Canada

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Patient Access to Physiotherapy or Physical Therapy Services / Entry Point

• In Canada, physical therapists are primary care providers. While patients may access physical therapists directly, physical therapy consultation may be initiated by physicians for hospitalized patients or outpatients (1). In some areas, physiotherapists are part of a primary care team. These teams are composed of doctors, nurses, physiotherapists, chiropractors, occupational therapists, midwives, dieticians, pharmacists, and mental health/addictions professionals (2). In collaboration with the Canadian Ministry of Health, Primary Care Teams (also known as Family Health Teams) serve to improve patient access, while customizing the team makeup depending on the local community served. "While professional practice is guided by each provider’s regulated scope of practice, it is recognized that the working relationship among the members of the team will also take into account the expertise, preferences and skill set of individual providers. No two teams will function exactly alike. Each, over time, will develop its own character, working relationships and culture" (2).

Therapist Preparation

      Degree/Credentialing

• Canadian PT students earn a Master of Science in Physiotherapy (MScPT) over two years, including approximately 30 weeks of clinical education at a university that is accredited by the Accreditation Council for Canadian Physiotherapy Academic Programs (ACCPAP) (3).
• The Canadian health care system also utilizes Physiotherapist Assistants, who are trained at an accredited career college to support the physiotherapist (5). The Physiotherapist Assistant curriculum is composed of three academic semesters, plus a sixteen week practicum.

      Specialization

• Common Canadian specialty practice include areas such as: Acupuncture, Animal Rehabilitation, Cardiorespiratory, Neuroscience, Oncology, paediatrics, Seniors Health, Women's Health (4). Those who plan to serve in an academic or research capacity may pursue a PhD in Rehabilitation Science or Applied Health Science.

Professional Associations

• The Canadian Physiotherapy Association (CPA) is the national professional association (1). The CPA is composed of 11 provincial branches and 14 territorial councils. Members of the Canadian Physiotherapy Association may belong to specialty divisions such as acupuncture, cardiorespiratory, neurosciences, oncology, orthopedics, paediatrics, seniors health divisions (4).

Information about the Patient Community

• Physiotherapists evaluate and treat Canadian individuals across the life span (6), either as general practitioners, or according to physiotherapist specialties detailed above.
  Canada's national health indicators mimic that of other industrialized countries, with respect to common morbidities such as heart and cerebrovascular disease, pulmonary disease, cancer and diabetes. " In Canada, as in other developed countries, health statistics have long shown that when men and women of the same age are compared, women have a higher prevalence of chronic disease and use more medical services, but men have higher mortality rates. This apparent paradox has been a major area of theory, investigation, and speculation for many years" (7). As of 2006, Malignant neoplasms was the most common cause of death in Canada (29.7% of all deaths), followed by heart disease (21.9%) and cerebrovascular diseases (6.1%) (8).

Social/Cultural Influences

• Canada's governmental structure is a constitutional monarchy, developed under the influences of both French and British empires (9). Canadian citizens are subject to three branches of democratic government: the executive branch (Queen, Prime Minister), the constitutional parliament (Senate and House of Commons), and the judiciary (court system) branch.
  With respect to cultural diversity, the Canadian officially adopted a multiculturalism policy in 1971 which details three tenets (10). First, this policy ensures the "value and dignity of all Canadians, regardless of their racial or ethnic origins, their language or their religious affiliations." Second, it affirms the rights of Aboriginal peoples. Third, the policy recognizes two official languages in Canada: French and English.
  The vast majority of world ethnicities are represented in Canada, with such ethnic foods, recreational activities, formal and informal associations available to Canadian citizens (11). Since 1994, Canada has been ranked as one of the top ten countries to live, with citizens benefit from ready access to education, high life expectancy, and low crime rates. Further, Canadians enjoy a very high standard of living, with approximately 70 percent of Canadians owning their own homes.
  Canadian family arrangements are diverse, including one parent, two parent, same sex couples (with and without children), common law couples (with and without children), couples with step children or with no children (12).Canadian families frequently include multiple ethnicities, and contribute to a variety of culturally influenced family dynamics. Dimensions of family dynamics include family interaction and cohesion, moral-religious emphases, intergenerational authority, empathy and family affect, all of which shape the management of household chores, lifestyle, and individual/collective health status (13).

Delivery of Care

• Is delivery of care provided in a timely manner?
• Special methods? Home health etc
  

Type of Health System

• Is it a national health system with universal access?
  

Payment System

• What methods to patient use to pay for service? (Insurance, bartering etc.)