On March 23, 2020, the Government of Ontario released a list of essential and non-essential services to help Ontarians better manage the transmission of COVID-19. On April 3, 2020, the government updated the list of essential businesses and the criteria used to determine qualification. Services and businesses deemed to be non-essential were directed to close for the 14 days starting Saturday April 4, 2020 at 11:59 p.m.

The College is concerned that some practitioners may not be adhering to the government’s directives, and the College’s guidance. Should the College become aware of concerns of this nature, then it will take appropriate action. 

The College of Physiotherapists of Ontario does not have the legal authority to direct facilities providing patient care and private practices to close. This direction can only come from the Ontario government. Physiotherapists who work in hospitals have been receiving direction from their employers.

To date, private practice, long-term care, retirement homes, and community care physiotherapist employers and non-physiotherapist employers have made their own decisions about whether to close their practices.

In the new statement from the government they directed that physiotherapists can continue to provide “urgent care” (see point 38) and virtual care. 

Even with this direction, each physiotherapist must assess whether the risk of not providing services outweighs the risks of exposing the physiotherapist, staff and/or the patient to COVID-19. If the risk of exposure to COVID-19 is greater to all, the physiotherapist cannot provide treatment until the Ontario government and Public Health Ontario advises that it is safe to resume care.

So what does this mean for physiotherapists? 

Physiotherapists who are employed by hospitals are essential services. Physiotherapists that work in that setting must take direction from their employers.

What about physiotherapists who work in private practice, long-term care facilities, retirement homes and organizations that deliver home care services?

Physiotherapists who work in those practice settings are restricted to providing urgent care only as per the government's direction on April 3, 2020.

What constitutes urgent care in a private practice setting?

Urgent care includes assessment and therapeutic intervention or services for conditions or situations where not receiving physiotherapy services (whether in-person or virtually) would put the patient’s safety at risk, or there is potential for significant harm or significant adverse patient outcomes. 

Significant harm or adverse outcomes means the patient may be at risk of hospital admission or re-admission, long-term incapacity or harm.

Specifically, situations which could be considered urgent under this definition include:

• A patient who is currently experiencing incapacitating neuromusculoskeletal dysfunction or pain.

• Any scenario where the inability to initiate care or the withdrawal of care would lead to the significant deterioration of a patient’s condition and the patient is at risk for imminent hospital admission or re-admission.

• Post-operative care immediately following surgery when necessary for cardiorespiratory and essential functional mobilization as an in-patient to prevent the delay of a patient being discharged home to the community.

• Follow-up immediately post-discharge from hospital to the community to ensure safe return to home and prevent re-admission to the hospital.

• A patient who has suffered burns that are incapacitating in nature.

• The patient is an individual such as a health care provider in an essential service in an acute care setting or other setting deemed to be essential, whose injury or condition requires physiotherapy care to return to work safely as soon as possible.

Physiotherapists in other settings may also be involved in:

• Cardiorespiratory care/tracheal suctioning for newly acquired acute illnesses or acute exacerbations of underlying respiratory diseases

• Post ventilation and rehabilitation phases for patients with COVID-19

See a list of FAQs (frequently asked questions) related to this update on the College's COVID-19 webpage.