Standing up for physiotherapists and public health

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By Jodie Pulsifer, Edited by Stephen Baker

Hi PABC Members! 

Welcome to the first blog from the PABC Scope of Practice (SOP) Committee.

For those of you who don’t know me, my name is Jodie Pulsifer and I’m a physiotherapist practicing in pelvic health and persistent pain in Metro Vancouver in a midwifery office and a multi-disciplinary clinic. Outside of my clinical practice, I run (a lot), cycle commute even in the rain, parent two tiny humans, am contemplating a PhD and decidedly have a few too many volunteer roles that keep me inspired and excited about our field.

I’m the Chair of PABC’s SOP committee, I’m on CPA’s National SOP Steering Committee, I’ve been on the PDAC for CPTBC, I’m just wrapping up a term on the steering committee for Pain BC’s Adaptive Mentorship Network and I’m the newly appointed Western Allied Health Director at Large for the Canadian Society for Pelvic Medicine. Clearly ‘Yes’ is something I like to say! 

Writing a blog is new territory for me as the chair of this committee and for PABC, as the organization tries to open up new (and/or improved) lines of communication through blogs, podcasts and digital media avenues. I hope these channels can connect us as we support each other in our diverse physiotherapy practice areas across BC.

If you had a chance to read the Digital Directions from May 2023 you will have some background as to the composition of our group, our role as a new(er) committee, and the work we are doing. 

The goal of this blog is to loop you into the work we are doing in light of the two pending changes to the Physical Therapist Regulation that you can see on the BC Government website. The first was published December 1, 2023 and simply updates the name of our regulatory college to the combined college that will be known as the “College of Health and Care Professionals of British Columbia”.

The seconds proposed change was published on January 23, 2024 and encompasses sweeping language changes to the definition of physical therapy, modernizes our reserved titles, and seeks to identify Restricted Activities for all physiotherapists and a few Restricted Activities reserved for certified practice registrants. 

CPTBC alerted us to the proposed changes and have encouraged us to participate in providing feedback to the Ministry of Health (MOH) directly via mail or email. It is important to note the MOH is attempting to solidify what physiotherapists currently do and are not attempting to make changes to expand any health profession’s scope of practice, even though that’s what is desperately needed. They are also doing this in light of the new HPOA and modernization of a shared scope of practice that you can read about here. They key elements is the understanding that all health professionals share scope and these don’t need to be defined in great detail and this act is meant to enable that sharing of scope. The restricted acts are what get limited and we need to make sure that what is restricted in one profession is reflected in our scope if we also do that activity. 

Expansion of scope will (hopefully) come later! You can read further FAQs about the changes and the role of the College in this transition on CPTBC’s website herePhysiotherapists have until April 23, 2024 to provide feedback, after which the proposed changes will likely come into force

Since the January 23rd proposed regulation was released, the SOP Committee has met bi-weekly to discuss the changes in language from the perspective of our different areas of practice. We have been working with input from Andrea (PABC CEO) who is in communication with PABC members, UBC, and CPTBC. We will also be having a meeting with the MOH this week to ask clarifying questions around context of the proposed changes so we can tailor our feedback for maximum effect. 

As a committee, we have been in conversation with our counterparts in other provinces, discussing legislation and scope of practice for physiotherapy nationally and globally. We have reviewed the language in other health professions’ regulations as well as the language in physical therapist regulations across Canada. 

Our primary goal is to support PABC in providing the MOH with wording fora definition of physical therapy that we feel encompasses all aspects of physical therapy practice in British Columbia. The secondary goal is to ensure the list of Restricted Activities in our regulation accurately reflects how physical therapists currently practice so no physical therapist finds themselves unable to practice once the regulation is passed into legislation.

When we have completed this work, it will go to the PABC Board of Directors who may approve and submit it to the MOH on behalf of PABC members. At this time, we will also share it with the members so they may use it as a template for their own feedback. 

There is strength in numbers and the more of us who write to the government with an organized and thoughtful response, the more likely we are to see positive change in our regulation. We hope to provide you with the tools you can use to write individualized feedback to the government. 

Key areas we have identified for feedback in the proposed language: 

  1. There are no references to our ability to diagnose conditions associated with movement, function and structure, recognizing that the diagnosis and treatment of persistent pain and mental health must be anchored by a physiotherapy goal. 
  2. In managing health conditions, physical therapists often focus on prevention and optimization, yet prevention doesn’t exist in our proposed regulation despite existing in other health professions’ regulations.
  3. We want to ensure that education, one of our most critical tools, isn’t missing!
  4. Finally, we want to make sure that the restricted activities encompass all aspects of physical therapy practice that we do if they happen to be listed on another profession’s restricted acts. If they are restricted for someone they are protected for them and we need to make sure we are not limited in our practice, especially with skills related to ventilation support, wound care, fabrication and fit of support devices, treatment by electrophysical agents, real-time ultrasound and other modalities. We also need to make sure delegation to physiotherapy assistants is reflected in the right place. 

Before we finalize our response, we will meet with the MOH to get some of our questions answered around the restricted acts, certified professionals and key words. We also want to hear from You! Our group is composed of public, private and academic backgrounds in orthopedics, para sport, persistent pain, pediatrics, acute care, oncology, and pelvic and reproductive health. If you feel your area of practice might not be represented in our discussions (we really are trying to think of you all!!), we encourage members to write into PABC through their feedback forms so our group can include your perspective and experiences and provide feedback to the MOH that accurately represents you! 

With the current focus on modernizing our regulation, we are also keeping an eye on the future of physical therapy in BC. Advocacy does not stop with this one proposed regulation or opportunity to provide feedback.

The CPA will be addressing a harmonized vision of a National Physical Therapy Scope of Practice at Congress in April and PABC plans to use this national initiative to continue to engage with government regarding the future of the physiotherapy profession and optimizing our scope and our skills to improve the health of British Columbians. We encourage you all to come out to learn and engage more!

Register for Congress to learn more

This is a bumpy road we are learning to navigate in order to maintain the health and resiliency of the physical therapy profession ahead.

Looking forward to continuing to support the physio profession in BC and meeting to dialogue at practice forum if you make it there!

Yours in health,