The Largely Unknown Profession: The PRT
I would like to take this opportunity today to talk about my profession, which is still largely unknown to the general public and the medical world.
Who we are
Physical rehabilitation therapists are Quebec health professionals who work in physiotherapy.1 This means that Quebec’s professional order for physiotherapy, the Ordre professionnel de la physiothérapie du Québec (OPPQ), governs the practice of two professional categories: physiotherapists (PTs) and physical rehabilitation therapists (PRTs). There are currently about 2,500 PRTs working in the public health system (hospitals, residential and long-term care centres, rehabilitation facilities) or in private physiotherapy clinics.
To hold the title of PRT, practitioners must be a member of the OPPQ and have graduated from a physiotherapy techniques program—this is a three-year diploma program offered by eight Quebec colleges (CEGEPs). PRTs’ hourly wage can range from $22.83 to $31.25.
What we do
In daily practice, PRTs work with clients of all ages who have various conditions affecting the neurological, musculoskeletal or cardiorespiratory systems. In my private practice, I treat patients who have been involved in workplace or road accidents, who are post-operative or who have had sports injuries. Our main goal is to help them regain function and get back to their activities of daily living as soon as possible.
For PRTs to treat patients, the code of ethics of physiotherapists and physical rehabilitation therapists requires that:
(1) Patients first be assessed by a physiotherapist or physician
(2) Patients have a diagnosis not restricted to the symptoms.
This is in contrast to PTs, who are able to assess patients themselves, and can do so without a medical referral.
Once a diagnosis has been made and a treatment plan is in place, PRTs treat patients with a variety of therapeutic modalities, such as manual techniques (e.g., massage, accessory mobilization), exercise, electrotherapy, hydrotherapy and heat therapy. PRTs correct patients’ posture and biomechanics, and help them make changes to improve their well-being.
PRTs can also deliver continuing education courses and teach in the physiotherapy techniques program. In fact, last winter, the program name was changed from “physical rehabilitation techniques” to “physiotherapy techniques” to further the recognition of physical rehabilitation therapy as a profession.
PRTs, following all applicable rules and procedures, can take on the full care of patients. In my clinical setting, physiotherapists and physical rehabilitation therapists work together. The three PTs perform the initial patient assessments and then transfer any cases they can to the two PRTs. With this interdisciplinary model, patients receive the best care possible, and the physiotherapists are kept up-to-date daily on how treatment is proceeding. Our work approach even enables us to develop innovative projects, like this one on isokinetics.
Our main goal is to help them regain function and get back to their activities of daily living as soon as possible.
So how are physiotherapists and physical rehabilitation therapists different? One of the main differences, as mentioned above, concerns whether they take on cases directly or through an intermediary. Another difference concerns the activities reserved for the different physiotherapy professionals.
For example, PTs can introduce an instrument or a finger in the human body beyond the labia majora or anal margin. They can introduce an instrument in the human body beyond the pharynx or nasal vestibule. They can also insert needles under the dermis and perform special manipulations provided they have undergone specific training.
As for PRTs, they can use invasive forms of energy and provide treatment for wounds, reserved activities that they share with PTs. This means that except in very specific cases (e.g., treatment of the pelvic floor or the jaw), PRTs and PTs can provide the same physiotherapy services.
Another question I am often asked is why PTs refer patients to PRTs rather than treating them themselves.
The answer is simple: to optimize patient care.
By transferring cases to PRTs, physiotherapists can focus on their specializations and the more complex cases, therefore maximizing the treatment they provide. This partnership between physiotherapists and physical rehabilitation therapists has existed for many years already in the Quebec health system.
In terms of continuing education, certain training opportunities are offered specifically to PRTs, which allows for the development of specialized expertise. This means that physiotherapy professionals can acquire different skill sets, increasing the range of services for clients.
All OPPQ members must complete 15 hours of continuing education training each year.
In addition to being a clinician, I work as an on-site emergency responder during sporting events as well as a therapist for the Cégép de Sherbrooke football team, alongside my physiotherapist colleagues.
Our profession is broad, which allows us to work in many areas including first aid, treatment and return-to-play monitoring. PRTs also play a role in prevention and health promotion. For example, for the past year, I have been administrating a professional Facebook page where I post information on the vast field of physiotherapy.
To sum up, physical rehabilitation therapists do more than just treat patients.
PRTs also supervise interns in the PRT program, give lectures to the general public, lead continuing education sessions for physiotherapy professionals, are involved with OPPQ, and much more.
Pierre-Yves Lauzon is a physical rehabilitation therapist (PRT) who graduated from the Cégep de Sherbrooke in 2009. He currently works at the Cégep de Sherbrooke’s physiotherapy clinic and sits on the OPPQ board of directors. He is the recipient of an OPPQ clinical research internship grant and will soon offer a continuing education training session on the use of isokinetics in rehabilitation.
Professional Facebook page:https://www.facebook.com/pierreyveslauzontrp