Discipline Case Summary 2000 0006

Discipline Case Summary

The following is a summary of a matter placed before a five-member panel of the Discipline Committee of the College of Physiotherapists of Ontario on October 29, 2001

The panel of the Committee considered a Joint Submission on Finding and accepted that, with the exception of paragraph seven, it established professional misconduct as alleged. Accordingly, the panel found Mr. Y guilty of professional misconduct as defined in paragraph 14 (falsifying a record) of Ontario Regulation 861/93, Professional Misconduct, Physiotherapy Act, 1991.

The Hearing

Mr. Y had obtained the advice of independent legal counsel, but chose to attend the hearing without counsel. The primary relevant facts were set out in the admissions by Mr. Y contained in Joint Submission on Finding as follows:

1. Mr. Y is a duly registered physiotherapist in Ontario.
2. Mr. Y worked at the XYZ from about April of 1996 to about September of 2000.
3. Mr. Y falsely recorded in documents used for workload statistics, management purposes and as patient records that he had seen patients when he had not seen them.
4. As a result, the hospital had inaccurate information about the attendance of these patients.
5. There were patients awaiting treatment during the spring of 2000 at the hospital.
6. As a result, the hospital had inaccurate information about Mr. Y’s workload.
7. Funding levels for the physiotherapy services in the hospital are determined, in part, on workload statistics.
8. Mr. Y made late or changed entries in the record of D. H. without indicating that he was doing so.
9. Mr. Y did not obtain any direct financial gain from these inaccurate records.
10. The conduct alleged above constitutes professional misconduct as defined in paragraph 14 (falsifying a record) of Ontario Regulation 861/93 as amended.

Additional evidence filed as part of the joint submission included various statements taken by the College investigator, including interviews with Mr. Y, hospital management, co-workers and patients, and records from the physiotherapy department.

Based on the evidence filed, it was the opinion of the panel that the evidence presented a compelling picture of deliberate (not accidental or incidental) and protracted (April 1996 – Spring 2000) falsification of records of patient attendance. Accordingly, the panel found Mr. Y guilty of professional misconduct for falsifying records.

Decision

A joint submission on order was filed and oral submissions were heard from counsel for the College and Mr. Y. Aggravating factors as presented by Mr. Steinecke were considered, including an implicit element of dishonesty; the chronic, extended nature of the practice; and the potential impact such record falsification might have on public access to the provision of physiotherapy.

The panel did not feel it could accept the final point or, similarly, item seven listed above from the Joint Submission on Finding. While the panel accepted that Mr. Y’s actions could “exacerbate the hospital physiotherapy waiting list,” or adversely affect funding by the Ministry of Health towards the global budget of the physiotherapy service, there was no evidence to establish this.

The panel found Mr. Y to be disingenuous in his assertion that he recorded last-minute patient cancellations as attendances to favour hospital productivity statistics. The panel felt it was incapable of accurately judging attendances and their impact on either access or funding.

The panel considered the following to be mitigating factors: that it was the first offense for Mr. Y in 26 years of professional practice; Mr. Y was cooperative; and when presented with the evidence, Mr. Y was willing to plead guilty, accepting responsibility for his actions and the public perception they might engender. Mr. Y’s willingness to plead guilty and agree to a Joint Submission saved the College considerable expense. Mr. Y agreed to the penalty set out below after receiving independent legal advice.

Penalty

The Discipline Committee ordered as follows:

1. That Mr. Y be reprimanded and the fact of the reprimand be entered in the public portion of the register.
2. That Mr. Y’s certificate of registration be suspended for a period of three months. However, that suspension shall itself be suspended if Mr. Y complies with and successfully completes the other provisions of the order.
3. That it be a term, condition and limitation upon Mr. Y’s certificate of registration that he successfully complete, in the opinion of the Registrar, a workload statistics course acceptable to the Registrar at his own expense within six months of the date of the order.
4. That it be a term, condition and limitation upon Mr. Y’s certificate of registration that he successfully complete, in the opinion of the Registrar, a course of remediation over a period of about 12 months regarding workload measurement statistics and related record keeping, that includes the following:
   1. Fully cooperating with a remediator appointed by the College at four meetings where the remediator will review and evaluate Mr. Y’s current workload statistics for a two to four week period and about 20 to 25 charts and provide a written report with any recommendations.
   2. Implementing any recommendations made by the remediator.
   3. Paying for the costs of the remediation sessions within 30 days of being invoiced. If the reports of the meetings with the remediator indicate, in the opinion of the Registrar, that additional meetings are not necessary, fewer than four meetings can be held.
5. That it be a term, condition and limitation upon Mr. Y’s certificate of registration that he successfully complete, in the opinion of the Registrar, a follow-up evaluation to assess whether he has successfully integrated the information learned in the course of remediation, that includes the following:
   1. Undergoing the evaluation, which will take place about six months after the course of remediation.
   2. Fully cooperating with an evaluator appointed by the College at one meeting where the evaluator will review and evaluate Mr. Y’s current workload statistics for a two to four week period and about 20 to 25 charts and provide a written report.
   3. Paying for the costs of the evaluation within 30 days of being invoiced for them.
6. That it be a term, condition and limitation upon Mr. Y’s certificate of registration that he not act as a supervisor for a holder of a supervised practice certificate of registration or under any arrangement in which a supervisor is required for another member by the College until he has satisfactorily fulfilled paragraphs 1 to 6 of this order.
7. That Mr. Y pay to the College $10,000 towards the costs and expenses of investigating and prosecuting this matter, payable in equal monthly installments over a period of 40 months, commencing the month after the date of today’s order.