France has more physiotherapists than ever, but their distribution across the country remains highly unequal, according to a report from the national health insurance fund, l'Assurance Maladie, covering 2027. The report found that in 2019 the best-served areas had 6.6 times more physiotherapists than the least-served areas, up from 6.1 times in 2016.
In other words, the growth in the profession's numbers has not benefited every region equally.
The report put the density of physiotherapists at 47 per 100,000 residents in Seine-Saint-Denis, compared with 269 per 100,000 in the Hautes-Alpes, against a national average estimated at 120 per 100,000.
Hautes-Alpes among best served areas
The Hautes-Alpes, a mountainous department in southeastern France, ranks among the best-provided areas in the country, with a density of physiotherapists well above the national average.
Several areas in northern France, by contrast, suffer from a much weaker supply. In the Hauts-de-France region, densities are particularly low in the Aisne, Oise and Somme departments, while the Nord department is better off, especially around the city of Lille, where density exceeds 170 physiotherapists per 100,000 residents. According to Assurance Maladie figures, close to 30% of the population lives in what the report calls a physiotherapy "desert."
Rules on new practices and delayed incentives
To address the imbalance, Assurance Maladie and the profession have tightened regulation of new practices. Since 2023, the most densely served areas have been subject to a "one departure for one new installation" rule, while financial aid is meant to encourage physiotherapists to set up practice in under-served areas.
Assurance Maladie also plans to require some newly qualified physiotherapists to begin their careers in an under-served area or in a healthcare or social care institution. The FFMKR, the profession's leading union, told La Depeche that ministerial and administrative work on this measure has fallen considerably behind schedule. The union said the rules are due to apply to students by 2028, but that the financial framework for the plan has still not been settled.
