Belgium Expands Video Consultations to Physio, Midwives

Belgian Health Minister Frank Vandenbroucke announced on Friday that video consultations will be expanded to physiotherapists, speech therapists, and midwives, marking a significant broadening of telemedicine beyond the medical profession. The policy, set to take effect this summer, aims to improve healthcare accessibility and continuity of care for patients across Belgium.

Context and Background

Video consultations have been permitted for medical doctors in Belgium since the COVID-19 pandemic, which served as a catalyst for telemedicine adoption across the healthcare sector. The legal framework established during the pandemic has remained in place for physicians, but allied health professionals have until now been excluded from offering remote consultations.

Telephone consultations, which were also reimbursed by Belgium’s national health insurance institute INAMI, saw explosive growth from 2.3 million consultations in 2022 to 6.3 million in 2023, leading the agency to suspend reimbursement in early 2025 due to escalating costs.

Key Developments

According to RTBF, the new policy introduces specific rules for each profession. Physiotherapists and midwives will be able to offer video consultations starting July 1, 2026, while speech therapists will follow on August 1, 2026.

All three professions require at least one initial in-person consultation before video sessions can begin. Strict limits on consecutive remote sessions have also been established: physiotherapists and midwives may conduct a maximum of two consecutive video treatments before requiring a return visit, while speech therapists may offer up to ten consecutive video sessions.

VRT NWS reported that Minister Vandenbroucke described the video consultations as “a useful addition to care,” noting that for healthcare providers it leads to fewer no-shows, while patients benefit from better follow-up without interruptions caused by busy schedules or difficult commutes.

Professional Reactions

Fabienne Vandooren, Director General of AXXON — the association representing physiotherapists in Belgium — welcomed the development. “It’s truly an opportunity to make the patient more active in their own health,” she told RTBF. Vandooren emphasized that video follow-ups allow practitioners to verify that patients are performing prescribed exercises correctly, promoting greater autonomy.

However, the response from speech therapists has been more cautious. Caroline Théate, Administrator of the UPLF (Union Professionnelle des Logopèdes Francophones), described the announcement as “mixed news.” She criticized the 18% reduction in fees for video consultations compared to in-person sessions, arguing that tele-speech therapy requires as much work as traditional sessions, if not more.

Clémence Vital, Vice-President of the Belgian Midwives’ Union, expressed cautious optimism. While acknowledging that improved access to care is positive, she emphasized that midwives are “rather asking for a fundamental reform to value the skills and autonomy of midwives.”

Analysis and Implications

The expansion represents a carefully calibrated attempt to balance improved access with quality assurance. The mandatory first in-person visit and limits on consecutive video sessions aim to ensure that remote care complements rather than replaces hands-on treatment.

For patients, particularly those with mobility issues, those in remote areas, or those with demanding schedules, the policy promises reduced travel burden and better continuity of care. The voluntary nature of participation — patients can choose whether to use video consultations, and practitioners are not obligated to offer them — provides flexibility.

The 18% fee reduction for speech therapists raises questions about whether telemedicine is being used partly as a cost-saving measure for the healthcare system. The minister’s office was not available for comment on this or other concerns raised by professional organizations.

What’s Next

The policy takes effect on July 1 for physiotherapists and midwives, and August 1 for speech therapists. Telemonitoring for physiotherapists — remote patient monitoring via questionnaires or electronic measurements — is also included, limited to a 7-day period under certain conditions.

As Belgium continues to normalize telemedicine beyond the medical profession, questions remain about how quality of care will be monitored, whether the fee structure for speech therapists will be reconsidered, and whether further expansions to other allied health professions may follow.