Quarterly report of all closed conduct files from August 1, 2023 – October 31, 2023.
Disclaimer: Decisions may vary depending on the circumstances. The reasons for a decision must be considered in light of the evidence and the actual issues pertaining to the allegation.
Case 1
Allegations
- The patient suffered an injury to their right lower leg as a result of the physiotherapist’s treatment on October 26, 2022.
- The physiotherapist failed to respond appropriately to the adverse event.
Investigation
A patient developed right dorsal foot pain and plantar numbness approximately five hours after receiving both physiotherapy treatment for the right knee and a right knee aspiration from a physician at the same facility. The patient’s reported symptoms involve both the superficial peroneal nerve and the medial plantar nerve. The symptoms were significant and lasted for several months eventually resolving. There were several discrepancies between the patient’s reports of the physiotherapy treatment and the physiotherapist’s reported treatment.
Regarding the second allegation, the physiotherapist did not communicate directly with the patient following the October 26, 2022, treatment, however, there was evidence that communication with the patient was undertaken by ‘the clinic’ rather than by the physiotherapist.
Decision
It is possible that the symptoms may have resulted from the treatment provided by the physiotherapist, however, the evidence did not support that the patient’s symptoms were a direct result of treatment provided by the physiotherapist. Ideally, the physiotherapist would have communicated with the patient directly after learning of their increased symptoms, however, there was insufficient evidence specific to the investigated allegations to support a finding of unprofessional conduct by a hearing tribunal. Both allegations were dismissed however, it was strongly recommended that the physiotherapist undertake the following recommendations to improve future practice:
- Ensure that documentation is complete and an accurate reflection of all patient interactions.
- Review the clinic policy and procedures regarding documentation of ‘cotreated’ patients. All regulated physiotherapists are responsible for consistently meeting the College of Physiotherapists of Alberta Standards of Practice regardless of employer policies.
- Read the Documentation and Record Keeping Standard of Practice
- Read CPTA’s Managing Challenging Situations Guide
- Review CPTA’s Webinar Now what? Responding When Things Don’t Go as Planned
Case 2
Allegation
The physiotherapist failed to report a 2020 criminal conviction to the College of Physiotherapists of Alberta and failed to advise the College of a criminal conviction upon renewal of their 2021/22 and 2022/23 practice permit.
Investigation
The physiotherapist was convicted of Driving While Under the Influence (DUI) in October 2021. The physiotherapist made two false declarations on their practice permit renewal applications to the College of Physiotherapists of Alberta, in 2021/21 and 2022/23. The physiotherapist failed to report the conviction and stated that they were unaware of the requirement to do so.
Decision
Section 127(4) of the Health Professions Act states that a regulated member must report in writing, as soon as reasonably possible, if convicted of an offence under the Criminal Code (Canada). The Standard of Practice regarding Legislative Responsibilities states that the regulated member practices are in compliance with all legislative and regulatory requirements of their jurisdiction.
The evidence supports that the physiotherapist did not consistently or fully meet the Legislative Responsibilities Standard of Practice, however, the evidence specific to the investigated allegation did not support the referral of this matter to be heard before a hearing tribunal. The physiotherapist received a formal caution regarding this matter. Any future complaint of a similar nature may result in a referral to a hearing. It was strongly recommended that the physiotherapist undertake the following recommendations:
- Read each of the College of Physiotherapists of Alberta Standards of Practice in detail to ensure a thorough understanding of the responsibilities and obligations of being a member of the self-regulated profession of physiotherapy in Alberta.
- Read the College of Physiotherapists of Alberta Code of Ethical Conduct in full.
The Code of Ethical Conduct applies to all members of the physiotherapy profession in all contexts of practice and through all stages of their career. It must always be used in conjunction with relevant federal and provincial legislation and with regulations, policies, procedures, and standards that regulate professional practice.
- Read the article, Rescinding Registration, to gain insight into understanding the seriousness of submitting a false declaration to a regulatory body. The article is about a different regulatory body in a different province, however, there are significant parallels between the physiotherapist’s actions and those of the regulated member in the article.
- Ensure a clear understanding of all future declaration documents, related to their registration as a physiotherapist, before signing and submitting.
Case 3
Allegations
- The physiotherapist billed the patient for physiotherapy services that they did not provide under their CPTA registration number.
- The physiotherapist permitted an unregulated staff member to provide assessment, interpret assessment findings, plan, and provide treatment to the patient without supervision or oversight.
- The physiotherapist did not advise the patient that services were being provided by a non-regulated staff member.
Investigation
The patient received and was billed for five physiotherapy sessions under the physiotherapist’s CPTA registration number. The physiotherapist was not involved in any part of the patient’s assessment or treatment, all assessment and treatment to the patient was provided by a kinesiologist. The kinesiologist and the physiotherapist were listed on all invoices and the treatment was identified as ‘physiotherapy’.
Evidence supports that the physiotherapist did not advise the patient that services were being provided by a kinesiologist. The physiotherapist stated that it was only after the care was terminated, that they became aware that the patient attended treatments provided solely by the kinesiologist, despite the clinic having job descriptions and policies to support that measures were in place to prevent this type of occurrence. Evidence supports that the staff and the physiotherapist were aware of the booking and billing requirements and that it is the physiotherapist who is responsible for all billings under their registration number. Evidence supports that the clinic policies were not followed during the treatment of this patient.
Decision
It is reasonable for kinesiologists to provide treatment and have the treatment billed as ‘physiotherapy’ provided the kinesiologist is working under the supervision of the physiotherapist in accordance with the Supervision Standard of Practice and the Supervision Guideline. Evidence supports that the physiotherapist did not consistently and fully meet the Fees and Billing, Supervision, and Consent Standards of Practice, however, there was insufficient evidence specific to the investigated allegations to support a finding of unprofessional conduct by a hearing tribunal. The matter was not referred to a hearing. The physiotherapist was provided with a formal caution regarding this matter, any future complaint of a similar nature may result in referral to a hearing. It was strongly recommended that the physiotherapist undertake the following recommendations:
- Review all College of Physiotherapists of Alberta, Standards of Practice,
- Review the following CPTA Guides:
- Review and revise the clinic’s Physiotherapy Policies and Procedures to ensure compliance with CPTA’s Standards of Practice and regulatory requirements.
- Refer to the college website for additional information and guidance in meeting regulatory requirements.
- Contact CPTA’s Practice Advisor for any additional information or clarification.
- Ensure that all clinic bookings, documentation, and billing procedures clearly and accurately reflect the care provided to the patient.
- Ensure that the physiotherapist and all staff fully understand the clinic Policy and Procedures.
Case 4
Allegation
The physiotherapist engaged in inappropriate verbal communication and sent harassing text messages to a colleague.
Investigation
On November 11, 2022, a private conversation was held between the physiotherapist and the complainant. The complainant had a business relationship with the physiotherapist unrelated to physiotherapy. The physiotherapist and the complainant had no therapeutic relationship. The complainant was never a patient of the physiotherapist.
The complainant alleged that the physiotherapist suggested to the complainant, in the private conversation, that the physiotherapist would provide listings and money in “exchange to physical activities”. The complainant did not provide details regarding what was meant by “physical activities”. The investigation was not able to obtain evidence to substantiate or refute what was said during the private conversation. Communication records (Text Messaging and WhatsApp) were collected from both the physiotherapist and the complainant. However, the records were not complete, there were numerous deleted messages.
Decision
Unprofessional Conduct Considerations:
- Off-duty conduct may be considered in the context of professional practice if there is a nexus between the conduct and the profession. Although off-duty conduct may be considered in regulatory conduct matters, the Health Professions Act and the Standards of Practice relate largely to the provision of clinical physiotherapy services.
- The Health Professions Act (HPA) refers to ‘conduct that harms the integrity of the profession’.
The allegation was specific to off duty conduct and did not affect the safety of patients under the physiotherapist’s professional care. The evidence does not support that the physiotherapist was guilty of unprofessional conduct to a level that would support referral of this matter to be heard before a hearing tribunal. The complaint was dismissed.
Case 5
Allegation
The patient’s continuation of care was not managed effectively when the physiotherapist stopped providing physiotherapy services at Clinic A.
Investigation
The evidence confirms that the physiotherapist verbally informed the patient of their impending departure from Clinic A. However, the physiotherapist did not share their ‘new’ location with the patient due to their understanding of the solicitation of clients’ clause in their employment contract.
Evidence supports that the physiotherapist provided a message that Clinic A could use to inform patients of their continuation of care options. Evidence also supports that the physiotherapist contacted Clinic A on several occasions to enquire if the message had been emailed. The physiotherapist was informed that a message would be sent.
The patient confirmed they did not receive a message from Clinic A as to their continuation of care options.
Evidence regarding what information was provided to other patients was not collected as part of this investigation.
Decision
There is no evidence of unprofessional conduct on the part of the physiotherapist. The complaint was dismissed.
