Just say their name. Physiotherapists.
I was struck by that thought when the one-year milestone of Ontario’s Primary Care Action Plan was announced. The Ontario government noted progress in attaching patients to a primary care provider and how much work there is left to do in expanding the definition of “primary care” and the role of “allied health professionals” in inter-professional care teams and beyond. While I applaud the progress made to date, the use of the word “allied” is a source of increasing frustration. It obscures the potential contribution of each of the health professionals referred to in this group.
Let me explain.
Physiotherapists are regulated health professionals. Patients don’t need a referral to access a physiotherapist, and where one is requested, it is usually the requirement of an insurance company. Physiotherapists work across the health system, in communities, in hospitals, in primary care, in homecare and in long term care, providing evidence-informed care to treat a wide range of musculoskeletal (MSK), cardiorespiratory and neurological conditions.
They are patient centric professionals dedicated to restoring movement and function, alleviating pain and improving quality of life for those recovering from an injury, managing a chronic condition, requiring pre- and post-surgical care or seeking to improve physical health and well-being.
For many seniors, access to physiotherapy by regulated physiotherapists impacts mobility, overall function and the ability to live independently. For MSK conditions, physiotherapists are often the first point of contact, and they assess, diagnose and manage these conditions each and every day. They work both independently and as members of an interprofessional care team in myriad settings.
In fact, if the scope of practice changes already approved in Ontario legislation in 2009 are enabled in 2026, physiotherapists would be able to order diagnostic tests, increasing timely access to care and providing a more seamless patient experience.
Enabling physiotherapists to practice at their full scope will:
- reduce the number of contact points needed within the health system
- reduce inappropriate utilization of walk-in clinics or emergency departments for imaging referrals.
Truly integrated care means that a qualified professional can act in patients’ interests to provide care without artificial barriers or any additional gatekeeping. With a patient centered lens, this could mean potential earlier return to function for patients, including care of self and family, and earlier return to work. There would be potential savings for employers with improved time to return to work, reduced expenses related to travel and fewer health-care visits. After all, this is about patients.
Recently, an article by two physicians suggested allowing physiotherapists to order diagnostic imaging would cause new problems and delay access to MRIs. Their statements were not based in evidence and drew a robust factual response from physiotherapists and the Ontario Physiotherapy Association. Published studies demonstrate that first contact physiotherapists order less imaging and reduce the need for prescription pain relief. It is unfortunate that Ontario has not followed the evidence from other provinces (Quebec, Alberta, Prince Edward Island) and countries (United Kingdom, Australia) where this authority exists.
As our health system continues to buckle under multiple demands, we need more physiotherapists working to full scope of practice. We would prefer to have “allies” enacting system change who understand the value and impact that access to physiotherapy across the continuum of care has for patients in our province.
And let us name and respect the contribution of all “allied” health professionals who make a tremendous impact on the health and well-being of Ontarians.
