Every day in Ontario, people end up in the ER for conditions that a physiotherapist could have treated months earlier.
“Patients are coming to the emergency department every day with pain that should have been managed weeks earlier by a physiotherapist in the community setting,” said Makaila Koshurba, a physiotherapist working in a Toronto-area emergency department.
The Canadian Institute for Health Information’s latest report confirms what Koshurba is describing. Emergency room visits across Canada have climbed to 16.1 million annually, and Ontario is no exception to that trend. CIHI is explicit: the factors driving longer wait times originate outside emergency departments, including a lack of access to primary care and community-based programs.
For the one in three people living in Ontario without private insurance, or for those who cannot afford to pay out of pocket, the public system is the only option.
“Every time I come to ask for treatment on aging issues, I am told that the waiting period is about four to six months,” wrote Joe, one of nearly 2,000 people living in Ontario who have signed our petition. “Treatment is needed right away. Otherwise, the issue becomes more severe,” he added.
Without that access, seniors whose mobility is declining end up in emergency departments rather than community clinics – often for falls and joint pain that community physiotherapy is specifically designed to prevent.
CPCs Prevent an Estimated 70,000 ER Visits
Ontario has the infrastructure to address this. The Community Physiotherapy Clinic Program operates through over 200 clinics across the province, preventing an estimated 70,000 emergency department visits in Ontario annually. Each dollar invested saves four dollars in downstream health care costs, reducing falls, surgeries, specialist consultations and visits to primary care.
The program hasn’t kept pace. According to OPA’s analysis of Ministry of Health data, since 2013 Ontario’s senior population has grown by 45 per cent, the cost of living has risen by more than 40 per cent, yet referral capacity has grown by just 14 per cent. Clinics that are paid a fixed lump sum regardless of how many sessions they provide are capping services and shifting toward private clients. In some communities, when a clinic exhausts its funded referrals, the nearest alternative is hours away.
Expand Access to Community Physiotherapy
One solution to the pressure on Ontario’s ERs already aligns with commitments this government has made: no hallway medicine, aging at home, and connected care for all. Expanding access to community physiotherapy is not a new direction. It is the most direct path to delivering on the ones already announced. Ontario’s primary care strategy is also expanding team-based care, but physiotherapists are rarely part of those teams – a gap that compounds the pressure on emergency departments every day.
The evidence is clear, the infrastructure exists, and the return on investment is proven. Physiotherapists across Ontario are ready to keep people out of emergency departments. What’s needed is specific: fund the 195,000 referrals people living in Ontario require, not the 140,000 the current model covers. The program that prevents 70,000 ER visits a year cannot be allowed to collapse for want of investment. Patients like Joe cannot wait months for conditions that will only get worse. Neither can the hospitals treating them.
Sarah Hutchison, MHSc., LL.M, ICD.D
Chief Executive Officer, Ontario Physiotherapy Association
