The College received a complaint from a patient about the conduct and practice of a physiotherapist. Regarding their own care, the patient reported that the PT did not conduct a thorough assessment, and the patient believed the assessment was faked to bill the Ontario Health Insurance Plan (OHIP). The patient also said the physiotherapist was treating five patients at the same time and reported witnessing the PT communicating inappropriately with another patient. According to the patient who made the complaint, the PT was raising their voice and being verbally abusive toward the second patient.  

In their response, the PT explained that the second patient, who is elderly, was having difficulty remembering one of the exercises given to them. The physiotherapist suggested that the second patient write down the exercises to help them remember. Although the PT noted that the second patient expected a pre-printed handout of the exercises, they were not distressed. When contacted by the College, the second patient said that they did not feel that the physiotherapist had been abusive to them in any way. 

The physiotherapist denied that the assessment was insufficient. They commented that they conducted a thorough assessment which included both physical observations and gathering appropriate medical history information from the patient.   

The PT also disputed the patient’s claim that they faked an OHIP assessment. The physiotherapist said there was ultimately no billing submitted for the complainant’s appointment, as they were transferred to another physiotherapist after the initial assessment. The PT also commented that they were not treating five patients at the same time, but said there were family members, patients in screening rooms, and patients in the gym at that time.  

Since learning about the complaint, the physiotherapist has given patients the option of having pre-printed exercise sheets, now limits the number of family members present in the clinic and treatment area, and ensures there are not too many appointments each day. 

According to the College’s resource on communication, confirming understanding with the patient is one of the six keys to effective communication. Physiotherapists should discuss goals and ensure a mutual understanding about next steps, possible outcomes of treatment, timelines, and more. Clear communication from the PT is essential to prevent misunderstandings about assessments, treatments, and learning methods. 

The Fees, Billing and Accounts Standard states that physiotherapists must ensure that any fee, billing or account that uses their name and registration number is an accurate reflection of the services and/or products provided. Physiotherapists must never charge fees or create billings or accounts that are inaccurate, false or misleading. While the Committee appreciated the patient raising concerns about suspected fraud, there was no evidence that OHIP was fraudulently billed by the physiotherapist.  

As detailed in the Record Keeping Standard, physiotherapists must maintain clinical records about their patients, and other records that are required by the College, by law, or by other organizations. In this case, the patient record showed evidence of a complete assessment.