Case of the Month
The Case
The College received a report from a clinic owner about a physiotherapist whose employment at the clinic was recently terminated.
The employer noted that the physiotherapist had a history of disappearing for periods of time and not coming to work. The physiotherapist did not speak to their employer about the absences ahead of time and did not make alternative arrangements for their patients.
Because of the sudden nature of the absences, patients were not informed that their physiotherapist would be away, and many appointments needed to be changed or cancelled at the last minute. Some of the patients were seeing the physiotherapist for rostered activities that other PTs working at the clinic were unable to perform.
Before one of their extended absences, the physiotherapist removed some patient files from the clinic without permission.
When the employer contacted the PT to ask about patient care and the missing records, the physiotherapist suggested that the patients could simply be assessed by another provider and that they would return the records next time they were at the clinic. The employer said one record was never returned.
In reviewing the patient files as part of the investigation, a number of issues were identified in relation to record keeping. These areas included multiple late entries, missing initial assessments, signatures, dates, objective information, outcome measures, smart goals and incomplete analysis sections. The College also became aware that the physiotherapist had changed employers nearly a year before and did not update their employment information.
The Standards
The College’s Code of Ethics reflects physiotherapists’ commitment to use their knowledge and expertise to promote high quality, competent and ethical care for patients and instill public confidence in the profession. By not communicating their absences to their employer, colleagues and patients, the physiotherapist demonstrated questionable decision making and a lack of professionalism.
The physiotherapist also ignored their professional accountabilities by not updating their employment information with the College. By law, up to date employment information needs to be included on the Public Register. PTs are required to update their employment information with the College within 30 days of the change.
Additionally, by not following the guidance for discontinuing care in the Providing and Refusing Care Standard, the physiotherapist put the safety, wellbeing and trust of their patients in jeopardy. As detailed in the standard, a PT cannot discontinue care unless the patient has been given a reasonable opportunity to arrange for alternative services, or alternative services have been made. The physiotherapist did not meet these requirements as they did not transfer patient care, inform their patients of their lengthy absences or arrange for another physiotherapist to provide treatment.
The physiotherapist also removed patient records from the clinic without permission which is a direct violation of privacy laws and the College’s Record Keeping Standard.
The Outcome
The Committee determined that these issues were significant enough for the physiotherapist to receive a caution and participate in a Specified Continuing Education or Remediation Program (SCERP). A caution stays on the Public Register permanently.
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