Perspective is Everything

Peter Ruttan, President, College of Physiotherapists of Ontario

Peter Ruttan – College Council President and Guest Blogger






Shenda’s Peter’s Blog

If the saying “perspective is everything“ holds true, then I got my fair share of ‘everything’ earlier this month at World Confederation for Physical Therapy (WCPT) in Singapore.

It was an excellent conference with more than 3,500 PTs from around the world coming together for three days of presentations, discussions, courses and networking.

Canada was well represented at WCPT, with well over 50 participants from Canadian universities, regulators and our national association.

Singapore is a grand location and the conference itself was very impressive, but I want to focus on the small, two-day conference called INPTRA, which preceded WCPT.

The International Network of Physiotherapy Regulatory Authorities (INPTRA) was started 15 years ago by CPO past-Registrar Jan Robinson, to give regulators an opportunity to share resources and experiences.

Sixty-fix people attended INPTRA, representing 16 countries and Shenda and I had a chance to present on how regulation works in Ontario and Canada and hear about the successes and challenges of different models in other countries.

Here is some of what I learned:


  • In Australia, all health professions are regulated by one agency and there is a common code of conduct and standards that apply to everyone.
  • Complaints from the public for all health professions go to this same agency.
  • There is one, national registry and PTs are free to move about Australia. Mobility to New Zealand is very straightforward.

United Kingdom

  • In the UK, there is a national registry of PTs and all health professions are governed by pooled standards.
  • Complaints from the public are also pooled, but profession-specific in how they are adjudicated.
  • Mobility is seamless between England, Ireland, Scotland and Wales.

Other Countries

  • USA has a state run licensure system with different standards for each state.
  • Singapore and Southeast Asian countries have good mobility and common standards, but the public does not have direct access to PTs.
  • Kenya, Croatia and Sri Lanka are in the fledgling stages of national PT regulation.

While having lunch with the Australians, it was a somewhat embarrassing to admit Canada has only 20,000 PTs, yet we have 10 separate PT Registers and PTs do not have the ability to move freely across Canada with one registration.

Without pooling of standards in Canada, there are 10 slightly different versions of the same standard.

Do we really need 10 record keeping standards for PTs?

I left Singapore with a new perspective on PT regulation in Ontario and with many questions. We are fortunate to have regulation of any kind to protect the public, a luxury many nations do not have. We also have the added privilege to have the opportunity for the profession to regulate itself.

However, we also have an obligation to learn from other countries and consider if it will work in the Ontario/Canadian context.

Would common standards work for all PTs across Canada?

Would common standards work for all health care professions in Canada?

Should one board adjudicate all complaints for all health professions?

Can we still have provincial regulation but at least have a national PT registry?

I think national standards for Canadian PTs would bring efficiency, clarity and may add to public confidence. I also think a national registry for PTs would efficiently give all provincial colleges access to one database and allow PTs in Canada to be more mobile.

Thanks to Shenda for letting me take over her blog this month. I’ve given you my perspective and now I’d like to hear yours. Tell me what you think below!

7 thoughts on “Perspective is Everything

  1. Hi Peter,

    Thank you for sharing that global registry perspective. I too found it very interesting and would agree with you analytical questions posed about our country and the profession. I think an “all professions” registry would be at this time a too lofty of a goal but I would support a Canadian PT registry that would make it so much simpler to be mobile with your job and there would be country wide transparency with ease for patient complaints and outcome decisions to those complaints on the individuals in concern. There would be assimilation and agreement of standards, I believe an increase in public trust and more money to pool together to goals as well as more cost efficiency (duplication and re-invention is both time and financially costly). Too bad there is so much separation in the USA (50/51) because free mobility to our next door partner with ease would be a future asset but not likely probable.


  2. Thanks Peter for sharing your perspective. I support national registry for PTs and common standards for PTs across all provinces. If at province level we can have one regulatory body for all health professionals, that would increase public trust, transparency, and be more cost efficient. Let’s work towards it.


  3. I feel a national registry could benefit the public by having clear and consistent standards for all PTs in Canada. In addition, significant efficiencies could be realized to reduce costs, red tape burden and administrative/beaurocratic duplication. Perhaps we could even see the general headquarters be located in an area of Canada which could benefit from the economic investment (eg Northern Ontario, the Maritimes, interior BC or central Saskatchewan) while reducing lease expenditures substantially (consider the cost of any of the above vs the current location in downtown Toronto).


  4. I totally support having common standards for all the PTs in Canada and definitely having national PT registry. It will really make it so much easier for us to work any part of the province and following common standards will be simply great on top of it!


  5. Thank you Peter. These are very compelling ideas. While we should be grateful for a history of highly capable and innovative regulation across Canada, we mustn’t lose sight of future potential. Imagine Physiotherapy in Canada with a truly national scope of practice, identical regulation in all provinces and territories, one entrance exam process (here today with the exception of Quebec), one registry, one continued competence verification process and a national electronic outcome measures database to demonstrate clinical effectiveness (CPA’s FOTO project for example). All of this is possible within a decade. There are no legislative changes required. The national exam is a great example. We simply need the will to move forward and a commitment to continuous improvement. The Canadian Physiotherapy Association encourages more of this dialogue with our regulatory colleagues, and supports all efforts to make it happen.


  6. I support anything that leads to more consistencies and efficiencies in health care. What are the next steps?


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