Critical Reflections on the Physiotherapy Profession in Canada (original) (raw)
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Physiotherapy Practice - Newsletter of the Canadian Physiotherapy Association, 2019
When thinking about the management of physiotherapy practice, physiotherapists often focus on delivering high quality care to each patient treated in their clinics or their department. Although this is clinically important and relevant on a one-to-basis rationale, the profession should also consider the global impacts of their practice management on the population as we strive towards high-quality physiotherapy services. The quality of physiotherapy practice has greatly evolved in many key dimensions. Unfortunately, one of these key dimensions has received comparatively little attention: equity.
A Description of the Canadian Entry-Level Physiothempist
1997
A thesis submirted in conformity with the requirements for the degree of Master of Arts Department of Curriculum. Teaching and Learning Ontario Institute for Studies in Education of the University of Toronto O Copyright by Susan Glover Takahashi 1997 National Library 1*1 of Canada Bibliothèque nationale du Canada Acquisitions and Acquisitions et Bibliographie Sewices services bibliographiques 395 Wellington Street 395. me Wellington Ottawa ON KI A ON4 Ottawa ON KIA ON4 Canada Canada Our iile Narre r e f d r~n t~ The author has granted a non-L'auteur a accordé une licence non exclusive licence allowing the exclusive permettant à la National Library of Canada to Bibliothèque nationale du Canada de reproduce, loan, distribute or sell reproduire, prêter, distribuer ou copies of this thesis in microform, vendre des copies de cette thèse sous paper or electronic formats. la fome de microfiche/fïlm, de reproduction sur papier ou sur format électronique. The author retains ownership of the L'auteur conserve la propriété du copyright in this thesis. Neither the droit d'auteur qui protège cette thèse. thesis nor substantial extracts fiom it Ni la thèse ni des extraits substantiels may be printed or othemise de celle-ci ne doivent être imprimés reproduced without the author's ou autrement reproduits sans son permission. autorisation, A Description of the Canadian EntryLevel Physiotherapist Susan Glover Takahashi Master of Arts, 1997 Department of Curriculum. Teactiing and Learning Ontario Institute for Studies in Education of the University of Toronto A bstract. A Description of the Canadian Entrv-LeireI Phvsiotheraoist profiles the Canadian physiotherapist at tlie entn-to-practice ievel and reviews the adequacy of three descriptions of the competencies of tlie Canadian physiotherapist at the entn-to-practice level In the contest of physiotherapy. competencies are the knowledge. skills. and attitudes required for safe. independent. ente-level physiotherapy practice. This anal>tic. qudi tatii e srudy revien-ed tu-O a d a b l e descriptions of the Canadian entn-level physiotlterapist. and developed a third description using a tlnctionaI-anaivsis model to profile tlie Canadian rntry-level phyiotherapist and the inventon of competencies .A cornparison of tlie tltree descriptions of tlie Canadian rntry-level physiotherapist found that there is some overlap and linkages among them. A Descnption of the Canadian Entn-Level Physiotherapist cm be used in teaching and evaluating physiotherapy students; in the rehiew and revision of the national certification euamination. and in measures taken to ensure and improve the quaiity of Canadian physiotherapy practice.
Possible futures for physiotherapy
New Zealand Journal of Physiotherapy, 2005
This paper discusses how physiotherapists might respond to the challenges of health care reform taking place in New Zealand. We begin by outlining the health policy initiatives that are challenging our understanding of physiotherapy practice. We then outline a socio-political history of physiotherapy, using the ‘body-as-machine’ as a metaphor. We then present four possible responses to New Zealand health reforms: watching and waiting, enhancing the body-as-machine, rejecting the body-as-machine and integration. These are then analyzed for their various advantages and disadvantages. We conclude by appealing to physiotherapists to reect upon the significance of New Zealand’s health care reforms and to begin considering their response.
Understanding Physiotherapists' Roles in Ontario Primary Health Care Teams
Physiotherapy Canada, 2014
Purpose: To understand physiotherapists' roles and how they are enacted within Ontario primary health care (PHC) teams. Methods: Following a pragmatic grounded theory approach, 12 physiotherapists practising within Ontario PHC teams participated in 18 semi-structured in-depth in-person interviews. All interviews were audiotaped and transcribed verbatim, then entered into NVIVO-8. Coding followed three progressive analytic stages and was iterative in nature, guided by grounded theory. An explanatory scheme was developed. Results: Physiotherapists negotiate their place within the PHC teams through five interrelated roles: (1) manager; (2) evaluator; (3) collaborator; (4) educator; and (5) advocate. These five roles are influenced by three contextual layers:
Weekend Physiotherapy Practice in Community Hospitals in Canada
Physiotherapy Canada, 2012
Purpose: To analyze weekend physiotherapy services in acute-care community hospitals across Canada. Method: Questionnaires were mailed to acutecare community hospitals (institutions with >100 inpatient beds, excluding psychiatric, mental health, paediatric, rehabilitation, tertiary, and long-term care facilities) across Canada from January to April 2010. The questionnaire collected information on patient referral criteria, staffing, workload, and compensation for weekend physiotherapy services and on the availability of other rehabilitation health professionals. Results: Of 146 community hospitals deemed eligible, 104 (71%) responded. Weekend physiotherapy was offered at 69% of hospitals across Canada, but this rate varied: b75% in all regions except Quebec (30%). Hospitals with a high proportion of acute-care beds were more likely to offer weekend physiotherapy services (logistic regression, p ¼ 0.021). Services differed among Saturdays, Sundays, and holidays in terms of the numbers of both physiotherapists and physiotherapy assistants working (Kruskal-Wallis, p < 0.02 for each). Physiotherapists were predominantly compensated via time off in lieu. Of hospitals not offering weekend physiotherapy, 53% reported that it would benefit patients; most perceived staffing and financial barriers. Social-work services were offered on the weekend at 24% of hospitals and occupational therapy at 16%. Conclusions: Substantial regional variation exists in access to weekend physiotherapy services in acute-care community hospitals. To address the importance of this variation, research on the efficacy and cost-effectiveness of such services is required.
Possible futures of physiotherapy: an exploration of the New Zealand context
This paper discusses how physiotherapists might respond to the challenges of health care reform taking place in New Zealand. We begin by outlining the health policy initiatives that are challenging our understanding of physiotherapy practice. We then outline a socio-political history of physiotherapy, using the 'body-as-machine' as a metaphor. We then present four possible responses to New Zealand health reforms: watching and waiting, enhancing the body-as-machine, rejecting the body-as-machine and integration. These are then analyzed for their various advantages and disadvantages. We conclude by appealing to physiotherapists to reflect upon the significance of New Zealand's health care reforms and to begin considering their response.
BMC Health Services Research
Background: In recent years, significant efforts have been made to improve the provision of care for compensated injured workers internationally. However, despite increasing efforts at implementing best practices in this field, some studies show that policies overseeing the organisation of care for injured workers can have perverse influences on healthcare providers' practices and can prevent workers from receiving the best care possible. The influence of these policies on physiotherapists' practices has yet to be investigated. Our objectives were thus to explore the influence of 1) workers' compensation boards' and 2) physiotherapy clinics' policies on the care physiotherapists provide to workers with musculoskeletal injuries in three large Canadian provinces. Methods: The Interpretive Description framework, a qualitative methodological approach, guided this inquiry. Forty participants (30 physiotherapists and 10 leaders and administrators from physiotherapy professional groups and workers' compensation boards) were recruited in British Columbia, Ontario and Quebec to participate in an in-depth interview. Inductive analysis was conducted using constant comparative techniques. Results: Narratives from participants show that policies of workers' compensation boards and individual physiotherapy clinics have significant impacts on physiotherapists' clinical practices. Policies found at both levels often place physiotherapists in uncomfortable positions where they cannot always do what they believe to be best for their patients. Because of these policies, treatments provided to compensated injured workers markedly differ from those provided to other patients receiving physiotherapy care at the same clinic. Workers' compensation board policies such as reimbursement rates, end points for treatment and communication mechanisms, and clinic policies such as physiotherapists' remuneration schemes and restrictions on the choice of professionals had negative influences on care. Policies that were viewed as positive were board policies that recognize, promote and support physiotherapists' duties and clinics that provide organisational support for administrative tasks. Conclusion: In Canada, workers' compensation play a significant role in financing physiotherapy care for people injured at work. Despite the best intentions in promoting evidence-based guidelines and procedures regarding rehabilitation care for injured workers, complex policy factors currently limit the application of these recommendations in practice. Research that targets these policies could contribute to significant changes in clinical settings.