College Blog 

In the spirit of transparency, we encourage open debate and constructive criticism. For this to be effective, comments need to remain professional and respectful. Comments will be reviewed and posts that include personal attacks, unfounded allegations, unverified facts, product pitches, or profanity will not be published.

  • Let’s talk about S*X

    Mar 02, 2015

    Sharon’s young. Ali’s great looking. She’s treating the rotator cuff he tore playing ultimate Frisbee. They both like House of Cards. The next thing you know, Ali is offering to meet Sharon at a local pub and teach her how to play pool. She finds him attractive, can she say yes?

    Joan is recovering from a bad car accident. Chaitan provides home care and sees her alone in her bedroom. She’s afraid she’ll never walk again and she’s in a lot of pain. Chaitan helps relieve the pain and gives her the hope and the therapy that lead to her recovery. Because of Chaitan, she is able to return to work when she never thought she would. The next thing you know, she’s planning to leave her husband for him. He finds her attractive. Can he pursue it?

    What do these two situations have in common? They both cross the appropriate border of the physiotherapist-patient relationship.

    Physiotherapists need to remember how special they are. Your expertise gives you an exceptional position in patients’ lives. Patients are likely to trust you more readily than they would trust someone they met in a different way. They are likely to feel grateful to you for helping them. They may feel intimidated by you because you have skills and knowledge they need but don’t have themselves. You spend time with them in treatment, you touch them, you see them alone and outside of their street clothes. All of these things can lead to a feeling of closeness that would not likely develop if you were to meet elsewhere.

    I know that we all think we can tell when it’s “the real thing” but the law says that Ali is not himself in that relationship—Sharon has a position of power over him that makes her more desirable or compelling than she would otherwise be. Maybe this is even more apparent with Joan and Chaitan—who wouldn’t fall in love with someone so kind and important in their life? In both cases, the law says that if the couple were to have sex, it would be abuse and the physiotherapist would lose his or her licence.

    Does the law go too far? Maybe. But the law is meant to protect the most vulnerable. When a doctor trades sex for drugs, it is easy to see he has taken advantage of a weak patient. But the patient is nearly always a little bit vulnerable. That’s why I want to remind you that you are special and powerful: you help patients to get better. But you must also hold the patient-therapist relationship sacred, by keeping a clear professional distance and remembering that they are your patients, not your friends.

    Related Resources:
    Standard: Therapeutic Relationships and Professional Boundaries
    Guide to Therapeutic Relationships and Professional Boundaries


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    Sharon’s young. Ali’s great looking. She’s treating the rotator cuff he tore playing ultimate Frisbee. They both like House of Cards. The next thing you know, Ali is offering to meet Sharon at a local pub and teach her how to play pool. She finds him attractive, can she say yes? Joan is recovering from […]
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  • Is It Health Care Or Is It A Business?

    Feb 04, 2015
    Does it have to be this way? I think that the difference between a health care profession and a business is simple: it’s in your motive. If you do this for a living to take care of patients, you are a professional. If your top priority is profit, you are a business person. Before you […]
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  • My support person hurt someone. Am I in trouble?

    Jan 05, 2015
    Scene 1: You assessed your patient and made a plan that included having her walk with a walker. But one day, in your absence, your support person independently decides that the patient is ready to use a cane instead. This was really bad judgement. Now the patient has fallen and broken her hip. Are you […]
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  • Bad Start to a New Career

    Nov 13, 2014
    I’m not kidding you, this was a conversation that one of my colleagues overheard recently on a train. Student 1 (let’s call him Jason): I’m going to start my own business. Student 2 (let’s call him Mateo): Me too—I’m never going to work for someone else. Jason: I know, right? And here’s what I’m going […]
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  • Physiotherapy Ethical Issues: Transparency to Patients and the Public

    Oct 16, 2014
    How much information about their health care providers should patients and other members of the public be able to see? Where’s the line between the public’s right to know and the professional’s right to privacy? All of the health care professions in Ontario have Public Registers on their websites. These Registers all have some information […]
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  • Joke: What Do You Call Uninformed Consent? Punchline: No Consent at All!

    Sep 11, 2014
    OK. I know, that was a lame joke. I hope you aren’t coming to this blog for humour. Let me tell you about something that happened to me a few years ago, before I was Registrar of the College of Physiotherapists of Ontario. I called a sports rehab clinic where I’d been before, to see […]
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  • What if Your Colleague Made a Mistake But You Got Punished?

    Jul 09, 2014
    A few years ago the British Parliament was considering how they could improve patient safety after a series of crushing hospital incidents. And here is what the members of parliament said, “Doctors could risk losing their licence if they fail to report fitness to practise concerns about their colleagues.”[1] Do you think about that for […]
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  • Why is the College such a lousy advocate for PTs?

    Jun 10, 2014
    Hi Everyone—the headline is a trick question. We aren’t advocates for physiotherapy or physiotherapists at all. We aren’t even allowed to be. The legislation that creates the College of Physiotherapists (and all the other health colleges in Ontario) gives us our power but also limits our power. It creates the College for the purpose of […]
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  • Clinic Regulation: Now What?

    May 20, 2014
    Two posts ago, I asked you whether you thought that the College ought to regulate clinics in addition to the physiotherapists who work in them. The overwhelming majority of comments favoured this idea. You told us that College regulation would mean higher quality care in the clinics and that it would make them safer places […]
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  • Should the College Regulate Physiotherapy Clinics? Thanks for the Feedback!

    Apr 03, 2014
    Thank you for all your input on the issue of whether the College ought to regulate clinics. We left the blog post up for longer than usual because new comments kept coming in. The College will be exploring the potential for clinic regulation over the next few years. Watch Perspectives or the website for updates […]
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Contact the Practice Advisor

Free and anonymous counsel for PTs, patients, & the public. Learn More 

practiceadvice@collegept.org
416-591-3828 ext. 241
1-800-583-5885 ext. 241