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Shenda Tanchak

This post was originally published on April 5, 2016 and can be accessed here. Content is republished with permission from the College of Physiotherapists of Ontario.


I am receiving more and more reports about physiotherapists sending patients for personal training or Pilates and enabling patients to submit receipts for these services under the physiotherapist’s registration number. 

Guess what? In many cases this is inappropriate and you could get in serious trouble.

The ONLY time that your credentials can be used to bill for physiotherapy is when the treatment is truly physiotherapy and it has been provided by you or by someone acting as your assistant.

There are cases where a patient presents with a health problem that requires a supervised exercise problem as part of a physiotherapy treatment plan.  In such situations, the exercise program can be a legitimate element of the physiotherapy care.

The physiotherapist might manage the exercise program directly or might have someone else manage that part of the patient’s care. The minute that someone else is managing a part of a physiotherapy treatment plan on behalf of a physiotherapist, they are acting as a physiotherapy assistant.

It doesn’t matter if they are a registered kinesiologist, an athletic therapist or a personal trainer: all of the requirements of the standard for Physiotherapists Working with Physiotherapist Support Personnel apply.


Does the College really take these cases seriously? 

Ask the three physiotherapists who’ve been to Discipline in the past 14 months for failure to meet the standard of care for the use of assistants in their work with personal trainers or athletic therapists. 

Ask the handful of physiotherapists who are presently under investigation for referring their healthy patients to gyms and Pilates classes and billing their sessions as preventative physiotherapy.

Every one of you who uses your credentials as a way of getting free non-physiotherapy services for your patients is undermining the credibility of the profession.

I know that your patients ask for it. That doesn’t make it right.

And if you know a physiotherapist who is not meeting the Standard – do them a favour and send them the link or make them a copy of it – get them to read it before they read their name on the Discipline page of our website.


Over to you

  1. Do you know someone who needs a nudge? What are you waiting for?
  2. Are you familiar with the standard of practice for working with physiotherapist assistants? Do you step outside the lines?


By Shenda Tanchak
The College of Physiotherapists of Ontario

Originally posted on APRIL 5, 2016


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Thank you!  Right on point!

Are you guys running out of Rep content?  This seems to be at least the 3rd time this type of message content has appeared.  Do we really need another 'rant'?  I'm starting to share the sentiments of other commenters who are finding this series to be becoming a real downer.

I agree.  Not sure if i'm reading the college newsletter or the CPA sometimes.  It would be helpful to move forward and start highlighting some positive aspects of our profession and not the select few who aren't practicing appropriately.  




I do find this fascinating, and I hope we explore preventative exercise as a modality in our profession in the future.

I am glad that this topic is being brought to the forefront.   After 26 years as a Physio in Alberta, I have seen a lot of things I question & one of the main ones is hearing from my patients that 'their last Physiotherapist came in the room for 5 minutes & then left...only to be replaced by 'an assistant' who does most of the treatment'. Patients feel cheated by this behaviour. They definitely notice.   I feel that we have some seriously talented Physiotherapists in this province & if they used their talent for a reasonable amount of 'one of one' time with their patients, the Physiotherapy professions reputation would improve. Thank you for helping to make our professional reputations better.


Thank you for your comments.  We will be sure to include this issue in the report of #30Reps that we submit to the Board of Directors.


We (physiotherapists) are well versed in much more than injury treatment. We are the movement experts. I agree that we should not bill as physiotherapy if someone else is in charge of the treatment, but we should be allowed to practice "health care" and not be restricted to "injury management". "Preventative physiotherapy" is not a bad word. We are frowned upon when we treat something that does not end with "itis". Physical health is much much more, and includes obesity (sedentary lifestyle), hypertension, etc. Our scope of practice needs to be revised to reflect current times. 

I couldn't agree more. We're constantly promoting our profession as movement and exercise experts; we spend a fair share of resources into injury prevention, working with athletes and exercise prescription as a profession. So why is it still taboo to work with healthy populations and be compensated for it. If we're going to explore this avenue of physio then should we not advocate for full control of this area. Billing rights through 3rd party insurance, freedom within our scope of practice and the ability to advertise this service. Physiotherapy has reached a breaking point. Where do we lie on the healthcare spectrum? It's time to choose.

Agree with "Are you guys running out of..." I have quit reading or clicking on the last few reps.



I really appreciate this new format of presenting practical information in bite sized pieces.  

I do admit that I am dismayed when reading the above submission that physiotherapists undermine our own profession by trying to skirt the rules for billing.  Everybody likes a deal, but please, not at the cost of our professional reputation.

Please, respect our profession and all the work that has been done over the years ensuring that physiotherapy is  seen as a respectable, dependable, honest, reliable profession.

A new gym opened in our town, so I spoke to the owner about doing talks on injuries, preventative exercise, correct lifting strategies and so on to the membership.  Originally, he was all for it.  We met a couple of times to talk about ideas.  At one meeting, he asked if I could send patients to the gym to see his personal trainers and bill those visits to the patients insurance as physiotherapy.  I said I wouldn't do it.  He countered with "other gyms and physios do it."  I reiterated that I wouldn't do it.  He said ok and suggested we meet in a few weeks.  Before that next meeting, I walked in the gym and there was a banner in the foyer advertising free chiropractic and physiotherapy assessments.  He obviously found someone that would do it!

Regarding free assessments.  You did the right thing.  You also mentioned it here.  The question for me now is - where does the baton go next?


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