Highlighting the Full Scope of Physiotherapy Practice with Andrew Tri, Emergency Department Physiotherapist

In the ever-evolving landscape of Ontario’s healthcare system, physiotherapists are stepping into new roles and settings with significant impact. Andrew Tri, a physiotherapist working in the emergency department at Toronto General Hospital, shares his journey, insights, and hopes for the future of the profession. 

A Dynamic Career Path 

From his early days working in private neurological rehabilitation and high-performance sport clinics, to supporting elite athletes at the Toronto Lakeshore Skating School and national teams such as Swimming Canada, Skate Canada, and Rowing Canada, Andrew Tri’s career has always been dynamic. Diverse education and a shifting healthcare landscape allowed him to move between roles in inpatient surgical units, sports organizations, and even a health tech company, which eventually led him to become a trailblazer in the emergency department. 

“My path has always included both public and private settings,” Andrew explains. “That hybrid approach kept my skills sharp and my perspective broad.”  

After earning his FCAMPT (Fellow of the Canadian Academy of Manipulative Physiotherapy) designation in 2018, Andrew pursued further education through the Master of Clinical Science in Advanced Health Care Practice (Sport and Exercise Medicine) at Western University (AHCP-SEM). This interdisciplinary program was a steppingstone to a new opportunity to work at Trillium Health Partners – Credit Valley Hospital, which eventually led Andrew to University Health Network, where he is helping define and expand the role of physiotherapists in the emergency department. 

Emergency Care

Andrew credits his wealth of postgraduate training and wide-ranging clinical experience for preparing him for the unpredictable nature of the emergency department. “The emergency department is one of the most unpredictable areas of the hospital” Andrew explains. “The AHCP – SEM program at Western is designed so that you’re in a mixed cohort of PTs and Physicians…I had the privilege of learning from some brilliant physicians, some of whom practice in the emergency department.” 

In the emergency department at Trillium Health Partners – Credit Valley Hospital, Andrew worked under medical directives that allowed qualified physiotherapists to order imaging, administer analgesia, and manually reduce dislocated joints:

“If a shoulder dislocation comes into the emergency department, we are the first ones to assess, order imaging, and initiate the reduction process.”  

This proactive, team-based approach helps streamline emergency operations and improves patient outcomes. Andrew has noticed that this model “allows individuals to receive appropriate care in a time-effective model that better utilizes resources and distributes work amongst team members.”  

Physiotherapists as System Changers

Andrew is part of a small but growing group of physiotherapists working to their full scope of practice in collaborative teams. “Having the experience of working in a role that allows for basic medical imaging and administering analgesia allows me to experience first-hand what a full scope of practice in Ontario could look like,” Andrew says.  

Andrew believes that high-quality roles where physiotherapists practice to full scope are powerful advocacy tools: “I believe doing the role, and doing it well, helps push the boundaries as we continue to serve as a strong representation of what PTs can do, or look to do once trained to do so.” 

Over time, Andrew has seen growing awareness of the value that physiotherapists bring to the emergency department: “There is a lot more understanding of what PTs can do and the value that can be provided in the emergency department.” From assessment and early management to discharge planning and education, physiotherapists play an integral role in improving patient care. 

Serving Underserved Populations

Musculoskeletal conditions, which are frequently underserved in traditional emergency department models, are an area where PTs shine.

“These musculoskeletal populations are in our wheelhouse as PTs,” says Andrew. “Our impact is in providing early, effective education and starting someone’s journey on a higher trajectory…This reduces the likelihood of those fear avoidant behaviours and maladaptive patterns.” 

He also highlights the PT’s role in managing chronic conditions and geriatric syndromes, both of which are areas where timely intervention can prevent unnecessary hospitalizations and future emergency department visits. 

In a system battling hallway medicine and capacity issues, Andrew believes physiotherapists are key allies. “We’re constantly assessing and developing management and discharge plans to ensure those who are in need of active emergency medicine, have the space to receive the appropriate care…”. 

Advocacy, Collaboration, and Moving Forward

Andrew believes that adding more physiotherapist roles in emergency departments is not only possible but essential: “We are trained to provide value beyond mobility and discharge planning, [and] we are well-positioned to contribute more to assessment and management”.  

For fellow health professionals, he emphasizes the need for collaboration:

“PTs can provide a lot of value to a healthcare system that is currently overloaded and understaffed. The deterioration that typically happens in the care areas of musculoskeletal, cardiorespiratory, neurological, and complex care systems often end up presenting to the emergency department in the form of falls, physical fragility, loss of function and independence, and generally failure to thrive.” 

As the healthcare system evolves, Andrew outlines a roadmap for progress: use data to demonstrate impact, build public and political awareness, advocate for new physiotherapist roles, and form task forces to address broader healthcare trends.  

He also urges physiotherapists to challenge the status quo and continue to grow: “We are in a profession of continued, life-long learning [and] times have changed. The stresses and demands on the health care system have changed. We must continue to advocate for the appropriate change in our scope of practice to better serve and support these new demands.” 

A Vision for Physiotherapists in Emergency Care

Andrew’s story is a case study of the untapped potential of physiotherapists within Ontario’s healthcare system. His work exemplifies how the profession, when supported to work to full scope, can transform emergency care and support system-wide goals. 

As Ontario’s healthcare landscape continues to shift, stories like Andrew’s are a powerful reminder of what is possible when physiotherapists are empowered to lead, innovate, and care at the highest level.

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