Physiotherapy Access in Ontario

Physiotherapy Access in Ontario: Why Advocacy Matters More Than Ever

Physiotherapy in Ontario is at a crossroads. For years, physiotherapists have been working in a system that doesn’t always make sense to the public—or even to many of us within the profession. As conversations about advocacy, funding, and access continue, it’s worth stepping back to examine how we got here and where our collective efforts should be focused next.

Advocacy vs. Lobbying: Where Are We Putting Our Energy?

Within professional associations, we often hear about the need for “advocacy,” but what does that actually include? Advocacy can mean raising awareness, educating government officials, participating in consultations, and representing the profession in public discussions. These are essential, but they’re broad.

Lobbying, however, is different—it requires a clearly defined agenda. Historically, we saw this with efforts around Bill 179, which aimed to expand physiotherapists’ scope of practice. But beyond that, do we as a profession have a unified lobbying objective?

If we did, one issue deserves to be at the top of the list: the long waitlists for community OHIP-funded physiotherapy clinics. Many Ontarians still face significant barriers to accessing physiotherapy. Could licensing more OHIP-funded clinics help reduce bottlenecks? Could primary care reform play a role? These are questions worth asking—and pressing for.

Yet not all sectors of physiotherapy share the same priorities. Acute care, private practice, community care—each has its own pressures and constraints. This diversity is a strength, but it also makes unified lobbying difficult. Still, without a clear direction, our advocacy risks being too diffuse to create meaningful change.

A System That Confuses the Public—and Frustrates the Profession

Ontario’s physiotherapy funding landscape has long been complicated. About fifteen years ago, when many OHIP clinics were delisted and moved to an “episode of care” model, the change reshaped the profession. Many private clinics benefited from the gap left behind, particularly for adults aged 20 to 64 who had limited access to publicly funded physiotherapy unless connected to a surgery or hospital stay.

Fast forward to today, OHIP-funded clinics can charge privately for faster access—at rates far lower than typical private clinic fees. While the pace of treatment may differ, the reality is that people without insurance often choose the more affordable option.

This raises an important question: What is the value of physiotherapy?
And how do we explain the difference between a $60 session and a $150 session when our regulatory body, appropriately, stays out of fee-setting?

This is where professional advocacy becomes essential—not just to influence government policy, but also to educate the public. People need clear explanations about how physiotherapy is funded, what their options are, and why care models differ. Without that, confusion persists, and access suffers.

Membership Decline and Trust: Lessons From the Past

Membership retention remains a challenge in our professional associations, and looking back, there are two key moments where trust may have faltered.

First, the delisting of OHIP clinics years ago fractured the profession. Many clinic owners, forced into the episode-of-care model, were left without a unified voice to advocate for their concerns. These physiotherapists hold valuable historical knowledge and should be part of current conversations about improving access. Re-engaging them could strengthen the profession’s advocacy efforts.

Second, during the COVID-19 pandemic, new physiotherapists faced extraordinary uncertainty. Many felt unsupported and unheard at a time when clear, decisive leadership was desperately needed. Silence—intentional or not—can erode trust quickly. The profession must learn from that experience.

If sudden changes in practice environments—whether from pandemics or political shifts—are inevitable, then risk management planning isn’t optional. It is a necessity. These lessons should inform how we prepare for future disruptions, including strategies tied directly to membership retention.

Moving Forward: A Call for Clarity and Collective Action

Improving physiotherapy access in Ontario will require a unified vision—one that includes:

• Clear definitions of our advocacy priorities
• Transparency about lobbying efforts and budgets
• Engagement across all sectors of the profession
• Public education about physiotherapy access pathways
• Intentional strategies for member support and retention
• Strong risk management planning

The challenges are real, but so is the potential. With thoughtful, coordinated effort, Ontario’s physiotherapy profession can strengthen its advocacy voice and ensure better care and access for the people we serve.