Collaborative Care FAQs

FAQs: Collaborative Care

• Can two PTs treat the same patient?

  Yes, as long as there is no unnecessary duplication and the PTs communicate with each other about the patient’s plan of care to ensure their approaches are complementary and do not conflict. Read the Collaborative Care Standard.

• Do I need a referral to assess or treat a patient?

  It depends on your setting. Outside a hospital, the College does not require physiotherapists to have a referral to assess or treat patients. Inside a hospital, physiotherapy treatment provided in a hospital falls under the Public Hospitals Act, Regulation 965, Hospital Management. The regulation indicates that a referral for treatment is required from a doctor, nurse in the extended class, midwife, or dentist. The Act is silent on the need for a referral to assess a patient.
  
  A referral is also needed to access government funded physiotherapy.
  
  Learn more about Regulation 965
  
  Find a Government-Funded (OHIP) Physiotherapy Clinic

• I treat patients with urinary and bowel incontinence. Can I ask a patient to document their fibre and fluid intake, add some types of fibre where appropriate and reduce certain foods to evaluate the food types' influence on bowels?

  The function of the pelvic floor is what you, as a physiotherapist, are addressing during the session. Bowel and bladder functions can be closely related to the integrity of the musculoskeletal condition of the pelvic floor.
  
  If you are doing your due diligence during an assessment and asking questions about the frequency of bowel and bladder elimination to assess the pelvic floor, then it does seem reasonable. 
  
  If you have highlighted a problem and suggest fibre intake to improve the patient's bowel motility, you should assess the risk of the recommendation. The risk is there could be another medical condition that you do not have the competency as a PT to evaluate thoroughly.
  
  A physiotherapist cannot diagnose a patient nutritional issue. Of the scenarios in question, the most problematic one is the prescription of the specific elimination diet. It is essential that results from a prescriptive diet are not interpreted by a PT as a nutritional diagnosis. 
  
  A physiotherapist should work with an MD or an RD to help guide a patient's care who is living with chronic diarrhea, as this is not a physiotherapy diagnosis.