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Shenda Tanchak
Registrar and CEO
College of Physiotherapists of Ontario

  • A Bedtime Story

    Apr 27, 2018

    Once upon a time there was a physiotherapist and a massage therapist working together in the same clinic.
     
    One day, a man in his thirties came in with lower back pain. He was sad to report that he had to cut back on his running because of his discomfort in his hip.
     
    He saw the physiotherapist who assessed him and said, “Your legs are slightly different lengths. I think that this is because your pelvis is tilted. I will treat you with muscle stretching around the hip area, adjustment first and then follow it with feedback on your posture when you run.”
     
    The patient saw the physiotherapist 6 times and started to feel much better. The physiotherapist felt the patient could benefit from some massage therapy but the patient's benefits did not cover massage and he couldn’t afford to pay out of his own pocket.
         
    The physiotherapist suggested that the patient could receive massage therapy and not have to pay out of pocket, they could just adjust the books a little. The invoices could be issued by the physiotherapist but the massage therapist would see the patient. If anyone asked, the massage therapist was acting in the capacity of a physiotherapist assistant.

    The patient used up his physiotherapy benefits, but by that time his pain had resolved. He gave the clinic five stars on Yelp.
     

    What Do You Think? OK or Not OK?

    First of all, a massage therapist or even a physiotherapist CAN work as an assistant to a physiotherapist—really anyone can work as a PTA.
     
    But when anyone works as an assistant, they MUST work under the supervision of someone else. The treating professional must have assessed the patient, established goals and a treatment plan, assigned and supervised the treatment being provided and must periodically reassess the patient. If those things have not happened, it cannot be billed as “physiotherapy”. Oh, and it actually has to be physiotherapy that is being provided.
     
    This is exactly the same in a gym setting. An athletic trainer might be acting as a PTA, but only if the conditions (PT diagnosis, treatment plan, supervision and reassessments) set out in the Standard are met. The trainer should not be developing or independently adjusting treatment plans.
     
    In the situation above, the physiotherapist should have handed the patient off to the massage therapist for treatment, if they needed that service. The RMT would have assessed the patient, and developed a treatment plan, and billed for the services.
     
    The bottom line is that if it’s billed under your number, you must use your own clinical expertise to oversee every element of patient care. Otherwise it looks a lot like you’re trying to rip off an insurance company.
     
    Fees, Billing and Accounts Standard

    Working with Physiotherapist Assistants Standard

    Questions? Contact the Practice Advisor

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  • Who Runs the College Anyway?

    Mar 02, 2018
    Full story
  • Did You Make a New Year’s Resolution to Lose Weight this Year?

    Jan 22, 2018
    Full story
  • The Assessment Program Undergoes An Assessment

    Dec 07, 2017
    Full story
  • Harvey Weinstein

    Oct 16, 2017
    Full story
  • The Common Denominator: Billing, Registration, Professional Identity

    Sep 07, 2017
    Jamie G. Dockx, PT Student Clinical placement at the College of Physiotherapists of Ontario   I have had the privilege of spending 5 weeks at the College of Physiotherapists of Ontario for my final student placement. After 4 clinical placements, it was time to learn the ins and outs at the College. Learning about the […]
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    • Policy
  • What’s Your Ism?

    Aug 09, 2017
    How do your conscious or unconscious biases affect your ability to provide safe and effective care for patients? If you work in a private practice setting, think about your office for a minute. Do you have posters for promotion or décor?  Do you have gym equipment?  Is there any chance that these décor elements might […]
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  • In It Together

    Apr 25, 2017
    You run a clinic. Your receptionist is rude. Your physiotherapist assistant bills for services not provided. Your brand-new PT burns a patient with a heating pad. Whose responsibility is all this? If you guess that you’re on the hook for behavior by those you employ or supervise, you are right. You work for a clinic. […]
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  • Doing The Right Thing – Nobody Said It Was Going To Be Easy

    Feb 03, 2017
    Have you heard of convicted serial killer Harold Shipman? He was a UK doctor found guilty of killing 15 of his patients. After his conviction, a two-year inquiry spearheaded by the British government revealed that he had in fact killed an upward of 250 patients throughout a 23 year span. Shipman’s killing spree began to […]
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  • How to Make Yourself COMPLAINT-PROOF!

    Nov 21, 2016
    Do you ever wonder who gets complained about? Look around at your colleagues and play a little game of detective with yourself. One way to start is to find someone who is rude—in writing or in person. A very high percentage of our complaints stem from inappropriate lapses in what you might call “customer service” […]
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