Allied Health Professions Explained! – A Guide for who you should see!

Overview - More Alike Than Different?

We typically think of allied health professionals are all unique and all have different focuses, treatments and recommendations. However, this idea doesn't fully reflect the reality. When the scope of practice and origins of each profession are compared, it becomes evident that there is significant overlap in the services they provide and the approaches they use to support client outcomes.

The origins of each profession are important to understand as it can be perceived that each profession was developed due to another profession lacking a certain skill set or knowledge. However, this is not true and all professions arose from a different time or country. As time has gone on, all the professions have added more therapies and types of clientele that can be treated to their scopes.

For example: Physiotherapy became popular in Australia from implementing massage therapy to WW1 casualties and grew to include other therapies in following years.¹ Chiropractic is typically stated to begin in late 1800s by a man called Daniel David Palmer who implemented an adjustment to improve a person’s deafness. From this point, this profession has grown to include other treatments but typically hold strong roots to adjustments.² Both these professions were recognised in other countries prior to becoming popular in Australia.

What is Scope of Practice?

Scope of practice refers to what a healthcare professional is trained, qualified, and legally allowed to do. It sets the boundaries for the treatments they can provide and the people they can care for, helping to ensure that patients receive safe and appropriate treatment.

Just because a clinician can, do they?

Being an expert in everything is impossible. Some clinicians may “have the capacity” to see a certain clientele under their scope of practice however they choose not to due to lack of knowledge in the area, lack interest in that client type or stereotypically do not. 

It is important in these situations that every clinician is unique with their own set of strength and weaknesses. Every clinician has a different level of knowledge and experience and it is important to also understand the more experience doesn’t necessarily mean more qualified. This is because as academic research is continually evolving, the clinician’s therapies are required to evolve with it.

We are going to look more in-depth regarding five allied health professions and understand the complexity of this issue. These include: Physiotherapy, Exercise Physiology, Occupational Therapy, Chiropractic and Osteopathy.

Brief Overview of each Professions Scope of practice

Physiotherapist: Health care professionals who assess, diagnose, treat and manage acute and chronic health conditions, disability and pain through various therapies. Physiotherapy has a broad scope of practice that allows them the ability to adapt therapies based on client’s needs, desires and goals.³

Physiotherapy is underpinned by ‘professional competence’. This means physiotherapy have no specific limitations to the people and treatments they can provide. However, only limited on the clinician’s knowledge, experience and competency to implement a specific therapy or treat a medical condition. If a clinician has completed a previous course on a topic and competent to undergo this therapy, they can implement it.

This causes that each physiotherapist can be vastly different with each having different knowledge and experience. For example, some physiotherapists may specialise in chronic pain management while another may specialise in lung diseases and implement therapies to improve breathing.

Some common stereotypical therapies that a physiotherapist have the capacity to complete are:

• Joint manipulations and mobilisation

• Soft tissue mobilisation (Massage)

• Acupuncture and dry needling

• Assistance and prescription of the use of aids, splints, crutches, walking sticks and wheelchairs

• Airway clearance techniques and breathing exercise

• Exercise therapy

Note* There are many other therapies and medical conditions that physiotherapist can see if they have they have undergone further study.

Occupational Therapist: Occupational therapy is a client-centred health profession concerned with promoting health and wellbeing through occupation (Occupation refers to everything you need, want or aspire to do in your day or life). The primary goal of occupational therapy is to enable people to participate in the activities of everyday life. Occupational therapists achieve this outcome by working with people and communities to enhance their ability to engage in the occupations they want to, need to, or are expected to do, or by modifying the occupation or the environment to better support their occupational engagement.^4,5

Occupational Therapist are similar to Physiotherapist where they have a broad scope of practice and can adapt therapies and recommendations based on client’s needs, desires and goals. They also do not have a specific limitation but limitations are based off the clinician’s experience and knowledge to complete a therapy or a specific medical condition. Again, similar to physiotherapy where they utilise a professional competency framework. If a clinician has completed a previous course or experience and competent to undergo this therapy, they can implement it.

Some common stereotypical areas that an Occupational Therapist have the capacity to complete:

• Equipment prescription for aged or disability care

• Home modifications

• Emotional regulation and behaviour, communication skills, developing motor patterns for paediatrics care

• Psychoeducation, graded exposure and skills-based approaches for mental health conditions

• Therapies focused at treating musculoskeletal injuries and diseases

Note* Again, there are other lesser-known conditions and therapies that an Occupational Therapist and Occupational Therapist’s can be vastly different.

Exercise Physiologist: Health professional that prescribe, deliver, and adapt movement, physical activity, and exercise-based interventions to facilitate and optimise health status, function, recovery, and independence. Exercise Physiologist's provide services to people across the full health spectrum. From healthy individuals, those at risk of developing health conditions, and people living with chronic diseases, disability, injury, or age-related conditions..⁶ 

Exercise Physiologist primarily known to be leading professionals in the implementation of evidenced based exercise interventions to rehabilitate, improve and manage acute and chronic medical conditions and injuries. They also have the capacity to screen, assess and measure a person’s physical capacity, ability to complete activities of daily living, work related activities and to inform interventions. Unlike Physiotherapy and Occupational therapy, Exercise Physiology are more specialised with their scope of practice however can broaden their scope with further qualifications.

Some common stereotypical areas that an Exercise Physiologist have the capacity to implement:

• Injury and chronic pain rehabilitation

• Improve physical function, balance and ability to complete activities of daily living

• Improve physical fitness, strength and flexibility

• Strength and conditioning for athletic population

• Improve health outcomes (Reduce risk of heart disease, diabetes management, osteoporosis management etc)

Osteopath: Osteopathy is a healthcare profession that is underpinned by biopsychosocial and holistic principles, and that focuses on the health and mobility of the body’s neuro-musculoskeletal systems. The emphasis on the neuromusculoskeletal system as integral to the body’s function, a person’s health and care is a defining characteristic of osteopathy. Osteopaths use multiple clinical approaches including manual therapy, movement-based therapy, exercise advice and prescription, lifestyle advice and education where appropriate.⁷ 

Osteopaths have a more concise scope of practice compared to Physiotherapist and Occupational Therapist. Osteopaths solely focus on implementing a broad range of therapies for a person suffering from an injury or disease involving the neuromuscular system (A system that involves the nervous system and musculoskeletal system (i.e. Muscle, tendon, ligament, bone).

Osteopaths have the capacity to implement the following therapies that involve the neuro-musculoskeletal system:

• Joint manipulations and mobilisation

• Soft tissue mobilisation (Massage)

• Exercise therapy

• Lifestyle advice and education

Chiropractor: Chiropractic is a profession concerned with the diagnosis, treatment, and prevention of mechanical disorders of the neuromusculoskeletal system; this includes the effects of these disorders on the function of the nervous system and general health.⁸

Chiropractors are most known for their high velocity joint manipulations; however, this is not all they do. They focus on a patient centred approach that can utilise a range of therapies to assist rehabilitation or manage back injuries or disorders. They make an assessment and develop a treatment plan in accordance with the needs of the patient and provide advice on future management strategies.

Chiropractors have the capacity to implement the following therapies that involve the disorders of the spine:  

• Joint manipulations and massage

• Soft tissue mobilisation

• Exercise therapy

• Ergonomic and lifestyle advice about movement to assist with health and wellness

What are the similarities?

When looking at each scope of practice, they are quite vague with the treatments they can deliver and clientele they can see. There are multiple areas of cross over between these 5 health professions. As some professions have the capacity to implement the same therapies as others.

Depending on your goal, the profession you choose may not be the most important factor. In many cases, several allied health professions are qualified to provide effective care. Instead, your decision should be based on whether the clinician has the knowledge, skills, and experience to deliver the most evidence based treatment to help you achieve your desired outcome.

For example: If a client presents with acute back pain; active rehabilitation is strongly recommended and considered best practice. Therefore, each health professional above has the capacity to provide education, encouragement and the above service (active rehabilitation) to assist the client with recovering. Theoretically, it shouldn’t matter which above health professional implements this service, as this service is part of each health profession’s scope of practice. However, as discussed, each clinician can be vastly different with the knowledge and therapy they implement even in the same health profession. Some clinicians may not have much knowledge in acute back pain management and therefore it is important to find a clinician that can help with your desired goal and condition. 

What are the differences?

There are some differences in each health profession that are unique in their scope. But, explaining these differences is hard as there is a lot of overlap between each profession. There are some unique areas of practice however, it is more important the differences of each individual clinician ability rather than the health profession. Each of the scope of practices rely on a clinician competency framework which means that a therapy a clinician provides is dependent of the knowledge of that person. If you have a specific goal or medical condition, it is more important to identify what areas of specialty the health professional provides so you can be provided with the best care.

Final Verdict – Who should I see?

Each health profession typically has a broad range of therapies and medical conditions they can treat. However, a clinician effectiveness of treatment strongly depends on the knowledge, skills and competency they obtain. Since there is a huge cross over with allied health professions and varies between clinician capability, it is more important to seek an appropriate clinician that has knowledge in the area that needs to be treated.

Do your research and enquire on the clinic/business with the treatments and conditions they treat.

Reference

1. Australian Physiotherapy Association. We've been a profession for over 115 years. https://australian.physio/aboutus/our-history

2. Kaptchuk, T., & Eisenberg, D., Chiropractic: Origins, Controversies, and Contributions. Arch Intern Med 1998;158;(20):2215-2224

3. doi:10.1001/archinte.158.20.2215

4. Australian Physiotherapy Association. Scope of Practice. https://australian.physio/tools/clinical-practice/scope-practice

5. Occupational Therapy Australia. Find an OT and Capability Framework. 2^nd Feburary 2025. https://www.otaus.com.au/

6. Occupational Therapy Australia. Position Paper: Occupational Therapy Scope of Practice Framework. 2017.

7. ESSA. Accredited Exercise Physiologist Scope of Practice. 2^nd July 2024. https://www.essa.org.au/Web/Web/Resources/Standards/aep-scope-of-practice.aspx

8. Osteopathy Australia. Statement of Scope of Practice in Osteopathy. January 2023.  https://osteopathy.org.au/article/osteopathy-scope-of-practice

9. Australian Chiropractor Association. About Chiropractic. https://www.chiro.org.au/