Thank you for your patience and vigilance in helping to control the spread of Covid-19. This virus continues to change how we deliver safe and effective physiotherapy. It is important that you understand the changes in policy & treatment, and to consider the risks of hands-on treatment for all physiotherapy appointments.
Protecting Yourself and Others.
• Practice the physical distancing / mask wearing and hand hygiene as recommended by health officials.
• Consider it a risk venturing to public spaces where physical distancing and mask wearing is not practiced, and remove yourself from this environment.
• Ensure that your social circle is 10 people and the 10 people of your social circle, does not change.
• If you have any doubts about exposure, do your own Covid screen and follow the directives of the result. Telehealth Ontario and your family doctors are additional resources.
• Stay informed about covid-19: Public Health Ontario and Windsor Essex county Health Unit.
ii) Clinical Safety Measures: Keeping Safe.
• Staff perform a covid screen and take their temperatures daily. We follow the same protocols we ask you to follow to prevent the spread of Covid; cancelling appointment/ not coming to work, and self-isolation for 14 days when exposure is suspected.
• I wear combinations of facemask, face shield and goggles, with gloves and gowns as options depending on your comfort for safety, and or the type of treatment.
• Wearing a facemask that covers your nose, mouth and chin is the new normal to enter and leave my building.
• I have filtered cloth masks to replace or supplement yours. If protection greater than a facemask is needed, I will provide a clean face shield.
• Barriers at reception and continuous filtering of the room by an ultraviolet lamp add extra protection.
• Our college recommends hands-on treatment only when it is essential your recovery and virtual appointments for when it is not. Please note that requesting an on-site appointment does not guarantee that you will be offered an onsite physio treatment.
• Another limit of our new normal includes certain techniques; intra-oral and supine rib ring release.
• My clinic door is now locked, ensuring that there is only 1 patient and it is only the person who has the appointment that enters the clinic.
• The debit machine features a disinfected plastic cover. I will not accept payment in cash.
• Patients have the option for us to have your credit card number safely stored on paper.
• Return appointments are now only 30 minutes.
• I will continue to use outside for parts of your treatment, and I will use any opportunity to go outside to teach and monitor the exercise parts of your program.
• Booking appointments.
• Walk-in appointments are not possible.
• All appointments are made using the phone. For those calling on Friday to book appointments, please email your request, and someone will reply by the following Monday at the latest. There are 2 Covid screens involved in having an appointment. The first one is done over the phone when you book your appointment. Prior to the screen, your verbal consent is required for my receptionist to administer this covid screen over the phone. The final screen is done immediately before your hands on appointment.
• Sanitize your hands upon ENTERING and LEAVING my clinic. A 20-second hand rub meets the prescription by health officials
• The floors, treatment table and other high touch surfaces are part of documented disinfecting routine as an extra safety measure.
iii)Covid-19 Screening Questionnaire
1. Have you been in a facility that has an outbreak? Are you awaiting results from a covid test?
2. Have you travelled outside of Canada in the last 14 days?
3. Have you been diagnosed with or in contact with someone who is covid-19 positive / or someone you suspect is covid-19 positive?
4. Do you have ANY of the following symptoms:
• New cough or worsened chronic cough
• Shortness of breath or difficulty breathing
• Sore throat or difficulty swallowing
• Runny nose or nasal congestion of unknown origin
• Unexplained fatigue, malaise, or muscle aching
• A decrease or loss of taste or smell
• Nausea, vomiting, diarrhea, or abdominal pain
• Pink eye
5. If you are 70 years old or older are you experiencing: delirium, new increased number of falls, rapid decline in function or worsening of chronic conditions?
If some of your behaviours within the past 14 days had the opportunity for you to be exposed, err on the side of caution by answering yes to the question, and we will gladly and promptly reschedule your appointment. If you find it difficult to follow all of the above conditions to be risk-free of exposure to the virus, I will be happily suggest alternate practitioners.
v) Types of Physiotherapy Treatment offered include: Onsite, Virtual, a combination of Virtual and Onsite, and Home Outdoor physiotherapy.
30-minute appointments will be the norm for onsite appointments. Assessments for new problems will now combine virtual, for the gathering of information and the subjective component and follows up with an onsite appointment.
The fee for 30-minute appointments, virtual or onsite remains $65.00. The fee for a 60 minute combined virtual and onsite visit is $130.00. The fee for a 30 minute home outdoor appointment is $80.00 or proportional fee at a rate of $160.00 per hour for longer appointments. The invoice for all treatments will record the fee and the type of physiotherapy service rendered.
Cancellation fees remain the same. The first missed appointment / late cancellation is half of the fee of the missed appointment. The second time this occurs the fee is for the full amount of the missed appointment. If it occurs a third time, you will be charged full amount of the missed appointment and you will be discharged from my care. In that situation I will provide options for other practitioners.
Onsite Treatment is similar to what we have done in the past (except intra-oral treatment or other techniques that necessitate getting too close to each other’s faces or exhaled air will now be excluded.) The 30-minute session now includes disinfecting, verbal consent for treatment, administering the Covid-19 Screen with a temperature check, and completing the subjective portion of your visit, all before you enter the facility. The College of Physiotherapists of Ontario has recommended that we place a 15 minute limit on our close indoor interaction with patients. Currently onsite “maintenance” treatments do not fit in the category as being essential, and they are suspended.
Risks / Benefits associated with Onsite Physiotherapy Treatment. In spite of all the efforts to provide a risk -free environment, it is impossible to have no risk of contracting the covid-19 virus. It is because of this, you must weigh the potential benefits of receiving an onsite, hands-on appointment against the risk. Additionally, as your physiotherapist, I do have the responsibility to decide the benefits vs risks for you receiving onsite treatment. If you are someone that has in the past benefitted from manual therapy and or dry needling, that will still be possible. Virtual physiotherapy treatment will be delivered on a secure internet platform and I will take notes as always to leave in your patient file. Virtual physiotherapy will be offered to those who prefer it; those whose medical conditions leave them more vulnerable; and those whose condition does not absolutely require hands on treatment. Virtual appointments are especially effective for review/demonstrations of self-mobilization techniques, exercises, and answering questions. You will continue to receive exercise and information sheets. If your virtual appointment includes anyone other than yourself, you need to consent for that extra person to be included. E.g. someone to help you with home treatment.
Risks / Benefits associated with Virtual Physiotherapy Treatment.
The biggest benefit in virtual physiotherapy is no risk of Covid-19 transmission. There is very little risk involved in a virtual appointment as long as you ensure that your environment is safe.
Home Outdoor Physiotherapy services
Temporarily, for some patients who have unique careers or health status, I will contact you to offer an outside, at-home appointment. Please ensure that access for the outside appointment does not include entering your home, and that the space is safe from all perspectives. These appointments will also include the verbal consent for treatment, administering the Covid-19 Screen with a temperature check prior to the usual subjective and objective aspects of your treatment. The same treatment techniques will be offered as onsite treatment.
Risks / Benefits associated with Home outdoor Physiotherapy services:
With the use of PPE, outdoor appointments offer a safer environment than enclosed spaces. This enables me to spend more time with hands on treatment if necessary. Potential risks still include the possibility of Covid transmission though it is reduced.