Physiotherapy … clearing the cobwebs

Photo: Sharon Gardiner

My paternal grandfather, Mark Billings, started every day by, as he would say, “clearing the cobwebs”. He did this by downing an 8 ounce glass of pure grapefruit juice that cleared his head and opened his mind to the questions of the day.

In my 40 years as a registered physiotherapist I have tried to spend much of my time clearing cobwebs … researching new interventions, digging deep to determine the source of my patients’complaints, providing my patients with the tools they need to function at their greatest potential.

Patients/clients often present questions pertaining to the profession of physiotherapy.

          “What training is required to become a physiotherapist?”    

          “What should I expect when I seek treatment from a physiotherapist?”    

          “Why is physiotherapy covered by OHIP in some instances but not in others?”   

          “Do I need a doctor’s prescription or referral to receive treatment?”   

These are good questions. Hopefully the following information will provide some answers.

Physiotherapy, like medicine, is both a science and an art. In Canada, the science is taught at the university level through a faculty of medicine. The art of physiotherapy is the ability to make that science useful to patients and clients. These skills are taught during internships and improved and fine-tuned with countless hours of clinical practice and post-graduate courses, often in a specialized area of therapist interest.

Upon completion of their university studies, students are required to complete a national physiotherapy examination consisting of a written component as well as a hands-on practical component. Success in this process leads to a Certificate of Registration with the provincial regulatory body … in Ontario, the College of Physiotherapists of Ontario (CPO). This process is similar to what we go through when we take driver’s education and then are required to pass an in-car test before receiving a license. To keep your driver’s license you must follow the rules of the road. The CPO exists to serve the public interest. It regulates and monitors the ongoing improvement of the practice of physiotherapists to ensure patients receive safe, effective care delivered in a professional manner. Patients can review the employment history of any registered physiotherapist or contact the Clinical Practice Advisor at the CPO ( with a question/concern at any time. Physiotherapists are required to renew their registration annually.

The standards set by the CPO require all physiotherapists to complete a detailed assessment of each patient, analyze the information and develop treatment goals and plans. For treatment to be successful there must be close cooperation between the physiotherapist and patient. Any suspicion of an underlying medical condition means a quick referral to a medical doctor or nurse practitioner for consultation. Physicians and physiotherapists work closely together in the interests of their patients.

In 1991, under Ontario’s Regulated Health Professional Act, physiotherapists were granted the privilege of direct access. This simply means that patients may seek care from a registered physiotherapist without prescription or referral.

However, specific funding models may still require a prescription –services provided in a hospital, long-term care facility, a designated community clinic. Some third-party payers (extended health plans) may also require a physician’s referral.

We are fortunate in the Madawaska Valley Township to have physiotherapy services available through publicly funded and privately funded models. Regardless of the funding model, all patients can be assured of safe, effective care when their therapist is registered.

Digesting the above information may not be as invigorating as a glass of freshly squeezed juice, but hopefully it has answered some questions. Still some cobwebs?  Post a comment.

About the author: Joanne (Billings) Olsen, a Madawaska Valley native, is a Registered Physiotherapist with the College of Physiotherapists of Ontario. After 40 years of successful clinical practice and Peer Mentoring in Regulation in Southern Ontario, Joanne has returned to her roots to share what she ventured off to learn.


  1. btconway

    Question? Do physiotherapists do preventative work? Say there was somebody who was preparing for a marathon or long walk (i.e. 500 mile El Camino in Spain). Would it make sense for such a person to consult with a physiotherapist to ensure their leg, knee, and ankle muscles were up to the challenge? Or is physio only about rehabing things that are broken/sprained?

    • Joanne Olsen

      Absolutely! Physiotherapists not only treat disease and dysfunction but have a huge role in prevention of injury and assisting individuals in achieving personal functional goals. The goal may be fitness related like the walk you mentioned or may involve education in ergonomics to ease the stresses of a work environment.

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