Under the Influence: Melissa’s Heartbreaking Dilemma

The Situation

Melissa is a physiotherapist who works at Wendell Chapel Clinic. One morning she arrives at work and encounters a fellow PT, Harry, who look disheveled and is behaving erratically. When Melissa speaks with Harry she realizes he’s slurring his words and smells of alcohol. This is especially distressing to Melissa as it’s the third time he’s displayed this behaviour within the past four months. She shares her concerns with a co-worker who tells Melissa to give Harry a break as he’s under a tremendous amount of professional and personal stress due to his hours at the clinic being reduced, his mother being in the hospital and his wife leaving him. When Melissa goes to check on Harry, she finds him asleep on a chair in the staff kitchen. To keep the situation from escalating or having patients become aware of the issue, Melissa quickly calls for a taxi to take Harry home and once he has safely and discretely left the clinic, she reassigns or reschedules his patients. Melissa is aware that Harry’s behaviour is dangerous and puts patients at risk, but she’s afraid to speak up because she believes doing so would result in Harry’s dismissal which would put him in an impossible position given all the other stress in his life.

The Requirement

Melissa’s obligation to report her colleague is not a legal one, but an ethical one as well as a question of professionalism. Melissa knows that reporting her colleague is the right thing to do, but she is worried about hurting him. Melissa should consider that her obligation to put patients’ interests ahead of her own includes Harry’s patients. Her failure to prevent those people from risk is a failure of professionalism. She should also consider that Harry will likely be better off if she goes through with the report:  the College’s response to mental health and addiction problems is focused on getting the PT the help that he or she needs. While Harry’s practice may be restricted until he is well enough to provide safe and effective care, his identity will be protected and the College will do its best to support him in his journey to wellness. 

In the end, Melissa did report to the College. You may not have heard anything about it because of the confidentiality protections, but Harry entered into an agreement with the College to see his family doctor, get treatment for his addictions and, after a short break from work to deal with his stress, is back to a full-time practice. Melissa still works with him every day.

More about reporting obligations

The Regulated Health Professions Act (RHPA) identifies a number of situations in which physiotherapists/physical therapists, other regulated health care providers and employers of these individuals have a legal obligation to make a mandatory report. The reporting obligations differ depending upon the role that one has when the situation arises. 

Read the Professional Reporting Obligations Briefing Note

Learn about Mandatory Reporting

Read more: What does Professional Misconduct Mean to Me?