Interprofessional Collaboration

Why This Matters for MTs

• Clients with complex conditions rarely see only one practitioner. Coordinated care avoids duplication, prevents contraindicated treatment combinations, and improves outcomes.
• Professional credibility with other HCPs depends on your ability to communicate clearly, respect scope boundaries, and contribute meaningfully to shared care plans.
• CMTO Standard of Practice #10 (Collaboration) requires RMTs to collaborate with other healthcare providers when doing so is in the client's best interest.
• Interprofessional competence is increasingly expected by employers, insurance companies, and referral sources.

Key Principles

Working with Specific Professions

• Physicians are the most common referral source for MT clients.
• Referral letters from physicians may be required by some insurance plans. Read them carefully — they may contain relevant diagnostic information, precautions, or treatment restrictions.
• When communicating with physicians, be concise and use medical terminology appropriately. Physicians are time-constrained and value brevity.
• Do not diagnose. Frame your findings as clinical impressions: "My assessment findings are consistent with..." rather than "The client has..."

• Physiotherapists and RMTs have the most overlapping scope in Ontario. Both assess and treat musculoskeletal conditions; PTs can also perform controlled acts (e.g., ordering diagnostic imaging, administering traction under medical directive in some contexts).
• Collaboration is most effective when roles are clearly defined: e.g., PT manages exercise rehabilitation and mobilization, RMT manages soft tissue treatment and pain reduction.
• Avoid turf wars. Focus on what each profession does best and how they complement each other for the client's benefit.

• Chiropractors focus on spinal and joint manipulation (a controlled act under the RHPA). RMTs focus on soft tissue assessment and treatment.
• Some clients see both an RMT and a chiropractor concurrently. Communication between providers ensures treatments are complementary, not contradictory (e.g., if a chiropractor is working on joint alignment, aggressive deep tissue work on the same segment on the same day may be counterproductive).
• Respect the different philosophical frameworks. Avoid making dismissive comments about other professions' approaches to clients.

• Clients receiving psychological treatment may benefit from MT for stress reduction, trauma-related body tension, or chronic pain management.
• Trauma-informed care principles are essential when co-managing clients with a psychologist. See Trauma-Informed Care.
• Never provide psychological counseling — that is outside MT scope. If a client discloses mental health concerns during treatment, listen supportively and suggest they discuss it with their psychologist or a mental health professional.

• OTs focus on functional capacity and return to daily activities. RMTs can complement OT goals by addressing pain, muscle tension, and ROM limitations that impede functional recovery.
• Collaboration is especially valuable for clients recovering from workplace injuries (WSIB), motor vehicle accidents, and post-surgical rehabilitation.

Referral Protocols

• When assessment findings suggest a condition outside MT scope (e.g., suspected fracture, neurological red flags, systemic illness signs).
• When the client is not responding to MT as expected and another approach may be beneficial.
• When the client's condition requires diagnostic imaging, pharmaceutical management, or a controlled act.
• When you identify psychological concerns (suicidal ideation, untreated depression/anxiety, suspected abuse). See Community Resources and Referral.

• Discuss the referral with the client first. Explain why you are recommending they see another provider and what you hope it will accomplish.
• Provide a written referral or communication letter (see Correspondence Standards below).
• With the client's written consent (PHIPA requirement), include relevant clinical information.
• Follow up: ask the client at their next visit whether they followed through on the referral and what the outcome was.
• Document the referral in the client's SOAP notes (Plan section).

• Acknowledge the referral with a brief response to the referring provider (with client consent).
• Clarify any treatment restrictions or precautions noted in the referral.
• Keep the referring provider informed of progress if the client consents to information sharing.

Shared Care Planning

• In multidisciplinary settings, participate actively in case conferences and care planning meetings.
• Bring your assessment findings and treatment observations. Do not defer entirely to other professions — your clinical observations are valuable.
• Use common language. Avoid MT-specific jargon that other professionals may not understand (e.g., say "increased tone in the upper trapezius" rather than "hypertonic UT with trigger point referral to the temporal region" unless the audience will understand the latter).
• Document your contributions to the shared care plan in the client's record.

Scope of Practice Boundaries

• Know your own scope clearly (MTA definition) and the scopes of professions you work alongside.
• Never perform controlled acts (joint manipulation beyond the MT scope, diagnosing, ordering tests, prescribing).
• If another provider asks you to do something outside your scope, decline professionally: "That is outside my scope under the MTA. I would be happy to address the soft tissue component."
• If you observe another provider practicing outside their scope or acting unsafely, you have a professional obligation to address it — initially through direct conversation, escalating to the relevant regulatory body if necessary.

Communication Standards for Interprofessional Correspondence

• Use clinic letterhead or a professional template.
• Include: date, recipient name and credentials, client name (with consent noted), your findings and clinical impression, treatment provided and outcomes, specific questions or recommendations, your name, credentials, and registration number.
• Tone: collegial, factual, concise. Avoid defensive language or self-aggrandizing claims about MT effectiveness.
• Keep a copy in the client's file.

• When calling another provider, identify yourself with your full name, credentials, and the reason for the call.
• Be prepared with the relevant client information before calling — do not waste the other provider's time while you look things up.
• Follow up verbal communications with a written summary for the record.

Clinical Application

• Build your referral network early in your career. Introduce yourself to local physicians, PTs, chiropractors, and OTs. Bring a professional card and a one-page description of your services and specializations.
• Create referral letter templates to reduce administrative time. See Third-Party Reporting for report writing.
• When receiving a referral, respond within 1-2 business days to acknowledge receipt.
• Attend interprofessional education events or workshops when available — they build relationships and mutual understanding.
• If you work in a multidisciplinary clinic, schedule regular informal conversations with other providers about shared clients (with appropriate consent).