Understanding Ultrasound and How the Law Permits Physiotherapists to Use It

Use of ultrasound for diagnostic and biofeedback purposes is an issue that has made its way on to the College’s radar and we think it important that you understand the legal aspects of how you are and are not permitted to use it.

Physios can offer therapeutic ultrasound because the laws that regulate health professionals do not restrict who can provide therapeutic ultrasound. However, Ontario does restrict who can provide diagnostic ultrasound. The difference between therapeutic and diagnostic is the important differentiating factor.  

The law defines diagnostic ultrasound in a very specific way: diagnostic ultrasound is any form of ultrasound that produces an image or other data. It is this legal framework that is causing problems for members who want to use ultrasound in new ways with patients.

The College has heard of physios using ultrasounds to provide biofeedback to patients to allow them to better understand the structure and movement characteristics of their musculature. This kind of ultrasound is known by a number of names, including biofeedback for ultrasound, rehabilitative ultrasound imaging (RUSI) or diagnostic real-time ultrasound (DRTUS).

Only health professionals who have the authority to perform the controlled act of applying or ordering the application of a restricted form of energy can use it without restrictions. Unfortunately, physiotherapists are not currently on that list! (Talk to your Association if you think you should be!)

This doesn’t mean you cannot do it, just that you need the activity to be delegated to you by a healthcare professional with the ability to do so. Check out this handy online tool: Guide to Medical Directives and Delegation and continue to provide the excellent care you do to patients, just be certain you are doing it within the scope of the law.

Still unsure about how you can or cannot use ultrasound in your practice? Have another burning question? Get in touch with one of the Practice Advisor's at 647-484-8800 or 1-800-583-5885 or at practiceadvice@collegept.org