The Situation

Dimitrios Tsaprailis, a physiotherapist with more than a decade of experience and no disciplinary record, came to the College’s attention when an employee at his private clinic was found to be holding herself out as a massage therapist while billing as a physiotherapist. The College of Massage Therapists of Ontario (CMTO) contacted the College after initiating an investigation. When the CMTO undercover investigator received a massage from Mr. Tsaprailis’ staff person, he was told the session would be billed as physiotherapy because the RMT’s registration number “had not yet come, but was expected at the end of the week.”

The College of Physiotherapists of Ontario immediately launched its own investigation and interviewed staff and the owner, Mr. Tsaprailis. He claimed he was unaware of the billing practice, but did acknowledge his responsibility for billing and his staff. The investigation quickly revealed that the person holding herself out to be a registered massage therapist had been working at the clinic for more than a year, and much of her massage therapy work had been billed as physiotherapy services using Mr. Tsaprailis’ name and registration number. In some cases, she was said to have  been acting as a physiotherapy assistant, but according to his records, Mr. Tsaprailis did not get patient consent for an assistant to provide treatments and he did not provide adequate supervision.

As part of the investigation, the investigator requested 10 patient files, however Mr. Tsaprailis could not locate two of them. The missing files arrived a few days later, but the College suspected they had been fabricated. Mr. Tsaprailis denied this at first, but after the College hired a forensic document examiner who could prove that the files had not been created in the usual course of patient care, Mr. Tsaprailis admitted that he had falsified the documents in an effort to cover up inadequacies in his practice. 

At the conclusion of the investigation, Mr. Tsaprailis was referred to the Discipline Committee where he was found to have engaged in professional misconduct related to the following actions: submitting a charge for services that he knew or ought to have known was false or misleading; for falsifying a record; for failing to co-operate with a College investigator; for failing to maintain the standards of practice of the profession; for failing to keep records in accordance with the standards; for failing to obtain informed consent for the involvement of someone else in a patient’s care; for failing to supervise the assistant; and finally for failing to maintain clinical notes and records for patients.  

The Consequences

Mr. Tsaprailis’ efforts to thwart the College’s investigation resulted in a more severe penalty for his actions than if he had chosen to cooperate with the College.

• 6 month suspension of his certificate of registration, with a possible 3 month reduction for successfully completing all of the conditions below.
• He must appear for reprimand before the Discipline Committee.
• He was required to successfully complete, at his own expense, the ProBe Ethics Course.
• He must participate in a 1-year practice monitoring program at his own expense.
• He must review the Professional Misconduct Regulation, Code of Ethics, the Essential Competency Profile for Physiotherapists and Physiotherapist Assistants, and the Standards and related materials on Record Keeping, Fees and Billing and Physiotherapists Working with Support Personnel.
• Should he provide physiotherapy services as a PTA while suspended, it must be under the supervision of a registered physiotherapist and he must advise the College in writing, of the name of the supervising physiotherapist and provide the supervising physiotherapist with a copy of the Notice of Hearing, the Agreed Statement of Facts, the Order and the Decision and Reasons.
• During the suspension period, if he acts as an assistant, he cannot supervise physiotherapy students.
• During the period where he is subject to practice monitoring, he cannot supervise physiotherapy students or College members practicing under a provisional practice certificate.
• He must pay costs to the College in the amount of $25,000.