Physiotherapists (PT) and Physiotherapist Assistants (PTA) both help patients with their rehabilitation, but those outside the field may not understand what the difference is between them. In this blog, I will go over what the difference is between a Physiotherapist and a Physiotherapist Assistant.

What is a Physiotherapist (PT)?

“Physiotherapists are highly skilled and autonomous health professionals who provide safe, quality client-centred physiotherapy through a commitment to service availability, accessibility and excellence.” 2012 Description of Physiotherapy in Canada

It’s difficult to describe what a physiotherapist is and any attempt to do so in a single line or paragraph cannot do justice to the grand scope of physiotherapists’ role in the Canadian health care system. To answer this question, it’s crucial to also explain what physiotherapists do and who they work with.

Physiotherapists can work in both public and private health care settings with clients in all stages of life and can treat a wide range of conditions aiming to maintain, restore, or enhance function of multiple body systems. This includes but is not limited to conditions affecting the cardiovascular, respiratory, musculoskeletal, and neurological systems of the body. 

What is a Physiotherapist Assistant (PTA)?

According to the College of Physiotherapists of Ontario, “a physiotherapist assistant is anyone who provides care on behalf of, or as directed by, a physiotherapist.” Simply put, a physiotherapist assistant is a person who assists a physiotherapist. I guess you figured as much based on the title “physiotherapist assistant.”  Physiotherapist assistants work in the same settings and with the same populations as physiotherapists and are a valuable part of the healthcare team. The difference between PTs and PTAs lies in their roles when working with clients.

The role of a PT vs PTA

The role of a physiotherapist is to examine a client and develop a treatment plan in order for the client to meet the goals discussed between the client, the physiotherapist, and other members of the health care team. These goals may include improving mobility (i.e., ability to move), restoring function, managing acute and chronic conditions or symptoms, preventing illness or injury, and improving health and wellness. The goals of treatment may vary widely from client to client but ultimately the work physiotherapists do with their clients are intended to improve the client’s quality of life from their current state.

The primary role of a physiotherapist assistant is to assist the physiotherapist in delivering physiotherapy services. The physiotherapist is responsible and accountable for all aspects of a client’s care including the care delegated to a physiotherapist assistant. To truly understand the difference between a physiotherapist and physiotherapist assistant we need to understand what a physiotherapist assistant cannot do that a physiotherapist can.

In Canada, physiotherapist assistants cannot:

• Assess or reassess a client.
• Create treatment plans.
• Change the treatment plan that was proposed by the supervising physiotherapist.
• Perform any part of specific specialized tasks such as acupuncture, communicating a diagnosis, spinal manipulation, or internal assessment and treatment of pelvic musculature.

What physiotherapist assistants can do is provide treatments as part of a client’s treatment plan assigned to them by a supervising physiotherapist with the exception of specific specialized tasks which may carry increased risk and/or require a high level of knowledge and skill.

It is the responsibility of the physiotherapist to inform the client of the relationship between the PT and the PTA and clarify their roles and responsibilities in the client’s care as to prevent any confusion. The physiotherapist is responsible for ensuring the physiotherapist assistant is competent in providing appropriate care to the clients that they assign to the PTA and what tasks they delegate to the PTA. Therefore, the roles and responsibilities of the PTA are dictated by the physiotherapist.

Education requirements for a PT vs PTA

To become licensed as a physiotherapist in Canada, a prospective physiotherapist must complete a university level entry-to-practice degree in physiotherapy and successfully pass a two-part national licensure examination known as the Physiotherapy Competency Examination (PCE). In Canada, the entry-to-practice degree in physiotherapy is a Master’s degree (with the exception of a handful of French physiotherapy programs in Quebec which are Bachelor’s programs). After completing an undergraduate degree, which typically takes 4 years for most students to complete, physiotherapists graduating from Canadian programs must also complete a 2-year Master’s program in physiotherapy prior to challenging the PCE. The Master’s physiotherapy programs in Canada are highly competitive and often require high GPA’s in undergraduate studies, specific course requirements (e.g., Anatomy, physiology, etc.), and a strong application. Physiotherapists who have completed an entry-to-practice physiotherapy degree outside of Canada may have done a Bachelor’s degree in physiotherapy, a Master’s degree of physiotherapy, or a Doctor of Physical Therapy (DPT) degree. Prior to being eligible to challenge the PCE, internationally educated candidates must undergo an assessment of educational credentials and qualifications known as “credentialing” to determine if his or her qualifications are not substantially different from the established standards in Canada. If their credentialing application is approved, the candidate may challenge the PCE and upon successfully passing the PCE they may apply for licensure in any province in Canada.

In Canada, there are no educational requirements to work as a PTA. Some PTAs may have completed college-level diplomas from a PTA program, some may have received degrees in kinesiology or athletic therapy, and some may have been trained on the job. Unlike the United States, there are no examinations or licensure processes to become a PTA in Canada.

Regulation of PTs vs PTAs

Physiotherapy is a regulated health profession. Physiotherapists are regulated by the physiotherapy provincial regulatory bodies of the provinces in which they are licensed and practice.

PTAs are not regulated by the physiotherapy provincial regulatory bodies. PTs are accountable for all care that is provided by PTAs they supervise.

Salary for PTs vs PTAs

PT median wage: $40/hr

“Physiotherapists (NOC 3142) usually earn between $26.32/hour and $49.45/hour in Canada. People working as a “physiotherapist” are part of this group.” Statistics Canada.

According to Statistics Canada’s market report the median wage of PTs in Canada is $40 per hour. The Median wage will vary by province and region with the highest median hourly wage can be found in Alberta at $44.68 per hour and the lowest median hourly wage can be found in Nova Scotia at $34.87.

PTA median wage: $21.54

“Other technical occupations in therapy and assessment (NOC 3237) usually earn between $14.00/hour and $29.25/hour in Canada. People working as an “aide, physical therapy” are part of this group.” Statistics Canada.

According to Statistics Canada’s market report the median wage of PTAs in Canada is $21.54 per hour. The median wage will vary by province and region.

Job Prospects (Supply vs Demand) for PT vs PTA

Statistics Canada projects that the job prospects for a PT in Canada are very good. The projected labour demand for physiotherapists is thought to far outpace the supply of physiotherapists from 2019 to 2028. According to the Canadian Occupational Projections System there will be a large labour shortage for physiotherapists at a national level. This is as a result of a rising expansion of demand due in part to a projected increase in immigration, an aging population, and a retiring work force.

There is limited data on the job prospects for PTAs in Canada. PTAs will have different job prospects depending on where they work in Canada. For a breakdown of job prospects for PTAs by province and region please visit the Statistics Canada market report here. It is reasonable to assume that the same forces driving an increase demand for physiotherapists will also apply for physiotherapist assistants.

Conclusion

While Physiotherapists (PT) and Physiotherapist Assistants (PTA) are both extremely valuable in the Canadian health care landscape, their roles, education requirements, regulatory oversight and responsibilities are very different.

For more information on the future outlook of the physiotherapy profession in Canada, we recommend reading The Market Profile of Physiotherapists in Canada by the Conference Board of Canada.