Delisting chiropractic and physiotherapy: False saving?

Delisting chiropractic services in BC and Ontario, and limiting community-based physiotherapy in BC, Alberta and Ontario are false economies, both professional associations claim.

Figure. Delisting physiotherapy will “strain an already overburdened health system.” Photo by: Comstock

The Ontario government hopes to save $100 million annually by delisting chiropractic services in December 2004 and another $100 million by cutting community-based physiotherapy this spring. Ontario plans to use the savings from delisting “less critical” services to boost cancer and cardiac care, and home- and long-term care.

However, a report by Deloitte Consulting Services commissioned by the Ontario Chiropractic Association predicts a 7%–14% increase in the number of patients visiting emergency departments and a 1.3%–2.6% increase in visits to family physicians, as Ontarians try to avoid paying for a chiropractor.

Graydon Bridge, president of the Canadian Chiropractic Association, says Ontario's delisting will “actually cost as much as $200 million as patients are diverted to more expensive and possibly less effective options.” Manitoba, Saskatchewan and Alberta provide partial funding for chiropractic services.

In BC, chiropractic and community-based physiotherapy were delisted in 2002 for all but the poorest 20% of residents. The savings of $130 million annually were funnelled into preminum assistance subsidies. But the Canadian Physiotherapy Association says delisting resulted in increased waiting times, a 28% decrease in patients accessing community-based care and reports of patients ending treatment prematurely.

Public funding for community physiotherapy services varies widely across Canada; most recently, Alberta limited funding to trauma or surgical patients.

The Canadian Physiotherapy Association says these actions will have a profound impact. “Without the early intervention and treatment provided by physiotherapists, many citizens will develop more significant health problems and cause additional strain on an already overburdened health system,” says CEO Pamela Fralick.