Frequently Asked Questions

Physiotherapists often work in treatment settings as part of a larger team that can include physiotherapist support personnel. Physiotherapist support personnel come from various educational backgrounds or job specific training experiences, and like physiotherapists, will contact the Practice Advisor with questions related to the appropriate assignment and supervision of tasks.

This article highlights a few questions that are commonly posed to the Practice Advisor:

How much supervision is required when treatment is assigned to a support person?

Most physiotherapists who ask this question are looking for a definitive answer. Unfortunately, there is no clear cut answer that can be applied to every setting. The amount of supervision will depend on a number of factors. The good news is that the College has updated the resources to assist physiotherapists in answering this question. In fact, the new Guide to the Standard of Professional Practice: Physiotherapists Working with Physiotherapist Support Personnel includes a similar question.

The Guide also includes a list of ‘Factors to Consider when Assigning and Supervising Care to Physiotherapist Support Personnel’ which is located in Appendix A. These considerations include factors related to the: patient, support person, environment, physiotherapy treatment and the physiotherapist.

For example, when deciding how much supervision is necessary, the following should be considered:

The acuity of the patient’s condition (a patient factor)
The experience of the support person (a support personnel factor)
The support person’s current workload demands (an environmental factor)
The risk associated with the treatment (a physiotherapy treatment factor)
The sphere of competence of the physiotherapist (a physiotherapist factor)

While this demonstrates a few of the factors to be considered, this is not an exhaustive list. Again, refer to Appendix A in the Guide for other considerations in addition to factors you may identify which are specific to your setting.

Ultimately, each individual physiotherapist must make a decision about the amount of supervision required to ensure safe, quality care in the best interest of the patient, as the physiotherapist is accountable for his/her choices.

A long term care facility would like the support person to also run a daily, 30 minute, general exercise program. Residents do not need to be assessed by a physiotherapist to participate in this class. If a resident is injured during the class, will the physiotherapist be accountable?

While the setting and the details of the scenario may vary, accountability is often a concern for physiotherapists.

It is important for physiotherapists to understand that they are accountable for the treatment that they assign to a support person and for appropriately supervising the support person. In some circumstances, support personnel may have multiple roles within a facility. In this example, the support person is carrying out a class that is separate from physiotherapy treatment. In other words, the physiotherapist did not assign care to the support person and for this reason the physiotherapist did not supervise this care. The physiotherapist would likely not be accountable for the support person’s actions.

Additionally, in this case the general exercise class would not be billed as physiotherapy treatment.

It is also important that the physiotherapist, the support person, other team members and residents understand the various roles and accountabilities that the physiotherapist and support personnel may have separately in this facility.

A kinesiology student was hired to work as a support person in a physiotherapist owned clinic. What title is he required to use?

In Ontario, support personnel are not regulated and College of Physiotherapists of Ontario do not have a protected title. It is up to the facility to determine what job title the person may use.

Job titles are different than protected titles. If the individual is working as a physiotherapist support person under the supervision of a physiotherapist it is likely best to use a job title that accurately reflects this role. The fact that the individual is also a kinesiology student is likely not relevant to the role he will be playing.

Do I need to complete a special program to work as a physiotherapist support person in Ontario?

Currently, physiotherapist support personnel are not regulated in Ontario. This means that individuals with a variety of training or education can work as a physiotherapist support person.

The College of Physiotherapists of Ontario does not require physiotherapists/physical therapists to hire physiotherapist support personnel that have obtained specific educational requirements. Some employers choose to hire support personnel with formal training; however this is the decision of individual settings.

The College issued the Standard for Professional Practice: Physiotherapists Working with Physiotherapist Support Personnel and the Guide to this Standard which are helpful references.

The Standard indicates that physiotherapists/physical therapists should ensure that physiotherapist support personnel have the knowledge, skill, and training to carry out the assigned treatment or task. This does not necessarily require the completion of a formal education program. There could be different methods to ensure that the physiotherapist support person is competent.

I completed a physiotherapy/physical therapy program in another country. While I am going through the credentialing and examination process to become registered in Ontario, can I work as a physiotherapist support person?

Yes. Physiotherapist support personnel are not regulated in the province of Ontario. This means that individuals with a variety of training or education could possibly work as physiotherapist support persons. It is up to employers to decide their hiring policies.

Individuals who are trained internationally to provide physiotherapy/physical therapy treatment may work as physiotherapist support persons, but cannot use the title of physiotherapist/physical therapist or lead patients to believe that they are a physiotherapist/ physical therapist. This title is protected and it can only be used by registrants of the College of Physiotherapists of Ontario.

An individual with physiotherapy/physical therapy training that is working as a physiotherapist support person and the supervising physiotherapist/physical therapist should understand the boundaries of the physiotherapist support person role. This is described in the Standard for Professional Practice: Physiotherapists Working with Physiotherapist Support Personnel.

Why does the College use the description ‘Physiotherapist Support Personnel’ rather than ‘Physiotherapist/Physical Therapist Assistants’?

In Ontario, physiotherapist support personnel are not regulated and therefore do not have an official title. This group includes individuals with a varied educational background. Some individuals working as physiotherapist support personnel may have a diploma from an Occupational Therapist Assistant/Physical Therapist Assistant (OTA/PTA) program, whereas other physiotherapist support personnel have received job specific training.

The term physiotherapist support personnel was chosen because it reflects the entire group – regardless of education or training.

Physiotherapist support personnel may have different job titles depending on the practice setting. Some employers may decide to use the title physiotherapist support personnel. It is up to the employer to decide.

It is important to understand that an individual is not functioning as a physiotherapist support person or physical therapist assistant unless the care is assigned and supervised by a physiotherapist/physical therapist.