Pangaea Express: Ontario Taking Next Steps to Improve Health-Care Access

Ontario is consulting with stakeholders in expanding the scope of practice for a range of healthcare professionals including optometrists, psychologists, physiotherapists and others. The province is assessing granting;

• Optometrists the authority to perform minor surgical procedures in the office, order diagnostic tests and treat open-angle glaucoma
• Psychologists, who have special training and education in psychopharmacology, the authority to prescribe certain medications for mental health conditions and order/ interpret diagnostic tests
• Dental hygienists, denturists, speech-language pathologists, physiotherapists, chiropractors and chiropodists, the ability to order and perform diagnostic imaging procedures (x-rays, MRIs and CTs)
• Pharmacists, the ability to prescribe for 14 additional minor ailments and administer more vaccines

This could result in earlier diagnosis and more prescribers of drugs to treat mental health and ophthalmic conditions, decreasing delays in treatment of these conditions. There are, however,  some challenges for consideration.

While the government is trying to find solutions for the province’s (and country’s) lack of physicians, these expansions of responsibility could overload other areas of the health system. Do we have laboratory capacity to carry out the increase in diagnostic testing if many more providers can request this work? Who/how will all these additional tests be analyzed? Without interoperative communications among health information technology providers, how will a psychologist, as an example, know which other drugs a patient is taking to avoid drug interactions? To enable healthcare providers’ ability to “work the full extent of their training and expertise”,  the broader healthcare system may need to be considered to ensure a smooth implementation.

No specific timing was provided in this consultation. A positive step for improving patient care, however, any changes will require legislative amendments which takes time. At this point, we do not expect any impact to 2026 plans but may be a consideration for future years. We will continue to provide updates with more details when known.

For more information, please contact Marc Lafoley at mlafoley@pangaea-consultants.com or Marla Weingarten at mweingarten@pangaea-consultants.com