Working with Physiotherapist Assistants Standard

1. Authority and Responsibility

A physiotherapist who assigns care to a physiotherapist assistant remains responsible for all of the patient’s care. *The physiotherapist must be listed on the College’s roster. This expectation will not come into effect until the required technology is in place.

2. Duties that Cannot be Assigned

A physiotherapist must not assign the following activities to a physiotherapist assistant:

  • care the physiotherapist does not have the knowledge, skills, and judgement to perform
  • initial assessments and re-assessments
  • treatment that would require the physiotherapist assistant, on their own, to change the established plan of treatment
  • any controlled act that has been delegated to the physiotherapist
  • any part of acupuncture, communicating a diagnosis, spinal manipulation or internal assessment or internal rehabilitation of pelvic musculature.

3. Assigning and Supervising Care

The physiotherapist must carefully balance the risks of assigning and supervising care with the patient’s best interests and quality of care. The supervising physiotherapist must:

  • Ensure that the physiotherapist assistant has the knowledge, skill, and judgment to deliver the assigned care safely and with the same quality of care as the physiotherapist would provide.
  • Discuss the roles and responsibilities of the physiotherapist and the physiotherapist assistant with each patient or their substitute decision maker. They should know the physiotherapist assistant by name and job title and give their consent to the care.
  • Ensure the physiotherapist assistant’s name and job title appear on invoices whenever they have provided all or part of the treatment.
  • Provide a level of supervision suitable for the patient’s condition, the clinical environment, the abilities of the physiotherapist assistant, and any other relevant factors.

4. Communication

The physiotherapist must have a written communication protocol that states:

  • how and when they will discuss patient care with the physiotherapist assistant
  • how to contact the physiotherapist
  • how to contact the alternate supervisor if the physiotherapist cannot be reached

5. Responsibilities of the Alternate Supervisor

The physiotherapist must designate another physiotherapist that the physiotherapist assistant can contact if they cannot be reached. If this happens, a transfer of care takes place. The alternate supervisor assumes responsibility for decisions about the patient’s care and the care the physiotherapist assistant delivers.

A physiotherapist who agrees to be the alternate contact for a physiotherapist assistant must:

  • be able to assume this responsibility
  • have the knowledge, skill, and judgement to perform the assigned care
  • be available to intervene according to the communication protocol

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Legislative Reference

Ontario Regulation 388/08 under the Physiotherapy Act, Professional Misconduct: Section 1, paras 1, 22, 23, and 41.

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Previous Standard Dates: June 2005, January 2007, January 2009, March 2010

Approved Date: June 17, 2016

Effective Date: June 29, 2016