, patients remain sceptical:
77.3% of the patients surveyed rate personal contact with their physiotherapist as “very important”/“important”.
Although 71.43% of the doctors surveyed would support more intensive collaboration, implementation fails.
86.62% of the physiotherapists surveyed state that intersectoral collaboration is too limited. Day-to-day collaboration seems difficult to im-
plement due to a lack of strategy and a common language for collaboration and shared goals.
The digitalisation of physiotherapy offers great opportunities, but many patients are still reluctant to embrace it. The PhysioStudie 2025–2035 study shows that 88.52% of physiotherapists see AI-supported treatment as a valuable addition to traditional face-to-face therapy, primarily for monitoring and intensification purposes. Modern wearables that analyse movement patterns and provide real-time feedback can personalise and optimise therapy plans. Despite these technological advances, patients remain sceptical:
77.3% of the patients surveyed rate personal contact with their physiotherapist as “very important”/“important”.
Although 71.43% of the doctors surveyed would support more intensive collaboration, implementation fails.
86.62% of the physiotherapists surveyed state that intersectoral collaboration is too limited. Day-to-day collaboration seems difficult to im-
plement due to a lack of strategy and a common language for collaboration and shared goals.
optaVita: future skills for modern healthcare
The results of the two studies show that healthcare is undergoing a fundamental change. Digitalisation, prevention and interdisciplinary collaboration are not just buzzwords, but critical factors for the future viability of physiotherapy and other healthcare professions. But change requires not only structural reforms – it requires above all a new mindset. This is where the optaVita workshop concept comes into play. It is a future training programme for all those who want to navigate and actively participate in an increasingly complex (health) world. Training is based on the insights of future psychology and conveys essential future skills to not only understand change processes, but to drive them forward and, above all, to avoid being left behind by the competition and continuous change.
The results of the two studies show that healthcare is undergoing a fundamental change. Digitalisation, prevention and interdisciplinary collaboration are not just buzzwords, but critical factors for the future viability of physiotherapy and other healthcare professions. But change requires not only structural reforms – it requires above all a new mindset. This is where the optaVita workshop concept comes into play. It is a future training programme for all those who want to navigate and actively participate in an increasingly complex (health) world. Training is based on the insights of future psychology and conveys essential future skills to not only understand change processes, but to drive them forward and, above all, to avoid being left behind by the competition and continuous change.
Why future skills are crucial
We are at the dawn of an era in which healthcare professions and their clients must work in a more connected, technological and interdisciplinary manner. But what good is the best technology if there is no common language? Future skills are the key to developing not only professional competence, but also resilience and pre-resilience, flexibility and an innovative spirit. This is where optaVita steps in. For one thing is certain: the health sector is changing. The question is not whether but how we will use this change. We can shape our future – with the right skills, the right knowledge and the right attitude.
We are at the dawn of an era in which healthcare professions and their clients must work in a more connected, technological and interdisciplinary manner. But what good is the best technology if there is no common language? Future skills are the key to developing not only professional competence, but also resilience and pre-resilience, flexibility and an innovative spirit. This is where optaVita steps in. For one thing is certain: the health sector is changing. The question is not whether but how we will use this change. We can shape our future – with the right skills, the right knowledge and the right attitude.
The digitalisation of physiotherapy offers great opportunities. Future skills are the key to developing not only professional competence, but also resilience and pre-resilience, flexibility and an innovative spirit.
Physiotherapy as the key to a future-proof healthcare system
The study results clearly show that physiotherapy must continue to develop as an independent healthcare profession to meet the increasing demands. Three key measures are essential:
Enable direct access: patients should be able to access physiotherapy services directly, without having to rely on a doctor’s prescription.
The study results clearly show that physiotherapy must continue to develop as an independent healthcare profession to meet the increasing demands. Three key measures are essential:
Enable direct access: patients should be able to access physiotherapy services directly, without having to rely on a doctor’s prescription.
Strengthen prevention: physiotherapy measures must be more strongly integrated into health policy planning and have financial support. Targeted use of digitalisation: technology must be deployed in a way that complements personal care and makes provision more efficient.
Physiotherapy has the potential to become a central pillar of health promotion and prevention. However, this requires political reforms, structural adjustments and a reorientation of care models. With the right strategic decisions, physiotherapy can become a critical factor for a future-proof healthcare system – in the interest of patients, physiotherapists and society as a whole.
Physiotherapy has the potential to become a central pillar of health promotion and prevention. However, this requires political reforms, structural adjustments and a reorientation of care models. With the right strategic decisions, physiotherapy can become a critical factor for a future-proof healthcare system – in the interest of patients, physiotherapists and society as a whole.
85.06% of the physiotherapists surveyed who participated in the online survey consider themselves professionally capable of making an adequate diagnosis.
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References:
- Vgl. hierzu die aktuellen Zahlen des GKV-Spitzenverbandes, der Kassenärztlichen Bundesvereinigung (KBV) und des Statistischen Bundesamtes (Destatis).
- Vgl. Rosian-Schikuta, Ingrid/Anja Laschhkolnig/Sarah Ivansits 2021: Betriebliches Gesundheitsmanagement. Köln: Deutsches Institut für Medizinische Dokumentation und Information (DIMDI) (= Schriften- reihe Health Technology Assessment, Bd. 144). https://portal.dimdi.de/ de/hta/hta_berichte/hta463_bericht_de.pdf [abgerufen am 04.02.2025].
- Vgl. Abuschuscha, Fuád 2015: Zukunftsmarkt Prävention: Heute das Gesundheitssystem von morgen denken. Eltville: FutureManagement- Group AG (= Market Foresights). https://www.futuremanagementgroup.com/ wp-content/uploads/2017/01/MF_Zukunftsmarkt-Praevention.pdf [abgerufen am 04.02.2025].