What do you need to keep in mind when applying for a license to operate independently in healthcare, including working as a self-employed physiotherapist?

First, it is important to keep in mind that there is a great deal of responsibility involved in working independently within the Icelandic healthcare system. Patients who seek out independent physiotherapists have the right to be assured that they receive first-class healthcare, that the workplace meets all of the Director of Health's requirements for healthcare operations, and that personal information and medical records are handled in accordance with laws and regulations.

Secondly, it is mandatory to have thoroughly familiarized yourself with all the laws and regulations that self-employed health workers must comply with. Therefore, we urge physiotherapists not to just copy any application they may have seen, but to carefully review all laws and regulations, read them and adopt them, it is not without reason that these requirements are set out. We, as consumers of health services, want the activities we seek to meet all the requirements of the Director of Health, it is equally important that those who seek us can be sure that our services meet them too.

This is why the Directorate of Health requests all this data and requires a description of the establishment and the activities that self-employed healthcare professionals intend to perform.

A change in workplace or a return to work after a long break also requires a review of the activities. A long break from work, a different workplace and possibly a different customer group requires a reassessment of the work permit.

Physiotherapy registration

The importance of good records cannot be overstated, and it pays to establish good record-keeping practices from the outset. A client's treatment will never be meaningful unless it is well-recorded. It is especially important to have good, detailed information on hand if clients return to the therapist after a long break or come in repeatedly.

From time to time, physiotherapists are asked to write reports for lawyers of clients who have filed claims for damages due to accidents. Such requests often come long after the client has completed treatment, and it is important to have good information about the examination, treatment, and condition upon discharge. It is worth noting that, by law, a healthcare professional who has written such a report can be called to court to testify about the validity of the report. This is extremely rare in cases involving physiotherapists, but not unknown and should be kept in mind.

Finally, it should be emphasized that both the Directorate of Health and the Icelandic Health Insurance make various demands on self-employed healthcare professionals, but do not confuse the demands set by each party.

Becoming a licensed physical therapist and starting an independent business

Application for a work permit

An application for a work permit is made to the Director of Medical Services (www.landlaeknir.is).

The application must be accompanied by a certified copy of the diploma stating the name, ID number and title of the degree.

The process takes 3-6 weeks. It is important to apply immediately after graduation and complete the application.

Announcement on the operation of healthcare services

The operation of healthcare services must be reported to the Director of Public Health (www.landlaeknir.is)

The notification must be accompanied by a legally valid work permit.

The process takes 3-8 weeks. It is important to apply as soon as possible and to be thorough in your application. It is a good idea to have all the necessary documents ready, i.e. the application is actually ready when the graduation date arrives. Then you can submit it as soon as the legalization is available.

 

Statutory insurance:

• Sickness insurance
• Free liability insurance

Other insurance is optional, but it is strongly recommended to be well insured.

Some people can purchase insurance through their practice, others get quotes from their insurance company.

Notification to Icelandic Health Insurance

Independent operations must be reported to the Icelandic Health Insurance (www.sjukra.is)

 

The notification must be accompanied by:

• A valid work permit
• Confirmation from the Director of Health that the physiotherapist is starting an independent business
• Confirmation of patient insurance and voluntary liability insurance
• Declaration regarding connections to the Icelandic health insurance network

Self-employed as a self-employed person

A self-employed physiotherapist is self-employed. As such, he must notify the tax authorities of the start of operations and submit a monthly withholding tax return on the calculated remuneration and social security contribution. He must also pay both the employer's and employee's share to a pension fund, and it is therefore important to familiarize yourself with the pension funds that are available.

Application for a license to operate healthcare services

Application form from the Director of Health

Completing the application form for the Director of Health

Item 4. Registration: Data – the registration system – to be included in the application

Example of a description of Data that can be used when completing an application for a physical therapist's license:

Electronic registration (further description)

A) Name of the electronic health record system:

Benefits of a physical therapist's medical record system

B) Who hosts the system? (further description according to the instructions of the Director of Health on the security and quality of medical records)

Sensa hosts the system and all aspects of the Director of Health's instructions on the security of hosting medical record information are followed. Backups are made daily.

C) Describe user access to the system (further description according to the instructions of the Director of Health on the security and quality of medical records)

Gagni is a web system where I have my own access with a username and password. The company's IP address is registered with the hosting provider, so if I want to access the system outside the office, I have to use electronic credentials to do so. My access is limited to medical record information registered within the office, but there is traceability as to who is viewing each person's medical record.

D) How will the statutory submission of activity information to the Director of Health be handled? (see Act No. 41/2007 on the Director of Health and Public Health and Minimum Registration of the Director of Health's Orders)

By strictly following what the law says.

E) Conjunctions:

1) Is the health record system shared with other operators? (further description)

In the

2) How is it planned to interconnect health record systems? (further description)

Permission has not been obtained to interconnect medical records with other operating entities.

There are therefore no plans to link medical records at this time.

Sections 7. Accommodation and 8. Equipment and facilities: A description of accommodation and facilities should be available at every physiotherapist's practice. Care must be taken to ensure that the information is up to date.

Section 9. Quality of service: Quality indicators in physiotherapy

The Directorate of Health is the regulatory body for health services and shall ensure that the services provided in this country are first-class. To that end, it is required that health professionals base their work on quality indicators, so that the effectiveness of the service can be assessed.

Quality indicators in physiotherapy can include, for example:

Physiotherapy tests and measuring instruments, see the Physiotherapy measuring instrument bank on the intranet.

European Standards in Physiotherapy – ER-WCPT (see below on the website)

Other standards/tests recognized in healthcare

Working independently

When discussing wages and conditions, all of the contractor's working hours must be taken into account, not just the time that the physiotherapist is with clients for treatment. It must also be kept in mind that contractors do not have sick leave or vacation rights and are without income during their retraining.

See the BHM calculator for self-employed individuals

Therefore, good insurance is important, both accident and health insurance, as well as mandatory insurance.

Insurance advice is not the responsibility of the company, but we would like to point out that the BHM health fund has now shortened the waiting period for daily sickness benefits for self-employed members from 3 months to two months.

Continuing and re-education of physiotherapists is extremely important. We strongly encourage self-employed physiotherapists to pay into the BHM Vocational Training Fund and the University Career Development Centre and utilize the rights it provides for continuous re-education. The profession is developing rapidly and it is important to keep up with and adopt the latest knowledge of the time.

• BHM grants and funds
• Self-employed specialists
• Membership fees to the Icelandic Association of Physiotherapists and BHM funds
• Maternity leave as a contractor