Physiotherapy and Health Regulation in Ontario

Prior to 1993, there were 16 regulated health professions governed by a number of different statutes. Generally speaking, the regulatory model governed scopes of practice and a professional was licensed to do anything within his or her respective profession’s scope (e.g., anything in the scope of medicine could not be performed by anyone other than a physician).

However, when the Regulated Health Professions Act (RHPA) came into effect in 1993, significant changes occurred. The RHPA is an umbrella act that lays out the common regulatory ground for the regulation of 23 health professions which are organized into 21 regulatory colleges. In addition to the common ground in the RHPA, each profession also has its own act that deals with the specific needs of the profession (e.g., professional title protection).

The RHPA also represented a departure from a scope of practice model to a controlled acts model. Controlled acts are the procedures carried out by health professionals that can potentially cause harm to patients.

In order to establish a comprehensive controlled acts model, the law review committee considered the full gamut of procedures carried out by health professionals. Those procedures that could cause a patient harm were broken out and categorized into 13 broad categories of controlled acts.

Next, the committee granted the various health professions the right to perform certain controlled acts. Some professions weren’t granted the right to perform any of the controlled acts (e.g., occupational therapists and dieticians) while others were granted the right to perform many (physicians were granted 12).

Physiotherapists were granted two controlled acts, manipulation and suctioning, and are permitted to perform these acts as well as any other form of rehabilitation that they are appropriately trained to do. By contrast, non-physiotherapists, including any unregulated person, can perform the full range of rehabilitation activities, but can not use the title "physiotherapist" or "physical therapist" or perform the two controlled acts unless they are members of a profession that has also been granted the controlled act.