Bill 466.

Summary.

The bill amends Law 47 of 1984 to define physiotherapy and/or kinesiology as a branch of health science concerned with the study, functional clinical assessment and physiotherapy diagnosis of human movement in prevention, health promotion, treatment and rehabilitation in the Republic of Panama. It repeals Article 2 of that law. It expands professional duties to include assessment, prognosis and physiotherapy intervention; service management; education and research; and participation in health policies and programs. Practitioners could refer patients to other professionals when their care falls outside the profession’s scope.

A physiotherapist and/or kinesiologist could examine, assess and treat impairments, limitations and disabilities on the basis of a physiotherapy diagnosis. The bill recognizes professional autonomy to select techniques and procedures using scientific judgment, conduct diagnostic tests and refer patients. Direct access to services would be supported by scientific evidence and endorsed by a physician who certifies the condition through a medical diagnosis. Practice in the Republic of Panama would require a professional license issued by the Health Technical Council (Consejo Técnico de Salud) of the Ministry of Health (Ministerio de Salud), with practice under medical referral. A licensed professional could work in public or private institutions, health facilities, sports settings, educational institutions and nonprofit organizations.

Recognition of new forms of practice and specialties would require a degree in physiotherapy and/or kinesiology and accreditation by the Health Technical Council. A license at degree level would require Panamanian nationality, a recognized and accredited university degree, authenticated academic records, an application submitted through a lawyer, and the specified health and academic documents. Related specialties endorsed by the responsible university would be recognized. A specialty license would also require a degree level professional license, recognized specialist training, an application through a lawyer and a certificate of good physical and mental health. Professional practice would be governed by the Code of Ethics (Código de Ética).

The bill creates the Interinstitutional Physiotherapy Committee (Comité Interinstitucional de Fisioterapia) as an advisory and support body working with the Health Technical Council. Its members would represent the Ministry of Health, the Social Security Fund (Caja de Seguro Social), the Council of Rectors of Panama (Consejo de Rectores de Panamá), the professional association, private hospitals, the Institute of Physical Medicine and Rehabilitation (Instituto de Medicina Física y Rehabilitación), the Santo Tomás Hospital Board (Patronato del Hospital Santo Tomás), the Children’s Hospital Board (Patronato del Hospital del Niño), and the National Disability Secretariat (Secretaría Nacional de Discapacidad). It would coordinate national processes, propose standards and protocols, and promote training, research and institutional cooperation. The Health Technical Council would investigate ethical and professional misconduct. Hiring unlicensed personnel and unlawful practice would be subject, as applicable, to sanctions under the Health Code (Código Sanitario), the Criminal Code (Código Penal) of the Republic of Panama and other applicable rules.

Assistants could work under professional supervision. Their career scale would have one level, with category changes governed by current agreements and addenda. The bill specifies their clinical support, patient transfer and administrative duties. It requires Panamanian nationality, a university diploma, certified health and registration with the Health Technical Council, which would issue a Work Permit. It provides equal rights for certain working assistants with postsecondary studies. For physiotherapy aides, it establishes training and health requirements and defines support duties. It would preserve the years of service of aides already employed, phase them out over time and suspend their training.

Finally, the bill provides for administrative investigations initiated by the authorities or upon complaint, participation of the professional association in Health Technical Council decisions, occupational safety and biosafety measures, and education, professional development, research and scholarship programs. It repeals Articles 26 and 27 of Law 47 of 1984. It directs the National Assembly (Asamblea Nacional) to prepare and publish in the Official Gazette a consolidated text of Law 12 of 1998 and provides for commencement two months after promulgation. Its provisions would concern health institutions, universities, employers, professionals, assistants, aides and patients.