Physiotherapists, chiropractors rejecting new rules governing insurance payouts for car accident victims
Physiotherapists and chiropractors are refusing to accept new rules on medical care for people injured in car accidents in Newfoundland and Labrador, saying government-imposed changes to regulations will make it more difficult for accident victims to secure proper treatment.
The Newfoundland and Labrador Physiotherapy Association says a physiotherapist is the primary care provider for the majority of people injured in accidents.
But new rules that came into effect this week means insurance companies only have to offer patients a limited number of treatment sessions with a physiotherapist, regardless of whether the patient has gotten better.
The recommended changes to the Automobile Insurance Act and the Insurance Companies Act come out of a 2019 Public Utilities Board review of automobile insurance in Newfoundland and Labrador, and went into effect Monday.
Michelle Sheppard, president of the association, says the province has ignored their criticisms of those recommendations, arguing not everyone fits into a neat box of treatment. The new model only offers two options: a 10-session treatment plan or a longer, 21-session treatment plan, she says.
"There's not quite enough information been given to clinicians, to clinics, to health-care providers to roll this program out effectively," Sheppard said. "What happens after those [21] treatments? We're not exactly sure."
Darrell Wade, CEO of the Newfoundland and Labrador Chiropractic Association, says those two treatment plans make little sense.
"They're kind of an arbitrary number," Wade says.
"There was some … suggestions that we would move forward on a model that gives quicker access to cure, removes the need for people to use their own private insurance. So that's kind of where this went to, but they didn't get it right. And that's where our concerns are, is that there are better models out there."
Dr. Darrell Wade is the CEO of the Newfoundland and Labrador Chiropractic Association. (Gary Locke/CBC)
Both associations believe insurance companies should be forced to pay instead for time-based treatment plans — unlimited sessions for a certain number of months — and say other provinces have adopted that type of model.
For now, both associations say they'll uphold the status quo rather than adopt the new model.
"People can still come to their chiropractor and physiotherapist after motor vehicle accidents and expect to get treatment," Wade said. "They just won't be under these protocols, which is unfortunate because a lot of … time and effort would have [gone] into making regulations. It just would have been more fortunate if we had had better consultation."
Service N.L. spokesperson Gina MacArthur directed CBC News to a June news release on the changes when asked for comment.
"New diagnostic and treatment protocols under the Automobile Insurance Act will allow accident victims to get quicker and more affordable treatment, specific to the most common types of injuries resulting from an automobile accident: sprains, strains and whiplash associated disorders," the release said.
"The protocols require automobile insurance companies to adopt processes that allow accident victims to seek treatment immediately, from a practitioner of their choice, without advance approval from the insurance company.... Accident victims will also no longer be required to exhaust their private health insurance coverage before claiming coverage under their automobile insurance policy."
The new model allows patients to access physiotherapy and chiropractic services right away. If they have private insurance, they can then add to their treatment plans after using up the treatment paid for through an auto insurance company.
But Wade says the two-tiered system often doesn't work.
"Giving somebody access to care early is a really good goal, but when they kind of drop off that cliff and then they have to still go and certify through their physician, have to use their private insurance … it creates this potential for there to be a significant gap in care, right when you're just getting to that recovery phase," Wade said.
"And that's where, really, the risk of harm is to patients."
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