Motivations, Main Challenges and Needs of Physiotherapists for Setting up a Private Physiotherapy Practice in Estonia: a Mixed Methods Study

Anna-Liisa Tamm,1 Armin Evert Lelle,1 Ülle Parm,1 Priit Pajuste2 1Physiotherapy and Environmental Health Department, Tartu Applied Health Sciences University, Tartu, Estonia; 2Centre for Educational Development, Tartu Applied Health Sciences University, Tartu, EstoniaCorrespondence: Anna-Liisa Tamm, Email [email protected]: The aim was to identify the motivators, main challenges and support for physiotherapists in setting up a private practice in Estonia.Methods: The questionnaire included three thematic blocks: 1) Motivations (18 Likert-scale items with comments), 2) Challenges and Needs (14 Likert-scale items, a free-response question, and multiple-choice on support), and 3) Business Factors (questions on experience, external services, and financial support). Results were presented as means with standard deviations (±SD), or proportions with percentages, and Likert scale (5-point) were used.Results: A survey was conducted with 16 physiotherapists (♀=14, ♂=2; age 37.1 ± 5.46 years) who had established private practices in Estonia, representing 21% of such professionals in country. The possibility of autonomy, including flexible working hours, was cited by all respondents as a motivator for starting a private practice. However, many faced financial challenges, with 63% citing difficulties in securing start-up capital and 50% reporting financial struggles in business development. While 80% found retaining clients relatively easy, 43.75% needed assistance in finding clients. Key challenges included a lack of funds, marketing skills, and time for promotion. None of the respondents felt adequately prepared by their education for entrepreneurship. Financial support was a common requirement, with 25% requesting details on available funding sources.Conclusion: The main motivation for physiotherapists to set up a private practice is autonomy. In the context of changes in professional legislation, it is important to ensure needs-based entrepreneurship training in cooperation with professional associations.Keywords: physiotherapy, private practice, motives, challenges, entrepreneurship education