Practice Advice

As a PT resident with a provisional licence and a PhD in anatomy, your signature on patient charts and invoices should clearly reflect your physiotherapy qualifications. You should use the name listed on the Public Register followed by your PT protected title.

Here is an example of how to craft your signature using professional credentials in a patient-facing environment:

Smita Mehta, PT Resident

MScPT, PhD (anatomy)

Standardized measures refer to measurement tools that are designed for a specific purpose in each population. Information is provided regarding the administration, scoring, interpretation, and psychometric properties for each measure.

Using a goniometer to measure range of motion or a sit to stand test to measure functional movement are examples of standardized measures.

Standardized measures allow for greater consistency and reliability in physiotherapy assessments, by allowing PTs to evaluate outcomes in a reliable way. When a standardized tool is used, PTs can compare results against different patients, settings or points of time. 

Many aspects of physical therapy – such as strength, range of motion, balance, or endurance – can be difficult to quantify without clear, objective metrics. Standardized measures provide numeric scores or classifications that remove much of the subjectivity from the assessment process, allowing for more precise and reproducible re-assessments.  This can also assist in setting SMART goals with your patient. 

Standardized tools can facilitate collaborative care, by improving communication between healthcare providers. They also allow for comparison with population norms or other patients with similar conditions, aiding in decision-making and prognosis.

These measurement tools are often developed and validated through research, meaning they have evidence supporting their reliability and validity. By using these tools, physiotherapists ensure that their assessments are grounded in best practices, which increases the likelihood of effective treatment plans.

If you’re unsure where to find examples of standardized measures, please reach out to our Practice Advice line for assistance.

A privacy breach occurs when personal health information is stolen, lost or used/disclosed without authority. Examples might include lost or stolen charts, or patient health information erroneously sent to people not involved in their care. 

When a privacy breach happens, whether intentional or not, physiotherapists should follow these steps – even if it’s just a single occurrence: 

1. Contain the breach and, if you are the agent of the health information custodian (HIC), notify your organization’s HIC and report the breach to them. 

2. Health Information Custodians must notify the affected person at the first reasonable opportunity and include mention that a complaint may be made to the Information and Privacy Commissioner of Ontario (IPC).

3. You (PT) and the HIC should determine whether your organization’s privacy policies and processes were followed.

4. Next, the HIC must determine:

• If this is a one-time occurrence or if it is part of a pattern of errors
• What the impact on the patient could be
• Whether the breach could happen again

Make note of the findings of the review.

5. The HIC must report the breach to the Information and Privacy Commissioner of Ontario (IPC) if it falls within one of the following seven categories. The categories are not mutually exclusive; more than one can apply to a single privacy breach. If at least one of the situations applies, you must report it. The following is a summary, for complete information see the regulation. 

1. Use or disclosure without authority
2. Stolen information
3. Further use or disclosure without authority after a breach
4. Pattern of similar breaches
5. Disciplinary action against a college member
6. Disciplinary action against a non-college member
7. Significant breach

Note: Not all privacy breaches need to be reported to IPC. For example, if a lost chart was a one-time occurrence, not intentional and not part of a pattern, the matter can be managed internally.

6. Debrief the issues with your team. Share the lessons learned so you can build a positive culture around privacy safeguards in your workplace.

When you’re leaving a practice and there’s no other PT available to take over your patients, it’s important to make sure they still have options for continuing their care. 

Talk to your employer about how you will let your patients know you’re leaving. Options may include providing your patients with a list of other physiotherapists in the area who can help them, or giving the patient an exercise plan to follow at home to keep up with their treatment.

Sometimes, your employment contract might have rules that stop you from telling patients where you are going next. If that’s the case, you can direct them to the College’s Public Register, where your new job will be listed. Make sure you update your information so patients can find you if they want to.

If a patient decides to keep seeing you at your new job, they can ask for a copy of their physiotherapy record from the Health Information Custodian at your previous clinic. This helps make sure you maintain the information you need to continue their care.

The Leaving a Practice Checklist outlines all of the things you’ll need to do before you leave.

The new Communication Standard guides physiotherapists to communicate professionally, clearly, effectively, and in a timely manner to support and promote quality physiotherapy services. One of the stated expectations is that the PT « documents all communications accurately, clearly, professionally, and in a timely manner. »

The College guidance regarding documenting communication has not changed. All forms of communication (for example, telephone, email or DM) that are relevant to the patient’s condition or the care provided are part of the clinical record. In the example above, a PT would not need to include a DM about what hours they are working.  However, the text message indicating a change in symptoms should be included in the patient’s record.

Yes! As a College-approved supervisor, you are an important and valued link for a PT resident to move towards their independent registration.  Not only do you act as a clinical mentor, but you also demonstrate for them how to behave as a regulated health professional.  

The College has a learning module called Supervising a Physiotherapy Resident: Everything You Need to Know as Their Supervisor. This module provides useful tips on how to manage your supervision, including keeping records of your meetings and tracking learning goals. It also introduces tools on the CPO website, such as the Identification of Learning Needs and Record Keeping Checklist.

Keeping records is key. For example:

• Track the dates and details of your check-in meetings.
• Monitor the progress of set learning goals.
• Document the results of any chart reviews.

If you have concerns about a resident’s practice or need advice on your supervision, please reach out to us at Practice Advice.

Yes, a physiotherapist can reduce or waive the cost of an assessment or treatment for patients who are struggling financially. According to the Fees, Billing, and Accounts Standard, any changes to the regular fee schedule can only be made to lower the fees. 

When offering discounts, physiotherapists should follow a professional and ethical approach. It’s recommended that physiotherapists document the reason for the fee reduction or waiver in the patient’s record and ensure that the amount charged is correctly reflected in any invoice given to the patient. 

It’s important to remember that reducing or waiving fees should not result in a shorter or incomplete assessment. Any treatment plan should be based on what is clinically necessary, regardless of the fee charged or waived.