What are unwritten standards and why do they matter?
All colleges have written standards. Yet many issues that come before the Inquiries, Complaints and Reports Committee (ICRC) and Discipline Committee at the College have to do with disregarding other rules – the unwritten standards that establish expectations for the profession.
Consider the Working with Physiotherapist Assistants Standard. When determining an appropriate level of supervision, you should factor in things like risk to the patient, caseload and treatment complexity. The standard doesn’t provide a limit for how many people you can supervise, or at how many locations. It doesn’t describe every risk. You, the professional, must fill in the unwritten part using your professional judgement.
A written standard is a signpost not a how-to manual. It lays out the basis for practice and describes a level of professional performance considered to be acceptable.
As a physiotherapist you are constantly using unwritten standards – things such as asking a patient for permission before you touch them, giving the person privacy when they change, or not being late for appointments.
Following unwritten standards comes from experience, seeking advice from peers about practice situations, reviewing cases, being lifelong learners of the profession, and running decisions through an ethical filter.
The College could never codify everything in written standards, even if it wanted to. Standards can’t cover every situation – and are often purposely written not to).
If you’re unsure about an unwritten standard, refer to this grounding principle: put the interests of patients above all else.
Some of unwritten standards PTs follow every day:
Being nice and polite to patients
Greeting patients when they arrive
Introducing yourself to patients, families, caregivers, colleagues
Knocking before entering a patient’s room
Doing what you said you would do
Being on time for appointments
Making eye contact
Responding to patients questions and concerns
Being truthful
Listening
Being empathetic
Asking permission before you touch
Giving a patient privacy when they are changing
Apologizing when you are wrong or make a mistake
Learn More
The Go-To Clinical Skill – Communications
Transitioning to Practice in Ontario Learning Modules