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Can’t We All Just Get Along?

Sep 17, 2018

The Case

The College received a complaint about the practice of a physiotherapist working in a long-term care facility. The daughter of a patient raised three concerns including that the physiotherapist was identifying herself as a doctor, not providing accurate employment information and history, and acting in an unprofessional manner. 

The patient’s daughter found the LinkedIn profile for the PT and noted that she was identifying herself as “Dr.” and including employment information that didn’t match the College’s Public Register. 

As well, the complainant noted that the PT behaved unprofessionally — particularly with one physiotherapist assistant at the long-term care facility, to the point where it was referenced in the complaint as “harassment and bullying.”
On one occasion, the physiotherapist yelled at the PTA in a common area, prompting a director to intervene and remind the PT to be respectful.
Both the physiotherapist and the physiotherapist assistant were asked to leave work for the remainder of the afternoon. 

A College investigator interviewed several staff members at the long-term care facility and while approximately half identified personal concerns with the professionalism of the physiotherapist, all of them acknowledged palpable tension and ongoing disagreement between the PT and the physiotherapist assistant. 

The Standards

The Regulated Health Professions Act stipulates that only chiropractors, dentists, optometrists, physicians and psychologists are permitted to use the title “doctor” or “Dr.” in the course of providing or offering to provide health care. This is further enforced by the College’s Restricted Titles, Credentials and Specialty Designations Standard.
 
The College’s By-Laws require that members notify the College of any changes to their personal information including: place of employment, home address, telephone number and email address within 30 days. 

The Collaborative Care Standard recognizes that in a collaborative care situation problems or conflicts may arise that could interfere with the delivery of safe quality care. It’s the responsibility of the physiotherapist to recognize the problems or conflicts and take reasonable steps to resolve them with the patient or the other care provider. 

The Decision

The physiotherapist indicated that in her home country the use of the title “Dr.” is appropriate for physiotherapists and assumed the same would be true in Canada. Upon being informed of the regulations she removed the title from her LinkedIn account, as verified by the College investigator. As such, the Inquiries, Complaints and Reports Committee elected to take no action related to this issue. 

Similarly, the Committee elected to take no action concerning the incorrect employment information of the physiotherapist as she indicated that she was unaware of the long-term care facility changing ownership and immediately corrected her information when it was brought to her attention. 

However, regarding the management of challenging interpersonal relationships, the Committee felt that the interaction between the PT and the assistant undermined the principles of professionalism and mutual respect. The incident had the potential to disrupt the delivery of quality care as outlined in the Collaborative Care Standard.
 
The physiotherapist was required to meet with a coach assigned by the College and successfully complete an educational course approved by the Registrar as part of a Specified Continuing Education and Remediation Program (SCERP), which will appear on the Public Register. All costs of the SCERP will be paid by the physiotherapist and she is required to complete a reflective paper at the end of remediation. 

Restricted Titles, Credentials and Specialty Designations Standard

Collaborative Care Standard 

Comments about this Case? Please share below. 
 
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  1. SANDEEP KAUR | Sep 10, 2024
    NO 
  2. DEMELIN C. TANYAG | Jul 04, 2024
    First of all the Physiotherapist must know that he/ she cant be address as a doctor. Secondly, He/she did not act professionally creating scene in the public. Truly I pity the Physiotherapist as this person lowered his/herself.
  3. dhara kothari | Feb 16, 2023
    we should follow the guidelines -restricted titles
  4. College of Physiotherapists of Ontario | Feb 06, 2023

    Hi Luciana,

    Physiotherapists who received their training in other countries may have a doctorate degree or may have been referred to as a doctor. In Ontario, the title “doctor” and its abbreviation “Dr.” are protected. By law only certain professions (Naturopaths, Chiropractors, Optometrists, Dentists and dental surgeons, Physicians and Surgeons, and Psychologists) are allowed to use the title doctor or Dr. when delivering care or communicating with others about patient care.

    Physiotherapists cannot use doctor or Dr. when delivering patient care or communicating with others about patient care. This is a good time to reflect on your practice and consider if any of your colleagues or staff refer to you as a doctor. If they do, please educate them about why they shouldn’t do this. If you use “doctor” or “Dr.” in your social media profiles, general communication, communication with others including patients, or in charts or email addresses that you use while providing patient care please make the changes to remove any reference to doctor as soon as possible.

    If you have a PhD, you are permitted to use the title “doctor” or “Dr.” only if you are not doing so in a way that is connected to patient care.

  5. Luciana S | Feb 05, 2023
    I have learn that in Canada  that a PT even with a Doctor degree the professional is not allowed to use the term Dr. with patients only with colleagues. I find unfair  that  the professional studied and worked very hard to reach a higher level of degree and can not be recognized publicly.
  6. Gregory Nason | Dec 11, 2022
    It is important for the PT to understand their title in Canada if they are trained or have practiced abroad. It is also important that the PT and PTA have a professional relationship and if there are any disagreements that they discuss this in a private setting away from patients.
  7. Mohammad Yazdchi | Aug 26, 2022
    It is important to inform some patients or even colleagues that PT is not a Dr and They should not call us Dr in clinic to avoid any misunderstanding for patients.
  8. Urvashi Patel | Aug 14, 2022
    We should follow CPO Tile's guidelines in clinical practice to avoid any conflicts.
  9. Heli Pancholi | Jul 11, 2022
    According to the ethical rule we should only use Resident Physiotherapist or Registered Physiotherapist depends on the title you hold.
  10. College Practice Advisor | Mar 01, 2022

    Hi Azmina,

    Thanks for your comment.

    The title of “Dr.” should not appear on anything a patient would receive or see during their patient experience. The Restricted Titles, Credentials and Specialty Designations Standard directly prohibits its use in the provision of care.

    Physiotherapists can use the title “Dr.” in non-clinical settings such as research or academia, or after their protected title. e.g. Mark Stewart, PT, PhD Psychometrics, DPT. If your Linked-In profile is used for purposes of communicating with the public and promoting your clinical practice, you should not be using the title of "Dr."   

    However, if you are using your Linked-In profile to connect with other researchers and it is not connected with your clinical practice, it may be appropriate to use the title "Dr." 

  11. Azmina Moosa | Feb 25, 2022

    If the PT is registered in Ontario and also have a DPT from US, I understand, they are not allowed to use the Dr. title in Canada but from my understandint, they are allowed to use the Dr. title in research, academia - my question is - on LinkdIn profile, are we NOT allowed to use Dr. title there as well?  Please advise.

     

  12. Mitchell Caprelli | Jan 11, 2022
    As per the CPO, when practicing in Ontario we should only refer to ourselves as designated appropriately. This is done to prevent confusion among other healthcare providers and to the patients. 
  13. Aby | Apr 26, 2020
    what about the physiotherapist who have completed doctorate degree. Our profession will never grow. What is the meaning of doing doctorate in physiotherapy, and still MD or PMR prescribing plan of physio care to physiotherapist? 
  14. Lauralee Merkley | Sep 24, 2018

    It would appear that more stress on newly immigrated physiotherapists needs to be placed on familiarizing themselves with the College standards and regulation of their newly adopted country. They obviously passed the written and practical standardized exam process but their seems to be a gap after that.

     

  15. Philip Naiman | Sep 21, 2018
    If this physiotherapist referred to herself as Dr. would this not have been picked up by her employer and discussed so that it would not become an issue?

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