Learn about the difference between being an employee versus being self-employed, and about working in public versus private practice.

1.  Where do you want to work: as an employee or self-employed?

CRA Factors for Employment Status

Employee

Self-Employed

Intention of working relationship 1

Contract of Services (COS)

Contract for Services (CFS)

Degree of control 2

Subordination

Results and Methods of Work

Method and Amount of Pay

Requires permission to work for others at same time

Assigned jobs

Receives training and direction from payer

Payer has final word

Works Independently

No supervision

May work for different payers at same time

Free to work when and for whom

Able to accept of refuse work from payer

Does not present a degree of loyalty, security, subordination, or integration

Tools & Equipment 3

Payer supplies tools and equipment

Responsible for repair, maintenance, insurance

Reimburses worker if they supply tools

Payer retains right of use

Provides tools and equipment

Worker retain right of use

Supplies own workspace and maintenance of space and tools

Subcontracting

Worker must perform the assigned tasks personally

May hire another person (e.g., PTA) to perform the work without the payer interfering

Financial Risk 4

Payer responsible for operating costs

Working relationship is continuous

Worker is not liable if contract is not fulfilled

Payer determines method and amount of pay

Pays hired helpers

Incurs expenses related to own workspace

Hired for a specific job/contract

Financially liable if contract if not fulfilled

Receives no benefits or protection from payer

Responsible for advertising their services and actively markets self

Responsibility for investment & management 5

Normally, worker has no capital investment

Worker has no business presence

Worker has capital investment

Worker manages their staff

Worker has established business presence

Opportunity for profit 6

Worker does not have profit or loss

Worker is entitled to benefit plans

Worker can hire substitutes

Worker is compensated by a flat fee and incurs expenses

 

1. Two parties mat have different understanding of what this means. The chosen status must be reflected in the actual working conditions as well as written in the contract
2. Self-employed physiotherapists may work at various clinics simultaneously, even if the clinics are in close proximity as long as both parties agree to a non-competition clause. Self-employed physiotherapists may not access the clinic’s benefits (e.g., healthcare, courses/training . . .)
3. Self-employed physiotherapists must own their own tools OR have a rental/lease agreement for the use of the clinics equipment and tools, as well as for work space in clinic. This must be a flat rate fee regardless of the amount of patients seen.
4. Self-employed physiotherapists must demonstrate financial risk (e.g., payment of fixed monthly expenses whether or not work is done). Not seeing the same amount of patients each month is not considered financial loss/risk.
5. To establish a business presence, a physiotherapist would have to market themselves and separate their work from the clinic’s business. This is the rationale behind supplying your own business cards, phone number and advertisements.
6. The chance to experience profit or loss is from the perspective of the worker and not the payer (e.g., autonomy in accepting work, negotiating prices for the job, working in multiple clinics and carrying expenses for having their business) 

2.  Where do you want to work: public or private practice?

 

Public Practice

Private Practice

Type of work available

Full-time, Part-time, Casual

Full-time, Part-time, Locum

Typical workplaces

Hospital

Community care and home health

Child Development centre

School board, University or College

Clinic Small and Large (1-14PTs)

Corporate clinic

Home visits

Consultant, case manager, administration

Corporation (Insurers, industry)

Compensation

Dictated by union collective agreement

Salary and generous benefits

1.6% of salary to union dues (e.g., HSA)

Negotiated with clinic owner

Varies among clinics

Dependent on billings or caseload rather than salary

Benefits

Dictated by collective agreement

Paid vacation (accrued without upper limit), family health and dental coverage, continuing education, leave of absence, parental leave, pension, long and short term disability coverage

Cost covered by the employer (~20% value in addition to salary)

Job security

Free education through in-services and course funding

Most private practice physios are self-employed, and  therefore cover their own benefits (no paid vacation or health benefits or education, etc)

Corporate clinics tend toward employee status, in which case benefits are up to the individual employer

Work Environment

Get experience in wide variety of areas, (e.g., in hospital: burn unit, paediatric nursery, cardio-respiratory, orthopedics)

Can focus on one area (e.g., post-surgical treatment)

Job options in research, leadership, educator

Work as part of an interdisciplinary team

Patient interaction, time management and treatment skills

Gain experience with acute medical conditions

Work in a urban suburban or rural location

Mentoring from experienced physiotherapist

Medical rounds

Generalize or focus on one area of expertise (e.g., orthopaedics, sport injury, work conditioning)

Practice alone of in large clinic

Have control over work schedule

 Gain business skills & explore new business opportunities

Work in an urban, suburban or rural location

Work in niche markets

Patients per hour depend on clinic expectations & own expectations