On May 11, 2026, the Ontario Ministry of Health announced future scope of practice expansions for several regulated health professionals, including physiotherapists. The Ministry has directed the College of Physiotherapists of Ontario to begin developing the regulatory framework to support qualified physiotherapists in ordering certain X-rays and diagnostic ultrasound.
As indicated in the Government of Ontario news release “… the government has now officially directed Ontario’s regulatory colleges for optometrists, physiotherapists, chiropractors, dental hygienists, denturists, and audiologists and speech-language pathologists to begin developing the regulatory framework that would further expand scopes of practice in their fields.”
It’s important to note that no changes to physiotherapists’ scope of practice have been implemented yet regarding x-rays and diagnostic imaging. The College of Physiotherapists of Ontario is beginning the work to develop the regulatory framework. OPA will continue to collaborate with the Ministry of Health and the College as the process moves forward.
Progress
We are hopeful, however, that this announcement demonstrates that the Ministry of Health is moving in the right direction to implement the remaining scope of practice changes for physiotherapists.
Background
OPA has tirelessly advocated for nearly two decades to advance scope of practice changes that enable physiotherapists to deliver more comprehensive care.
In 2008, the Ontario Physiotherapy Association and the College of Physiotherapists of Ontario collaborated on a joint submission requested by the Health Professions Regulatory Advisory Council (HPRAC) to review the scope of practice of physiotherapists.
Successes to Date
This joint submission proposed scope of practice amendments, which were all accepted and recommended for implementation by HPRAC, except for one – the authority to refer to specialists.
In 2012, physiotherapist’s scope expanded to include:
Communicating a diagnosis (controlled activity that is within scope at the entry to practice level)
Treating a wound below the dermis
Internal pelvic exams (including putting an instrument, hand or finger beyond the labia majora or beyond the anal verge)
Administering a substance by inhalation (when the substance has been ordered by an authorized person)
Why We Continue to Advocate
Awaiting implementation and not able to put into practice:
Ordering a prescribed form of energy (e.g., diagnostic ultrasound or MRI)
Ordering diagnostics (e.g., X-rays or CT scans)
Ordering laboratory tests
OPA’s Continued Advocacy
Current advocacy on PT scope of practice focuses on implementing outstanding changes for activities that still need regulation changes, including ordering diagnostic imaging. Implementation will positively affect access to care, improve health system efficiency, and reduce workloads for all providers. It will lead to people in Ontario getting the right care at the right time, and better sustainability in career paths for physiotherapists.
We encourage you to watch for further updates from both OPA and the College. Be sure to check OPA’s news where you can filter to access all scope of practice updates. Check out our dedicated Scope of Practice page for the latest information as this process unfolds.
After graduating from Queen’s University in 2023, Madison Ames began her career as a physiotherapist at North York General’s Finch Site Reactivation Care Centre (RCC). Her early experience involved working with a geriatric alternate level of care (ALC) population, which supported patients who had been discharged from acute care but were not yet ready to return home safely.
“Our primary goal was to enhance patients’ functional mobility and support discharge planning, whether that meant returning home with supports, transitioning to community programs, or entering long-term care.” Madison explains. Later, she transitioned to the rehabilitation unit at Finch Site RCC, treating geriatric patients with varying rehabilitation needs.
Establishing the Emergency Department Role
In March 2025, Madison took on a completely new challenge: establishing a physiotherapy presence in the Charlotte & Lewis Steinberg Emergency Department (ED) at North York General Hospital (NYGH). It was as brand new position for this hospital. “I was responsible for developing and defining the scope of the physiotherapy role within this fast-paced environment,” she says.
Unlike most physiotherapy roles in emergency departments, Madison’s work primarily targets admitted patients who remain in the ED while awaiting a bed on an inpatient unit. With patients often spending more than 24 hours in the ED due to high hospital volumes, her role is critical in preventing early deconditioning. “These patients are at significant risk of complications like pneumonia, delirium, and functional decline,” she explains. Early mobilization is essential to preserving independence and ensuring a smoother recovery.
Because the role was entirely new, Madison had to build everything from the ground up.
“Through trial and error, I established an effective workflow and clinical routine,” she says. “A critical part of this role is determining which patients are appropriate for mobilization, particularly given the medical instability and diagnostic uncertainty often present at this stage.”
When patients present to the ED, there is often limited information available about their background and overall functioning. As one of the first health professionals to assess many of these patients, Madison plays a vital role in collecting functional and social histories, often uncovering information that hadn’t yet been captured. “Families and patients have disclosed falls, cognitive concerns, or weight loss that hadn’t come up in previous conversations,” she notes. “By identifying these concerns early, I am able to relay key information to the appropriate team members and support timely interventions during hospitalization.”
The value of Madison’s role expands far beyond her assessment skills and encompasses the compassion and patient-centered approach she brings. “Even though I may have seen many patients with similar conditions, I remind myself that for the individual in front of me, this is new, frightening, and overwhelming,” she reflects. “What feels routine to me as a healthcare provider is, to them, a life-altering moment.”
Her role has been particularly impactful with geriatric patients suffering from conditions like urinary tract infections, pneumonia, delirium, and failure to cope. Madison’s role is critical in these cases, as this patient population is at risk for significant decline after only a few days of hospitalization: “A patient who walked independently at home could become unable to ambulate more than five meters after just one or two days in hospital,” she explains. Interventions such as therapeutic ambulation, supporting patients to mobilize to the washroom, transferring to a bedside chair for meals, or simply encouraging them to dangle at the edge of the bed can have a significant impact on reducing deconditioning and maintaining functional independence.
In addition to preventing deconditioning, Madison’s assessments often support complex discharge planning. She assists with stair assessments, mobility strategies for patients with complex conditions, and supports discharges directly from the ED, helping avoid unnecessary hospital admissions.
Collaborative Care and System-Wide Impacts
Madison’s role also aligns closely with system-level goals like reducing hallway medicine and improving patient flow. Collaborating with the Geriatric Emergency Management (GEM) nurses, Madison has helped streamline transfers directly to inpatient rehabilitation facilities, thereby avoiding acute admissions and ensuring patients receive the focused support they need.
“Through established relationships with several rehabilitation hospitals across the Greater Toronto Area, we have developed an efficient process to identify suitable patients [for inpatient rehab], set goals and care plans, complete applications, and successfully facilitate admissions and same-day transfers,” Madison shares. This process has been particularly impactful in reducing admissions to acute care units and reducing the associated risks.
To make a lasting impact, Madison believes it’s critical for both decision-makers and healthcare providers to recognize the value of physiotherapy and early mobilization. “Deconditioning begins within hours of immobility,” she stresses. “In just 24 to 48 hours, patients begin to lose strength, limiting their ability to perform basic functional tasks.”
Madison points out that one in five geriatric patients develops delirium after just 12 hours in the ED. “Facilitating mobility…can help maintain orientation and reduce the risk of delirium,” she says.
For other hospitals or leaders looking to replicate this model, Madison emphasizes the need to educate all staff members about the role and benefits of physiotherapists in this setting. Madison notes the equal importance of empathy and compassion in the emergency department “Patients are often in pain, unwell, anxious, or uncertain about next steps, [and] understandably, walking or mobilizing is not always something they feel ready to do.”
A Day in the NYGH Emergency Department
A typical day for Madison begins with reviewing consults and prioritizing patients. Her caseload can vary from just a few consults to over 40 in a given shift. “On high-volume days, when it is not feasible to assess every patient, I begin with a brief chart review to identify priorities,” she explains. She often prioritizes geriatric patients, those with the longest ED stay, and those at high risk of deconditioning. Detailed chart reviews, collaborative discussions with interdisciplinary team members, and care coordination are all part of Madison’s role in the emergency department. Between assessments, treatments, and documentation, Madison manages to maintain a level of flexibility, allowing her to respond to emerging needs throughout the day.
Looking ahead, Madison believes advocacy and funding roles like hers are essential to transforming patient care.
“Having a physiotherapist embedded in the ED… helps reduce the risk of deconditioning,” she says. “Patients are mobilized sooner; their mobility status recommendations are clearly documented, and unit physiotherapists receive patients with a more complete understanding of their functional baseline and discharge plan.”
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!
Sarah Arulchelvam is a new to practice physiotherapist making impactful strides in a unique and evolving role in an Emergency Department (ED). With a passion for acute care and a flexible, team-based approach, she is helping to push the boundaries of physiotherapy practice in Ontario.
“I graduated from McMaster University’s physiotherapy program in August 2024, so I still consider myself a relatively new graduate,” Sarah explains. “After completing the program, I was drawn to the acute care setting because of the fast-paced, collaborative nature of the hospital environment.”
Sarah began her career at Michael Garron Hospital, a community hospital in Toronto, where she primarily worked in oncology and geriatrics. Her interest, however, in exploring different practice areas and settings developed early on.
“During school, I became aware of physiotherapy in the Emergency Department as an emerging role, though full-time opportunities were quite limited at the time,” she says. “So, when a position opened in the ED at Markham Stouffville Hospital, I was excited to take the opportunity and make that transition. I’m still new in this position and continue to learn and grow within the role, but it’s been a rewarding experience so far.”
Pushing Scope and Supporting Flow
Working in the Emergency Department requires adaptability and interdisciplinary collaboration. “In the ED, the dynamic and resource-limited environment often calls for physiotherapists to extend their role beyond traditional boundaries, always within safe, ethical, and team-based frameworks,” says Sarah.
“As the consistent allied health provider on the floor, I frequently take on tasks that support patient care and flow.”
Sarah often assists with occupational therapy responsibilities, such as equipment recommendations, activities of daily living (ADL) assessments, and basic cognitive screenings. She also initiates referrals to community services and contributes to discharge planning, all of which are roles that are not traditionally part of physiotherapy but are essential in this setting.
“I believe this kind of interdisciplinary flexibility is necessary in today’s emergency care settings and reflects how the physiotherapy role is evolving in acute environments like the ED.”
A Generalist Approach for Complex Care
Rather than narrowing her focus early, Sarah chose a broad clinical approach to meet the unpredictable needs of the ED. “As a new graduate, I bring current, evidence-based knowledge across all major areas of physiotherapy, including musculoskeletal (MSK), neurological, and cardiorespiratory,” she says. “I’ve embraced a generalist approach, which has been a real strength in the ED.”
This approach allows her to perform MSK special tests, vertigo assessments like the Dix-Hallpike, and assist in patient flow coordination. While some of these assessments are atypical for a hospital setting, they are critical for providing thorough assessments and optimal care.
Sarah also works closely with geriatric nurse practitioners to create discharge plans for non-admit older adults. She balances short-term supports with long-term planning, such as initiating long-term care applications or retirement home referrals.
Impact on Patient Outcomes and System Goals
The physiotherapy role in the ED is particularly impactful for non-admit patients such as those who receive care without being formally admitted. “A significant portion of these individuals are older adults who present with issues such as falls, pain, or difficulty coping at home,” Sarah explains.
“While they may not require hospital admission, their needs still warrant timely assessment and intervention.”
By optimizing mobility, supporting pain management, and contributing to discharge planning, Sarah helps prevent unnecessary admissions and ensures safe transitions back to the community.
“Although still early in my time in this role, I’ve seen firsthand how early physiotherapy involvement can support better patient flow and lead to more appropriate, timely discharges.”
She also emphasizes the importance of early mobilization in reducing deconditioning and contributing to shorter ED stays, especially for high-risk or geriatric patients.
Policy, Advocacy, and Education
Sarah believes that for system-level goals like reducing hallway medicine and readmissions, physiotherapists must be engaged from the outset. “Many government-funded clinical pathways are designed with the expectation of short hospital stays,” she explains. “To meet these timelines, system-level decision-makers must recognize that discharge planning begins the moment a patient is admitted.”
She urges policymakers to appreciate how early physiotherapy assessment can coordinate care and prevent complications.
“Early mobilization not only prevents deconditioning and reduces complications but also serves as a cost-saving strategy.”
More research is needed, particularly in Canada, to highlight the value of physiotherapy and early mobilization in EDs, she adds.
Sarah also wants fellow physiotherapists and health professionals to understand the unique demands of ED practice. “The ED is a dynamic and unpredictable environment. ED physiotherapists must be highly flexible. In addition to managing patients in the ED, we often function as float physiotherapists, assisting colleagues on inpatient units when needed.”
A Day in the Life
“A typical day for me as an emergency department (ED) physiotherapist runs from 9 am to 7 pm, and no two days are ever quite the same,” says Sarah. “The work is dynamic and often unpredictable. It requires flexibility, communication, and frequent coordination with various members of the healthcare team.”
Sarah begins by reviewing the ED patient count, focusing on non-admitted patients. She often collaborates with the geriatric emergency management (GEM) nurse practitioner and works with the Access and Flow team to identify patients who may benefit from physiotherapy.
After chart reviews, she typically sees patients in blocks of two or three, checking with bedside nurses first and often hunting down essential equipment. “ED mobility aids like two-wheeled walkers and canes tend to go missing due to fast patient turnover, so I frequently search the department or even other units,” she explains.
Assessments may require creativity and often involve adapting to the available physical environment and maintaining ongoing communication with physicians, occupational therapists, and flow coordinators to ensure a safe discharge.
“Since the ED is constantly evolving, I regularly check for PT referrals throughout the day. New patients are always arriving or being flagged for discharge, so it’s important to stay on top of the caseload daily.”
She also supports other departments when the ED is quieter. “Ultimately, working in the ED requires not only clinical expertise but also strong collaboration, creativity, and a proactive mindset to support patient flow, safety, and quality care under high-pressure conditions.”
Sarah’s experience highlights not only the evolving scope of physiotherapy but also the profession’s vital contribution to system-wide healthcare goals. Her story offers inspiration and insight for other physiotherapists, whether they are new graduates or seasoned clinicians. It’s a compelling case for why more ED-based physiotherapy roles are deserving of increased funding and support.
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!
The Government of Ontario invites workers, organizations, businesses and communities to share what matters most to inform the 2026 Ontario budget.
OPA submitted a response to the annual budget consultation. Our response illustrates how physiotherapists can contribute to building a ‘more competitive, resilient and self-reliant province”, part of the government’s plan to protect Ontario.
Our 2026-2027 pre-budget submission focusses on attainable, impactful investments that will support the government in achieving the goal to increase capacity in Ontario’s health care system. The priorities are:
Provide required resourcing of physiotherapy positions in primary care, home and community care, and long-term care to bring compensation in line with the hospital sector.
Strengthen the Community Physiotherapy Clinic program as a strategy to support primary care access and to support seniors living in the community.
Address the health human resource crisis and improve access to care by enabling physiotherapists in Ontario to practice to full scope of practice.
Part of Our Continued Advocacy
The priorities outlined are informed by conversations, meetings, and surveys across various sectors throughout the year. OPA consults with members and health care leaders, including our advisory committees, Board of Directors and Districts. These conversations and information have been critical to identify the priorities of OPA’s 2026 Pre-Budget Submission.
More About What OPA Wants on Behalf of PTs and Patients
PHYSIOTHERAPY COMPENSATION EQUALIZATION ACROSS PUBLIC SECTOR
Physiotherapists have an essential role in delivering care in the community whether as part of a primary care team, at a patient’s place of residence, or in a long-term care facility. Access to care in each of these settings is critical to keeping Ontarians healthy, mobile and contributing to their communities and the economy. The challenge is that recruitment and retention in these positions is near impossible when the compensation is well below that of hospitals. To offset more costly institutional care, sufficient funding in the primary care, home care, and long-term care is essential to support health human resource needs long term.
STRENGTHENING THE COMMUNITY PHYSIOTHERAPY (CPC) PROGRAM
The Community Physiotherapy Program (CPC) is a well-established program which has been providing access to essential physiotherapy care for over 10 years. This program partners with over 200 community clinics and outpatient hospital facilities to deliver physiotherapy services. Unfortunately, continuation of the CPC program is becoming increasingly precarious, as the funding model has not kept pace with increasing operating costs. Episode of Care (EOC) funding has increased by only 7% since inception of the program; from $312 in 2013 to $334.38 in 2025. Without access to this care, individuals are put at risk for chronic pain, limited function, and delayed return to work. This is not a risk we can afford. The bottom line is that insufficient government funding of the CPC program is creating a significant exposure of risk to Ontarians.
ENABLING PHYSIOTHERAPISTS’ SCOPE OF PRACTICE IMPLEMENTATION
For physiotherapists, expanding scope to include diagnostic imaging and laboratory testing was included in changes to the Physiotherapy Act in 2009, as approved by the legislature. However, still today, the Ministry has not yet implemented the regulatory changes required to enact these changes.
The result? Where once a leader, there are now four provinces who have surpassed Ontario with implementing scope changes, including Alberta, Quebec, PEI and Nova Scotia. Ontarians continue to deal with “circular referrals” where they must return to their family physician (or worse yet, the Emergency Department or Walk in Clinics) for referrals for diagnostic imaging, when it is already within scope of physiotherapists.
As the government looks to attach two million people to primary care by 2029, expanding the scope of physiotherapists to include diagnostic imaging, will not only relieve the burden on family doctors – it will promote earlier diagnosis, earlier intervention, reduced system costs and promote better health outcomes. Expansion of scope will optimize any current and future investments in the community. The province cannot afford to wait any longer to enact this opportunity.
OPA’s advocacy work is ongoing, and our Pre-Budget Submission is one example of what we continue to do to advocate for our members.
All Sectors are Affected
Our recommendations affect the physiotherapy community in all practice areas. Whether it’s increasing compensation in primary care, home care, and long-term care, increasing funding for the Community Physiotherapy Clinic program, or enabling the implementation of physiotherapists’ full scope of practice, all members are impacted and would benefit from our suggested solutions.
What’s Next
We look forward to working with the government to implement these solutions. We will be looking for these commitments in this year’s budget, which is usually released in March.
As we move into 2026, we share an extraordinary degree of optimism for the physiotherapy profession. We believe it will be recognized and valued even more for the impact we have on function, health, and well-being.
Physiotherapy helps people across their lifespan, wherever they access health care in the system.
Our mission at OPA is clear. We are here to Support our members through advocacy, professional development, and career support. We Influence and shape decisions that affect the profession. We Empower our members to provide the utmost in safe and high-quality care to all people and communities we serve.
As your provincial professional association, we recognize both the honour and the importance of representing your voice. Working with the Ontario government and key decision-makers, we represent you on the issues that matter most to you. Our focus is on the policies, funding decisions, and structures that affect your work every day and your patients.
As we head into the New Year, we are set on achieving progress in the following areas:
A Thriving Workforce and Practice Settings Our priorities include:
Continuing our efforts to advance scope implementation
Supporting the development and appropriate funding of physiotherapists in first contact primary care roles
Advancing the Community Physiotherapy Clinic program in 2026 with a focus on program awareness, expansion and appropriate compensation
Refining our 2026 OPA Fee Guideline with sector-specific information
Working with FRSA (Financial Services Regulatory Authority of Ontario) and the Ministry of Finance to make long-overdue compensation changes
Health System Transformation
We are supporting physiotherapists and their teams by:
Promoting interprofessional team-based care
Advancing physiotherapists’ participation in health system transformation with a focus on Home and Community Care and Long-Term Care
Making it easier to deliver informed patient care by gaining access to provincial digital assets (Diagnostic Imaging Repository, OLIS – Ontario Laboratories Information Systems)
Our Membership
We are most successful with your involvement and partnership. This is why OPA listens to and engages students, new graduates, PTAs, and physiotherapists throughout their careers. Our volunteers on committees, district executives and our Board of Directors make sure our work is relevant and positively impactful. We couldn’t do this without you.
Transparent and Inclusive
The processes and supports we develop matter. We continue to make them more accessible, inclusive, and transparent. We celebrate our wins, share progress with our members regularly and invite you to participate at any time.
As we move into 2026 and our bold initiatives, reflecting on the successes of 2025 provides us with confidence and a roadmap for moving forward. Thank you for your support and confidence in us – together, we can accomplish so much more!
When Natasha Bhesania graduated from the University of Toronto with a Master of Physical Therapy in 2007, she was immediately drawn to the intensity and complexity of acute care. She took on several roles across intensive care, neurotrauma, orthopedics, and general internal medicine units. A permanent role on Mount Sinai’s geriatric consult team eventually opened the door to a new opportunity that would push the boundaries of traditional physiotherapy practice.
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.
Innovative Care
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.
Health System Impacts
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 the Life
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.
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!
We are excited by all that OPA has accomplished this year on behalf of our members and the profession overall. While advocacy never really stops, we are taking a moment to reflect on our successes.
1. Significant Progress on Scope of Practice Implementation
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:
Ongoing meetings with the Ministry of Health
Meetings with the Premier, Minister of Health and MPPs across the province with our members
Submitting detailed scope of practice submissions
OPA’s CEO presenting to the Standing Committee on Finance and Economic Affairs on Bill 2, showing the importance of scope implementation to keep pace with other provinces and increase labour mobility.
Building relationships at Queen’s Park, including meeting with Premier Doug Ford and Deputy Premier and Minister of Health Sylvia Jones. We also met with MPP France Gélinas, Physiotherapist, who spoke about scope of practice implementation in the legislature.
Writing letters for member’s meetings with Premier Doug Ford and Minister of Health Sylvia Jones
We hope to see movement on the scope of practice implementation in 2026!
2. Advancing Physiotherapists’ Role in Primary Care: OPA successfully advocated for physiotherapists to be recognized in Ontario’s Primary Care Action Plan. We:
Received a letter from the Deputy Premier & Minister of Health and Dr. Jane Philpott as the Chair of the Primary Care Action Team. We were pleased to see the recognition that Primary Care Teams should be made up of family physicians or nurse practitioners along with nurses, physician assistants, social workers, physiotherapists and other health care professions.
Presented at multiple primary care conferences. OPA staff shared the evidence that PTs on interprofessional teams can increase patient attachment rates by approximately 425 rostered patients (24%), particularly important since 20-30% of primary care visits involve musculoskeletal conditions.
3. Strong Member Engagement, Education & Resources: OPA hosted successful events and provided members with helpful resources. This included:
OPA’s InterACTION conference with over 300 attendees
Northern Ontario District’s conference Physio North 2025, inspiring attendees and providing them the opportunity to network
4. Recognition and Award-Winning Communications: OPA’s communications and marketing continue to expand and reach new audiences with effective strategies.
Our “New Voices, New Ideas & New Opportunities” campaign won multiple prestigious awards including a Silver Telly Award and three gold Healthcare Digital Marketing Awards. We effectively showcased the association’s evolving leadership and value to members.
We also launched a bold new website which is easier to navigate and is a reflection of OPA’s commitment to transparency and accountability. OPA’s new website and its key features were driven by members’ feedback and drove every decision.
5. Equity, Inclusion and Diversity Commitment: OPA continues its commitment to have equity, inclusion and diversity embedded into everything we do.
OPA developed a position statement advocating for improved Jordan’s Principle processes. With Indigenous Services Canada committed to reforming the administration, OPA is pushing for:
Reduced systemic barriers that prevent access to physiotherapy services
Culturally safe service delivery with collaborative community co-design
Continuity of care through longer-term contracts with trusted partners
Increased administrative capacity with transparency to address backlogs
Recognition of physiotherapy as essential preventive and early intervention care
Support the advocacy work we do on behalf of the physiotherapy community in Ontario. Join OPA/CPA!
“My journey in the field of physiotherapy began in 1999, when I recognized how many patients were living with pain and disability without timely access to proper care,” says Venkadesan (Ven) Rajendran. “This observation motivated me to pursue a 4½-year Bachelor of Physiotherapy program at The Tamil Nadu Dr. MGR Medical University, which I completed in 2003.”
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.
Continuing Professional Development
“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.”
Evolution of the Role
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.“
Advocacy and System-Level Approaches
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.”
Health System Impacts
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.
Members of the leadership team at Health Sciences North share their perspectives on the importance of the APP role:
“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.
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!
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
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.
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.
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
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.
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.
