Home Physical Therapy in Taiwan and Thailand

Hello everyone, my name is Natharin Boontha, an international PhD student under supervision of Professor Lin, as well as, an academic staff in the musculoskeletal and cardiopulmonary fields at the Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, THAILAND.  I guess you may have some questions into your mind that why I choose to study at NTU, Taiwan. In my opinion, NTU is one of the best universities that has a combination of western and eastern knowledge especially in physical therapy area. So, that is one of the most important reasons that I am here and I am so proud to study here too J

As a first year international student at NTU, I have only few experiences of PT in Taiwan due to language limitation. Fortunately, teachers and staffs of School and Graduated Institution of Physical Therapy have given me an opportunity to be a teaching assistance that opens my eyes to learn more about PT in Taiwan. During spring semester last year, I had an opportunity to visit the pioneer home physical therapy clinic, namely暐凌居家物理治療所, with two master students from Mahidol University, Thailand. Form the event, I learn that there are some differences between doing home physical therapy in Taiwan and in Thailand according to different health care systems.

I heard that it was not easy to open a private home physical therapy in Taiwan in the past. Fortunately, once the first home physical therapy clinic was established, a couple years later, more than 100 clinics are opened. Most home cases are usually those with extremely limited mobility such as stroke, prolonged bed rest, palliative care, and they have been supported by NHI or government with different conditions and limitations. After getting consultant from the local center or hospital, patients’ information and illness history with or without special investigation results will be sent to PT. PT needs to visit patients at their house, takes an examination both subjective and objective, gives them proper treatments and education, and writes the report to the center. PT can earn the treatment cost from the government case by case.

In Thailand, when we talk about home PT or “home visit”, we usually think about the private business of PTs with license. They are able to do “home visit” with or without having their own PT clinics. For home PT services, the patients and their family need to take responsibility to pay by themselves for the services. Basically, Ministry of Public health of Thailand will support medical expenses based on condition of work status (Government, private, no job).  Apart from that, some people with medium to high income also have an extra health insurance which may cover only with hospitalization status or more medical fees of charge based on health insurance plans. Most home cases are usually those with moderate to extremely limited mobility. However, personal trainers (PT) are common in recently years. Generally, patients or their family can directly consult PTs or can be referred from doctor or other health professional. In the opposite way, PTs also can refer the case back to doctor for future investigations as needed.

Apart from the health care systems, I think we also use the same concept of a home physical therapy management based on an updated standard of PT treatment.

For being a home physical therapy, PT may need to have a lot of knowledge that related to our patients not only PT knowledge but also medication, environment design, social welfare, and laws etc., to be safe for both patients and PT.

Finally, I still believe that home physical therapy gives PTs the freedom to decide the most suitable training content of home treatment under professional judgment, provide patients with higher quality services and better protections of patients’ privacy, we should do it with greater responsibility.