Many Albertans will find themselves in a situation where they require physiotherapy services. The nature of your injury, the funding involved, your location, and your needs as a patient can create some challenging decisions to make. The goal of this article is to provide information about how to access care, how to find and verify a physiotherapist, and what to be aware of regarding the advertising of physiotherapy services. We will also discuss other parts of physiotherapy practice such as the use of support workers and the purchasing of products through your physiotherapist so that you can make informed decisions.
It should be comforting to know that when physiotherapists are providing services they are guided by a Code of Ethical Conduct which provides a moral anchor on which they can base decisions. They also have legislative requirements that are set by the Government of Alberta and Standards of Practice that are set by the College of Physiotherapists of Alberta. Each of these pieces lays a framework that physiotherapists must abide by when advertising and delivering services to Albertans. We will refer to these throughout the article to raise awareness of their use and to give you a better understanding of how they function when it relates to being a consumer of physiotherapy services. This article will guide you through several parts of your physiotherapy experience in which you may need to make decisions as a savvy consumer.
Physiotherapists work in many different sectors and are involved with various potential funders. You can access physiotherapy that is funded publicly through Alberta Health Services, or you can choose to pay out of pocket for privately funded physiotherapy services. Commonly physiotherapy can be funded by 3rd party payers such as WCB, motor vehicle insurance, or your extended health benefits, but how do you figure out where and how to get access to see a physiotherapist for your injury or condition? It is a good question as many different things can affect your access to physiotherapy care and funding. Below are several points that should help address common questions the public has regarding physiotherapy care and make you a bit savvier.
- Physiotherapists are able to work in many different locations from traditional physiotherapy clinics and hospital settings to in-home services and more recently delivering services via virtual means. If you are unable to access care in a physical location, then you may be able to find a physiotherapist who can come see you in your home physically or virtually through online methods.
- Physiotherapists are primary healthcare practitioners, so you do not need a doctor’s referral to access care. However, some extended benefit providers require a physician’s referral prior to accessing your benefits. It is best to check with your insurer to see what funding you have access to and what the requirements are to receive those funds.
- In other cases, such as a workplace injury or if you are injured in a motor vehicle collision, you would access physiotherapy through your insurance funding- either the Workers Compensation Board or your motor vehicle insurance.
Often this can be a stressful time for patients, but you should have a claims manager attached to your file that can help guide you. The claims manager may provide suggestions if you are unsure of which physiotherapist to see and occasionally in the case of a workplace injury, they may have set requirements of seeing a specific person or attending a return-to-work program. If you are dealing with insurance through a motor vehicle collision, however, they cannot require that you see a specific physiotherapist or attend a specific clinic. You have the final choice over who your physiotherapist will be, as long as they can provide appropriate care and meet the funder's requirements for insurance coverage.
There can be limitations to what physiotherapy is publicly funded in communities. Outdated information on public funding for physiotherapy still persists, so if you are unsure if you are able to access publicly funded physiotherapy it is best to contact Alberta Health Service’s Rehab Advice Line for more specific information.
Finding a Physiotherapist
Beyond recommendations from claims managers in the case of workplace injuries or motor vehicle collisions, how would you go about finding a physiotherapist who would be able to meet your needs? How do you make savvy decisions on which physiotherapist is going to be best for you?
Verifying Your Physiotherapist
The first thing to be aware of when you start your search is to look for the designation “PT” or title physiotherapist. You can confirm that the person is a regulated physiotherapist permitted to provide physiotherapy services in Alberta by accessing the College of Physiotherapists of Alberta’s Verify A PT tool. You can use this tool to find out if your physiotherapist is registered, if there are any conditions on their practice permit, and to find out if there have been any notices of hearing or professional conduct decisions posted related to complaints about their physiotherapy practice.
One thing to pay attention to is if a physiotherapist has a condition of supervision on their practice permit. This often occurs when a physiotherapist is new to physiotherapy practice in Canada, either as a recent graduate of a Canadian physiotherapy program or having recently moved to Canada. When physiotherapists are new to Canadian practice they first apply to be on the Provisional Register. Once on the provisional register, they are authorized to use the title physiotherapist intern and have a condition of supervision on their practice permit. It is important to understand that a physiotherapist intern is a registrant of the College and is subject to all of the Standards of Practice and other professional obligations of physiotherapists.
Now that you know how to verify your physiotherapist, there are several approaches to actually finding one that will hopefully meet your needs as a patient. One option for finding a physiotherapist is the traditional search method of looking to see who is in your neighborhood or near your place of work. Location is important as travelling to see your physiotherapist could be a potential barrier to care. You can also talk with people to see if they have a physiotherapist that they have a good professional relationship with. You may have a friend, co-worker or family member who can recommend a physiotherapist so it might be worthwhile to reach out.
Advertising of Services
Another way many patients find a physiotherapist is through the advertisements physiotherapists use. The rules of advertising that govern physiotherapy practice can be found here. According to the Code of Ethical Conduct and the Standards of Practice, physiotherapists must use advertising that is truthful, accurate, and verifiable. If you go online to a search engine like Google, you will most likely be presented with several options in your community. When you are reading the physiotherapists’ websites or scrolling through their professional social media accounts you should be presented with an accurate account of the services they provide, the conditions they treat, and the fees they charge. This can help you narrow your choices down to whom you wish to book an appointment with.
It is good to keep the above requirements of truthful, accurate, and verifiable advertising in mind as you read through your search and click on some websites. Most websites will indicate who they have working in the practice setting and you can peruse each physiotherapist’s biography to find out what education they have, any additional training they obtained after graduation, years of experience, and conditions they may focus on. If you see a jumble of letters after the physiotherapist’s name and PT designation you can read their biography and expect to find details as to what that jumble of letters means.
As you read through the websites some common areas of concern that you should be aware of include
- Guarantees: As the saying goes, there are no guarantees in life outside of death and taxes. The same holds true in the physiotherapy profession. Nothing a physiotherapist does is guaranteed to work for you. Exercise may be the one exception that seems to help with almost everything, but outside of that don’t get sucked in by any claims that guarantee success with your tennis elbow, knee pain, plantar fasciitis, or any other condition.
- Generalized Statements of Success: Claiming that something works for “everything” is also untrue. Physiotherapists have treatment choices they select based on patient assessments. Having one modality like shockwave, dry needling, or joint manipulation that can work for everything rings the same bell as a guarantee.
- Free: Like guarantees, there are rarely things in life that are truly free and free from obligations. If you see advertisements for “free biomechanical assessment”, “free gait assessment”, or “free consultation” it is advisable to steer clear. Most often these are used as a way to get you in the door and try to convince you that you need orthotics, treatment for something they find during the consultation, or something else that will come at a financial cost to you.
- Prizes or Gifts: Usually these create another opportunity to get you or someone else through the door. Giving out prizes or gifts to refer a friend or family member is against the College's expectations regarding advertising. Gift certificates for physiotherapy services are also prohibited as they can lead to the provision of unnecessary services.
The College of Physiotherapists of Alberta actively monitors and provides feedback to physiotherapists about the websites and social media accounts where their physiotherapy services are advertised. Most physiotherapists easily comply with the expectations established in the Advertising Standard of Practice. Failure to do so can result in fines and other consequences, so the issues listed above should rarely be seen. You can read more about the Advertising Compliance Verification Tool which we use to monitor physiotherapy advertising here.
Now that you have some extra savviness around physiotherapy advertising, let’s move on to the physiotherapy visit.
Physiotherapy Support Workers
Many physiotherapy practice settings employ physiotherapist support workers in the delivery of physiotherapy services. This is true in both private and publicly funded settings. Physiotherapist support workers can be an integral part of your care. These unregulated health providers have a range of education and training backgrounds. They may be trained on the job; however, it is increasingly common that physiotherapist support workers will have a degree in Kinesiology or a diploma as a therapy assistant from a post-secondary institution. Regardless of their background they are assigned tasks by your physiotherapist and are under the supervision of your physiotherapist.
The physiotherapist support worker’s role in your care must be explained to you and your physiotherapist must get your consent to involve a physiotherapist support worker in your plan of care. Physiotherapists have limitations to what they can and cannot assign to physiotherapist support workers. You can read more about the supervision process and requirements here and here. It is important to understand who is on your physiotherapy team and what their role is. If you are not clear about who is providing care, their credentials, or their role, ask.
As part of your treatment plan or discharge plan, you may be advised to purchase products. But, as a savvy consumer, what do you need to know? For example, if you are having a knee or hip replacement, you can expect to receive directions on how to get a commode or where you will find a walker that you can borrow or purchase for your recovery. These may come from your local hospital, an equipment loan program, or you may be provided with a list of vendors to purchase equipment from.
Other physiotherapy settings may have products available for purchase like you would see at a retail store or pharmacy. Your physiotherapist may recommend that you purchase products such as exercise equipment, splints, or braces to protect you from further injury. Regardless of the reason, you should be able to make your own decisions regarding what you are purchasing and where you purchase it from. The Conflict of Interest Standard of Practice and the Code of Ethical Conduct both prohibit physiotherapists from receiving financial incentives for selling products, and your decision to purchase equipment elsewhere must not affect the physiotherapy services you receive.
There is much to consider as a savvy consumer of physiotherapy services. This article has summarized access to physiotherapy care and hopefully has helped provide you with information you can use to navigate the funding of your care. There were also sections on how to find a physiotherapist in your community and being able to verify them via the College’s website. The Standards of Practice and Code of Ethical Conduct are used to review the professional expectations physiotherapists must meet in the advertising of physiotherapy services and the sale of products as well as discussing the use of physiotherapy support workers in your plan of care. All of this will hopefully assist you in gaining a better understanding of how to be a savvier consumer of physiotherapy services.Sean FitzGerald, PT