The Situation

Niall is a physiotherapist at the Walk This Way private practice clinic in southern Ontario. Many members of Niall’s large extended family work at the neighbouring plant. Each family member at the plant has $500 of physiotherapy benefits per year. So far, the benefits have not been required. Niall’s cousin Vera suggests this is a waste as they already pay into the program through their payroll deductions and they are getting nothing for it. She suggests they submit claims for physio and split the reimbursement. All Niall needs to do is complete the form. She assures Niall that it’s not a big deal because insurance companies have a lot of money and he can use the money to improve his clinic, which will ultimately help his patients. It’s a pretty temping offer and Niall really doesn’t want to cause another family quarrel. What difference could it make anyway? 

Requirement:

Members are expected to uphold the reputation of the profession. Falsifying a record, submitting an account or charge for services that a PT knows—or ought to know—is untrue or misleading is unethical behaviour and in direct violation of the Professional Misconduct regulation.

What Happened?

Niall had a bad feeling about the situation, but he was still on the fence. He did not want to get in trouble with the family, but trouble with the insurance company might be worse and Walk This Way was his passion. He just wasn’t sure how to get out of the situation and make his family understand things were not as simple as signing his name to a claim form. He called the Practice Advisor to talk through the dilemma. Once Niall learned how very serious the situation could be, the decision became crystal clear. He printed off a copy of the Professional Misconduct regulation and some headlines about business fraud and gave them to Vera. She was disappointed, but not as angry as he thought she would be. Niall knew he had made the right choice.