Acupuncture, Consent and Infection Control 

The Case 

The College received a report from a coworker who had concerns about how a physiotherapist at their clinic was practicing acupuncture. 

The reporter said the physiotherapist used expired solution to sterilize equipment, and needles were often not properly disposed of. Discarded needles were sometimes found in the clinic’s treatment areas or laundry room.  

The clinic had also received a complaint from a patient who said they didn’t understand what they were agreeing to before receiving acupuncture treatment from the physiotherapist.  

The Standards 

Acupuncture is a controlled act, meaning physiotherapists need to complete specialized training before rostering to perform it in their practice. Physiotherapists also must be able to demonstrate that their acupuncture skills, knowledge and judgement are up-to-date and current.  

Controlled acts carry these extra requirements because if they are performed incorrectly, there is a high risk of harm to patients.  

The Infection Control Standard requires physiotherapists to comply with current infection prevention and control best practices. This includes ensuring all physiotherapy spaces and equipment are cleaned and disinfected before patient use and properly disposing of devices and materials.  

For acupuncture, best practice includes using sterile, single-use needles and disposing of them only in a rigid, puncture-resistant sharps container. 

When it comes to the complaint that the physiotherapist did not get consent before performing acupuncture on a patient, the physiotherapist said during the first appointment, they fully explained the treatment, including the expected benefits and risks. After ensuring the patient understood what they were proposing, they received consent from the patient to insert acupuncture needles into their back. The College reviewed the records from that appointment and found all the requirements for consent were met.  

The problem happened during the patient’s second appointment. Seeing that the patient hadn’t improved much, the physiotherapist decided to change the acupuncture technique they were using. Speaking to the College after, the physiotherapist acknowledged that they should have gotten consent before introducing the new technique, but they assumed the patient was fine with it based on their conversation at the previous appointment.  

This does not meet the legal requirement for consent. Consent is never a one-time conversation. It needs to be ongoing throughout treatment. Anytime you are introducing a new technique, make sure you pause to ensure your patient understands what you’re proposing and agrees to it.  

When it comes to controlled acts like acupuncture, you need to take extra care when having conversations about consent. Never assume because a patient has consented to the controlled act before, that you can perform it again without asking.  

The Outcome 

The physiotherapist was required to complete several educational activities, including working with a practice enhancement coach and reviewing resources on consent, controlled acts and infection control.  

Resources