Practice as a Self-employed Physiotherapist in France

The self-employed practice represents 80% of the physiotherapy profession. One practitioner among two is in an individual practice, just over one in four in a group practice and 3% in a company. The choice of the self-employed practice is often based on three criteria :

• the diversity of the patient base;
• financial attractiveness (relative to the employed status);
• independence in the management of its activity.

With the exception of a few specifics (sports physiotherapy, urogynecology, respiratory physiotherapy), self-employed physiotherapy is very much that of the first resort : we treat patients who present to the practice. Practicing as a self-employed physiotherapist is therefore general, which makes it one of the structuring interests of the profession.

The contracted activity is paid for by the act by the French Healthcare System which, since November 2017, has restricted the freedom of establishment of the self-employed physiotherapists, through this agreement (convention). France has been divided into areas known as "over-endowed", "intermediate" and "under-endowed", as part of measures to rebalance the supply of physiotherapy treatments on the territory. Thus, to settle in as a self-employed in over-dense zone, it is from now on necessary that the establishment project respects the principle known as "1 for 1", namely a definitive cessation of activity for an establishment.

Establishment in other types of area remains free or restriction, but it must be taken into account that in less populated areas, the activity will a priori be less important. The densest areas are the PACA, Languedoc-Roussillon, Île-de-France, Brittany and Nord-Pas-de-Calais regions. Conversely, predominantly rural regions such as the Center, Upper-Normandy, Picardy, Champagne-Ardenne and Franche-Comté have few practitioners.

In the event of self-employed practice in an area classified by the regional health agency (ARS) of your area of installation as being "very under- endowed "or" under-endowed ", membership in the " physiotherapist incentive contract " allows you to receive annual flat-rate assistance and to benefit from Health Insurance participation in the payment of your social contributions due for family allowances.

The activity of self-employed locum physiotherapists is not subject to zoning. There are no restrictions on their registration.

Another important point, the CPAM data shows that there is a great disparity in income according to self-employed physiotherapists, which can vary from 1 to 7.7 depending on the location, the type of clientele, and the organization of care in the office, meaning that the 10% of physiotherapists with the highest incomes earn on average 7.7 times more than the 10% lowest-income physiotherapists.