Read OPA’s op-ed on the Canadian Healthcare Network.

Check out OPA’s op-ed on Healthy Debate.

As Ontario marks one year of its Primary Care Action Plan, the Ontario Physiotherapy Association (OPA) is calling for a critical shift in how we talk about healthcare professionals. Stop using the term “allied health” and start naming the specific expertise that matters. 

OPA leadership argues that lumping physiotherapists and other regulated health professionals under the umbrella term “allied” obscures their critical role in Ontario’s healthcare system and the patient outcomes they deliver. With over 275,000 Ontarians newly attached to primary care in just one year, the province is on track to meet ambitious targets. But truly integrated care requires recognizing physiotherapists not just as supporting players, but also as frontline providers who diagnose, manage, and treat musculoskeletal and neurological conditions every single day. 

A recent physician-authored op-ed questioned physiotherapists’ authority to order diagnostic imaging which is a scope expansion already approved in Ontario’s legislation. It has also been successfully implemented in other jurisdictions including the UK, Australia, and several Canadian provinces. Evidence shows that when physiotherapists have this authority, they order less imaging and reduce unnecessary pain medication. Despite this, Ontario has yet to enable this change. 

With Ontario’s health system under mounting pressure from population growth, aging demographics, and complexity, the province needs physiotherapists working at their full scope of practice. That means removing artificial barriers, enabling evidence-based scope of practice expansion, and most importantly, calling these professionals by name. 

Read the full op-ed below. 

Going Beyond ‘Allied’: The Critical Role of Physiotherapists in Ontario’s Primary Care System 

Just say their name – Physiotherapists 

I was struck this past week as 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 for me. It obscures the potential contribution of each of the health professionals who are 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 a member of an interprofessional care team, in a myriad of settings.     

Enable Full Scope of Practice in Ontario 

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. This would increase timely access to care and provide 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  

Patients would get appropriate and comprehensive care where and when they need it. Truly integrated care means that a qualified professional can act in the patients’ interest 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, 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 to eliminated healthcare visits. After all, this is about patients. 

Important Role of PTs in Ordering Diagnostic Imaging 

Recently a newspaper article published by two physician authors questioned the role of physiotherapists in ordering diagnostic imaging suggesting that this would cause new problems and delay access to MRIs. Their statements were not based in evidence and drew a robust factual response from OPA member physiotherapists citing the evidence. 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 lead and the evidence from other jurisdictions (UK, Australia, QC, AB and PEI) where this authority exists. Although, we remain hopeful that before the second anniversary of the Primary Care Action Team this will finally have advanced. 

Our health system continues to buckle under the demands; whether that’s population growth, population distribution in the province, our aging population or the complexity in navigating our health system of systems. We need more physiotherapists working to full scope of practice to meet these grown demands. 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. Finally, let us name and respect the contribution of all of those “allied” health professionals that make a tremendous impact of the health and well-being of Ontarians.   

Sarah Hutchison, MHSc., LL.M, ICD.D

Chief Executive Officer, Ontario Physiotherapy Association   

Jody Lemieux is a registered physiotherapist at the Huron Shores Family Health Team in rural Northern Ontario. With more than 30 years of clinical experience, Jody has worked across hospital, private practice, home care, and community settings. For the past two and a half years, she has been practicing in a primary care team, supporting a large and geographically dispersed population across Blind River, Thessalon, Bruce Mines, and Richards Landing. 

Jody’s move into a primary care team was motivated by a desire to work in preventive care. After years in acute and inpatient hospital care, particularly during and after the COVID-19 pandemic, she observed many hospital admissions that she felt could have been prevented with earlier intervention.

“So many people were coming in with failure to cope,” she explains. “If there had been some intervention earlier on, it definitely could have prevented that or at least delayed it quite a bit.” 

The State of Primary Care in Rural Northern Ontario 

Providing physiotherapy in primary care in Northern Ontario looks very different than in urban or southern regions of the province. Jody’s Family Health Team’s catchment area encompasses more than 14,000 people and spans a vast geographical region, which includes communities without consistent physician coverage. Approximately 7,000 individuals have access to a primary care provider through her health team’s four sites. Although many others across this area have access to a primary care provider through other means, a significant number remain without a primary care provider. Also, there are no walk-in clinics in the region, and two of the three emergency departments are regularly closed due to lack of physician coverage. Thus, the Huron Shores Family Health Team endeavours to provide certain programs that are accessible to all individuals, irrespective of their clinic roster status. 

“Rural Northern Ontario is totally different,” Jody says. “The geography, the travel, the lack of resources, all of those things matter.” 

Because of these realities, Jody worked closely with leadership and regional partners to develop a role tailored to community needs. “The slate was wide open,” she notes. “I was able to look at what our population actually needed and build something that made sense here.” 

A Focus on Healthy Aging and Prevention 

In addition to providing individualized physiotherapy services, a major component of Jody’s role has been the development of a comprehensive Healthy Aging Program. The program focuses on early identification of frailty, falls risk, bone health concerns, and other barriers to aging well. The Healthy Aging program is available to everyone, including screening and education sessions, regardless of roster or attachment status, or ability to pay. However, the screening component is currently only for those 65 and older.

“It’s about identifying issues early and addressing them before they become crises,” Jody explains. “A lot of these things are not even discussed with primary care providers,” Jody explains. She adds that physician and nurse practitioner workload constraints are significant barriers to screening and addressing needs related to healthy aging, including falls risk and preventive care.

The screening process is intentionally thorough, combining early frailty identification with a pre-falls pathway to ensure important risks are not missed. Jody notes that this blended approach has helped identify individuals who may have otherwise been overlooked: “We’re catching a lot of other problems by taking the time to ask the extra questions.” 

Measuring Impact and Delaying Long-Term Care 

The Healthy Aging Program has been supported through funding from Healthcare Excellence Canada as part of the Enabling Aging in Place Collaborative. While some outcomes are still being formally measured, early feedback has been overwhelmingly positive. 

“All of the clients surveyed either agreed or strongly agreed that the program is helping them age in place longer,” Jody shares. Participants also reported highly positive experiences with the screening process itself. 

The screening aspect of the program has generated dozens of referrals to physiotherapy, primary care providers, diagnostic testing, bone health assessment, and community supports. In some cases, osteoporosis and other chronic conditions were identified for the first time, allowing for earlier education and management. 

Team-Based Care and Expanded Capacity 

Jody emphasizes that this work would not be possible without interdisciplinary collaboration. Nurses now lead the screening process at each site and assist with providing fall prevention programming. This allows Jody to focus on program oversight and more complex clinical needs. Recently, base funding was secured through the Algoma Ontario Health Team to support a permanent physiotherapist assistant (PTA) three days per week, which further supports community needs. 

“Having a physiotherapist assistant has made a huge difference,” Jody says. “A lot of what I do is education and exercise-based care, and that support helps us reach more people.” Jody adds that the PTA who works with her provides tremendous benefit to the community. They not only offer various group exercise classes and lead the fall prevention programming, but they also support Jody in working with her one-on-one physiotherapy caseload. 

Jody also highlights the importance of team-based solutions when unattached patients are going through the Healthy Aging Screening. In these cases, a nurse practitioner supports follow-up and diagnostics when needed, helping maintain continuity of care within the team. 

The Value of Physiotherapists in Primary Care 

Jody believes physiotherapists are uniquely positioned to strengthen primary care, particularly in underserved and rural regions. “We’re regulated health professionals with a lot of education and training,” she says. “When it comes to musculoskeletal issues, bone health, chronic disease management, and healthy aging, we’re well suited to identify problems and refer appropriately.” 

She also notes the value of time and patient connection. “We get to spend more time with people. Patients often tell us they’ve never been asked these questions before or that they were worried about something but didn’t want to bring it up because there were so many other things to talk to the doctor about.” 

For Jody, primary care physiotherapy is empowering, preventive, and flexible. “We’re all aging. There are a lot of modifiable factors, and people are eager to learn what they can do to help themselves.” 

Looking Ahead 

As Ontario continues to invest in team-based primary care, Jody hopes more teams will consider how physiotherapist roles can be adapted to meet local needs. “It doesn’t have to look the same everywhere,” she says. “It’s about identifying what your community needs and being open to doing things differently.” 

Her work demonstrates how physiotherapists can support healthier aging, reduce strain on hospitals, and improve access to care, particularly in rural Northern Ontario. As Jody puts it, “The sky is the limit when you’re willing to think outside the box”. 

Are You our Next Member Spotlight?

Do you want to be featured? Are you in an innovative role? Spoken about physiotherapy in a podcast or the news? Published an article? Or represented the physiotherapy profession through advocacy?

We want to celebrate you as a physiotherapist, PT or PTA student or PTA!