The Case
Between March 2018 and March 2019, the College received a series of complaints from members of the public about the practice of a physiotherapist at a wellness clinic where personal training sessions were being billed as physiotherapy.
The physiotherapist worked at the clinic on a part-time basis and attended the clinic once a week for a few hours. The clinic owner was not a regulated health professional but would provide services as a physiotherapist assistant.
Invoices were issued to clients using the physiotherapist’s name and registration number; however, the services were personal training sessions that did not qualify as physiotherapy treatments.
In many cases, the PT had not assessed the client or provided any type of physiotherapy treatment.
Any assessments or treatments that were documented in client files failed to meet the standards of practice. The physiotherapist neglected to include any clinical analysis, diagnosis or detailed treatment plans specific to client conditions. She did not discharge clients when it was clinically indicated to do so and failed to reassess them to determine their progress.
Further, the PT had no control or direction over which physiotherapy assistants (PTAs) were assigned to her clients and failed to provide adequate guidance to the “assistants” who were in fact acting as personal trainers.
The PT noted that she was offered the job at the clinic during a challenging time in her life and was grateful for the employment opportunity. She also said that she had no knowledge of or involvement in the invoicing of clients.
The Standards
The physiotherapist failed to meet a number of professional standards.
Physiotherapists are accountable for any fee, billing or account that uses their name and registration number and must be aware of how their name and registration number is being used. The PT noted that she was not involved in the invoicing of clients, however her name and registration number were frequently used to bill sessions as physiotherapy. In this case, clients were being invoiced for multiple ‘physiotherapy’ sessions even though they never met the PT.
Regarding working with PTAs, the physiotherapist failed to obtain valid, informed consent from clients to include assistants in their care and failed to adequately supervise the PTAs.
The PT noted that treatment at the clinic was focused on exercise, strengthening and stretching, however her assessments and treatment plans (or lack thereof) were well below the standards for the profession. In most cases, assessments or reassessments were not documented in the clinical notes at all.
The Outcome
This is professional misconduct. The PT had her certificate of registration suspended for 15 months, appeared before the Discipline Committee to receive a reprimand and had to pay $2,000 to cover costs to the College.
This case serves as a reminder that there are some employers who will attempt to lure PTs into inappropriate business practices with a tempting job offer.
Remember, if a job offer seems too good to be true, it probably is.
Ask questions and make sure you are still able to meet the standards and your professional obligations.
Fees, Billing and Accounts Standard
Working with Physiotherapist Assistants Standard
Record Keeping Standard
Consent Resource
Essential Competencies