The College received a complaint from a patient about the conduct and practice of a physiotherapist. The patient said the physiotherapist repeatedly asked them to purchase equipment from the clinic and discouraged them from purchasing the equipment from a discount store, even after the patient said they were on a limited budget. The patient also said the PT didn’t provide clear information about fees.

The patient noted that the clinic tried to charge the patient’s credit card several times, even though the patient thought the entire appointment would be covered by their insurance. Lastly, the patient claimed that the physiotherapist did not tell the patient what the equipment was for or how to use it. 

The patient received an email from the clinic shortly after their appointment, discharging them because of their behaviour. The patient believed that they were discharged because they wouldn’t purchase equipment from the clinic.   

The physiotherapist denied that they or any clinic staff ever pressured the patient to purchase products from the clinic. In fact, the PT claimed that they recommended that the patient purchase the equipment from a discount store. The physiotherapist also insisted that they showed the patient the equipment, explained what it was and told the patient why they would be using it.  

The PT explained that before they led the patient to the treatment room, they confirmed that the patient had filled out the clinic’s physiotherapy consent form and general intake form, which outlines the patient’s financial responsibilities when receiving treatment at the clinic. Since receiving the complaint, the physiotherapist has ensured that the front desk staff also verbally confirm the fees with patients.  

As for the credit card charges, the physiotherapist was informed that staff attempted to charge the patient’s credit card for the remaining balance owed, which was not covered by their insurance policy.  

Lastly, the PT explained that they overheard the patient become agitated with the front desk staff when the patient was told that the session was not fully covered by insurance. The physiotherapist was later informed by the clinic’s management that they decided to cancel the patient’s follow up appointments because of their behaviour with staff.  

According to the College’s Providing and Refusing Care Standard, physiotherapists must not make decisions about providing care based on discriminatory reasons. In this case, the patient thought they were refused care because they could not afford equipment.

The Standard states that a physiotherapist can discontinue care if they believe that the patient may become abusive. The clinic decided to cancel the patient’s follow up appointments because of their behaviour with staff. However, the Standard also states that physiotherapists who choose to discontinue a patient’s care should ensure that the patient has been given a reasonable opportunity to arrange alternative services. 

The Communication Skills resource explains how effective communications can improve patient satisfaction and experience, among many other benefits. The reason for discharging the patient was unclear and the PT wasn’t involved in the decision, which caused a breakdown of trust within the therapeutic relationship. Without a complete explanation, the patient felt abandoned and unjustly discharged.

The Fees, Billing and Accounts Standard emphasizes that physiotherapists must ensure that patients are given clear information about fees, and that they understand the information before providing care. While the patient claimed that they were not aware of all the fees, the physiotherapist confirmed that the patient had filled out the clinic’s physiotherapy consent form and general intake form, which outlined the patient’s financial responsibilities.