Ontario Doctor Sounds the Alarm: Cutting Publicly Funded Physiotherapy Will Cost Us Far More 

A Toronto family physician is calling out the Ford government’s decision to freeze publicly funded physiotherapy. The numbers behind her argument are hard to ignore. 

Dr. Iris Gorfinkel

Dr. Iris Gorfinkel, a family physician and clinical researcher, recently published an op-ed in the Toronto Star describing the real-world consequences she sees daily in her practice. “I typically see three patients a day who require rehab,” she writes. “Most don’t want medications. They want to get better.” What they need, she explains, is supervised exercise, but what she can prescribe, without limit, is drugs. 

Read Toronto Star op-ed (open to Toronto Star subscribers only) 

A System Built on Underfunding 

The Ontario Physiotherapy Association (OPA) has long raised concerns about chronic underfunding of the Community Physiotherapy Clinic (CPC) Program; a program that provides publicly funded physiotherapy to primarily seniors and youth. The gap between need and funding has been growing for decades, and it’s getting worse. Since 2013, Ontario’s senior population has grown by 940,000. In that same period, available CPC referrals grew by only 17,000. Operating costs for program delivery have risen 40%, while program funding has increased by a mere $20 in 13 years. While clinics deliver on average 6.2 visits per patient referred, the funding of $334 only covers about 3 of those visits, forcing them to operate at a loss. 

The Ford government’s latest move freezes clinic funding at zero growth for the next two years. Ontario needs funding to serve 195,000 referrals annually to this program to align with the growing senior population. Current funding will cover only 140,000. 

The Math Is Clear 

What makes this freeze especially difficult to justify is the return on investment. Every $1 invested in the CPC Program saves the government $4 in other healthcare costs. The program prevents an estimated 70,000 emergency department visits every year, while also reducing hospital admissions, diagnostic imaging, surgeries, and specialist consultations. 

Defunding physiotherapy doesn’t eliminate the need for care. It shifts the cost to much more costly care – emergency rooms, operating rooms, and long-term care – and access to physiotherapy is still needed. 

Real Patients, Real Consequences 

Dr. Gorfinkel describes one of her patients: a 72-year-old grandmother in tears, her knee failing her, who had already waited six weeks on a physiotherapy waitlist. “She could have fractured her hip,” Gorfinkel writes. Falls and fractures are among the most costly and preventable outcomes in senior care, and timely physiotherapy is one of the most effective tools we have to prevent them. 

Research backs this up. A landmark Sunnybrook study following nearly 900 colon cancer patients found that those in a supervised exercise program were more likely to remain disease-free eight years later and cost $1,600 less per patient than those who received educational materials alone. Exercise and rehabilitation aren’t optional. They are evidence-based medicines. 

The Downstream Risk 

OPA has also flagged that underfunding the CPC Program impacts other publicly funded programs, including the Bundled Care Program for hip and knee replacements. When the government underinvests in rehabilitation, it signals that access to physiotherapy is optional, while simultaneously pushing greater demand onto already-strained parts of the healthcare system. 

Several physiotherapy clinics across Ontario have decided that they can no longer afford to deliver care through this program. And many more have signaled their planned departure from the program, if the funding does not increase to meet their operational costs.  Each departure from the program means one fewer physiotherapist available to people in Ontario who rely on publicly funded services; leaving many with no access 

What Needs to Change 

The fix is evident:  

1. Eliminate the cap of 142,000 patient referrals and fund the access that people in Ontario actually need.  

2. Raise the per-patient rate to account for increasing operating costs, and ensure people in Ontario continue to have access to essential physiotherapy services. 

As Dr. Gorfinkel states: “When my patient is left to cry because she can’t get rehab without her credit card, the real sickness isn’t arthritis; it’s political neglect.” 

The evidence hasn’t changed. The question is whether Ontario’s government is willing to act on it.