Physiotherapists Scope Of Practice In Canada: Why It Matters

A physiotherapists scope of practice can vary from place to place, and staying on top of current practice guidelines can make or break your success as a provider. With so many other topics to keep up with while trying to practice to the best of your ability, you probably need a reminder on the status of the field in Canada.

Don’t worry, we’ve got you covered. In this article we’re going to explain what the current physiotherapy scope of practice is in Canada, how PTs want to change it, and why an expanding scope of practice matters for therapists in Canada.

What The Current Scope Of Physiotherapy In Canada Is

The scope of practice for physiotherapists in Canada includes a variety of diagnostic and interventional procedures for injury rehabilitation and prevention that is constantly expanding. Current examples include physical therapy evaluations, manual therapy, therapeutic exercise, education, modalities, referral to other providers, and prescriptions for equipment or work accommodations.

At first glance of a physiotherapists scope of practice in Canada, it might be hard to differentiate their scope of practice from that of a medical doctor. Here are a few quick notes to clearly separate these distinct professions:

• Physiotherapists are not licensed to prescribe or provide medications to their patients.
• Physiotherapists are not licensed to order lab tests or imaging for their patients.
• Physiotherapists are not licensed to perform surgery on their patients.

Conversely, there are several areas within a physiotherapists scope of practice in Canada that many people aren’t aware of. Here are a few examples:

• Physiotherapists are licensed to perform dry needling on their patients (in most places).
• Physiotherapists are licensed to perform spinal manipulations on their patients.
• Physiotherapists are licensed to see patients without a referral from a medical doctor.

Generally speaking, most physiotherapists are able to operate independently of other healthcare providers or overseeing primary care physicians. However, frequent communication and collaboration with other healthcare providers is considered standard for providing great care to your patients.

Ultimately, the physiotherapist role in Canada is one of great responsibility, with many opportunities to engage with other members of the healthcare community and make a major difference in the lives of patients.

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What Physiotherapists Want The Current Scope Of Practice To Be

Many physiotherapists in Canada want their scope of practice to continue expanding into new areas to provide improved care to their communities. Most notably, the ability to refer to MD specialists and order diagnostic imaging are new areas of practice currently being discussed and explored.

While a physiotherapists scope of practice in Canada is fairly robust, there are some key pain points that need to be solved sooner rather than later to improve access and quality of care for patients.

While a physiotherapist is able to refer their patients to other healthcare providers for non-medical or primary care services, the ability to refer patients to medical specialists - such as a dermatologist or cardiologist - is not within scope. Many physiotherapists argue that including this within their scope of practice would streamline patient triage and minimize wait times or drop off for patients in need of important medical services.

Another major struggle around a physiotherapists scope of practice in Canada is the ability to order medical imaging for their patients such as X-rays or MRIs, which is not currently allowed. This means that if a physiotherapist wants their patient to have an X-ray performed for a condition such as a suspected fracture, the patient needs to see their primary care physician or orthopedic MD first, which extends the amount of time for the patient to receive the service and can often lead to frustration.

Expanding the scope of practice for physiotherapists in Canada to include diagnostic imaging and specialist referrals may be an effective solution not just to improve care quality and access for patients, but also a way to further integrate physiotherapists into the medical field and improve the reputation of PT as a whole.

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Why Expanding The Scope Of Practice For Physiotherapists Matters

One of the most important reasons for expanding the scope of practice for physiotherapists in Canada is that it decreases the volume of tasks that are typically only performed by primary care physicians, alleviating significant bottlenecks that keep patients from getting important care and reducing burden on the healthcare system.

When a physiotherapist needs to involve other providers or processes in their care for tasks that could be handled within their own scope of practice, it can slow down their ability to provide care to their patients. At scale, this is a major contributor to the logjam that happens in primary care and slows down just about every other area of the healthcare system by association.

By reducing the burden of tasks that could be circumvented in primary care, physiotherapists are able to help ease the workload of doctors and speed up care for patients in the healthcare system.

It’s also important to remember that most modern physiotherapy programs are teaching students how to perform tasks such as diagnostic imaging evaluation and multi-system medical triage, and prohibiting these areas of practice may be considered a waste of that training because physiotherapists are not able to practice at the highest end of their licenses.

The good news is that changes do happen with time, and a physiotherapists scope of practice in Canada gradually catches up to their level of training. Staying on top of what your scope of practice is and how it could improve is a great starting place to getting involved, joining the conversation, and making a difference!

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