Manitoba physiotherapists concerned about ‘two-tier health care’ with new funding model

Physiotherapists in Manitoba are questioning why the province has decided to cover post-operative care at just three physiotherapy clinics — all located in Winnipeg and all privately run.

“You have this client base that likely have relationships with [their own] physios in the community, and now they can’t see them if they want to access the public funding because they are being redirected and funnelled into these three particular clinics,” said Anna DiMarco, president of the Manitoba Physiotherapy Association.

“And of course, the two-tier health-care system that has occurred, we would like that not to be a part of this equation.”

In response to a recommendation from the diagnostic and surgical recovery task force, the province is offering funding for post-op outpatient physiotherapy and rehabilitation to patients who have had total hip and knee replacement surgeries.

Previous coverage for total hip replacement physio was cut several years ago, while the cuts to knee physio came in 2017.

The province has not made a formal announcement about the funding. MLA James Teitsma posted about it on Facebook on Nov. 22, listing the three private clinics as Elite Sports Injury, Pure Lifestyle and the Wellness Institute, which is based at Seven Oaks General Hospital.

Up to six individual physiotherapy sessions or 10 group sessions will be available at one of the three providers contracted to offer services, Teitsma posted.

CBC News reached out to the province to ask about the changes. An email from a spokesperson said, “Our government is providing physiotherapy to support a successful recovery for hip and knee orthopedic patients at three Winnipeg facilities because it is the right thing to do. The diagnostic and surgical recovery is working to add additional providers for this service in the near future.”

While the Manitoba Physiotherapy Association is “incredibly excited” to have funding back for post-op care, DiMarco said, she wonders why it was done so quietly.

“There wasn’t a lot of transparency about how this was done, so that generally isn’t healthy in any type of health-care model where we’re trying to collaborate with partners,” she said.

“We’re all kind of going, ‘This just doesn’t look right. Something doesn’t feel right and doesn’t feel fair for the patients or for the physiotherapy community.'”

Inequity

Offering the service at just those three clinics suggests those providers are somehow better at providing that care, but total hip and total knee replacement care is a core competence any graduate physiotherapist can do, DiMarco said.

Then there is the inequity between patients in Winnipeg and those in rural Manitoba, she said.

“I think the easiest solution would have been to figure out how to fund it in the private clinics that are scattered throughout the city and in rural Manitoba,” she said.

“If we had allowed the funding to go to wherever the patient wanted to go, these providers were perfectly capable of providing the care that was required. The patients would have had greater access and more fair access.”

DiMarco hopes the province will hear the physiotherapy association’s concerns and adjust funding models in the future. 

“We were told that this was a short-term solution, and that they will be looking at different models of access … and that there’s a longer-term plan, but we are not privy to any of that yet,” she said.

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