Advancing the Role of Physiotherapists in Primary Care

What’s the Issue

On Friday, September 6, OPA President Courtney Bean, CEO Sarah Hutchison, Primary Care Advisory Committee Chair member Emily Stevenson, and Government Relations Representative Don Gracey met with Dr. Jane Philpott, and Carly Bergamini, Director of the Primary Care Action Team (PCAT), an Ontario government initiative. The mandate of the PCAT is to ensure 100% of people in Ontario are attached to a family doctor or a primary care nurse practitioner working in a publicly funded team, where they receive ongoing, comprehensive, and convenient care. 

OPA highlighted how approximately 20-30% of primary care visits are for musculoskeletal conditions,^{i, ii}. Based on clinical experience in physiotherapy in primary care settings and suggested attachment rates for physicians, OPA estimates that a physiotherapist on an interprofessional primary care team can increase attachment rates by approximately 425 total rostered patients (on average) or 24%.  

With funding now available as teams expand to meet the government’s mandate of ensuring access to primary care, physiotherapists can deliver incredible value in their ability to independently diagnose and manage musculoskeletal conditions and increase attachment.   

Here’s What We Want 

1. OPA is advocating for an expansion of physiotherapists in primary care teams in first contact roles.  

2. OPA is advocating for the necessary statutory amendments to enable physiotherapists to prescribe x-rays and order lab tests and “forms of energy” to be completed. Physiotherapists in other provinces and “extended practice” physiotherapists in hospitals, etc. have been authorized to do for some time. It’s time for the remaining regulations to be implemented in Ontario.  

With more physiotherapists on primary care teams, and working to their full scope of practice, we can reduce wait times, enhance access to care and improve patient outcomes at no net additional cost to the healthcare system. 

Progress Made to Date 

At this time, there are physiotherapists who are part of Family Health Teams, Community Health Centres, Nurse Practitioner-Led Teams and Indigenous Primary Care Teams. However, PTs are not frequently represented on these teams, and precise figures are not readily available from government sources, especially as organizations have moved to global budgeting models and so PT positions may be independent of specifically allocated funding. For the funding year 2023-2024, the following FTEs were identified: 

• 29.44 FTE PT in Family Health Teams 

• 54.03 FTE PT in Community Health Centres 

• 2.40 FTE PT in Nurse Practitioner-Led Clinics 

These FTE values are likely a small undercount of the actual number of FTEs for physiotherapists in primary care teams.  

Continuous Advocacy for PTs in Primary Care Roles 

To ensure awareness of physiotherapists in team-based primary care roles, OPA meets with the Association of Family Health Teams of Ontario (AFHTO) and the Alliance for Healthier Communities (Alliance) as well as individual OHTs. Discussions center on how PTs can increase attachment rates, and to collate various supports and resources for primary care teams regarding physiotherapists.  

Collaboration & Expanded Capacity 

OPA supports a collaborative approach to the integration of all rehab providers in primary care teams. It is important to note that communicating a diagnosis is within the existing scope of physiotherapists, which supports functioning independently as part of a team to expand capacity.  

Why This is Critical for Our Profession 

It is important to expand the number of physiotherapists in first contact roles in primary care teams to ensure Ontarians get the right kind of care when they need it.  

Current Challenges 

Implementing Scope of Practice Changes 

Well over a decade ago HRAC approved, and the necessary statutory amendments were made to enable physiotherapists to prescribe x-rays and order lab tests and “forms of energy”. The necessary regulations, however, have been held up in the Ministry for the better part of 15 years. We are hopeful that those regulations will be passed soon to reduce wait times, enhance access to care and improve patient outcomes at no net additional cost to the healthcare system. 

Increase Compensation for Physiotherapists in Primary Care Teams

OPA recently contributed to an advocacy initiative led by AFHTO and the Alliance. The OPA provided comparative data on current compensation rates in all sectors, and a proposed updated rate that accounts for inflation since 2015, when positions for PTs in primary care teams were first established with a salary of $75,000. There is also advocacy for salary rates at CHCs to rise to the same levels as Family Health Teams. OPA proposed a salary range of $97 110-$102 075, and acknowledged that these figures only account for inflation, and are not rooted in a value-based approach.  

How OPA Supports PTs in Primary Care Teams 

OPA has supported physiotherapists in primary care teams, and those looking to add physiotherapists to their teams with: 

• Free educational modules to support PTs in primary care, developed through evidence-based and consensus processes – Preparing PTs for Team-based Primary Care  

• Consultation on applications to the Primary Care Action Team 

• Resources and individualized support for recruitment and retention, including job descriptions, compensation reports, interview guides and free job postings. 

• Communication to members regarding primary care developments 

We Continue to Advocate 

Dr. Philpott acknowledged the role and value of physiotherapists in team-based care and we look forward to our continued partnership to advance opportunities for physiotherapists.   

i MacKay C, Canizares M, Davis AM & Badley EM. Health care utilization for musculoskeletal disorders. Arthritis Care & Research. 2010; 62(2): 161–169. Retrieved December 2023 from https://doi.org/10.1002/acr.20064.

ii Power JD, Perruccio AV, Paterson JM, Canizares M, Veillette C, Coyte PC et al. Healthcare utilization and costs for musculoskeletal disorders in Ontario, Canada. J Rheumatol. 2022; 49(7): 740-747. Retrieved March 2025 from https://www.jrheum.org/content/49/7/740.