Ontario’s move to allow physiotherapists to order X-rays, lab tests and ultrasounds removes barriers and enables patients to access the treatment they need.
There are almost 9,000 registered physiotherapists in Ontario. Each one, regulated by the College of Physiotherapists of Ontario, is an important, though often overlooked, contributor to the wellness of our provincial health care system and the quality of life of many Ontarians.
Over time, and through amendments to the Physiotherapy Act, the government of Ontario has increased the number and kinds of services that the province’s physiotherapists are authorized to perform. Most recently, the Ministry of Health and Long-Term Care announced the government’s intention to expand the scope of practice to allow physiotherapists to order X-rays, laboratory tests and diagnostic ultrasounds.
At first glance, it may seem like a relatively small, administrative change. In reality, however, it is an important signal from the government that the nature of primary health care is changing in significant ways. As Ontario continues to implement its Patients First strategies and increases access to a range of health care services, delivered by highly trained, highly regulated allied health care professionals such as nurses, nurse practitioners, pharmacists and physiotherapists, it is important that we understand this changing landscape.
We know the narrative: as a population, we are aging. We are also, among other things, living longer, surviving more accidents and relying more on home care services. Increased demand means increased stress on an already struggling health care system.
Enter physiotherapists. According to the College of Physiotherapists of Ontario, physiotherapy is “treatment to restore, maintain, and make the most of a patient’s mobility, function, and well-being. Physiotherapy helps through physical rehabilitation, injury prevention, and health and fitness.” The Ontario Physiotherapy Association also reminds us that physiotherapy can help manage chronic pain; aid recovery from concussions, other injuries and even stroke; and help maintain physical strength during cancer treatment.
We fully realize the value of these professionals when we look at how they can alleviate not only our pain but the chronic pressure on our current health care system.
For example, many people don’t realize that a doctor’s referral is not necessary to see a physiotherapist. Once patients find a physiotherapist through their own research, word of mouth or using an online search tool like the pt Health clinic locator, they can book themselves an appointment, as they do when they see a physician. This route eliminates the need — and the backlog-inducing wait — to see a physician only to ultimately be sent to a physiotherapist, particularly for ailments such as sprains or back pain, which are the types of conditions that physiotherapists specialize in and should be the first point of contact for.
For our system to work most efficiently, we need to be informed consumers of primary care and understand how and where we can access these services. The traditional see-a-physician-first mentality not only unnecessarily clogs an already overwhelmed system but also keeps patients from receiving the treatment they need when they need it.
As Ontarians look for improved health outcomes, assurance that patients can easily access the health care services they need, or reduced wait times for those services, it is clear our health care system is struggling under a constant and ever-increasing burden of demands. It is also clear that physiotherapists are a fundamental part of the solution. Allowing them to order diagnostics will significantly reduce wait times in family doctors’ offices, walk-in clinics and emergency rooms.
But there’s even more to be done. If the government of Ontario is in fact committed to ensuring access, then it needs to continue to empower physiotherapists and other allied health professionals. This includes, for example, expanding the kinds of physiotherapy services that are covered by OHIP, encouraging the inclusion of professionals such as physiotherapists and chiropractors in family health teams, and offering funding for public education about these kinds of services as important primary care options.
With Ontario projected to spend more than $53 billion on health care this year (a number estimated to increase to $58.1 billion in 2019-20), shouldn’t we spend these dollars as wisely as we can? When we have trained, front-line professionals who are educated, regulated and willing to step into an expanded role, we need to offer them the tools and support to do so. Otherwise, Ontarians will continue to struggle to overcome unnecessary, wholly removable barriers in order to access the treatment they need.
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