Discipline Case Summary
The following is a summary of the matter placed before a five-member panel of the Discipline Committee of the College of Physiotherapists of Ontario on November 9-10, 2005, December 7, 2005, January 4, 2006 and April 6, 2006.
The Allegations
The Discipline Panel found that the conduct alleged in the statement of agreed facts and joint submission on finding constitutes professional misconduct as defined in the College’s Professional Misconduct Regulation of Ontario 861/93 as amended: paragraph 2 (standards of practice), 3 (lack of consent), 13 (failing to keep a record), 14 (falsifying a record), 16 (signing a false statement), 17 (issuing a misleading document), 18 (submitting a misleading account), 23 (act or omission inconsistent with the legislation), 25 (unprofessional conduct), and 29 (failing to supervise) and the conduct also constitutes incompetence as per section 52 of the Health Professions Procedural Code, in that his professional care of his patients « displayed a lack of knowledge, skill or judgment or disregard for the welfare of the patient of a nature or to an extent that demonstrates that the member is unfit to continue to practice or that the member’s practice should be restricted ».
Summary of Factual Findings
Between 2003 – 2005, Mr. Dei-Amoah attended various clinics for a few hours about once or twice every two weeks. He would conduct assessments of some, but not all, new patients. The patients would then be treated, reassessed, reported on and discharged by unregistered persons often in Mr. Dei-Amoah’s absence. Mr. Dei- Amoah had actual knowledge of the above concerns because he regularly reviewed the patients’ records. The unregistered persons routinely performed activities that physiotherapists are not permitted to assign, including assessments, reassessments, amendments to treatment plans, and entering clinical documentation for the same. The services would be billed as physiotherapy services using Mr.Dei-Amoah’s name and billing number. In some cases, Mr. Dei-Amoah never saw the patient. When asked about these matters, Mr. Dei-Amoah declined to assume professional responsibility for the care and billing of the patients for which, in the circumstances, he was the responsible physiotherapist.
Order on Penalty and Costs
The Discipline Committee delivered the following orders as to Penalty:
- The Registrar was directed to revoke Mr. Dei-Amoah’s certificate of Registration commencing April 6, 2006.
- Mr. Dei-Amoah will pay costs to the College in the amount of $17,500, payable within three years from April 6, 2006.
The Panel’s Reasons
Finding of Misconduct and Incompetence
The Panel accepted the evidence from a number of witnesses who testified at the request of the College including co-workers, patients, professional colleagues and the College investigator. The Panel also found that even some of the evidence given by Mr. Dei-Amoah supported the allegations. The Panel did not accept much of evidence given by Mr. Dei-Amoah as it was implausible and inconsistent with the evidence of the other witnesses and the documents and the statements he made earlier to the College’s investigator.
The uncontradicted evidence of the physiotherapist expert witness was that Mr. Dei-Amoah’s conduct fell below the accepted standard of practice of the profession, was unprofessional, was contrary to publications by the College and fit the definition of incompetence. The Panel accepted that evidence.
Penalty
In assessing the proposed penalty order, the Panel considered those audiences with a vested interest in the matter – the public, registrants and the profession. The College, which governs the self-regulating physiotherapy profession, is charged with the responsibility of protecting the public.
Although Mr. Dei-Amoah pleaded to be allowed to continue to practice until retirement, he was persistent in his denial of responsibility for the billing irregularities and outright fraud perpetuated on the insurance companies and other payers. He never acknowledged his deficient standards of care, which included all facets of patient care including assessment, reassessment, documentation, treatment planning, ongoing treatment, assignment of duties and discharge planning.
Mr. Dei-Amoah never considered the consequences of his actions and inactions. At no time was he heard to say that he would seek help to rectify his practice and change his ways. The Discipline Committee considered Mr. Dei-Amoah’s actions serious and inappropriate and concluded that Mr. Dei-Amoah did not have the capacity to do a proper patient assessment or change his behavior. Therefore, the Committee determined that Mr. Dei-Amoah could not have the opportunity for remediation and rehabilitation and decided that revocation of his certification of Registration was required to protect the public interest.
Costs
The Discipline Committee determined that Mr. Dei-Amoah should pay costs for this case due to the serious and intentional nature of the misconduct. However, the Panel also considered his difficult personal financial circumstances and approximately a third of the overall costs incurred for the hearing by the College were ordered to be paid by Mr. Dei-Amoah. This amount was added to a previous order to pay costs of $2,500 as the result of an adjournment. The Committee fixed the total amount owed by Mr. Dei-Amoah at $17,500.