Policy Analysis of Scope of Practice Changes to Physiotherapy and the Newly Regulated Health Profession of Kinesiology

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spineNew HHR legislation in Ontario has been recently introduce to expand the scope of practice for physiotherapists (i.e. Bill 179) and regulate kinesiologists (i.e. Bill 171). Under Bill 179, physiotherapists will be able to (1) communicate a diagnosis, (2) treat a wound below the dermis, (3) assess or rehabilitate pelvic musculature, (4) administer a substance by inhalation, (5) order a prescribed form of energy, (6) order diagnostics (i.e. x-rays), and (7) order specific laboratory tests. Under Bill 171, kinesiologists will create self-regulatory framework for their practice.

In this study, we conducted key informant interviews (n=24) and provincial surveys of physiotherapists (n=292) and kinesiologists (n=241), in order to explore educational, regulatory, professional and health system perspectives on these changes. We found that stakeholders view these changes as positive advances in terms of addressing the emerging health needs of Ontarians, especially from a health promotion, wellness and rehabilitation perspective. However, even though legislation has been passed, there are barriers to fully implementing these proposed changes. Physiotherapists are now able to communicate a diagnosis, and if they self-assess their competency to be sufficient they can provide controlled acts 2, 3, and 4 listed above. However, regulatory frameworks around controlled acts 5, 6 and 7 have not fully approved, and thus cannot yet be performed.

Kinesiologists have created a transitional regulatory council, but full acceptance of documentation is pending and regulation of the practice has not yet occurred. The preliminary stages of these new legislations limit the extent to which outcomes can be evaluated, however Bill 179 and Bill 171 do indeed create the prospect to shift the boundaries in health care delivery, and may represent an opportunity to provide more appropriate provide services, by the right provider, in the right place, at the right time, and for the right price.

For more information contact Dr. Michel Landry: This e-mail address is being protected from spambots. You need JavaScript enabled to view it