He celebrates the strength of Ontario’s physiotherapy community, thanks volunteers, and all the physiotherapists, physiotherapist assistants and student members for their contributions. Courtney also acknowledges the many connections OPA maintains with health care leadership, other associations and organizations that help drive our advocacy initiatives forward.
Watch his video now!
Natasha initially began offering physiotherapy services in the emergency department for non-admitted patients. The goal was simple but powerful: to help avoid unnecessary hospital admissions. Recognizing the need for additional preparation, she completed several weekend courses on allied health in the emergency department to strengthen her skill set for this unique environment.
What started as a small 0.2 FTE addition to her full-time role quickly revealed its potential.
“I recognized the value of physiotherapy in the ED, particularly in preventing non-medical admissions, reducing length of stay through early mobilization, and facilitating discharge planning,” Natasha explains.
Inspired by this insight, she partnered with an occupational therapist colleague to launch a Science of Care quality improvement (QI) project. Together, they set out to demonstrate the impact of having full-time physiotherapy and occupational therapy coverage in the ED over a two week pilot as compared to baseline data of 0.2 PT/OT compliment over 2 years.
Their data told a compelling story: patients moved through the system more efficiently, hospital length of stay decreased, and satisfaction among physicians improved. The results were later presented at the International Learning Collaborative Conference in Portland, Maine in 2023. Natasha and her OT colleague’s quality improvement work was well-received by the ED staff. Earlier this year, Mount Sinai received funding from Ontario Health to support full-time PT and OT coverage in the emergency department. As of March 2025, the hospital now benefits from 12-hour physiotherapy and occupational therapy coverage on weekdays and 8-hour coverage on weekends from 2020 to 2022.
Natasha’s work extends well beyond mobility management. Physiotherapy assessments often provide valuable complementary insights that support the overall clinical picture. “Our functional assessments can sometimes highlight neurological changes—such as signs consistent with stroke or early Parkinson’s Disease—that may not yet be evident on initial imaging,” she explains. These observations often lead to collaborative discussions with physicians and other team members, helping guide further assessment and contributing to diagnosis. It’s a strong example of how physiotherapists play an integral role in enhancing patient care through interprofessional teamwork.
Innovation is central to Natasha’s approach. As part of the rehab team at Mount Sinai, she recently began integrating the Clinical Frailty Scale (CFS) into initial assessments for patients over 65, which helps guide discharge pathways with the goal of ensuring that both admitted and non-admitted patients receive the most appropriate care trajectory. It’s a data-informed strategy that enhances efficiency and targets resources where they’re needed most.
The impact is especially clear in key populations. “Our assessments are critical in the non-operative management of fractures following falls, particularly in older adults,” Natasha says. From prescribing gait aids and connecting patients to community resources and facilitating inpatient rehab applications directly from the emergency department, her interventions often help prevent avoidable hospital admissions. She also plays a pivotal role in managing pain for patients with musculoskeletal injuries, which is an area where early education and treatment can significantly affect outcomes.
Importantly, Natasha’s work supports broader system goals. By conducting early functional assessments, she helps minimize patient deconditioning, enables direct transfers to rehab, and contributes to smoother patient flow through the ED. “We are key contributors to disposition planning from the emergency department” she says. It’s a role that combines clinical skill with system thinking and it’s making a measurable difference.
To decision-makers across the health system, Natasha offers a clear message: “As our population ages and community resources remain limited, physiotherapists in the emergency department are essential for early assessment, mobilization, and discharge planning. We have the expertise to optimize function and facilitate safe transitions, whether back home or into rehab, directly from the emergency department.”
And while she’s passionate about advocacy, Natasha emphasizes that it must be grounded in evidence. The QI project she helped co-lead serves as a model not just for funding conversations, but for demonstrating the cost-effectiveness and value of physiotherapy in emergency care.
“Advocacy should be grounded in research and data,” she says. “By highlighting existing evidence, including our own QI project, we can demonstrate the value and cost-effectiveness of physiotherapists in emergency care.”
A day in Natasha’s life is fast-paced and ever-changing, which is exactly how she likes it. She starts by scanning the emergency department census to identify patients who could benefit from physiotherapy. These patients might be older adults recovering from a fall, individuals with musculoskeletal injuries, or those with mobility challenges or complex discharge needs. From there, she collaborates with the broader care team to determine who is medically stable and appropriate for physiotherapy intervention. Her work includes bedside assessments, gait aid prescriptions, education on safe mobility, and input on discharge planning, all of which is aimed at avoiding unnecessary admissions and ensuring safe, timely transitions of care.
“No two days in the ED are ever the same, and that’s part of what makes this role so dynamic and rewarding,” she reflects. It’s a role that blends clinical expertise, system navigation, and patient advocacy, and it shows just how far physiotherapy can go when professionals like Natasha are empowered to work to their full scope of practice.
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!
The Government of Ontario announced plans to implement regulations allowing physiotherapists to order diagnostic imaging (X-rays, CT scans, MRIs, and diagnostic ultrasounds). OPA’s relentlessly advocated through:
We hope to see movement on the scope of practice implementation in 2026!
Support the advocacy work we do on behalf of the physiotherapy community in Ontario. Join OPA/CPA!
OPA’s four clinical advisory committees meet quarterly, and in their recent October meetings, engaged in discussions around several advocacy items.
The Hospital Advisory Committee met on October 7, 2025, and focused its advocacy discussions on addressing:
The Hospital Advisory Committee is made up of volunteer members who advise OPA staff and the Board of Directors on issues affecting physiotherapy practice in hospitals and rehabilitation centres across Ontario.
This committee ensures that the interests and concerns of physiotherapists in these settings are heard and considered in policy decisions.
Interested in joining? We welcome new volunteer members who want to help shape the future of hospital and rehabilitation physiotherapy in Ontario. Contact us at physiomail@opa.on.ca.
After graduating, Ven began his career working in rehabilitation settings treating patients with complex medical conditions. It didn’t take long before he identified a significant gap in care: “Within two years, I noticed that individuals with neurological conditions, especially those who had experienced a stroke, faced significant challenges in accessing specialized rehabilitation and assessments. That led me to pursue a master’s degree in advanced physiotherapy in neurology (MPT).”
Ven’s training in the MPT program deepened his expertise in neurological rehabilitation and introduced him to specialized clinical practices. “As part of the program, I gained experience conducting electromyography (EMG) and nerve conduction velocity (NCV) studies and worked closely with neurologists to triage patients with stroke and spinal injuries, bridging the gap between acute care, outpatient clinics, and community rehabilitation,” Ven explains.
Ven eventually brought this expertise to Canada. He joined Health Sciences North (HSN) in Sudbury and began conversations about the possibility of expanding physiotherapy’s role in stroke care, which the leadership team supported. “This role emerged from the unique convergence of personal vision and institutional strategy,” Ven says. Because of Ven’s efforts, Health Sciences North was the first academic hospital in Canada to implement an Advanced Practice Physiotherapist (APP) role specifically for stroke, which has allowed him to extend the boundaries of physiotherapy practice while directly addressing system-level challenges to improve patient outcomes.
“My professional advancement happened gradually and strategically within the same healthcare system” says Ven. He notes that continuity within Health Sciences North allowed him to build institutional knowledge, trust, and strong interprofessional relationships. Building on these foundations, Ven has continued to pursue ongoing professional development to adapt to the ever-changing Canadian healthcare landscape.
“Even after completing my PhD in Rehabilitation, I felt it was important to stay current” he explains. “I completed a one-year graduate certificate in stroke rehabilitation from the University of Alberta to better understand stroke rehab practices in Canada.”
Over time, the APP role has grown beyond its original scope. “It started with a focus on direct clinical assessment and research, but now it includes leadership responsibilities and managing system-level triage pathways for stroke patients.”
He has also led initiatives that challenge traditional care models. One of these is the ‘MObile TIA and Stroke with AdaptiVE Workflow (MOTIVE)’ project, which utilizes an expert stroke team that tends to patients throughout every area of the hospital setting, not just in the stroke unit.
One of the most innovative aspects of our MOTIVE project involves rehabilitation triage of mild stroke patients in collaboration with stroke neurologists and other interdisciplinary members, ” Ven said. “We were able to triage patients with rehabilitation needs within hours or on the same day, which significantly reduced delays and facilitated faster discharge of patients with TIA/minor stroke.“
To further support this shift, Ven has begun advocating for legislative and regulatory changes.
“I’ve had preliminary discussions with the leadership team at HSN about implementing Bill 179 for stroke care” he explains. “If adopted, physiotherapists could use diagnostic tools like X-rays, CT scans, and MRIs to identify red flags and triage patients for rehabilitation and treat them more effectively. This wouldn’t replace physicians; it would enhance system efficiency and stroke care.”
In addition to his clinical expertise, Ven brings a systems-thinking approach to his role. “I completed Lean Six Sigma Green Belt certification and gained knowledge in Implementation Science. These tools have helped me move beyond individual treatment plans and look at redesigning entire clinical workflows.”
The APP role has proven especially impactful for patients with acute stroke and TIA, where rapid decision-making can dramatically influence outcomes. “This patient group really benefits from quick triage and early discharge planning” says Ven. “By addressing initial system inefficiencies, we can reduce length of hospital stays and direct patients to the right rehab pathway once they’re medically stable.” Ven points to the MOTIVE Project as a clear example of success: “We were able to triage patients within hours or on the same day. Working collaboratively with stroke neurologists, physicians, Occupational Therapists, and Speech Language Pathologists allowed us to significantly reduce delays and support faster discharges.”
Ven has seen the significant impacts of his role within the hospital system:
“My role helps reduce hallway medicine by preventing unnecessary admissions and ensuring timely discharges. That improves patient flow, optimizes bed use, and reduces re-admissions.”
Ven believes strongly that the value of APP roles needs to be communicated in system-level terms. “There’s already strong evidence that APPs in musculoskeletal care are a cost-effective way to assess and manage patients. The same applies to stroke. Investing in APPs isn’t just about staffing, it’s an economic strategy. These roles help improve patient flow, reduce hospital admissions, and deliver advanced care at a lower cost compared to relying solely on physicians for triage.”
He emphasizes that APPs are intended to work alongside and not in place of physicians.
“It’s important for other health professionals to know that APP roles are designed to complement, not compete” Ven explains. “In stroke care, our involvement enables timely assessments and planning, so that neurologists and physicians can focus on high-acuity medical needs.”
When asked how the profession can better advocate for APP roles, Ven stresses the importance of aligning with system priorities. “Advocacy needs to go beyond individual clinical outcomes. We need to show the impact on things like ALC days, and length of hospital stays. For example, our MOTIVE project focused on reducing length of stay and readmission risk for stroke patients. If we can connect physiotherapy to government goals like improved flow and reduced wait times, we’ll have a much stronger case.”
For others looking to replicate this model, Ven offers some clear advice: “Effective advocacy for an APP role has to be tied to a specific system issue, not just professional ambition. Focus on solving inefficiencies, like long waits for specialist consults. Use quality improvement methods to measure outcomes and back up your work with data. To ensure sustainability, the role should include clinical practice, leadership, research, and education.”
Ven’s work offers a compelling example of how physiotherapists, when supported to work at full scope, can play a transformative role in patient care and health system design.
“Allowing physiotherapists to order diagnostic tests within their professional scope can enhance patient care by minimizing delays associated with waiting for physician assessments and orders. Advanced Practice roles in internal medicine and stroke care further facilitate collaboration with stroke neurologists and physicians, thereby promoting timely and efficient triage for rehabilitation” – Lisa Zeman, Clinical Manager of Internal Medicine and Acute Stroke, Health Sciences North.
“Advanced Practice Physiotherapist (APP) play a vital role in stroke care, partnering with stroke neurologists to provide expert functional assessments and guide timely, and evidence-based rehabilitation decisions.” – Dr. Ravinder-Jeet Singh, Stroke Neurologist, Health Sciences North; Medical Director, NEO Stroke Network.
“Integrating Advanced Practice Physiotherapy (APP) into our stroke team has greatly enhanced both patient care and system performance. At Health Sciences North, we’ve seen measurable improvements in research, clinical outcomes, access to care, and interdisciplinary collaboration. Our APP has demonstrated exceptional clinical leadership and has been instrumental in strengthening the overall effectiveness of our stroke program” – Chantal Liddard, Administrative Director Medicine Program, Health Sciences North.
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!
Northern Ontario District members welcomed the physiotherapy community to their district’s bi-annual conference in Timmins.
The event took place over two days, from October 3-4, and included many amazing sessions, a pre-conference course, and a chance to network with the Northern and Northwestern Ontario physiotherapy community, among others.
“It was truly a valuable experience for both skill development and networking opportunities. It was great connecting with so many engaged professionals.”
“Amazing coming together of the North.”
When asked what they liked most about the event, attendees shared:
“Networking with colleagues, meeting/interacting with the CEOs of the CPO and OPA”
“Networking with peers and sharing what is important to Northeastern Ontario Physiotherapists with OPA and the College”
Craig Roxborough, Registrar & CEO and Mary-Catherine Fraser Saxena, Manager, Practice Advice (CPO) both echoed there were lots of meaningful conversations, and they appreciated the opportunity to connect with PTs in the North to hear their perspectives.
Courtney Bean, OPA’s President, said he had such a great time and it really filled his bucket. He said he has some good understanding of the challenges of rural care but now realizes the amazing passion of people providing care in rural locations. He also learned a lot about care in the North…a lot more than he ever knew.
Sarah Hutchison, OPA’s CEO, gained a deeper appreciation of the challenges that rural and remote physiotherapists face and how the OPA might advocate further. She also observed that the sense of community was incredible and contagious!
Physio North 2025 is one example of the amazing work done by district volunteers. Thank you to Rhonda Matthews, Northern Ontario District President, and Jody Lemieux, Secretary, for making this event happen!
Regional representation at OPA through our 16 districts is invaluable. While districts may share similarities, understanding the unique populations and advocacy needs in each district contributes to OPA’s success. We encourage all members to get involved in their districts.
OPA is currently looking for member volunteers in these districts. Contact Prerna at ptawde@opa.on.ca if you are interested in volunteering.
OPA has submitted a detailed response addressing all consultation questions, backed by evidence, research, and the results of our 2024 survey of Ontario physiotherapists. Members are welcome to reference, adapt, or use content from our submission in their own responses to the government consultation.
Our submission emphasizes how implementing the authority for physiotherapists to order diagnostic imaging (X-rays, CT scans, MRIs, and diagnostic ultrasounds) will:
Our submission includes compelling data from the 2024 OPA survey of Ontario physiotherapists who responded that:
Research from jurisdictions where physiotherapists already have this authority demonstrates:
This consultation focuses on diagnostic imaging. OPA will continue to advocate for the authority to order laboratory tests- the final piece of scope expansion approved under Bill 179 in 2009 that has not yet been implemented.
Your voice matters. Here’s how you can support this critical scope expansion:
Since 2009, physiotherapists have been waiting for the regulations needed to implement scope of practice changes that are already approved in legislation. Four other provinces- Alberta, Quebec, Nova Scotia, and PEI- have successfully implemented this authority for physiotherapists.
With Ontario facing:
OPA remains optimistic that the government will move quickly with the needed regulation changes following this consultation period.
The recent announcement by the Government of Ontario about pending scope of practice implementation for physiotherapists in Ontario is an important and welcome step. OPA remains optimistic that following the completion of the Government consultation on November 3, 2025, the Government will move quickly with the needed regulation changes to expand the scope of practice for physiotherapists.
OPA also continues to advocate for the remaining needed changes so that physiotherapists can order laboratory tests, which the announcement did not reference.
Anthony Grande, PT and OPA member, met with Premier Doug Ford on September 25 and Deputy Premier and Minister of Health, Sylvia Jones on October 7, 2025.
OPA provided Anthony with a letter of acknowledgement and appreciation for the Premier and Minister of Health on behalf of 12,000 physiotherapists in Ontario for their leadership in announcing plans to implement the needed changes. Anthony thanked both the Premier and Deputy Premier in person for the recent Government of Ontario announcement regarding plans to implement the needed changes for physiotherapists to be able to order diagnostic imaging.
We thank all members who recently submitted feedback to OPA regarding the Government consultation. OPA is also encouraged by all members, like Anthony, who dedicate time and energy to advocating for the the physiotherapy profession, and the implementation of our full scope of practice.
The Government of Ontario consultation on the proposed changes to scope of practice closes on November 3, 2025. OPA will share our submission with members prior to the government’s consultation closing.
Our voices are stronger together!
Questions? Contact OPA at physiomail@opa.on.ca
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.
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.
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.”
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.
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…”.
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.”
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.
Do you want to be featured and 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!
Today we recognize the National Day for Truth and Reconciliation. On September 30 we honour and remember the Indigenous children who never returned home, survivors of residential schools, and their families and communities.
Watch Courtney Bean, OPA’s President, speak about this day, its history, and significance to all of us. Check out resources below mentioned in the video.