Urgent Care and Telerehabilitation: Information for Patients
April 8, 2020
Leanne Loranger, PT
Physiotherapy is a touching profession, so directions to practice physical distancing and avoid person-to-person contact during the COVID-19 pandemic don’t translate well when applied to physiotherapy treatment. As this pandemic has unfolded, direction to physiotherapists has centered around maintaining a safe practice environment through enhanced cleaning practices, increasing social distance in waiting rooms and treatment spaces, and encouraging those who are ill, both patients and physiotherapists alike, to stay home.
On March 27, 2020, Premier Kenney and Chief Medical Officer of Health Dr. Hinshaw announced new restrictions on businesses that involve personal contact due to the pandemic and the risks of transmission of the virus through person-to-person contact.
As a result, private practice physiotherapy clinics and other physiotherapy businesses were directed to close except when providing emergency and urgent services.
As a rule, physiotherapists do not provide emergency services. Defining urgent physiotherapy care is difficult due to the many settings where physiotherapists provide services and the many different patient groups physiotherapists serve.
We know that physiotherapists provide health services that are valued by their patients. We also know that those services are important to the health and wellbeing of patients. However, at this time, the directions from the Chief Medical Officer of Health make it clear that the risks of in-person care, in most cases, outweigh the benefits both for patients and health-care professionals.
Until the orders of the Chief Medical Officer of Health change, physiotherapists may only provide in-person services in physiotherapy clinics or through home-based or mobile physiotherapy practices if:
- Their patient will suffer serious and imminent harm AND is at risk of needing to go to the emergency department or be admitted to hospital because of a lack of physiotherapy.
- The patient is an essential service provider (e.g., EMS, health-care professional) and is unable to work due to a new injury or flare-up of a pre-existing condition.
These services are categorized as urgent and may require in-person services. For those at risk of hospitalization, physiotherapy is needed to keep the patient out of hospital and to avoid further straining a health system that is already burdened with increased patient care demands due to the pandemic.
For the second group, services are considered urgent as these patients are needed at work to maintain the systems we all rely on, including the health system, the emergency response system, and the food supply chain.
We recognize that these restrictions on in-person services can lead to challenging conversations and unhappy patients. Patients want to receive care. They would not seek physiotherapy services if they did not perceive a need for it.
However, physiotherapists are required to screen potential patients to determine if the patient meets the criteria for urgent, in-person care. If a physiotherapist provides care that is not urgent, they could be found to have breached the orders of the Chief Medical Officer of Health, face fines and may face disciplinary action as well.
Physiotherapists are also required to screen patients for signs, symptoms, and risk factors for COVID-19 before providing in-person services. To keep your physiotherapist, their family, and their other patients safe, your full cooperation in this process is appreciated.
Even if a patient is categorized as requiring urgent care, physiotherapists are asked to consider if that care can be provided using a different method of delivery (such as telerehabilitation), to only provide in-person services when an alternate delivery method is not an option, and to carefully consider the frequency of in-person treatment.
One way that your physiotherapist may be able to help you until these restrictions are lifted and it is safe for you to access in-person services again, is to provide telerehabilitation services. Telerehabilitation is the use of telephone, text messaging, video conferencing or other technologies to connect with patients and provide an assessment, education, and treatment. Telerehabilitation does not require person-to-person contact and is, therefore, something that your physiotherapist can offer to patients who do not meet the criteria for urgent, in-person services, while still doing their part to limit the spread of COVID-19.
Although these services differ from traditional, in-person care, they are still subject to the same standards and expectations for safety and quality.
We encourage you to speak with your physiotherapists about this option if you do not qualify for in-person services at this time.
Physiotherapists want to provide you with care. By nature, physiotherapists want to help our patients to get well; therefore, it is difficult to be directed to stop providing in-person care. However, in the face of an unprecedented pandemic that is resulting in illness and deaths among many of the patient groups that physiotherapists serve, this is the right thing to do.
We encourage you to follow the instructions of the Chief Medical Officer of Health and adhere to directions aimed at limiting the spread of COVID-19.