Abstract Has medical dominance declined as a result of the increasing autonomy of developing health professions? The paper argues that to answer this question it is first necessary to define medical dominance and professional autonomy. The paper outlines a categorisation of different types of professional autonomy, which correspond to different types of medical dominance. This categorisation is used to identify the particular aspects of professional autonomy in physiotherapy which have developed over recent years. It is concluded that whilst these changes correspond to a decline in aspects of medical dominance, there is no evidence of a significant decline in medical dominance in health services or that the changes which have taken place are solely a result of developing health professions' struggle for autonomy.