Case of the Month

Read real cases and their outcomes

  • Missing: Consent, Communication and Acknowledgement

    Feb 19, 2019

    The Case

    The College received a complaint from a patient soon after she attended a physiotherapy appointment which left her feeling confused about the treatment she received and uncomfortable about the way the physiotherapist interacted with her.

    The patient had her first physiotherapy appointment for treatment of an ankle sprain. While she was on a plinth in a long-seated position with her hands behind her, the PT began explaining the nature of her injuries, using a textbook. The physiotherapist proceeded to place the book on the patient’s lap and repeatedly poked her thigh with his finger as he referenced the diagrams.

    The patient was uncomfortable with how close the PT was to her during this explanation and did not understand why the contact with her upper thigh was relevant to the treatment of her ankle.

    The physiotherapist then put the book away, told the patient that she would make a full recovery from her injuries and rubbed her upper back without acknowledgement or explanation, possibly in an effort to reassure her.

    He then proceeded with mobilization of the ankle followed by an ankle stretch during which he placed the patient’s foot in his crotch area and she felt his genitals under her foot. After approximately 20–30 seconds he moved her foot to his upper thigh and continued with the stretch but did not acknowledge the contact with his crotch area.

    Finally, when the patient was leaving the room at the end of the appointment the PT touched under her arm and the side of her breast without acknowledgement or explanation, possibly in an effort to guide her to another treatment room.

    Following the appointment, the patient contacted the local police and then the College as she felt very uneasy about what had happened.

    The Standards

    Ensuring that patients have a solid understanding of the treatment and have provided valid, informed consent is a key component of competent physiotherapy care.

    As outlined in the Boundaries and Sexual Abuse Standard, PTs need to appropriately manage the boundaries within the therapeutic relationship while recognizing that boundaries will be unique to each patient and their experiences. 

    This case raised questions about whether or not the physiotherapist was touching the patient in a clinically appropriate way that would fall within the scope of physiotherapy. Further, could any of these touches have been sexual in nature?

    The Outcome

    The committee that considered this matter found that the PT had engaged in clinically inappropriate touching, violation of the patient’s personal boundaries and failure to obtain valid, informed consent for specific aspects of treatment.

    The PT’s Certificate of Registration was suspended for three months, he received a reprimand, and is required to complete a two-year practice monitoring program and a boundaries education course, at his own expense. This information appears on the Public Register.

    More About Consent

    Boundaries and Sexual Abuse Standard

    Communication Skills

    Full story
    • complaint
    • treatment
    • Consent
    • Boundaries
    • physiotherapy scope
    • Communication
    • Case of the Month
  • Float On, but Don’t Say it’s Physiotherapy

    Jan 23, 2019
    Full story
    • insurance
    • Delisting
    • registration number
    • billing
    • fees
    • scope of practice
    • float therapy
    • physiotherapy
    • Case of the Month
  • There is Such a Thing as Too Friendly

    Dec 11, 2018
    Full story
    • patient
    • physiotherapist
    • relationship
    • friendship
    • professional boundaries
    • therapeutic relationship
    • record keeping
    • informed consent
    • Consent
    • mechanical traction
    • insurance
    • accounts
    • billing
    • fees
    • Boundaries
    • Case of the Month
  • When Acupuncture Goes Very, Very Wrong

    Nov 13, 2018
    Full story
    • physiotherapist
    • physiotherapy
    • acupuncture
    • Case of the Month
  • 1,200 Hours Short of a Certificate

    Oct 19, 2018
    Full story
    • Ontario
    • College of Physiotherapists
    • physiotherapist
    • Case of the Month
    • practice hours
    • registration
    • certificate
  • Can’t We All Just Get Along?

    Sep 17, 2018
    Full story
    • specialty designations
    • restricted titles
    • PTA
    • physiotherapist assistant
    • physiotherapist
    • physiotherapy
    • relationships
    • collaborative care
    • Case of the Month
  • Don’t You Forget About Me

    Aug 21, 2018
    Full story
    • ICRC Committee
    • essential competencies
    • physiotherapy
    • acupuncture
    • Case of the Month
  • Caught Up in the Cryo Hype

    Jul 18, 2018
    Full story
    • physiotherapist assistant
    • advertising
    • billing
    • physiotherapy
    • cryotherapy
  • You Can’t Laser Over History

    Jun 14, 2018
    June 2018 Case of the Month from the College of Physiotherapists of Ontario. The case outlines the use of laser therapy on a patient with a history of melanoma.
    Full story
    • physiotherapist
    • College of Physiotherapists
    • essential competencies
    • record keeping
    • laser therapy
  • The Snowball Effect

    Feb 20, 2018
    Full story

Practice Advice

Free and anonymous advice for patients, physios, students and employers.
Learn More 

practiceadvice@collegept.org
647-484-8800
1-800-583-5885