The College’s role is to safeguard and serve the public interest through effective regulation of the practice of physiotherapists in Alberta. As part of fulfilling our role, the College investigates public and patient concerns about physiotherapy services received. The College investigates all written, signed complaints deemed in the College's jurisdiction and following the investigation phase, complaints may be resolved, dismissed, or referred for a hearing.
During the 2022-2023 registration year, the College has seen an increase in the number of complaints received as compared with previous years and what is most concerning is that the nature of these complaints has changed.
The College typically receives between 19 and 26 complaints per registration year. In the registration year of October 1, 2021, to September 30, 2022, the College received 19 complaints. In contrast, in the 10 months between October 1, 2022, and August 1, 2023, the College has already received 26 complaints. Furthermore, between June 1, 2023, and August 1, 2023, the College received 9 complaints alone.
Of the 26 complaints received between October 1, 2022, and August 1, 2023, six (6) related to allegations of sexual abuse or sexual misconduct. That means that 23% of all complaints received during that 10-month period were related to allegations of sexual abuse or sexual misconduct.
For comparison, in the 42 months between April 1, 2019, and September 30, 2022, the College received a total of 8 complaints that included allegations of sexual abuse or sexual misconduct, compared to the 6 complaints received in the 10 months since September 30, 2022.
The complaints in question are in the investigation or hearing phase, meaning that currently, these are allegations only. However, the trends in both the total number of complaints received and the nature of the allegations are concerning.
All Alberta health profession regulators are required to report on complaints and findings pertaining to sexual abuse and sexual misconduct in their annual reports. As part of understanding the trends in the physiotherapy data, the College reviewed publicly reported data from regulators of other Alberta health professions that generally have similar physical contact with their patients, and whose registrants typically have ongoing therapeutic relationships with patients.
In the review, we included the College of Physicians and Surgeons of Alberta, the College of Chiropractors of Alberta, the Alberta College of Occupational Therapists, the College of Registered Nurses of Alberta, and the College of Licensed Practical Nurses of Alberta. To ensure fair comparisons were made, the number of complaints was normalized by calculating the number of complaints of sexual abuse and sexual misconduct per 1000 registrants of each regulatory body.
What we found was that physiotherapists had more than double the number of complaints of sexual abuse or sexual misconduct per 1000 registrants as compared with the next highest proportion.
There are several potential explanations for these trends:
- Perhaps there are more instances of sexual abuse or sexual misconduct occurring in physiotherapy practice.
- Perhaps patients and the public are more inclined to report these occurrences.
- Perhaps the existence of standards of practice and patient relations programs pertaining to sexual abuse and misconduct increases the likelihood of a report when an incident occurs.
- Perhaps complaints that would have been categorized differently in the past are now being categorized as sexual abuse or sexual misconduct due to the existence of the Sexual Abuse and Sexual Misconduct Standard.
- Perhaps all health profession regulators are experiencing increased complaints of sexual abuse and sexual misconduct and a reporting delay is artificially inflating the apparent differences between regulated health professions.
- Perhaps differences in the approach used by different regulators to categorize complaints are contributing to differences in the reported number of complaints.
What is clear:
- All current registrants have been required to complete mandatory education regarding sexual abuse and sexual misconduct through either the 2021 College Selected Activity or as a registration requirement and have declared to the College that they have completed the mandatory education.
- The number of complaints regarding sexual abuse and sexual misconduct has increased.
- When a complaint includes allegations of sexual abuse or sexual misconduct, the matter is investigated and, in every instance to date, a hearing has been held.
- As the College investigates the complaints received in the past 10 months, more hearings will be scheduled.
- Sanctions established by the Health Professions Act of Alberta include mandatory revocation of the registrant’s practice permit and a lifetime ban on registration as a health professional under the Health Professions Act if a registrant is found to have engaged in sexual abuse of patients.
- Sanctions established by the Health Professions Act of Alberta for sexual misconduct include mandatory suspension of the registrant’s practice permit for a specified period as determined by the hearing tribunal. If a registrant’s practice permit is cancelled because of a finding of sexual misconduct, the registrant is not eligible to apply for reinstatement for 5 years.
- The provisions of the Health Professions Act include a requirement that regulatory bodies provide funding for treatment and counselling for patients who make a complaint that relates to sexual abuse and sexual misconduct of the patient by a registrant. The maximum funding available to a patient who qualifies is $23,300 within 5 years from when the funding is approved.
- As the number of investigations, hearings, and patients accessing treatment and counselling funds increase, the costs to respond to these complaints will also increase.
Whether allegations of sexual abuse or sexual misconduct are ultimately proven, for each complaint, there is a client who perceived that something inappropriate happened, and that client was sufficiently affected by the situation that they contacted the College and made a formal written complaint.
Again, the trends in both the total number of complaints received and the nature of those complaints are concerning enough that the College is bringing this matter to registrants’ attention and asking for their help to address the issue.
In the coming months, the College will be developing further resources to address this issue and support physiotherapists’ understanding of and adherence to their professional responsibilities.
The October 15 episode of the College Conversations podcast will go into further detail about the trends we have discussed and some of the themes underlying these trends. You can find College Conversations on the College’s website or wherever you get your podcasts.
