Clinic Regulation: Now What?

Two posts ago, I asked you whether you thought that the College ought to regulate clinics in addition to the physiotherapists who work in them. The overwhelming majority of comments favoured this idea. You told us that College regulation would mean higher quality care in the clinics and that it would make them safer places for physiotherapists to work. You also told us that regulation by the College would reduce inappropriate business practices. We heard you loud and clear. Although we regulate you individually, and although there are standards that speak to both care and business practices, these are not enough. You confirmed that business owners who are not regulated can be an impediment to physiotherapists being able to meet the College standards.

Physiotherapists, as a self-regulating profession, are in the best position to determine how best to regulate the profession in the public interest. That’s why you elect representatives for our Council. As you may recall, Council directed that we explore clinic regulation, but at every step along the way, your feedback will be absolutely necessary.

So now what?

The next steps will be slow (perhaps painfully so). It is not within the College’s power to begin to regulate clinics. Everything that we are allowed to do is set out in the Regulated Health Professions Act and its associated regulations. These are Ontario laws and may only be changed by provincial parliament.

Our next step will be to gather and collate hard evidence of the problems that arise in the present (non-regulated) clinic environment. Then we need to develop proposals for legislative change that would address these problems. During the course of developing these materials we will need to consult with many stakeholders—you, the public, other health care professionals who work with physiotherapists in the clinics and the clinic owners. We will be reaching out to you through Perspectives, this blog and in other ways to get your input.

We will need to identify a regulatory solution that does not cause more problems than it solves (for instance, physiotherapists and massage therapists often work together in the same clinics—should we be considering a regulation that requires clinics to have any type of regulated health professional at the helm, or would it have to be a physiotherapist? Would the clinics need to be owned by physiotherapists or would we require a physio (or another regulated health professional) to be designated as responsible for decisions made there? What would be the financial implications for working physiotherapists?).

Once we have done the data collection and have developed what appears to be a reasonable legislative approach, we must ensure that our stakeholders support it. The government needs to see significant support before it will consider new legislation and, of course, many stakeholders will have suggestions for change that we would need to incorporate.

After all our homework is done, we will make a submission to government. If government supports the change, then the parliamentary process begins.

I hope that this long list of activities does not sound like an excuse for foot dragging. I wanted you to understand the complexity of the decision-making and reassure you that even if you don’t see or hear much about this issue, we will be pursuing it. The process could take several years.

In the interim, you are always welcome to check out our Council materials (or come by and observe a meeting) to get an update, or contact me through e-mail or a phone call.

And by the way—happy spring!

6 thoughts on “Clinic Regulation: Now What?

  1. I think in Shenda we see a ray of hope and here is a person who is able to understand the ground realities.
    what we can do as a physiotherapist is take the opportunity of provincial elections and talk to our potential MPPs to change the law to bring physiotherapy on par with other professions like pharmacy or dental which have checks and balances for non professional starting the business. Make sure you reach out to Liberals, NDP and Conservative for this important change. .
    College can start doing more frequent checks on the physiotherapist working in these shady clinics which will discourage physiotherapist from working in these clinics.
    Also they can make a database to be shared with insurance companies about these “shady” clinics. We can do all these changes without regulations.
    I believe the college can partner with payee (Insurance companies) and the providers (Physiotherapist) to bring more transparency.


  2. I think if the purpose is to improve quality of care and prevent fraud, the best things college can do to stop support service’s provided by PTA in clinical setting. I can’t imagine how we could talk about quality of care where we give treatment of patient in hands of PTA with 9 months training or none at all, this opens the hands of shady clinics for fraud.pressuring physiotherapist is not going to help. After all training and experiences all PT can do is the assessment , PTcant do the treatment because it is cheaper to work with PTA!.What is the point of upgrading ,


  3. Everything seems to be so “regulated”. It all seems so political. I always do what’s best for my clients and luckily I haven’t had someone telling me I can’t because of money issues. I know that this is not always the way it is for all physios and sadly it’s likely because we can’t all afford to have our own clinics. We need to improve our public image. I hope our college can help us with this


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