ONTARIO HYSIOTHERAPY ASSOCIATION

Hospital Liaison GroupOver the summer, we had the opportu-

nity to confirm members of the HospitalLiaison Group who would like to continueto provide and disseminate information toand from our members working in hospitalsacross Ontario. Our goal is to have a phys-iotherapist representative from each hospi-tal in Ontario. If you are interested inbecoming a member of this discussion andinformation-sharing group (which is not acommittee and has no specific time require-ments), please contact jenniferh@opa.on.ca.

WSIBWith input from the WSIB Advisory

Committee, and in partnership with repre-sentative of the WSIB, we are working ondeveloping WSIB practice scenarios as aregular section in the newsletter beginningin January. We will be meeting with theWSIB to share our current issues and discusspotential solutions. The WSIB AdvisoryCommittee is developing a list of commonpractice issues, but we would love to hearfrom the membership. Please forward yourquestions to jenniferh@opa.on.ca, and theymay just appear in a future issue ofPhysiotherapy Today!

Provincial Focus GroupThank you to everyone who participated

in the Provincial Focus Group in Toronto.The group of representatives from acrossOntario came from varied areas of practice,and each brought a unique perspective tothe discussion. The Board of Directors willbe using the input from the Provincial

Focus Group as well as individual feedbackfrom regional focus groups and the onlinesurvey to create a new Strategic Plan for theAssociation in November.

Career CentreOPA is developing an online career cen-

tre with information about resume writing,interview tips and job searching info. Doyou have other resources you would like tosee as part of the Career Centre? Ideas canbe emailed to physiomail@opa.on.ca.

Mentorship ProposalThe Ministry of Health and Long Term

Care developed The Interprofessional,Mentorship, Preceptorship, Leadership andCoaching Fund (IMPLC Fund) as part ofHealthForceOntario, Ontario’s HealthHuman Resources Strategy.

The purpose of the Fund is to supportcollaborative team-based health servicedelivery and to prepare health professionalsto work in the health care system, enhancetheir career satisfaction, increase their lead-ership capacity, and facilitate career transi-tions within the health sector.

OPA submitted a proposal in partner-ship with CPA for the development of anonline matching system for mentorship onOctober 6th to the Ministry, and also part-nered on a joint submission with the OntarioSociety of Occupational Therapists thoughthe leadership of groups at McMasterUniversity and Western University. Thereview of all submitted proposals was com-

ONTARIO HYSIOTHERAPY ASSOCIATION

Issue # 104 October/November 2006

In This Issue

President’s Address .................... 2

CEO’s Message ............................3

Advanced Practice Q & A..............4

OPA Provincial Focus Group and

Media Training Session ................5

Trans-Canada Virtual

Relay Update................................5

Ottawa District Update ................6

York Region and

Scarborough Update ....................6

ALBI Evidence-Based

Recommendation #5 ....................7

Compensation Survey

2006 Update ................................7

The Rising Costs of Education ......8

Clinic Management

Software Review ..........................9

Names in the News ....................11

Notice of Annual Meeting of

Members ..................................11

The Newsletter of the Ontario Physiotherapy Association

By Jennifer Holstein

ISSUES UPDATE

Continued on page 12

10791_PhysioToday2:10574_OPA 11/7/06 12:29 PM Page 1

In September, I had the opportunity toattend the Power Within Conference inLondon. One of the speakers was MitchJoel, whose topic was “Building YourPersonal Brand”. His talk sparked my inter-est since, over the last two years, the OPABoard has been working to create a physio-therapy brand in Ontario as part of ourReputation Management Project. I alreadyunderstood the value of this concept in pro-moting our profession and, as I listened tohim speak, I started to realise how the con-cept of branding could be equally useful toindividual physiotherapists. Given today’shealth care environment, I see branding asa tool that can help the profession and indi-vidual physiotherapists continue to be suc-cessful in the health care system.

Branding is about creating an identity ordefining the experience a person can expectfrom a product, service or – in our case – aprofession. To be successful, brandingshould leave a lasting, positive impressionwith people such that the brand becomessynonymous with a specific product or serv-ice and is ‘top of mind’ whenever a personthinks about these types of products or

services. The other critical piece to successfulbranding is consistency – creating a brandpromise that people can rely on. If there is adisconnect between the brand promise andwhat people actually experience, then thebranding will not be successful and couldeven be detrimental if the brand becomesassociated with a negative experience.

If you’re like many people in health care,you may perceive branding as a negativeword because it sounds too ‘business-like’and may be wondering if there is a place forsuch a concept in health care. I would sug-gest “yes, there is” for two reasons: 1)Branding is about trying to define yourservice or product in order to help meet aneed. In these times of fiscal constraint andhigh change in health care, all stakeholders,including the public and payors, are lookingfor ways to meet their own or their con-stituents’ health care needs with a costeffective, efficient, high quality approach. Ibelieve they are open to listening to anyonewho has ideas about how best to achievethis. If we can succinctly describe whatphysiotherapy is all about, how our profes-sion can contribute to improving the healthof Ontarians in a cost effective way and,probably most importantly, what makesphysiotherapists unique in helping toachieve people’s health goals, our profes-sion’s position in the health care system,both public and private, will be solidified.2) As the baby boomers retire and theworker shortage increases in all industries, Ibelieve having a physiotherapy brand willalso help encourage people to become, orcontinue to be, physiotherapists. We canhave a great brand promise; but, if we can’tdeliver on the promise due to a lack ofphysiotherapists, then the success normallyassociated with a well-defined and estab-lished brand will not be realised.

We all know that we are members of avery diverse profession which affords usnumerous opportunities in terms of careerchoices. The one drawback to our diversityis the challenge it creates when we try todescribe the physiotherapy brand promisein 30 seconds or less, in a way that ade-quately describes what we do, how we’redifferent from other professions and leavespeople wanting to know more about us andwhat we can do to help them achieve theirhealth goals. In 2004, the OPA board start-

ed to define and create the physiotherapybrand and brand promise. The results todate have been the new logo and tagline,new colour scheme and format on the OPAwebsite and newsletter and a definition ofphysiotherapy. Our goal is to create animage of physiotherapy, such that whenpeople hear a reference to physiotherapy orphysiotherapists, an accurate impression ofour profession comes to mind.

As I mentioned in my introduction, dur-ing Mitch Joel’s presentation, a ‘light bulbwent off’ for me. Not only is there value indefining physiotherapy’s brand promise;but, each physiotherapist can and, I wouldsuggest, needs to build their own personalbrand. The profession’s brand promise canserve as a starting point for physiotherapiststo begin building their own, personalbrand. After all, on a more micro-level, arewe not each, in some way, having to pro-mote ourselves and our skills to our currentor prospective employers, patients or clientsso they choose us over another provider tomeet their needs? If you agree, then takingit one step further, you will be able to seethe value in creating your own 30-seconddescription or elevator pitch to use whenpeople ask you questions like: ‘what do youdo for a living?’, ‘why do you want thisjob?’, ‘why should I seek treatment fromyou for my health care needs?’, etc.

At our November Board meeting, yourOPA directors and staff will be creating astrategic plan to guide the Association’sactivities for the next 3 years. How to con-tinue building our profession’s brandpromise will be one of the topics we discuss.Seems like an appropriate time for everyphysiotherapist to take a moment to consid-er taking this concept to the next level andcreate their own personal brand. To get youstarted, let me leave you with a couple sug-gestions from Mitch Joel’s presentation. 1)Find the real you by writing the story ofyour life, i.e., your successes, how you haveovercome challenges, etc., in order to beginto identify and define your own uniqueabilities and strengths – your brand prom-ise. 2) Create your 30 second elevator pitchto describe your unique abilities andstrengths in a way that engages your audi-ence and leaves them wanting to know

2

By Kim Wolny

Number 104October/November 2006

Ontario Physiotherapy Association

55 Eglinton Avenue EastSuite #210

Toronto, Ontario M4P 1G8

Tel: 416.322.6866Toll Free: 1.800.672.9668

Fax: 416.322.6705Email: physiomail@opa.on.ca

Web: www.opa.on.ca

Physiotherapy Today is published bi-monthly. The information and views inletters or advertisements published in thisnewsletter do not necessarily reflect the

policies and opinions of OPA.

All items for the December/January edition should be submitted to the OPAoffice no later than December 15, 2006.

PRESIDENT’S ADDRESS

Continued on page 3

10791_PhysioToday2:10574_OPA 11/6/06 4:15 PM Page 2

3

I thought I would take some time tohighlight two initiatives in which OPA isengaging. Both of these initiatives contributeto the development of the profession andwhere we are going in the province.

Professional Developmentand Best Practice Advisory Committee

OPA has struck an advisory committeeto further our strategic initiatives in profes-sional development and best practices.Members of the committee are Judy King,Grace Liu, Rhona McGlasson, Pat Miller,Maureen O’Connell, Susan Putney, NancySalbach, Karen Tausendfreund and JoanneZee. Already, ideas have emerged from thisgroup that have facilitated OPA to moveforward in partnership with CPA to submita proposal to the Ministry of Health as partof the Mentorship, Coaching, Leadershipand Preceptorship Fund. The committeemet for a day-long face to face meeting atthe OPA office on October 21st to initiatethe formulation of a coordinated strategyfor professional development and best prac-tice for the Association.

Advanced Practice Roles in Physiotherapy

Advanced practice has been in Ontariofor rheumatology/orthopaedics for over adecade, with some programs and studiesdating back to 1995. New roles are beingdeveloped in other areas such as neurologyand emergency care.

What is advanced practice? An advancedpractice physiotherapist has demonstratedexperience and expertise in a particular clin-ical area and has engaged in additionaltraining (most often interprofessional innature), which allows for the physiothera-pist to perform additional acts such asordering diagnostics or prescribing certainmedications. These roles have emergedwithin organizations in response to clientand organizational needs, and the mecha-nisms used to allow for the additional actsare organization specific. For example,medical directives are used to delegate theperformance of additional authorized acts.The skills and competencies that form theadvanced practice role will depend on thecontext, the area of practice and the needs

the role fulfills within those organizations.Advanced practice physiotherapists work inmany settings, such as triage, withinorthopaedic clinics and rheumatology clin-ics and new roles continue to emerge.

There has been much activity over thelast six months concerning advanced prac-tice roles for physiotherapists in Ontario.Some of these activities include:

The Health Professions RegulatoryAdvisory Council’s report Regulationof Health Professions in Ontario: NewDirections contained a recommendation toexamine an orthopaedic specialist physiother-apist role (advanced practice) to respond topressures within the health system such aswait times and human resource shortages.

The College of Physiotherapists ofOntario held a policy forum on evolvingpractice roles on May 26th, 2006. Thesummary from that day can be found on theCollege website www.collegept.org underOntario Physiotherapy Policy Forum.

Coming from that Forum, OPA hasformed a task force with representatives fromOPA, CPA, the College, the Chairs fromOntario University Physiotherapy Programsand those with expertise in advanced practiceroles to develop a discussion paper on amodel for advanced practice for physiother-apists in Ontario. We have just completedan expert review of the paper, and the TaskForce is reviewing the feedback prior to

completing a next draft to go out for broadmembership consultation.

Various LHINs are either examiningoptions for advanced practice roles or are inactive development of these roles to meet

the needs of their regions. OPA is committed to informing the

membership about advanced practice phys-iotherapy in Ontario and, in keeping withthis, will be implementing a communica-tion strategy to further the discussion with-in the profession and to our external stake-holders. One example of this is found in thisnewsletter as we introduce an advancedpractice physiotherapist from Sudbury whoshares some of her experience in her role inpaediatric rheumatology. We also coordi-nated a session at the Ontario HospitalAssociation Conference on advanced prac-tice roles for physiotherapists in Ontario.

Opportunities for advancing physiother-apy through professional development,attention to evidence-based practice andemerging practice roles are present intoday’s environment. Your Board recog-nizes this in moving forward strategies tocapitalize on these opportunities. Watch forfurther information on the activities of theProfessional Development and Best PracticeAdvisory Committee and in the develop-ment of the model for Advanced PracticePhysiotherapists in future newsletters andon the website.

By Dorianne Sauvé

CEO’S MESSAGE

Developing and Advancing the Profession

more. To get you started, try filling in theblanks of the following sentence provided byMitch during his talk: “You know whenyou…., I give you…, or I do... to help you...”

Knowing the challenges the Board hashad trying to define and further develop ourprofession’s brand, I suspect defining a per-sonal brand will prove an equally challeng-

ing task. However, I believe the efforts willpay dividends in the long run – just consid-er the success of product brands like Coca-Cola, Pepsi and Kellogg’s and personalbrands like Oprah, Madonna and Dr. Phil.Perhaps one day physiotherapy and individ-ual physiotherapists will be just as wellknown and successful!

President’s AddressContinued from page 2

“Opportunities for advancing physiotherapy...

are present in today’s environment.”

10791_PhysioToday2:10574_OPA 11/7/06 10:07 AM Page 3

Q: How/why/when were you selected for theadvanced practice position at your facility?

A: In January 1999, I applied to the pro-gram for advanced clinical practitioner inpediatric rheumatology offered by theHospital for Sick Children. I was acceptedand completed the program. There werethree clinicians in the program - two PTsand one OT.

Q: Why did your facility choose to implementsuch a position?

A: I had been treating children witharthritis for the past 15 years, and the“practitioner” position did not exist whenI completed the program. As there is noresident pediatric rheumatologist in Sudburyand the surrounding area, the need for localexpertise was present. Last year, the Hospitalrecognized the position with increasedresponsibility and remuneration.

Q: What training did you undertake tobecome an advanced practitioner?

A: The training program offered at theHospital for Sick Children and the Universityof Toronto included an academic componentand a clinical internship. The academic com-ponent covered relevant dense connective tis-sue pathology, immunology, radiology, phar-macology, outcome measurement, psychoso-cial function and nutrition as it relates topediatric rheumatology. The academic com-ponent included lectures, seminars, casewrite-ups and oral and written presentations.The clinical internship was under the supervi-sion of the rheumatology division of theHospital for Sick Children.

Q: How does your current role differ fromyour previous position as a physiotherapist ina general practice setting?

A: The knowledge gained through thetraining program has enabled me to pro-vide better and more comprehensive careto children with arthritis. I see childrendiagnosed with juvenile idiopathic arthri-tis, juvenile dermatomyositis, fibromyal-gia, regional pain syndromes, systemicsclerosis and SLE with arthritis. Withinthis enhanced role, the patients’ needs areaddressed in a timely manner, especiallywhen they flare or when their arthritis isuncontrolled. We are also working ondeveloping medical directives within ourinstitution to further enhance my role as apractitioner.

Q: What do you find rewarding aboutadvanced practice?

A: The advanced role has had a majorimpact on career satisfaction. I am able toprovide care to children with arthritis clos-er to their homes. I feel respected by bothmy peers and the medical community. Localpediatricians recognize this expertise anddirect referrals to me.

Q: What are some of the challenges you face?

A: There have been some challenges alongthe way. This is a new initiative for the profes-sion, and so the expanded role was not initial-ly supported or recognized. There is a lack ofawareness for this position/expanded role.The University of Toronto has developed aprogram – Advanced Clinical Practitioners inArthritis Care (ACPAC) with its first gradu-ates in 2005/2006. It is now a certificateprogram. The certification is issued by theDivision of Continuing Medical Education atthe University of Toronto. There were 5graduates (three PTs and two OTs) last year(2005/2006). There are five more graduatesthis year, 2006/2007 (four PTs and oneOT), and the first three trainees – myself andthe two others – will do the certificate com-pletion. The program is expanding, and grad-uating more practitioners is great news forthe profession!

Nicole Graham, B.Sc. (P.T.), is a physio-therapist at Children’s Treatment Centre,Sudbury Regional Hospital.

Advanced Practice Q & A With Nicole Graham, Physiotherapist

4

Nicole Graham

OPA Billboard Photo Contest

Thank you to everyone whosubmitted photos for the OPABillboard contest! We are delight-ed to announce that Cara Bernieris the winner of the $50 GiftCertificate from Chapters/Indigo.Congrats, Cara!

Contest winner Cara Bernier stands in frontof OPA the billboard at Algonquin Avenue &Airport Road in North Bay.

10791_PhysioToday2:10574_OPA 11/7/06 1:07 PM Page 4

OPA held its 2006 Provincial FocusGroup and Media Training workshopSeptember 16th in Toronto. Participantsfrom across Ontario gathered in the morn-ing to present the views and opinions oftheir districts while engaging in visioningfor the Association as part of our strategicplanning process.

In the afternoon, the focus group par-ticipants took part in media spokespersonworkshop by Nancy Coldham of the CGGroup. During the session, Nancy offeredpointers on effective public speaking andshared strategies for dealing with mem-bers of the media.

OPA thanks the following members foroffering their time and providing excellentfeedback during the Focus Group session:

Dawn O’Connor Rea (KW)Karen Deacon (KW)Jacqui Holloway (Westgate)Diana Sinnige (CTD)Chetan Vora (Georgian Bay)Kelly Hunter (Georgian Bay)

Celeste Bouffard (NON)Emma Rousseau (NWO)Gail North (NWO) Nelum Wijesekera (Ottawa)Audrey Mohr (Ottawa)Sonya Vani (Windsor)Chris McCormick (Windsor)Frank Gielen (QSL)Caroline Gill (Hamilton)Sue Putney (Niagara)

Erdem Huner (YRS)Sabrina Handa (YRS)Grace Liu (YRS)

We also offer very special thanks toRon Knowles for facilitating the focusgroup and Nancy Coldham for hosting aninformative and entertaining media train-ing workshop!

OPA Provincial Focus Group and Media Training Session

5

Focus Group facilitator Ron Knowles encouragesparticipants to share ideas during the morningsession.

Nancy Coldham’s own captivating delivery demon-strates the power of effective public speaking.

The WCPT Congress 2007 Virtual RelayMap is now posted on the CPA web site, witha torch indicating our (approximate) positionon the trail.

The map and other Virtual Relay informa-tion (including tracking forms) can be foundat www.physiotherapy.ca – go to the MemberServices section, then to the WCPT 2007 sidemenu. From the map page, there is a link toa page that has all the stats – the total trail dis-tance in kilometres by province, the totals trav-eled so far by month, and the totals traveled sofar by province.

What is the Trans CanadaVirtual Relay?

The Canadian Physiotherapy Associationand its provincial / territorial Branches haveembarked on a “Trans Canada Virtual Relay”to raise awareness about physiotherapy and theWorld Confederation for Physical Therapy(WCPT) World Congress being held inVancouver June 2-6, 2007. We are excited topartner with the Physiotherapy Foundation ofCanada and the Trans Canada Trail

Foundation for this event.Physiotherapists across Canada are chal-

lenged to track their kilometres as they run,walk, bike, hike, wheel, rollerblade, ski, canoeand participate in other mobility-promotingactivities from July 2006 through May 2007.

Our Virtual Relay will use the Trans-Canada Trail as our route and participantsare encouraged to use the Trail for theiractivities when possible. The Trans-CanadaTrail is a wonderful trail network that notonly includes more of the populated area ofCanada than does the Trans Canada

Highway, but also meshes well with ourefforts to promote increased physical activityfor health and well-being.

The Virtual Relay map on the CPA website tracksour progress from East to West, using the 18,078KM Trans-Canada Trail as our route from St. John’sto Vancouver!

Trans-Canada Virtual Relay Update

PART-TIMEPHYSIOTHERAPIST

New Physio owned Clinicin Aurora seeking evening

Part Time Therapist. Primarily Private clients

with mechanical and sports injuries.

Manual/sportsTherapy experiences an asset.

Can help with future mentoring

Hours for A’s/B’s.Fax resume to

(905) 726-2250

10791_PhysioToday2:10574_OPA 11/7/06 10:07 AM Page 5

The Ottawa District is gearing up foranother busy yet exciting year ahead. Wekicked it off at our fall AGM on September28th with an awards presentation to thoselocal physios who have been OPA membersfor 20, 30, and even 40 years. Twenty mem-bers were recognized with pins or certificatesfor their dedication to the profession.

One of the key issues raised at the AGMwas the fundraising initiative driven by theCPA International Health Division to helpbring delegates from lesser-developedcountries to attend the WCPT 2007 inVancouver. We noted that the OPA pro-vides each local district with an annualstipend of $300 to cover basic operatingexpenses. As the Ottawa District does notneed this allowance, we agreed to donate itto the IHD’s fundraising initiative. We alsochallenge all other local OPA districts (thatare able), to do the same with their funds.

The AGM was followed by a night offascinating guest speakers. Pelle Stenbring,a physiotherapist at the Children’s Hospitalof Eastern Ontario, spoke about his journeycycling across Canada in support of CysticFibrosis. Julie Lessard related her experi-ences working in a small, rural village inMexico through an international health andrehabilitation initiative. We also had ShaunCleaver, Co-Chair of CPA’s InternationalHealth Division, update us on the Division’sactivities and offered ideas on how we canaffect “global health” from the homefront.Thank you again to our speakers for a veryinspiring and informative evening.

As we have done in the past, the OttawaDistrict is hosting another year of the pop-ular Nights of Education, where we havelocal physiotherapists come out to inform

us of their particular area of practice orexpertise. This year’s speakers will cover arange of topics from palliative care to hip-potherapy (using horses in therapy). Theseevenings are always are great opportunity tolearn and network with our peers.

With a very successful 2006 OttawaPhysiotherapy Run behind us, we are nowlooking ahead to the 2007 Run, co-chairedby Lyne Orser and Kristine Houde. Thisevent has grown in numbers and reputationin recent years, and we’re looking forwardto another quality event next year onSunday April 29th. Proceeds from the runwill be divided between the PFC and TheOutCare Foundation, a local palliative carecharity network.

Over the years, the Ottawa District haskept local members abreast of local activi-ties, events, education sessions and jobopportunities via our quarterly newsletter.With e-mail fast becoming the most popu-lar and efficient means of communication,we have distributed the newsletter in both

paper and electronic format. Effectivenext year, we will be sending the newslet-ter in electronic format only. However,those who are without e-mail access orwho prefer to continue receiving theirnewsletter in hard copy should contactJudy King at jking@uottawa.ca.

Ottawa District UpdateBy Andrea Barrass

6

Several members of the Ottawa District Executive(left to right): Audrey Mohr, Lyne Orser, AndreaBarrass, Nel Wijeskera, Judy King and MarianneThornton.

Left to right: Award winners Clifton Charie,Margaret Martin, Ashok Bartey, and OPA OttawaDistrict liaison Marianne Thornton at the AnnualGeneral Meeting and Awards Ceremony in Ottawa.

The evening’s festivities included fascinating talksby local therapists Shaun Cleaver, Pelle Stenbringand Julie Lessard.

The York Region and Scarborough District (YRSD) executive are seeking voting delegates for the OPA 2007 Annual GeneralMeeting. Discounts on the OPA Conference will be awarded to those participating. For more information, please contact SandraManherz prior to January 5th, 2007 at sandramanherz@yahoo.com.

Looking to get more involved with your district? YRSD is seeking candidates for the positions of Secretary, Treasurer and President Elect. Interested parties should contact Sandra

Manherz no later then January 19th, 2007 at sandramanherz@yahoo.com to put their name forward.

York Region and Scarborough District Update

10791_PhysioToday2:10574_OPA 11/7/06 12:29 PM Page 6

“…low job satisfaction and low socialsupport at work provide worse prognosisfor returning to work than work involvingheavy lifting (van del Heuvel 2004).

This 3-year follow-up study aimed atdetermining the prognostic factors relatedto the recurrence of LBP and future sick-ness absence due to LBP (van den Heuvelet al 2004).

According to this study, the followingwork-related factors predict a poor progno-sis of low-back pain: • Low job satisfaction• Low decision authority at work• Low social support at work • Repeated or excessive flexion of the trunk• Repeated or excessive rotation of the

trunkInterestingly enough, lifting weights

did not influence the risk of recurrencesor sick leave.

Clinicians may try their best to provide themost appropriate intervention for a patient’sLBP, but if there is underlying low job satis-faction and discontentment about work, it isan uphill battle of getting the patient back towork. Most health care professionals are obvi-ously limited in how much they can influencethese non-physical work factors, consequently,the long-term solution to these issues arebeyond outpatient physiotherapy.

These issues may be best dealt with cog-

nitive-behavioural therapists, case managersor employers and sometimes, job/career re-training may be essential… if permanentdisability is to be avoided.

Answers to the following two simplequestions may set off alarm bells:1. Do you believe you will be back at work

within 3 months?2. On a scale of 0 to 10, what is your level

of satisfaction at your current job /workplace?If they answer “No” to the first question

or below 5 to the second question, contactthe case manager and discuss the situation as amore comprehensive return to work planmight be required other than treadmill walk-ing, mobilizations, transverses abdoministraining, etc.!

More on the latest evidence on the man-agement of acute low back pain may be foundin the textbook “When a Back GoesOut…Where Does It Really Go?” available onwww.aptei.com.

References:van den Heuvel SG, Ariens GA,

Boshuizen HC, Hoogendoorn WE, BongersPM. Prognostic factors related to recurrent low-back pain and sickness absence. Scand J WorkEnviron Health. 2004 Dec;30(6):459-67.

Bahram Jam will be providing an

informative, comprehensive 3-day AcuteLow Back Pain clinical course Feb. 2-4,2007. Please refer to www.aptei.com forregistration information.

ALBI Evidence-Based Recommendation #5:Work Related Factors / Low Job Satisfaction

By Bahram Jam, DSc (Candidate), Mphty, BScPT

7

CLINICFOR SALE

Well established privatephysiotherapy clinic for

sale in Scarborough.Serious buyers please

contact (416) 716 4734

PhysiotherapistRequired Part-Time

Carlisle Physiotherapy• Located 10 min from Waterdown or

20 min from Burlington/Hamilton/Guelph

• Part-time (10-20 hrs/wk) required atprivate practice physio owned clinicin Carlisle (at Medical Centre)

• Hrs available Mon to Thurs after-noons with potential to increasehours/days (negotiable)

• Level III Manual training or higherpreferred

• Competitive wage offered

Please fax resume to 905-690-0789 or call to inquire 905-690-9335.

SEEKING PHYSIOTHERAPISTS

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Send your resume by:e-mail: opportunity@telizon.ca

Fax: (705) 725 1983

CompensationSurvey 2006Update

In August, OPA conducted Compen-sation Survey 2006 using the web-basedSurveyMonkey.com software. We received886 responses, with excellent represen-tation across the province and all sectorsof employment and practice. Survey results(to be published later this fall) will allowthe employees and the employers of publicand private physiotherapists to observesalary trends in Ontario.

As promised in the August 3rd i-blast,the names of two respondents were drawnat random to receive $100 HBC gift cer-tificates. Congratulations to our winners,Jill Hooper and Eric Robitaille!

OPA wishes to thank all those whoparticipated!

10791_PhysioToday2:10574_OPA 11/6/06 4:15 PM Page 7

Giving our fall volunteer university talkson demystifying financial planning forWestern and U of T soon-to-be physios, Iwas reminded how much more expensiveattending post-secondary education is today,even from 10 years ago (when I went).

The cost of university and college educa-tion is increasing at a rate of 7% per year;that’s 4% higher than the average inflationrate! The government is making it more dif-ficult to access student loans, as funding islimited and the competition for scholar-ships is increasing. It might be importantthat you plan ahead to ensure that your childwill have enough funding for his or her postsecondary education. A great way to save is totake advantage of the Registered Education

Savings Plan (RESP), a tax deferred programthat allows you to save for your child’s postsecondary education.

The government provides an incentive

for you to save using an RESP by offeringthe Canada Education Savings Grant(CESG), which amounts to 20% of yourcontribution to maximum of $400 per yearfor each child. The sooner you start, the fasteryou get compound interest working on yourside. We can help project how much moneyyou might need as well as help choose thebest investments to reach your goals.

If helping fund your child’s education isan important Lifegoal for you - we are hereto help.

Healthcare Financial Group specializesin financial planning for physiotherapists.To speak with one of their planning profes-sionals email info@hcfinancialgroup.com or(416) 907-4595

The Rising Costs of Education

By Bradley Roulston, CFP, Healthcare Financial Group

8

PHYSIOTHERAPIST POSITIONSFrancis & Associates has been a provider ofhealthcare opportunities for over a decade now. We work with hospitals, non-profit organizations,private companies and more.

Our positions vary from full time, part time, casual, permanent and temporary positions.

Homecare positions are popular choices with thetherapists who register with Francis & Associates.They have a flexible schedule and there is a variety in the patient caseload (adults/pediatrics)

If you’re looking to add a few more hours to yourwork day or need a change/challenge call usabout our casual hours working in the community.

WE CURRENTLY HAVE POSITIONSin rural and urban cities across Ontario, Albertaand Britsh Columbia In community(homecare/long term care/insurance) hospital andprivate clinics.

British Columbia (Vancouver, Langley, Abbots-ford,Coquitlam, Victoria, etc) Alberta (Red Deer, Calgary,Stettler, Grand Prairie, etc)

Ontario (Windsor, Welland, Hamilton, Burlington,Brampton, Maple Ridge, Ottawa, etc.) Other citiessuch as Montreal and Halifax…

If you’re the active type or you’re just plain lookingto slow the pace down try our Northern positions,Huntsville,Brace Bridge, Sudbury, Thund Bay andmore… The scenary is beautiful, the pay is goodand the stress levels is low.

Give us a call or visit our website for more details on our opportunitieswww.francis-associates.com Email your resume to generalinfo@francis-associates.com

Attention: Human Resource Department

OPA Board Nominations Deadline Extended!

The nomination deadline for the OPA Board of Directors has been extended until Friday,December 8, 2006. We are seeking candidates for the positions of Director (three positions)and President-Elect. The election will be held at the end of March 2007, at OPA’s AnnualGeneral Meeting in Toronto. In accordance with OPA Bylaws, there will be no nominationsfrom the floor at the Annual General Meeting.

Complete nomination packages are available on the member’s side of the OPA websitehttp://www.opa.on.ca/ - In The News section.

Nominations must be received in the OPA office by fax, mail, e-mail or hand-delivery, bythe December 8th deadline. All nominations will be acknowledged - send in yours today!

OPA HolidaySeason Hours

The Ontario Physiotherapy Associationoffices will hold holiday hours on the fol-lowing dates through the season:

Fri., Dec 22nd ........Office closes at noon

Mon., Dec. 25th ..................Office closed

Tues., Dec. 26th ..................Office closed

Wed., Dec. 27th ....................Office open ......................................w/skeleton staff

Thurs., Dec. 28th ..................Office open ......................................w/skeleton staff

Fri., Dec. 29th ..............Office open until............................noon w/skeleton staff

Mon., Jan. 1st ......................Office closed

Tues., Jan. 2nd ..................Office reopens

Phone and email messages will bechecked regularly; however, only urgentissues will be addressed. Thank you for yourpatience.

Our best wishes to all for a safe andhappy holiday season.

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Disclaimer: The following review is theopinion of the writer and does not necessarilyreflect the view of the Ontario PhysiotherapyAssociation. The Ontario PhysiotherapyAssociation does not endorse any one clinicmanagement software.

In the evolving e-business world, technol-ogy pushes the boundaries of productivity andefficiency. Like any other profession, physio-therapy must also change, adapt and imple-ment new technologies to gain a competitiveedge over competitors and now competingfields of health care. Clinic management soft-ware becomes a key piece of the efficiencypuzzle in the overall management of clinicservices. Traditional clinic management soft-ware has focused on simply scheduling andpatient information management; however, anew breed of software is emerging.

This new breed of software packagesmoves beyond the traditional clinic man-agement sense and goes into many key areassuch as data-mining, electronic medicalrecord keeping and customer surveying tolist a few, effectively making them fullfledged business solutions. Data mining, forthose unaware of the term, is a functionwithin software that enables the user toextract any form of data to export for busi-ness analysis. Some software have limiteddata mining abilities while others have moreextensive utilities that allow for any cus-tomizable report to be produced.

These new full fledged business solu-tions however, do not come cheap and thenew monthly or yearly fee structures mightseem costly in comparison to the tradition-al one copy license program. So the impor-tant question that emerges is whether thesenew fancy packages are worth the invest-ment. As always, the answer will varydepending on which software package youlook at and the needs of your clinic. In thissoftware review, seven packages are evaluat-ed. Their executive summaries appear herein this article while the full review can befound on the OPA website.

Careware Clinic Manager(Traditional)http://www.careware-software.com

One of the long-standing products of

the clinic management software industryis the Careware Clinic Manager. Its list offeatures isn’t long, but it has been a stablemanagement system that has been proventime and time again. Unfortunately, itdoes not make full use of the new wave oftechnologies. Its interface isn’t as cleanand simple as other newer pieces of soft-ware, the date navigation function is a bitawkward and the data-mining tool is limit-ed but still better than most traditionalpieces of software. With any piece of soft-ware, basic documentation generation is amust; although Careware does the basicinformation generation it does not allowfor customized reports to be automaticallyproduced from the data-mining tool. In theend, Careware has had a good run as one ofthe titans of clinic management software,but may be falling short of the newer piecesof software available that have a longer fea-ture list and tools available for varying sizesof clinics.

InTouch Health Systems(Traditional)http://www.getintouch.ca/

This product is an established namewithin the clinic management softwaregenre but does not suffer as much stagna-tion as many other traditional pieces of soft-ware. The interface is very clean and simpleand resembles Microsoft Outlook’s inter-face. The same can be said of its billing andreminders tool; it is clean and simple andstraight forward. Combining these featureswith an excellent PDF generator makes thesoftware bundle a good starting software.However, this program does have its poten-tial downsides: it has limited customiza-tion compared to its newer counter parts;it lacks the data mining tools that are aseffective as its competitors for businessanalysis and lastly, has limited documentgeneration. In the end, this traditionalpiece of clinic management software holdson to its relevancy with a few upgradedfeatures but lacks the complexity of otherhigh-end newer systems. This disadvan-tage is not necessarily a problem for small-er clinics that do not need full-fledgedbusiness solutions

Abel Soft Med Physio(Traditional) http://www.abelmed.com/

Abel Soft Med Physio’s interface is a bitunwieldy in comparison to today’s sleekand stylish alternatives; this reviewer foundits first splash screen inappropriate for frontdesk management. While the software’sfunctions and abilities are quite decent, thecontrols and processes to get to these toolscan be cumbersome. Another redeemingquality of this software is that there are verylow system requirements to use the soft-ware, thus making it one of the only viableoptions for clinics that are running oldercomputers. However, this software doeshave an extensive list of features surround-ing the basic scheduling model. It alsoboasts a moderate degree of customization.

Private Practice SoftwareMost foreign-made software has numer-

ous teething problems adapting to the intri-cacies of the Canadian health care system.Private Practice Software, a UK developedsoftware makes a valiant attempt and hassome redeeming qualities that make it anattractive product. Its interface is clean,simple and intuitive, combined with an easypop up reminder system and date naviga-tion system for scheduling. While the docu-ment generation system isn’t as complex as others, it serves as a good base.Unfortunately, the program suffers the for-eign software dilemma as many key sectionsare inapplicable in the Ontario healthcarefield. Furthermore, there is a lack of cus-tomizability, so any further shortcomingscannot be avoided. In the end, while this soft-ware works well as a scheduling manager,other elements such as client information andbilling/claims management fall short.

Antibex Universal Officehttp://www.antibex.com/

In the changing e-business world, reduc-ing paper redundancies is the holy grail of anymanagement software. Antibex’s UniversalOffice comes close to achieving this goal ofreducing nearly all forms of paper duplicationthrough its extensive form integration within

Clinic Management Software Review

By Kevin Woo

9

Continued on page 10

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the software package itself. It boasts not justa few WSIB forms within the software butnearly all the updated forms. Date naviga-tion, client information management andscheduling all are done well in this software,and the main meat of this application, thedatabase management, boasts many impres-sive features that include multi user cus-tomizability and an expandable database.Form, report and information field cus-tomization allows the software to be tai-lored to the varying needs of different clin-ics. However, this software does have itsown defects, such as having inoperable but-tons on the interface. Furthermore, setupof this software is quite complicated andrequires the assistance of software specialistsin the installation as well as requiring thelatest version of Microsoft Office, thusadding more to the software costs. Lastly, akey problem with the multi user customiz-ability feature is that it does not allow foraccess privileges to be set to disallow formor information editing. Overall, however,this software is an excellent deal and offersa lot of key features that many clinics willfind appealing.

Addatech Clinic Masterhttp://www.addatech.ca/cm/index.html

Addatech’s Clinic Master is a true gem;it boasts an almost infinite amount of cus-

tomizable fields, reports and options intheir software. Furthermore, its initialscheduling interface is clean and easy tobrowse eliminating scrolling and allowingfront desk operators to have a quick glanceof any information at a moment’s notice.While the software boasts many key featuresthat make it a great clinic management soft-ware, it goes further in providing excellentbusiness tools ranging from a bevy of docu-ment generation options allowing man-agers, at a quick glance, to read customizedreports dealing with any aspect of the busi-ness process. The software also has a clienttracking system that automatically sendsout various notifications and a referral sys-tem that may help generate more revenuefor the clinic. Yet again, the only downsideto this software is the lengthy setup processinvolved and training required to make fulluse of all its abilities; fortunately, they havea good customer support system that takesyou through the process. One small disad-vantage this software has is the lack ofWSIB form integration in comparison toother products listed in this review. In theend, however, this software is an excellentbusiness tool.

York Medhttp://www.york-med.com

While Addatech’s Clinic Master takesthe scheduling software and expands into amore complete business package, YorkMed’s software goes in the opposite direc-tion focusing more on the clinical side.With their strong Puckerje electronic med-ical systems software, combined with theirbilling and scheduling modules, it creates aharmonious system that completely removesall need for any paperwork. One of their keystrengths is their innovative use of cuttingedge technology, primarily tablet PCs. Usinga tablet PC with their electronic medicalsystems software allows clinics to writeassessment notes on the spot. The power ofthe electronic medical record system is itsability to link those on-site assessments withthe billing and scheduling software at thefront desk. This intricate interplay betweenthe two main modules makes use of keytechnologies that will transform the wayclinics are run in the future. Unfortunately,because the technology and the approach

that it uses are cutting edge, many peoplewill be hesitant or downright unable tomake the financial leap in investing in thissystem. While the total costs in the end mayseem steep, this new approach to overallclinic management is the wave of the future.Yet again, like any complex software, setupbecomes the primary factor against it. Quitea lot of training and time must be spent tobring employees up to speed but these newtools will pay dividends in the long run.Unlike Addatech’s Clinic Master, it doesnot have as an in-depth data-mining tool asdo its newer competitors, as the software’sfocus is geared towards a clinical setting;nonetheless, it fulfills the roles of billing,scheduling, and claim management well.

Closing RemarksIn closing, each and every software are

unique and the needs of each clinic as well;however, key differences between thesepackages make them stand out as excellentor poor investments. Older software thathave been the name brand in clinic manage-ment software may have fallen behind in theinnovation department in comparison totheir newer competitors. The newer soft-ware, however, do have faults of their own,including long setup times and large setupcosts, and require a significant financial andhuman resource investment.

While some may be hesitant to make thefinancial leap with the newer software, inthe end these new systems can yield divi-dends in productivity gains that far out-weigh their costs. My only regret is thatAddatech and York – Med have not gottentogether to make a near complete busi-ness/clinic management software package.Both pieces of software excel at theirrespective areas, but if they combinetogether into one complete package, thedebate on software superiority will be clearas no other competitor can muster up any-thing close to the power of their combinedpackages. Like always, however, software isa very personalized service. Some peoplemay find some features more desirable thanothers and potential buyers should alwayslook further into each developer’s packageto see if they can help fit your needs.

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Clinic Management Software ReviewContinued from page 9

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The Province (Vancouver), CalgaryHerald, Edmonton Sun, Star Phoenix(Saskatoon), Toronto Sun, NB TelegraphJournal (Saint John) – Lorraine Hendry, aphysiotherapist at the University of OttawaSports Medicine and Physiotherapy Centre,was included in a national article on thehealth benefits of stretching and warmingup before participating in sports. She rec-ommends proper preparation for physicalactivity to help prevent osteoarthritis.

Chronicle-Journal Thunder Bay –Elaine Foster-Seargeant and theNorthwestern Ontario District of theOntario Physiotherapy Association raisedmoney to aid physically-challengedAfricans advance from crawling to beingable to stand and, in some cases, walk.Earlier this year $500 was spent to buytwo wheelchairs for patients at a hospitalin Tanzania.

The St. Marys Journal Argus – JuliaArmstrong, owner of the first private phys-iotherapy practice to open in St. Marys, cel-ebrates ten years in the community. Juliasays she’s come a long way since openingher doors in 1996, having expanded bothher office space and her staff since then.

U of T Bulletin Toronto – Maria Tassone,a lecturer in physical therapy, is the recipientof the Canadian Physiotherapy AssociationMentorship Award, given to recognize

physiotherapists in early to mid-career whoprovide inspiration and leadership to colleagues by acting as role models forprofessionalism and voluntarism. Mariareceived the award during the Association’s2006 congress.

The Daily Observer Pembroke – AllisonFelix was recently welcomed as a new mem-ber to the team at the Deep River andDistrict Physiotherapy Centre. Allisonbegan her position as Director of

Rehabilitation in August.

Waterloo Chronicle – As the WaterlooSports Medicine Centre celebrates 20 yearsand more than 50,000 patients, physiother-apist Randall Helm says the centre isfocusing on supporting the active lifestylesof the baby boomers who want to continuethe activities they’ve always enjoyed.Randall says patients don’t need to be eliteathletes to visit the clinic, “They can be awalker, runner, golfer, whatever.”

11

By Cathy Sewell, Media Relations Coordinator, CPA

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Ontario PhysiotherapyAssociation Notice ofAnnual Meeting of Members

In accordance with By-law. No. C 4.7 (a), notice is hereby given of the AnnualGeneral Meeting of the Ontario Physiotherapy Association, to be held Sunday,March 25, 2007 commencing at 9:00 am at the Doubletree International PlazaHotel, 655 Dixon Road, Toronto, Ontario.

1. Receive the financial statements of the Association.2. Consider the appointment of auditors3. Consider the election of Directors.4. Consider such other business as shall properly come before the meeting.DATED this 1st day of November, 2006ONTARIO PHYSIOTHERAPY ASSOCIATIONKim Wolny, President

Reminder: OPA AwardsNominations

Don’t forget to nominate a deservingstudent or colleague for an OPAaward before January 19th, 2007!

All of the nomination information(including forms) can be found on the OPA website http://www.opa.on.ca/or by calling the OPA office.

10791_PhysioToday2:10574_OPA 11/6/06 4:15 PM Page 11

Publication MailRegistration No. 40008853

55 Eglinton Avenue EastSuite 210

Toronto ON M4P 1G8

www.opa.on.ca

FREEDOM TO FUNCTION

pleted at the end of October and will go tothe Minister for approval of which projectsto fund, and to what degree. We hope tohear the results by the end of November.

Communicating a DiagnosisOPA, along with representatives of the

College of Physiotherapists and OntarioUniversities, met with Dr. Josh Tepper,ADM Health Human Resources StrategyDivision, with Barry Monaghan, LHINCEO Toronto Central and lead in the devel-opment of advanced practice roles for theLHINs, with Dr. Jim McLean, lead forFamily Health Teams, and with HughMcLeod, ADM, Health SystemAccountability and Performance Division(responsible for the wait times strategy). Themeetings focused on establishing our case forstrengthening of our scope of practice and tofacilitate the participation of physiotherapistsin government initiatives related to healthsystem reform. We received support andrecognition as to the need to include com-municating a diagnosis, as well as other actssuch as titration of oxygen and acts related tothe treatment of incontinence, in our Act.

Perceived barriers by those we met withinclude the fact that many professionsrequire a review of their scope of practiceand authorized acts related to their practice,the timing of making such a change, theneed to ensure that due process occurs.Despite these barriers all indicated that theyheard and understood our issues and thatthey viewed physiotherapists to be key inmoving forward the initiatives of this gov-ernment.

LHINsThe Ministry of Health requested com-

ments on the newly proposed draft regulationfor creation of Health Professionals AdvisoryCommittees (HPACs) that each of the 14Local Health Integration Networks is requiredto establish. HPACs are advisory bodies thatLHINs would engage as part of its communi-ty engagement function. HPACs would pro-vide LHINs with an opportunity to heardirectly from health professionals with special-ized knowledge about the local health system,the need of patients and clinical issues. Thedraft regulation as well as OPA’s response hasbeen posted on the OPA website. Of partic-

ular concern is the number of physicians(who for the most part do not even fallunder LHIN jurisdiction) and nurses onthe advisory committee who will have themajority representation. Of even greaterconcern is that the draft calls for represen-tation on the committees of an cccupationaltherapist or a physiotherapist. The OPA strong-ly opposes the concept that these two profes-sions should be jointly represented, and thatappointment of one profession to the commit-tee would mean the exclusion of another.

Once the infrastructure for developingthe HPACs has been finalized, OPA will beencouraging members to apply for repre-sentation. This position is a clear opportu-nity to provide physiotherapy-specific feed-back and influence to each LHIN.

Each of the 14 LHINs is developing itsown Integrated Health Service Plan(IHSP), and several LHINs have alreadypublished these documents in draft forreview and comment. Visit your LHIN’swebsite (accessible via main LHINs web-site, www.lhins.on.ca) for more informa-tion on this process and to see what yourLHIN is planning for your area.

Issues UpdateContinued from page 1

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