Frequently Asked Questions for Providers

The questions below will help you understand all the important aspects of the new ESP Clinic model of care.

How does ESP Clinics benefit patients with joint or spine pain and their primary care provider?

Among other benefits, ESP Clinics provides:

  • Patients with joint or spine pain timely access to assessment and treatment plan emphasizing patient education and self-management strategies
  • Primary care providers with an integrated referral alternative for their patients with joint or spine pain
  • Patients with joint or spine pain more streamlined access to specialists and appropriate diagnostic imaging services when indicated

How can a primary care provider access the services provided by ESP Clinics?

Primary care providers must first attain referral privileges. In order for referral privileges to be granted, the primary care provider must complete ESP Clinics free training in joint and spine assessment and management and agree to take part in program evaluation and satisfaction questionnaires. Upon completing our training course, participants will be granted full privileges to the e-Referral Platform.

How can a primary care provider become part of the ESP Clinics model of care program?

If you are a primary care provider (family physician, general practitioner and nurse practitioner) in Ontario and interested in participating in this model of care program, we encourage you to create an online profile and submit your referrals using our e-Referral Platform.

What types of patients can primary care providers refer to ESP Clinics?

ESP Clinics is targeting patients with:

  • Persistent joint (shoulder, elbow, hip, knee) or spine related symptoms 6 weeks to 12 months after onset
  • Unmanageable recurrent joint or spine related symptoms

Specific exclusions to this patient population will be provided during the training course.

Who will be responsible for the ongoing care of patients referred to ESP Clinics?

ESP Clinics shared-care management approach is key to the sustainability of ESP Clinics. As the patient’s most responsible provider, the primary care provider will be expected to monitor his/her patient’s progress with treatment goals and, if no clinical improvements are realized, refer to ESP Clinics for further assessment.

ESP Clinics will also incorporate the use of patient reported outcome measures using the DADOS Connect and WyseOp Platforms and will provide support for the monitoring of patient progress.

Will ESP Clinics provide patients with pharmacological or ongoing adjunct therapy to support their pain self-management plans?

No – ESP Clinics, however, will take the time to show patients proper exercises to improve their mobility and function. Certain patients may be advised to seek out ancillary services from a community provider (e.g., Physiotherapist/Chiropractor) to support their treatment plans. Suspected surgical, inflammatory, pain disorder or complex patients will be referred to the most appropriate medical specialist. ESP Clinics will arrange for one or more follow-up appointments with patients identified as being at risk of chronic pain, narcotic dependency and/or other serious risks.

Who will assess patients in ESP Clinics?

Patients will be assessed by an Extended Scope Practitioner (ESP) such as a Physiotherapist, Nurse Practitioner or Chiropractor who has been trained in the assessment and first line management of joint and spine conditions. A Practice Leader and Orthopaedic Surgeon provide ongoing clinical oversight and supervision of the Extended Scope Practitioners.

Where is ESP Clinics located?

ESP Clinics are currently located in Toronto at the Toronto Western Hospital. As the program expands additional ESP Clinics will be made available throughout cities in Ontario to provide better access to care and improved outcomes.

How will referrals to ESP Clinics be handled?

Primary care providers will send referrals to ESP Clinics using our e-Referral Platform. The ESP Clinics office will contact the referred patient and book an appointment in the ESP Clinic nearest to the patient. Patients will be matched with an ESP Clinic based on location proximity and availability to optimize patient assessment and access to care.

What type of communication will the referring primary care provider receive from ESP Clinics about their patient?

The patient’s primary care provider will be provided with a summary consult note after the comprehensive assessment outlining the patient’s diagnosis, self-management plan and next steps in care pathway, including a recommended schedule for follow-ups. For complex patients, an ESP may contact the patient’s primary care provider directly to discuss the consult.

Are there similar programs in Canada?

ESP Clinics builds from the great work of the Ontario pilot program for low back pain assessment and management called ISAEC (Interprofessional Spine Assessment and Education Clinics) and other jurisdictions such as the province of Saskatchewan (Saskatchewan Spine Pathway).