Dijon: physical therapists angry plan a protest this Thursday in front of the health insurance to express their frustration

In a context where the rise of social tensions impacts several professions, physiotherapists in Dijon are preparing to make their voices heard. A demonstration scheduled for this Thursday in front of the Primary Health Insurance Fund (CPAM) sounds the alarm about the concerning situation of this profession. This protest movement, initiated after a national demonstration in Paris in early July, aims to denounce the postponement of the promised fee revalorization, the stagnation of working conditions, and a general feeling of contempt towards health professionals. The mobilization brings together several local and national unions, including the French Federation of Massage Therapists and Re-educators (FFMKR), the National Union of Massage Therapists and Re-educators (SNMKR), and Alizé, supported by an increasing number of the entire chiropractic community.

If physiotherapists are expressing this outburst of frustration, it is partly because they are confronted with a long-standing lack of financial and regulatory recognition commensurate with their efforts and daily commitment. The announced fee increases for the period 2024-2026, initially promised in an addendum signed at the end of last year, are struggling to be effectively implemented in 2025. This delay significantly impacts the quality of life and the economic viability of clinics, especially in a medical desert already fragile. The growing anger and this action aim to draw the attention of Health Insurance and health authorities, in hopes of obtaining concrete acts and effective corrective measures to preserve public health and the well-being of professionals.

In Dijon, where the chiropractic community includes approximately 1,168 practitioners, the movement is diverse, bringing together actors with varied profiles, but all affected by these constraints. The initiative planned on Boulevard de Champagne, in front of the CPAM, is thus presented as a strong symbolic declaration, where worn-out equipment and tired work supports will be displayed to testify to the progressive deterioration of working conditions. This demonstration is a warning signal reflecting a broader issue, that of an insufficiently valued reform and a healthcare system seeking balance between budget oversight and support for its essential pillars.

The main issues of the protest of physiotherapists in Dijon against Health Insurance

The demonstration scheduled in Dijon represents a key point in the fight that physiotherapists are leading for recognition worthy of their profession. For several years, various demands underpin this movement, sometimes confused with those of other liberal health professions but which nonetheless have their own specificities. Understanding these issues makes it possible to more precisely grasp the frustrations and expectations expressed by these professionals.

A blocked fee revalorization context

At the end of 2023, an addendum to the General Nomenclature of Professional Acts aimed to guarantee a fee revalorization over three years by the National Health Insurance Fund (CNAM). This commitment provided for a cumulative increase of 4.5% in physiotherapy act fees between 2024 and 2026, conditioned among other things on an agreement regarding the regulation of practices in under-served areas. However, despite an initial start in 2024 with an effective increase of 1.5%, the continuation of this plan was officially suspended in 2025 with a postponement to January 1, 2026, citing a “lack of budgetary resources”.

This suspension reflects a gap between government announcements and the financial reality these professionals face. This fracture is denounced by unions, criticizing the use of a legal article to justify this postponement while physiotherapists have adhered to their commitments, notably regarding installation and practice in less-served areas. The non-implementation of these fee increases aggravates a loss of purchasing power highlighted for years, which strongly influences economic dynamics and the capacity to invest in suitable equipment and premises.

Pressure on installation and professional organization

A significant issue of this reform is the regulation of physiotherapists’ installations. By renouncing part of their freedom to establish themselves, these professionals agreed to contribute to a more equitable distribution of healthcare across France, especially in under-served areas. However, this concession requires financial commitments from the State, via CNAM, which have not yet materialized fully. The weakness of incentives for establishing in crowded zones undermines the quality and distribution of care, representing a significant risk for access to health services in these sectors.

Thus, physiotherapists criticize the low consideration for their contribution, recalling that the loss of installation freedom was a significant effort to contribute to the overall well-being and a more balanced healthcare system. The absence of a clear contractual framework and adapted tools also complicates the management of clinics and administrative and financial follow-up, constraints that weigh on a profession already demanding and often at the heart of daily care.

The broader context of healthcare professionals in the Dijon region

Dijon is among the territories where difficulties faced by healthcare professionals are particularly marked. In Côte-d’Or, about 1,168 physiotherapists work, often in private practice, but the proportion of unionization remains low, which does not limit the volume of demands and solidarity expressed in these collective movements. Frustration comes on top of an alarming inflationary context, rising professional charges, and economic prospects that are not reassuring.

The profession also suffers from a lack of attractiveness, leading to a gradual desertification in certain areas, increasing territorial inequalities in access to care. This situation has led several unions to call for mobilization, advocating for greater consideration and relevant measures to ensure the maintenance of quality and accessible services.

• 📌 Rising charges and heavy taxation
• 📌 Discrepancy between promised and effective revalorization
• 📌 Lack of incentives for practicing in rural areas
• 📌 Absence of a dynamic contractual framework
• 📌 Declining attractiveness and progressive desertification

Year	Revalorization commitment (%)	Effective revalorization (%)	Comments
2024	1.5%	1.5%	Initial compliance with signed addendum
2025	1.5%	0%	Postponed to January 1, 2026, for budget reasons
2026	1.5%	To be confirmed	Uncertain application

A social movement at the heart of a profession essential to health and well-being

Physiotherapy, an essential profession in the French healthcare landscape, plays a major role in maintaining public health and patient well-being. These practitioners not only provide rehabilitation and re-education care but also actively participate in prevention and sustainable management of chronic conditions and functional disorders. However, this vital mission today faces challenges from working and remuneration conditions perceived as degraded.

A fundamental role in the care chain

The physiotherapist intervenes in various cases: locomotor issues, trauma, neurological conditions, chronic pain… Their rehabilitation can significantly improve patients’ quality of life, foster rapid autonomy recovery, and prevent complications. Their contribution is thus central in the health system, but recognition does not always follow this reality.

In recent years, evolving practices and growing demand have increased responsibilities and workload, without corresponding adaptation of working conditions. Physiotherapists suffer from a marked gap between the evolution of their métier, their increased skills, and the legal or financial framework within which they are obliged to operate.

The consequences of sustained frustration on quality of care

Disengagement, discouragement, and increasing precarity surrounding professional conditions have direct repercussions on the sustainability of offered care. Material wear is also symptomatic, as symbolized by the demonstration where worn equipment—canes, walkers, aprons—will be displayed in front of the CPAM to illustrate a declining work environment.

Physiotherapists warn of a risk of decreasing practice numbers, which could intensify medical deserts, reduce proximity of care, and penalize local populations’ well-being. Access to quality physiotherapy thus appears as a major issue to defend, beyond financial questions.

• 💡 Increase in chronic pathology cases related to demographic aging
• 💡 Emergence of innovative techniques but limited without investment
• 💡 Risk of practitioners’ scarcity in rural areas
• 💡 Pressure on quality and continuity of care
• 💡 Strong involvement in local public health initiatives

Factor	Impact on the profession	Consequences for the population
Population aging	Increased demand for rehabilitation	Greater need for quality and accessible care
Lack of equipment renewal	Technical constraints in care delivery	Decreased comfort and efficiency of care
Economic pressure	Fewer resources for training and investments	Risk of service degradation

The unions in Dijon and their central role in mobilizing healthcare professionals

The French Federation of Massage Therapists and Re-educators (FFMKR), the National Union of Massage Therapists and Re-educators (SNMKR), and Alizé are at the heart of this mobilization. Their coordination helps structure the movement and carry a common voice to better defend the interests of physiotherapists. These unions have played a crucial role in organizing national and local events, including the Paris demonstration on July 1st and the upcoming one in Dijon.

Claims supporting collective action

The unions rely on specific demands, notably based on the signed addendum and respect for revalorization commitments. They also emphasize the need to improve work tools, strengthen the impact of support measures for installation in under-served areas, and advocate for a more favorable contractual framework for the profession’s development. Their message is clear: “a contract has been signed and we have fulfilled its terms, we want the State to do the same.”

In a recent statement relayed by media such as Le Bien Public, unions show their determination to continue the fight, aware of the difficulty but confident in the mobilization of members to pressurize decision-makers.

Symbolic and media action strategy

The decision to assemble worn equipment and symbols of the profession in front of the CPAM illustrates a strong impact approach. This call to demonstration under the evocative name “The Cane Festival” aims to effectively highlight frustration, emphasizing both infrastructure wear and financial difficulties. This action, scheduled at 1:30 p.m. on Boulevard de Champagne, will benefit from the support of other professions such as nurses and pharmacists, who have already demonstrated recently for their own demands in the region.

• ✊ Coordination between local and national unions
• ✊ Mobilization of physiotherapists rejecting the reduction of their purchasing power
• ✊ Symbolic actions to maximize media visibility
• ✊ Support from other health professions in solidarity
• ✊ Dialogue desired with health insurance authorities

Union	Role	Recent actions
FFMKR	Local organization, departmental representation	Demonstration in Dijon, local mobilization
SNMKR	National demands, consultation with the Ministry	National demonstration in Paris on July 1st
Alizé	Regional support and coordination	Awareness-raising actions, targeted demonstrations

The potential consequences of this mobilization on access to care in Dijon and its region

The exasperation of physiotherapists in Dijon fits into a broader issue, likely to significantly impact access to care and the quality of services for patients. The social tension amplified by these demonstrations can be seen both as a warning signal and a symptom of a system struggling to reconcile budget requirements and health needs.

Risks related to professional tensions and medical desertification

The mobilization serves as a warning about the risks of deterioration in care management, particularly in rural and under-served areas. An increasing number of physiotherapists now refuse installation in these sectors, worsening shortages and lengthening waiting times for essential care. Confrontation with Health Insurance over revalorization and installation conditions must not lead to an impasse that worsens existing difficulties.

The consequences could quickly translate into:

• ⛔ Prolonged delays in access to care
• ⛔ Decreased quality of care provided
• ⛔ Exodus of professionals to more attractive areas
• ⛔ Growing shortage in underserved departments
• ⛔ Loss of patient trust in the healthcare system

Consequence	Impact on patients	Impact on professionals
Prolonged patient waiting list	Frustration, worsening conditions	Increased stress, workload overload
Reduced territorial coverage	Medical “white zones”	Isolation and recruitment difficulties
Reduction in the number of practitioners	Decreased care quality	Loss of motivation and attractiveness

The importance of dialogue with health insurance in the reform of physiotherapy practices in Dijon

The relationship between physiotherapists and Health Insurance occupies a central place in the evolution of working conditions and the implementation of reforms. The current climate, marked by dissatisfaction and mobilizations, underscores the urgency of constructive and respectful dialogue. It particularly involves a thorough review of commitments made and the establishment of regular consultation to define a framework adapted to both professionals’ expectations and budget constraints.

A contract to honor to ensure trust

Physiotherapists particularly insist on respecting the signed addendums and agreements. The feeling of having fulfilled their part of the contract, especially regarding regulation of installation, calls for reciprocity which has so far been lacking. Several union voices demand that Health Insurance authorities quickly implement the announced financial commitments, thus preventing an escalation of tensions.

This desire for appeasement must pass through:

• 🤝 Transparent and regular negotiations with unions
• 🤝 A pragmatic consideration of economic data
• 🤝 Adoption of a balanced approach between budgetary rigor and support for professionals
• 🤝 Clear communication on schedules and implementation modalities
• 🤝 Development of tools to facilitate administrative management