Advocacy Update Archives - Page 3 of 7 - Ontario Physiotherapy Association

Read Our Submission & Respond to Scope of Practice Consultation

Following our September update about the Government of Ontario’s public consultation on scope of practice changes, OPA has completed our comprehensive response to the Ministry of Health.

The consultation period closes on November 3, 2025, and we strongly encourage all physiotherapists to participate and make their voices heard. See below for how.

OPA’s Submission: Ready for Your Use

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:

Improve Access to Care

Reduce Healthcare System Burden

Work Within Established Quality & Safety Frameworks

Read our submission

What the Evidence Shows

Our submission includes compelling data from the 2024 OPA survey of Ontario physiotherapists who responded that:

74% experience difficulties obtaining diagnostic imaging or lab results needed for patient care

84% report that these challenges lead to delayed treatment for patients

82% have completed tests but never received the reports

62% have seen inaccurate diagnoses result from these barriers

Research from jurisdictions where physiotherapists already have this authority demonstrates:

No significant increase in overall imaging utilization

High concordance between physiotherapist and specialist physician ordering patterns

27-49% reduction in healthcare costs (systematic review)

Most Alberta physiotherapists order an average of only 22 imaging tests per year

Outstanding Authority: Laboratory Tests

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.

Three Ways to Participate Before November 3

Your voice matters. Here’s how you can support this critical scope expansion:

Use OPA’s submission: Reference or adapt content from our comprehensive response.

Submit directly to the government consultation: Visit the Ontario Regulatory Registry to provide your feedback.

Contribute to ongoing advocacy: Participate in OPA’s letter writing campaign to decision-makers.

Read our submission

Why This Matters Now

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:

Challenges for patients across Ontario to access care

2.5 million people without a family physician (projected to reach 4.4 million by 2026)

Increasing wait times for specialist consultations

Emergency departments overwhelmed with non-urgent visits

Implementation of these scope changes will allow physiotherapists to better serve patients, reduce system pressures, and deliver on the government’s commitment to provide “the right care in the right place.”

Timeline Reminder

Consultation closes: November 3, 2025

What happens next: Following the consultation, the Minister of Health will need to make regulation amendments (subject to Cabinet approval).

OPA remains optimistic that the government will move quickly with the needed regulation changes following this consultation period.

OPA Member Meets with Premier Doug Ford & Deputy Premier and Minister of Health Sylvia Jones

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.

Member Meets with Premier Doug Ford & Minister of Health Sylvia Jones

Ontario Premier Doug Ford holds a letter from the Ontario Physiotherapy Association given to him by Anthony Grande, PT and OPA member

Honourable Sylvia Jones, Deputy Premier and Minister of Health with an OPA letter being handed to her by Anthony Grande, PT and OPA member

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.

Read letter to Premier Ford

Read letter to Minister Jones

Every Member Makes a Difference

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.

Continued Advocacy is Needed

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.

Here is how you can have input:

Respond directly to the government’s consultation.

Continue with your letter writing advocacy in support of scope expansion for physiotherapists.

Our voices are stronger together!

Questions? Contact OPA at physiomail@opa.on.ca

Member Spotlight – Expanding Horizons: A Physiotherapist’s Role in Ontario’s Emergency Departments

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

Andrew Tri, smiling Physiotherapist at an emergency department at Toronto General Hospital

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.

Are You our Next Member Spotlight?

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!

Submit your story

CPC Program Update

Here’s the Issue

Clinics participating in the Community Physiotherapy Clinic (CPC) Program through a Transfer Payment Agreement (TPA) with the Ministry of Health (MoH) continue to face issues although improvements were made in 2024. As a new TPA is expected in April 2026, OPA continues to advocate with the Ministry about the issues that physiotherapists encounter with the program. Consulting with OPA’s CPC working group prior to meeting with the Ministry, the current concerns include:

High threshold for the # of visits in an episode of care

Wait lists for clinics not able to provide service because they have met their EOC allocation

Inadequate compensation for an episode of care

Lack of timely data sharing

How We Are Advocating

On September 10, 2025, Sarah Hutchison, OPA CEO, and Don Gracey, Government Relations for OPA, met with the CPC Program staff in Kingston to address some of these issues.

In the summary data for fiscal year 2024-25, the average number of treatments per EOC was 5, and the overall utilization of program EOCs was 93.7%. Members of the working group noted that the demand for the CPC program has continued to increase as have waitlists for many providers. The Ministry does not currently track waitlists raising the question of whether there is a need to track unmet demand along with its potential impact on patient care and practices.

Commitment to Increase Data Sharing

One of the concerns identified by the working group has been timely data sharing. This is an ongoing challenge given the retrospective nature of the program and the timing for billing/submissions/reconciliation. The Ministry has committed to providing quarterly data at the end of the following quarter.

What We Are Working Towards

OPA is holding its next meeting with the CPC working group on October 9 to discuss issues and priorities for the 2026 Transfer Payment Agreement.

Critical for Physiotherapist Profession

The Community Physiotherapy Clinic Program provides publicly funded physiotherapy to residents of Ontario that may not have access otherwise. OPA was pleased to see changes made to the previous TPA in March of 2024 that included:

An increase in fees: 3% in the first year of the TPA, and 2% in the second year

One diagnosis for one Episode of Care (EOC) rather than the previous ‘whole body’ multiple diagnoses approach

Replacement of the annual Review Engagement Financial Statement with an annual attestation

Support access to virtual care as per College of Physiotherapists of Ontario guidelines

Enabling of reallocation of available EOCs when a clinic closes or identifies they are unable to fulfill all EOCs assigned, or when the Ministry chooses to allocate unused EOCs

Remove the requirement for referral from physicians or nurse practitioners

Current Challenges

With feedback from the CPC working group and members who deliver care in the CPC program, OPA will continue to advocate for needed improvements to the CPC Program, including inadequate compensation for an episode of care, high wait lists and high thresholds within an episode of care. The Ministry has previously included OPA’s feedback into changes to the TPA and we are hopeful about conversations moving forward.

Scope of Practice Update

Thank you to everyone who has been engaged with the recent announcement about pending scope of practice implementation for physiotherapists in Ontario. We are equally excited about these next steps and want to assure our community that we will share additional information as soon as it becomes available to us.

Following the Announcement, the Government of Ontario opened a public consultation on the scope of practice for a number of regulated health professions and specifically included the authority for physiotherapists to order diagnostic imaging.

What’s Been Completed

Scope of practice expansion began under the Physiotherapy Act, 1991 in 2009. Specifically, members will recall that the Physiotherapy Act was amended to:

Expand the legislative description of the scope of practice of physiotherapy in section 3 of the Act;

Authorize physiotherapists to “communicate a diagnosis”;

Perform several procedures relating to wound care;

These changes have been in place for some time. Combined with the earlier extension of authority to “administer a substance by inhalation” that was extended prior, the scope changes arguably represent the most extensive granted to any profession that was regulated by the Health Professions Regulations Act when it came into force and effect in 1993. With the pending addition of diagnostic imaging, the only outstanding authority is the ability to order of lab tests.

In the fall of 2024, OPA collaborated with the College of Physiotherapists of Ontario to update past submissions to the Ontario Government on scope of practice implementation. This included the results of a 2024 updated survey of Ontario physiotherapists to understand the current landscape. A comprehensive submission has already been made to the Ministry in advance of this announcement. OPA has been committed to advocacy in this area dating back to 2009. View the timeline of OPA activities related to scope changes.

What Needs to Happen for Scope of Practice Changes to Advance

It is important to know that few of the health professions that are seeking scope expansion are at the same point in terms of the necessary enabling legislation. In this regard, the physiotherapy profession is among the furthest advanced. In our case, the necessary statutory amendments have already been made and have been proclaimed.

Once this current consultation period has ended, the following amendments to regulations need to occur. The changes to regulations are under the authority of the Minister of Health, subject to approval by Cabinet. Implementation of the physiotherapy scope of practice changes require:

A regulation under section 6(2) of the Healing Arts Radiation Protection Act to add prescribing of X-rays by physiotherapists.

Amendment to the Exemptions section of O. Reg 107/96 “Controlled Acts” under the Regulated Health Professions Act, 1991 is required to give physiotherapists the authorization to order the following “ prescribed forms of energy”:
o MRIs, under Sections 3.1 and 7.4,
o Diagnostic Ultrasound, under Section 7.1(2), by including “a member of the College” as a “member with ordering authority.”

Physiotherapists are also seeking the ability to order laboratory tests, but the announcement did not reference this request. The following regulation changes would be required:

Amendment to O. Regs. 45 /22 Sections 17 & 18, under the Laboratory and Specimen Collection Act to permit physiotherapists to order laboratory tests (9.1(a)) as appropriate.

Amendment to O. Reg. 207/94 General, Section 12 under the Medical Laboratory Technology Act, 1991 to permit taking blood samples when ordered by a physiotherapist.

What the Government Announcement Means

This announcement is consistent with the government’s commitment to advance scope of practice expansion. The public consultation is a forum for the government to share its intent and to receive input on the benefits and risks of implementing scope of practice changes for multiple regulated health professionals including physiotherapists. We remain optimistic that following the completion of the consultation on November 3, 2025 the government will move quickly with the needed regulation changes to expand the scope of practice for physiotherapists.

What Information We Do Not Have Yet

Specific timelines for the drafting and approval of the necessary enabling regulation changes. We are hopeful that the regulations pertaining to physiotherapy could be in place as early as mid-year 2026.

Timeline from approval of regulation changes to clinical implementation including confirmation of the College of Physiotherapists processes for rostering that will be adapted to support this new authority. We understand that the College is preparing for implementation so that once the government has made the final regulatory changes, they will be ready to move forward. We will continue to work with CPO on implementation related considerations.

Government of Ontario Consultation

Thanks to all who provided thoughts to inform OPA’s feedback. This feedback closed October 8, 2025.

The Government of Ontario has released a consultation on the proposed changes to scope of practice closing on November 3, 2025.

Continue with your letter writing advocacy in support of scope expansion for physiotherapists.

Respond directly to the government’s consultation.

We are actively collecting feedback from the physiotherapy community to include in our response to this consultation, which closes on November 3, 2025.

In addition to a summary of the existing PT competencies and scope of practice already passed in legislation, OPA will ensure the following points are clearly articulated with supporting evidence.

Continued access to diagnostic imaging must to be publicly-funded.

Implementing the authority for physiotherapists to order diagnostic imaging will:

Increase access to the right health care at the right time for many people in Ontario

Improve efficiencies and reduce costs in the healthcare system by eliminating redundancies and red tape

Require additional education and ongoing learning by PTs to ensure best practices

Be implemented safely and effectively by the College of Physiotherapist of Ontario’s robust and proven rostering process and quality assurance

OPA will share our submission with members prior to the government’s consultation closing.

We strongly encourage all PTs to provide their support through any of the two remaining pathways with comments directly to the Government’s consultation or continue with our letter writing campaign. Our voices are stronger together!

Questions? Contact OPA at physiomail@opa.on.ca

Scope of Practice Expansion Announcement

We are pleased to share that today the Government of Ontario announced proposed changes to expand scope of practice for physiotherapists.

For physiotherapists, proposed scope expansion enables ordering of diagnostic imaging further enabling our ability to diagnose. OPA has long advocated for these changes so that people in Ontario have timely access to care. We are pleased to see this progress and OPA is committed to continue to advocate to take scope expansion across the finish line.

The government has recognized that scope expansion provides more timely access to care for people when they need it most. Supporting and enabling physiotherapists to work to the full extent of their training and expertise will further contribute to the optimal use of Ontario’s health human resources. The regulation changes for physiotherapists are straightforward and within the Ministry’s authority under current legislation, and we look forward to working with the Government to complete this important work this fall.

Sarah Hutchison
Chief Executive Officer
Ontario Physiotherapy Association

Read Ministry News Release

Advancing the Role of Physiotherapists in Primary Care

What’s the Issue

On Friday, September 6, OPA President Courtney Bean, CEO Sarah Hutchison, Primary Care Advisory Committee Chair member Emily Stevenson, and Government Relations Representative Don Gracey met with Dr. Jane Philpott, and Carly Bergamini, Director of the Primary Care Action Team (PCAT), an Ontario government initiative. The mandate of the PCAT is to ensure 100% of people in Ontario are attached to a family doctor or a primary care nurse practitioner working in a publicly funded team, where they receive ongoing, comprehensive, and convenient care.

OPA highlighted how approximately 20-30% of primary care visits are for musculoskeletal conditions,^{i, ii}. Based on clinical experience in physiotherapy in primary care settings and suggested attachment rates for physicians, OPA estimates that a physiotherapist on an interprofessional primary care team can increase attachment rates by approximately 425 total rostered patients (on average) or 24%.

With funding now available as teams expand to meet the government’s mandate of ensuring access to primary care, physiotherapists can deliver incredible value in their ability to independently diagnose and manage musculoskeletal conditions and increase attachment. 

Here’s What We Want

OPA is advocating for an expansion of physiotherapists in primary care teams in first contact roles.

OPA is advocating for the necessary statutory amendments to enable physiotherapists to prescribe x-rays and order lab tests and “forms of energy” to be completed. Physiotherapists in other provinces and “extended practice” physiotherapists in hospitals, etc. have been authorized to do for some time. It’s time for the remaining regulations to be implemented in Ontario.

With more physiotherapists on primary care teams, and working to their full scope of practice, we can reduce wait times, enhance access to care and improve patient outcomes at no net additional cost to the healthcare system.

Progress Made to Date

At this time, there are physiotherapists who are part of Family Health Teams, Community Health Centres, Nurse Practitioner-Led Teams and Indigenous Primary Care Teams. However, PTs are not frequently represented on these teams, and precise figures are not readily available from government sources, especially as organizations have moved to global budgeting models and so PT positions may be independent of specifically allocated funding. For the funding year 2023-2024, the following FTEs were identified:

29.44 FTE PT in Family Health Teams

54.03 FTE PT in Community Health Centres

2.40 FTE PT in Nurse Practitioner-Led Clinics

These FTE values are likely a small undercount of the actual number of FTEs for physiotherapists in primary care teams.

Continuous Advocacy for PTs in Primary Care Roles

To ensure awareness of physiotherapists in team-based primary care roles, OPA meets with the Association of Family Health Teams of Ontario (AFHTO) and the Alliance for Healthier Communities (Alliance) as well as individual OHTs. Discussions center on how PTs can increase attachment rates, and to collate various supports and resources for primary care teams regarding physiotherapists.

Collaboration & Expanded Capacity

OPA supports a collaborative approach to the integration of all rehab providers in primary care teams. It is important to note that communicating a diagnosis is within the existing scope of physiotherapists, which supports functioning independently as part of a team to expand capacity.

Why This is Critical for Our Profession

It is important to expand the number of physiotherapists in first contact roles in primary care teams to ensure Ontarians get the right kind of care when they need it.

Current Challenges

Implementing Scope of Practice Changes

Well over a decade ago HRAC approved, and the necessary statutory amendments were made to enable physiotherapists to prescribe x-rays and order lab tests and “forms of energy”. The necessary regulations, however, have been held up in the Ministry for the better part of 15 years. We are hopeful that those regulations will be passed soon to reduce wait times, enhance access to care and improve patient outcomes at no net additional cost to the healthcare system.

Increase Compensation for Physiotherapists in Primary Care Teams

OPA recently contributed to an advocacy initiative led by AFHTO and the Alliance. The OPA provided comparative data on current compensation rates in all sectors, and a proposed updated rate that accounts for inflation since 2015, when positions for PTs in primary care teams were first established with a salary of $75,000. There is also advocacy for salary rates at CHCs to rise to the same levels as Family Health Teams. OPA proposed a salary range of $97 110-$102 075, and acknowledged that these figures only account for inflation, and are not rooted in a value-based approach.

How OPA Supports PTs in Primary Care Teams

OPA has supported physiotherapists in primary care teams, and those looking to add physiotherapists to their teams with:

Free educational modules to support PTs in primary care, developed through evidence-based and consensus processes – Preparing PTs for Team-based Primary Care

Consultation on applications to the Primary Care Action Team

Resources and individualized support for recruitment and retention, including job descriptions, compensation reports, interview guides and free job postings.

Communication to members regarding primary care developments

We Continue to Advocate

Dr. Philpott acknowledged the role and value of physiotherapists in team-based care and we look forward to our continued partnership to advance opportunities for physiotherapists.

i MacKay C, Canizares M, Davis AM & Badley EM. Health care utilization for musculoskeletal disorders. Arthritis Care & Research. 2010; 62(2): 161–169. Retrieved December 2023 from https://doi.org/10.1002/acr.20064.

ii Power JD, Perruccio AV, Paterson JM, Canizares M, Veillette C, Coyte PC et al. Healthcare utilization and costs for musculoskeletal disorders in Ontario, Canada. J Rheumatol. 2022; 49(7): 740-747. Retrieved March 2025 from https://www.jrheum.org/content/49/7/740.

OPA Calls for Improvements in Integrating Physiotherapy into ICHSCs

OPA recently sent a letter to the Ministry of Health with important feedback about the integration of physiotherapy in the Call for Applications for Integrated Community Health Services Centres (ICHSCs). We thank members who provided feedback which helped inform our letter.

The Impact

We recognize the impact that ICHSCs will have in all sectors where physiotherapists work, and in particular, the direct impact that will be imposed upon physiotherapists working in the private sector and those who currently operate within the Community Physiotherapy Clinic (CPC) Program.

Several significant points we made include:

Insufficient Compensation

Compensation for physiotherapists serving patients within the ICHSC model remains unclear. We are very concerned that insufficient funding that is not based on current market rates for physiotherapists will not result in a sustainable program.

OPA has previously expressed concerns with the existing Bundled Care program and the distribution of funds within the bundle that has resulted in underpayment of physiotherapy services. Given the Ministry’s goal of improving access to community-based surgery for hip and knee replacements, our concerns have escalated about the ability of the public to access rehabilitation before and after surgery if there are not appropriate resources and funding available for community physiotherapy partners.

Complexity of Patients

It is essential that funding for physiotherapy services reflects the rehabilitation complexity of the patient regardless of where they have surgery. Physiotherapy should NOT be discounted in the community because they are considered low risk from just a surgical perspective.

Navigation

As noted in OPA’s ongoing communications with the Bundled Care team at the Ministry of Health, there have been increasing challenges in system navigation of services for patients as the hospital role in navigation has eroded over time. OPA maintains the position that patient choice continues to be a priority. Currently, patients who undergo surgery at a hospital can choose where they access post-operative physiotherapy services, and the hospital bundle-holder is responsible for reimbursing the clinic of choice. This model has not been presented as a feature of the ICHSC program and has the potential to adversely impact accessibility and care outcomes.

Communication

OPA asks that the current communication issues be addressed that exist in the Bundled Care program prior to ICHSCs opening. Communication to and from bundled care holders to the patient and to physiotherapists are all needing to be addressed.

Why this is Critical for our Profession

Insufficient Compensation Impacts all Physiotherapists

A compensation model that is both underfunded and shifts the risk to physiotherapists for rehabilitation outcomes not only impacts physiotherapy clinics providing care for ICHSC patients but erodes the value and compensation of physiotherapists in all sectors.

Current Status

This is an important issue for the profession and we commit to communicating any response we receive from the Ministry that responds to the concerns we have identified.

Advocacy is Continuous

Advocating with the Ministry and government will be ongoing until we believe that needed program changes are in place and are communicated to the profession. We know that rehabilitation for patients is critical to support good surgical outcomes. The service model needs to be built on a fair and transparent framework so that our members can participate knowing that they will be equitably treated at fair market rates. Read more news related to ICHSCs linked below.

We encourage all members of the physiotherapy community to email the Ministry of Health and share your concerns. Use content from our letter and contact us for any additional resources at physiomail@opa.on.ca.

Read our letter

Annual Fee Guideline Review: We Want Your Input!

Nearly one year has passed since OPA published the 2024 Physiotherapy Fee Guideline, and we’re continuing our commitment to annual reviews that keep pace with the evolving private practice landscape.

Supporting Your Practice Success

The Annual Fee Guideline Review ensures that physiotherapists have access to current, relevant fee guidance. This review process examines market trends, practice realities, and member needs, to deliver a tool that serves our profession.

This resource is designed for all physiotherapists, with particular focus on those in private practice who face daily decisions about fee structures while striving to deliver exceptional patient care and maintain sustainable businesses.

Addressing Real Practice Challenges

We know you’re navigating an increasingly complex practice environment. Economic pressures, changing patient expectations, insurance considerations, and evolving service delivery models all impact how you structure your fees. Without current guidance, it becomes challenging to make confident decisions that balance patient accessibility with practice sustainability.

The private practice landscape doesn’t stand still, and neither should the resources that support your success.

How Your Input Drives Meaningful Updates

Our annual review process is built on member engagement. We’re seeking your insights through a survey that explores your current fees, fee models, and experiences using the Fee Guideline as an advocacy tool in your practice.

This data collection allows us to continue to evolve and modify the Guideline with your real-world experience as the foundation.

The Value You Receive

By participating in this annual review, you gain:

Evidence-based fee guidance that reflects current market conditions

A powerful advocacy tool to support conversations with patients, insurance providers, and other stakeholders

Professional confidence in your fee decisions, backed by peer input

Practice sustainability support that helps balance patient care with business viability

Community connection through shared insights and collective professional growth

Your Participation Matters

The survey takes just minutes to complete but provides invaluable insights that strengthen our entire profession. Your responses help us understand emerging trends, identify challenges, and ensure the Fee Guideline remains practically relevant for diverse practice settings across Ontario.

By participating, you are actively contributing to a resource that supports thousands of physiotherapists in delivering quality care while maintaining sustainable practices.

Looking Forward

Stay tuned for updates this fall as we compile insights, analyze trends, and prepare the updated guideline. This collaborative approach ensures the Fee Guideline continues evolving as a relevant, practical tool that serves our growing professional community.

Supporting Your Professional Journey

This annual review exemplifies why OPA exists: to provide physiotherapists with the tools, resources, and support needed to thrive in all practice settings. Whether you’re establishing fees for a new service, advocating with insurance providers, or simply ensuring your practice remains sustainable, the Fee Guideline serves as your professional foundation.

Ready to contribute? Complete the survey today and help shape the resource that supports our profession’s future.

Surgical Centres

August 15, 2025

Surgical Centres

As previously announced, the Government of Ontario is moving forward with a plan to provide insured orthopaedic services, specifically hip and knee joint replacements, in community-based settings.

The Call for Applications to propose an Integrated Community Health Service Centre (ICHSC) that includes orthopaedic services has opened, with applications due August 27, 2025, at 11:59 pm EST.

OPA continues to advocate for increased clarity and transparency on the requirements and the bundled facility fee that funds rehab care for patients related to their surgery. A major concern is that these bundled fees are lower than the current fees for hospital-based surgeries, and it is not clear how this change will impact the financial sustainability of essential rehab services. ICHSC applicants need to understand the value of physiotherapy care that is included in the bundled fee. Physiotherapy clinics cannot afford to provide services to patients below market rates. Ensuring that physiotherapy remains appropriately integrated and publicly-funded as a core component of care in these centres is vital for maintaining health system quality and equity across Ontario.

As part of the application process, prospective licensees are required to demonstrate partnerships with rehabilitation providers, which may include physiotherapists.

For more information on the Call for Applications, please visit the Government of Ontario’s website.

How You Can Support OPA’s Advocacy

Your input will help OPA continue to advocate effectively for the integration and appropriate compensation of physiotherapy services in this evolving healthcare landscape and ensure that patients receive comprehensive care throughout their orthopaedic surgical journey.

OPA would like to hear from you about your participation in the application process. We will inform our advocacy by understanding how physiotherapy services are represented in the applications, which may include details about reimbursement rates or how an episode of care is defined. Please share your feedback below.

OPA will continue to monitor developments and provide updates to members as this initiative progresses.