End of authorization to practice physiotherapy: towards a national modernization

The end of the requirement for employees to practice physiotherapy represents a major shift in the organization of work for healthcare professionals in Switzerland. This reform of the physiotherapy practice authorization process, announced for July 2025, is being initiated by the cantons of Zurich and Basel-Landschaft. It is a direct response to the current challenges of labor shortages and administrative complexity.

The objective is clear: to modernize access to the profession for employees and promote more effective skills management. This transformation is part of a broader approach to administrative simplification and national harmonization of practices.

What is authorization to practice physiotherapy?

The authorization to practice physiotherapy (often abbreviated as AP) is an official document, issued at the cantonal level, that allows a physiotherapy professional to legally practice their profession. The authorization to practice physiotherapy used to vary from canton to canton, creating an unequal situation between the Swiss regions.

How the current system works

Historically, each Swiss canton managed the authorization to practice physiotherapy independently, creating a complex regulatory patchwork:

• Variable requirements: Each canton defined its own criteria and procedures
• Varying timeframes: Processing times could vary from a few days to several months
• Heterogeneous costs: Authorization fees ranged from CHF 200 to CHF 800 depending on the canton.
• Required documents: The supporting documents requested were not standardized.

Constraints for employees

For employed physiotherapists, the authorization to practice physiotherapy was often a redundant process. Although they worked for recognized healthcare institutions, they still had to submit an individual application, accompanied by supporting documents and payment of fees that could reach up to 800 CHF. The processing time for obtaining authorization to practice physiotherapy could extend to several weeks, or even months, delaying the professionals' entry into their positions.

Main difficulties encountered:

• Administrative burden: Compilation of complex files with multiple supporting documents
• Financial costs: Significant expenses for recent graduates
• Waiting times: Delays in starting work
• Inter-cantonal complexity: Difficulties in practicing in several cantons
• Renewals: Recurring procedures in certain cantons

Professional mobilization

This complexity of the authorization to practice physiotherapy has been highlighted by many institutions, notably Physioswiss, the umbrella association of Swiss physiotherapists, which has been campaigning for several years for a national standardization of administrative requirements.

The arguments put forward by the profession included:

• Mismatch between administrative requirements and the reality on the ground
• Barriers to inter-cantonal professional mobility
• Unjustified administrative burden for employees
• Negative impact on the attractiveness of the profession

Why remove this authorization for employees?

The removal of the authorization for employees to practice physiotherapy is based on three main arguments that reflect the contemporary realities of the Swiss healthcare system:

1. Reduction of bureaucracy

Employees work under the supervision of healthcare institutions that are already subject to strict standards and regular inspections. Individual authorization therefore becomes an unnecessary administrative burden.

Existing institutional framework:

• Approved establishments: Hospitals, clinics and practices are already certified and inspected.
• Hierarchical supervision: Professional guidance provided by qualified managers
• Regular audits: Periodic quality checks of establishments
• Liability insurance: Institutional risk coverage

2. Promote professional mobility

By removing the requirement for authorization to practice physiotherapy, professionals can be recruited without waiting for approval from the cantonal administration, which is crucial in a tight job market.

Advantages for mobility:

• Accelerated recruitment: Immediate integration of new employees
• Geographic flexibility: Facilitating changes of canton
• Responsiveness of employers: Quick response to staffing needs
• Professional attractiveness: Reducing barriers to salaried employment

3. Reduce the financial burden

By avoiding the costs associated with applying for a physiotherapy license, each physiotherapist saves an average of 800 CHF. A significant sum, especially for recent graduates.

Economic impact:

• Direct savings: CHF 200-800 per permit avoided
• Indirect costs: Reduction in administrative time
• Accessibility: Facilitating entry into the profession
• Competitiveness: Improved net wage attractiveness

Context of shortage

This reform comes in the context of a shortage of healthcare staff in Switzerland:

• Growing demand: Aging population and increasing needs
• Limited supply: Insufficient number of new graduates
• International competition: The need to attract foreign professionals
• Retention: Improving working conditions to foster loyalty

The decisions of the cantons of Zurich and Basel-Landschaft

Canton of Zurich: pioneer of reform

Since July 1, 2025, the Canton of Zurich has officially abolished the requirement for salaried physiotherapists to hold a license. This measure applies to all employees except those in management positions, where a license remains necessary. Physiotherapists who have already paid for their license can request a refund.

Implementation details in Zurich:

• Effective date: July 1, 2025
• Scope: All non-managerial employees
• Exception: Management and supervisory positions
• Retroactivity: Refund of fees already paid is possible.
• Transition: Support for institutions and professionals

Canton of Basel-Landschaft: rapid adoption

The canton of Basel-Landschaft followed suit in May 2025. After extensive discussions with representatives of the profession, including Physioswiss, the canton decided to eliminate the requirement for employees to obtain a license to practice physiotherapy. Implementation was immediate, allowing for a swift transition.

Decision-making process in Basel-Landschaft:

• Consultation: Dialogue with Physioswiss and professionals
• Legal analysis: Feasibility and legal compliance study
• Decision: Adoption in May 2025
• Implementation: Immediate application without a transition period

Elements common to both reforms

The two cantons have adopted similar approaches:

• Retention for managers: Specific responsibility for management positions
• Strengthened institutional framework: Accountability of employing establishments
• Quality assurance: Maintaining training and experience requirements
• Support: Assistance for professionals and employers

Industry reactions

Feedback from the field has been largely positive:

• Physioswiss: Satisfaction at seeing years of advocacy come to fruition
• Establishments: Facilitation of recruitment and HR management
• Professionals: Relief from administrative simplification
• Patients: No negative impact on the quality of care

Impacts on the physiotherapy profession

Administrative simplification

Professionals are no longer required to compile complex files and chase the cantonal administration for authorization to practice physiotherapy, which frees up time for patient care.

Time savings and efficiency:

• Elimination of administrative steps: No more forms to fill out or documents to gather
• Elimination of follow-ups: End of time-consuming administrative tasks
• Clinical refocusing: More time spent with patients
• Stress reduction: Decreased anxiety related to administrative procedures

Agility for employers

Practices and clinics can integrate new staff without administrative delays, promoting responsiveness to growing healthcare needs.

Organizational advantages:

• Express recruitment: Immediate integration of new employees
• Simplified planning: Improved workforce predictability
• Increased flexibility: Rapid adaptation to variations in activity
• Competitiveness: Advantage in attracting talent

Improved attractiveness of the profession

The end of the authorization to practice physiotherapy improves the perception of the profession, particularly among young graduates who feared the administrative burdens upon leaving school.

Impact on professional attractiveness:

• Simplified entry: Easier path to becoming a professional
• Modern image: Profession perceived as less bureaucratic
• Mobility encouraged: Facilitating changes of employer
• Initial savings: Reduced professional installation costs

Evolution of responsibilities

The elimination of individual authorization is accompanied by a strengthening of the role of institutions:

• Employers held accountable: Increased verification of qualifications
• Enhanced supervision: Closer professional oversight
• Continuing education: Institutional support for skills development
• Regular evaluation: Continuous monitoring of professional performance

Adaptation Challenges

This transition requires some adjustments:

• New contracts: Adaptation of contractual clauses
• HR Procedures: Review of Recruitment Processes
• Team training: Raising awareness of the new legal frameworks
• Information Systems: Updating Management Tools

National implications: towards a comprehensive reform?

Ripple effect

The decision taken by Zurich and Basel-Landschaft serves as a model. Other cantons are considering similar reforms to the licensing of physiotherapists.

Cantons undergoing reform:

• Schwyz: Ruling in favor of abolishing the AP
• Valais: Motion accepted by the Grand Council
• Fribourg, Vaud, Neuchâtel: Consultations and studies underway
• Bern: Discussions are underway at the cantonal level
• Geneva: Discussions initiated with professionals

Physioswiss's leading role

Physioswiss plays a leading role in this dynamic by advocating for a harmonized national abolition of the authorization to practice physiotherapy.

Physioswiss actions:

• Political advocacy: Lobbying cantonal authorities
• Documentation: Provision of arguments and evidence
• Coordination: Harmonization of procedures between cantons
• Communication: Raising awareness among professionals and the public

Challenges of harmonization

The generalization of this reform on a national scale presents several challenges:

Obstacles to overcome:

• Cantonal autonomy: Respect for constitutional powers
• Local resistance: Concerns about the quality of care
• Inter-cantonal coordination: The need for a concerted approach
• Legal aspects: Adaptation of cantonal legal frameworks

Advantages of national harmonization

A widespread reform would bring many benefits:

• Equal treatment: The same working conditions throughout the territory
• Easier mobility: Free movement of professionals
• Overall simplification: Unified and understandable rules
• Enhanced attractiveness: Modern image of the profession
• System efficiency: Optimizing human resources

Tentative schedule

The move towards national harmonization could follow this pace:

• 2025-2026: Adoption by 3-5 additional cantons
• 2026-2027: Impact assessment and adjustments
• 2027-2028: Extension to the majority of cantons
• 2028-2030: Full harmonization possible

Challenges for the quality and safety of care

Maintaining quality standards

Contrary to the fears expressed by some observers, removing the authorization for employees to practice physiotherapy does not negatively impact the quality of care. On the contrary, this reform allows for a refocusing of skills assessment on truly relevant criteria, emphasizing professional experience, continuing education, and the quality of patient care.

Arguments for preserving quality

Several elements clearly demonstrate the maintenance of standards:

Enhanced institutional framework:

• Accredited facilities: Physiotherapists are employed by facilities that are regularly audited and subject to strict quality of care standards.
• Employer responsibility: These institutions assume the responsibility of verifying the qualifications of their employees.
• Ongoing supervision: Daily professional guidance from experienced managers
• Quality controls: Regular inspections of establishments by the authorities

Mandatory continuing education:

• Requirements remain unchanged: Continuing education remains mandatory, regulated by both employers and cantonal requirements.
• Constant updating: Updating knowledge, particularly in relation to musculoskeletal pathologies, new rehabilitation techniques, and digital innovations
• Continuous certification: Regular validation of acquired skills
• Specialization encouraged: Development of cutting-edge expertise

Technological security tools:

• Digital traceability: Digital tools like Phyzio.ch ensure traceability, compliance, and efficiency in patient monitoring.
• Secure documentation: Every action, note, and invoice is time-stamped and secured.
• Enhanced transparency: Improving the overall quality of the care pathway
• Objective monitoring: Continuous measurement of therapeutic performance

Positive feedback

Feedback from the field, particularly in cantons that have already implemented the reform, confirms that the quality of care has not deteriorated, quite the contrary: professionals can devote more time to their patients instead of managing unnecessary administrative procedures.

Quality indicators maintained:

• Patient satisfaction: No deterioration observed
• Clinical results: Therapeutic efficacy preserved
• Security: No incidents related to the removal of the access point
• Time spent on care: Refocusing on clinical activity

Alternative control mechanisms

The elimination of individual authorization is offset by other mechanisms:

• Establishment certification: Enhanced accreditation and control of facilities
• Professional audit: Regular evaluation of practices
• Peer review: Peer review within teams
• Patient feedback: Systematic feedback on the quality of care

Evolution of the control paradigm

This reform reflects a shift towards:

• Continuous assessment: Rather than a one-off check at the entrance
• Collective accountability: Involvement of the entire team
• Continuous improvement: Ongoing quality approach
• Innovation encouraged: Focus on results rather than procedures

Field testimonies

Feedback from professionals

Testimonials gathered from physiotherapists illustrate the positive impact of this reform:

"I can finally change cantons without wasting two months filling out forms for authorization to practice physiotherapy. It's a real relief, especially when you have interesting professional opportunities."

— Salaried physiotherapist, Zurich

"The AP (Attestation de Professionnel de l'Autonomie - Professional Activity Authorization) was useless for employees. The reform of the authorization to practice physiotherapy was long overdue. Now I can focus on my patients rather than on paperwork."

— Physiotherapy practice, Basel-Landschaft

Employer testimonials

Healthcare facilities also welcome this development:

"We can now recruit physiotherapists immediately, without waiting weeks for cantonal authorization. This is crucial when we have urgent staffing needs."

— Human Resources Director, Cantonal Hospital

"This reform really improves our attractiveness as an employer. Candidates appreciate being able to start immediately without administrative constraints."

— Private practice manager, Zurich

Feedback from recent graduates

The new physiotherapists express particular relief:

"After 3 years of study, avoiding 800 CHF in fees and weeks of waiting is a real plus. It allowed me to start working immediately after obtaining my diploma."

— Recent graduate, HES-SO

Trainers' perspectives

Physiotherapy schools are also observing benefits:

"Our students are less stressed as they approach the end of their studies. They know they will be able to practice quickly without unnecessary administrative barriers."

— Academic Director, School of Physiotherapy

Impact on patients

Patients indirectly benefit from this reform:

"My physiotherapist seems less stressed and more available. He explained to me that he can now focus solely on treatment."

— Patient undergoing rehabilitation

Good practices to adopt

For professionals

Physiotherapists must adapt their practices to this new regulation:

Regulatory monitoring:

• Check the cantonal status: It is essential to stay informed of the latest cantonal decisions via official websites or Physioswiss press releases.
• Stay up-to-date with developments: Subscribe to professional newsletters to stay informed
• Consult official sources: Regularly check the websites of the cantonal administrations

Professional documentation:

• Keep all your continuing education certificates: These documents are essential to ensure your professional compliance and may be requested at any time by your employer or health insurance provider.
• Organize your supporting documents: Maintain a complete and up-to-date file of your qualifications
• Documenting your experience: Keeping a record of your professional activities

Management tools:

• Use management software like Phyzio.ch: This type of solution ensures regulatory compliance, facilitates LAMAL & LAA billing, and centralizes patient data in a secure environment.
• Automating documentation: Reducing the risk of errors through digitization
• Securing data: Complying with data protection requirements

For employers

Institutions must adapt their organization to this new situation:

Human Resources Management:

• Adapt employment contracts: Ensure that new contractual clauses reflect the absence of a requirement for authorization to practice physiotherapy for non-managerial positions
• Review HR procedures: Update recruitment and onboarding processes
• Training the teams: Raising staff awareness of the new regulatory frameworks

Communication and attractiveness:

• Specify the short hiring timeframe: Mentioning in your job postings that onboarding is immediate improves your attractiveness to candidates.
• Emphasize simplicity: Highlight the absence of administrative constraints
• Communicating about quality: Reassuring people about the maintenance of professional standards

Institutional commitment:

• Participating in public consultations: Your involvement can positively influence the evolution of standards
• Collaborating with Physioswiss: Supporting the initiatives of the professional association
• Sharing best practices: Contributing to the development of the profession

For training institutions

Schools must inform and prepare their students:

• Early notification: Raising student awareness of regulatory changes
• Job preparation: Adapting vocational training modules
• Employer partnerships: Facilitating links with recruiting institutions
• Graduate follow-up: Supporting professional integration

Phyzio.ch: ensuring compliance without administrative burdens

In the context of the administrative simplification represented by the end of the authorization to practice physiotherapy, Phyzio.ch supports professionals and their employers to maintain the highest standards of quality and compliance.

Simplified regulatory compliance:

• Automatic monitoring: Automatic updates of cantonal and federal physiotherapy requirements
• Centralized documentation: Centralization of all professional supporting documents (diplomas, continuing education, certifications)
• Complete traceability: Automatic recording of all professional activities
• Proactive alerts: Automatic notifications for continuing education deadlines

Support for professional mobility:

• Data portability: Access your professional file from any institution
• Multi-establishment: Simplified management for professionals working in multiple facilities
• Rapid onboarding: Tools to accelerate integration into new roles
• Inter-cantonal synchronization: Automatic adaptation to the specific characteristics of each canton

Optimization for employers:

• Integrated HR management: Automated tracking of team qualifications and training
• Compliance dashboard: Comprehensive view of the regulatory status of all employees
• Streamlined hiring process: Rapid verification of new employee qualifications
• Automated reporting: Generation of reports for audits and quality controls

Enhanced quality and safety:

• High standards: Automatic adherence to good clinical practices
• Data security: Hosted in Switzerland with end-to-end encryption
• Continuity of care: No interruption in patient follow-up despite administrative changes
• Continuous Improvement: Analytical Tools to Optimize the Quality of Care

With Phyzio.ch, the end of the authorization to practice physiotherapy does not mean the end of professional rigor. On the contrary, our platform allows you to maintain the highest standards while fully benefiting from simplified administrative processes.

Administrative reform frees up time and resources: Phyzio.ch helps you invest them wisely in quality care and professional development.

To discover how Phyzio.ch can support you in this transition, visit: https://phyzio.ch/fr/logiciel-physio .

Prospects for development and challenges

Future trends

The evolution initiated by Zurich and Basel-Landschaft opens up several perspectives:

Gradual harmonization:

• National standardization: Towards unified rules across the entire territory
• Continuous simplification: Extension to other administrative aspects of the profession
• Increased digitalization: Complete dematerialization of administrative processes
• Interoperability: Connected systems between cantons and institutions

Challenges to anticipate

This transformation also raises certain issues:

Maintaining quality:

• Enhanced surveillance: Development of new control mechanisms
• Continuing education: Strengthening of skills update requirements
• Accountability: The evolving role of employers and professionals
• Quality indicators: Development of performance metrics

Transition management:

• Adaptation period: Support for professionals and institutions
• Communication: Clear information on the new processes
• Training: Upgrading of administrative teams
• Evaluation: Monitoring impacts and necessary adjustments

Development opportunities

This reform opens up new perspectives for the profession:

• Innovation: More time to develop new therapeutic approaches
• Specialization: Facilitating the development of specialized expertise
• Collaboration: Strengthening interprofessional partnerships
• Research: Increased involvement in clinical research

Societal impact

In the long term, this development could transform:

• Access to care: Improving the availability of professionals
• System costs: Reduction of overall administrative expenses
• Professional attractiveness: Strengthening the image of physiotherapy
• Innovation sector: Stimulating innovation in healthcare

Conclusion

The elimination of the requirement to practice physiotherapy in several Swiss cantons marks a significant transformation for the profession. By streamlining administrative procedures and removing barriers to inter-cantonal mobility, this measure directly improves working conditions for employed physiotherapists. It also facilitates recruitment for healthcare facilities, which often face a shortage of qualified staff.

This change reflects a political will to simplify access to the profession, without compromising the quality of care, which remains regulated by accredited institutions, continuing education requirements, and digital tools such as Phyzio.ch. These tools ensure a high level of traceability and compliance, guaranteeing optimal patient safety.

The major challenge now is to extend this progress to all cantons, in order to establish a national standard for physiotherapy practice authorization. Such harmonization would not only reduce regional inequalities, but also build a coherent, modern regulatory framework adapted to the current realities of the healthcare sector.

To achieve this, active collaboration between cantonal authorities, professional associations such as Physioswiss, and digital management platforms is essential. This synergy will allow physiotherapy in Switzerland to enter a new era, one that is more agile, more attractive, and perfectly aligned with contemporary requirements for quality, safety, and efficiency.

Thus, this reform represents not only administrative simplification, but also a genuine lever for modernization for a profession that plays an increasingly important role in the Swiss healthcare system. The future of physiotherapy looks promising, driven by this dynamic of simplification and innovation.

FAQ

Do employees still need authorization to practice physiotherapy?

No, not in the cantons of Zurich and Basel-Landschaft since 2025. Other cantons are currently studying this possibility. It is important to check the status of your canton of practice.

Are management positions affected?

Yes, they still require authorization to practice physiotherapy in most cantons. This requirement reflects the specific responsibilities associated with management and supervisory roles.

Which cantons will follow?

Valais, Schwyz, Fribourg, and Vaud are in the process of studying or implementing a reform regarding the authorization to practice physiotherapy. Bern, Geneva, and Neuchâtel are also considering the matter.

Are patients affected?

No, this does not change their access to physiotherapy without specific authorization. The quality of care remains guaranteed by institutional oversight and mandatory continuing education.

Can we invoice without AP?

Yes, if you are employed in a canton that has abolished the requirement to have a license to practice physiotherapy. The employing institution assumes responsibility for regulatory compliance.

What happens to permits that have already been paid for?

Cantons that have abolished the AP (Advance Payment) scheme generally offer the possibility of requesting a refund of fees already paid. It is advisable to inquire with the relevant cantonal administration.

Does this reform affect independent physiotherapists?

No, this reform only applies to employed physiotherapists. Self-employed professionals must still obtain authorization to practice according to cantonal requirements.

How can I check the status of my canton?

Consult your cantonal health administration website or Physioswiss communications to find out the current status of your canton regarding the authorization to practice physiotherapy.

Is continuing education still mandatory?

Yes, absolutely. Removing the authorization to practice does not change the continuing education requirements, which remain essential to maintain the quality of care and the updating of skills.

What are the advantages for employers?

Employers benefit from an accelerated recruitment process, reduced administrative costs and greater attractiveness as an employer thanks to the simplification of procedures.