I’m hoping someone can prove me wrong on this. I’ve been a clinic owner and a practicing physio in Ontario for 12 years, but I find it hard to recommend this career path to anyone lately.
First, the education takes six years, yet only two are actually focused on PT. People graduate with massive debt, whereas nursing degrees are dedicated to the field for all four years.
Second, we don’t seem to have a unique niche anymore. In hospitals, nurses can handle walking and transferring patients. In long-term care, mobility assessments can also be done by nursing staff. In private clinics, kinesiologists or athletic therapists can teach the exercises. With the current focus on the biopsychosocial model, we’re even being steered away from manual therapy and modalities. Meanwhile, RMTs and osteopaths are performing similar manual techniques, and I’ve even seen massage therapists giving out exercises.
AI is even starting to handle clinical diagnoses. Specialized fields like neuro or pelvic health require expensive extra certifications that aren’t even part of the basic curriculum—why is that? Most of us have to pay for extra courses just to be competent.
I believe that until we have a dedicated 4-to-6-year program covering everything from A to Z, we won’t truly evolve. In the next couple of decades, I fear the profession won’t look anything like it does today. I’d love to hear what others think, and I really do want to be proven wrong.
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You’re spot on. There is way too much overlap right now between physios and other health professionals like osteopaths, RMTs, and chiros. You’re also right about the specialization trap; it feels like everyone is just trying to make money by selling courses. Once you finish a course, you’re hit with more costs for insurance and equipment. It’s very discouraging for new grads, especially when so many other jobs now offer remote work.
I think physios will stick around in some capacity. Patients with acute injuries like strains still need rehabilitation, and physios are the best equipped for that. But I agree the future looks pretty dark. We put in so much effort for very little return. Unless there’s a major policy shift regarding our role, the profession might end up in a much worse state.
I agree! The UK is really leading the way in evolving the profession. We need to catch up to them regarding advanced practice roles. We are perfectly positioned to take some of the load off of surgeons and doctors, especially when it comes to restoring movement and physical health. Just like we evolved during the war, we will adapt to the era of COVID and AI.
For what it’s worth, I’ve felt this way for my entire 20-year career. I’ve long believed that physio, chiro, RMT, osteo, kin, and OT should all be merged into a single rehab professional role, at least for new students. An expanded scope would also let us use the skills we have that other fields don’t, which would help the healthcare system. I know the ‘rehab professional’ idea is a non-starter unless the government completely changes the regulations, though.
I’m hopeful that Ontario will pass the expanded scope soon, allowing for imaging, blood work, and certain medications. That would be a huge boost for us. Keep an eye on the OPA newsletters; they are aiming to get this passed by the end of the summer.
People in Ontario often assume the rest of the country is the same. I’m an exercise therapist in Saskatchewan. Ontario is actually the only place where kinesiologists have a regulated college; everywhere else, we work under a PT’s insurance. If kin colleges keep being ignored by the medical field, physios will be fine. Also, here in Saskatchewan, chiros were allowed to order MRIs during the pandemic. As a professional, you could help push for these kinds of scope expansions for PTs. It’s something to think about.
I think it’s still a very broad field despite the overlaps. Specialized areas like sports or neuro physio allow for a lot of depth once you’re in private practice. Hospital and long-term care settings are one thing, but private clinical practice is much more in-depth.
I just finished my PCE written exam. Is anyone hiring? I’m looking for a job that offers LMIA. Location doesn’t matter to me. If anyone is interested, we can talk in an interview.
Only physios handle neurological rehab for things like strokes or degenerative conditions in outpatient settings. It’s totally different from MSK work. Neurologists don’t have the time for it, and chiros have no scope for it. We’re talking about serious cases like patients who can’t get out of bed or have neglect issues. Another unique area is vestibular rehab; vestibular physios know more about it than anyone except ENT specialists. We actually work in so many areas of public hospitals that would surprise you—my hospital has 16 different rotations just for entry-level physios.
In geriatric wards? You’re right, you’re basically wasting your skills moving people and cleaning up. But in neuro rehab, that’s where we actually make a difference and our expertise matters.
I’m a PT trained and practicing in the US. I agree that other jobs can do parts of what we do, but nobody else does the whole thing. There’s an efficiency and a specific perspective that comes with our training. Even if nurses can move patients, they don’t analyze the quality of movement the way we do. They don’t have the same insight into deficits and how to fix them.