The requirement for trained healthcare professionals increases as the pandemic continues to cause overcapacity in hospitals, and as a result, the Ministry of Health is proposing new legislation to support patient care.  The “Advancing Oversight and Planning in Ontario’s Health System Act, 2021 will include many initiatives, including increased funding for community care, increased scope for PSW and the use of Physicians Assistants (PA) as physician extenders.  This would give PA’s the legislative authority to identify and communicate a diagnosis, casting, prescribing medications/eyeglasses/hearing devices.

As Respiratory Therapists, it is important to remember that despite the increased authority that would be given to PA’s under this purposed legislation, we are currently not permitted to receive orders from these professionals. Under  the Respiratory Therapy Act (RTA), RT’s may only receive orders from Members of the College of Physicians and Surgeons of Ontario, the College of Midwives of Ontario, the College of Dental Surgeons of Ontario, and the College of Nurses of Ontario (those who hold the title of Extended Class).  There is the ability for RTs to be able to accept an order from “a member of a health profession that is prescribed by regulation” [RTA s.5 (1)(c)]. However, there is currently no regulation that would allow an RT to accept an order from a PA.

We are permitted, however, to receive the communication of a direct order or medical directive, through a PA, from a physician. This is not considered to be “ordering”. Remember, as a profession, we do not require delegation (or transfer or authority) from any healthcare professional for a controlled act that we are already authorized to perform.

For more information on this topic, and this purposed legislation, please follow these links:



Orders for Medical Care PPG (

Ontario Introduces Legislation to Strengthen Health Workforce Accountability and Enhance Data-Driven COVID-19 Response | Ontario Newsroom











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