Can Physiotherapists Use Incentives?

The College of Physiotherapists of Ontario does not have a specific rule about the use of incentives. Incentives may include things like discounts, rewards, gift cards, points programs or free parking or discounts for example. 

If you are a physiotherapist considering offering incentives or the practice where you work is considering offering incentives, you should reflect on the following things before making a decision. 

• Your professional judgment should not be compromised when offering incentives. 
  
  
• You should only provide care that is clinically indicated regardless of whether an incentive is offered.
  
  
• The cost of the incentive cannot be added to the cost of the service / invoice which is then provided to a third-party payor 
  
  
• You must protect patients who are vulnerable to unethical business practices when offering incentives
  
  

A conflict of interest of any kind (including the use of incentives) has the potential to compromise the trust that a patient has placed in their physiotherapist and, on a wider scale, the confidence that the public has placed in the physiotherapy profession. 

Offering incentives comes with risks. When making the decision as to what incentive you might offer patients you must ensure that incentives provided for patients’ benefits (things like free parking or a $10 discount on assessment) do not affect your clinical decision-making when recommending ongoing treatment. 

Incentives linked to ongoing care may present an opportunity for certain patients with high or unlimited extended health benefits, and low personal income, to be taken advantage of should you offer goods in exchange for physiotherapy services. Doing this would be inappropriate. At no time should a physiotherapist provide care based on the patient’s benefits rather than objective findings and clinical reasoning.

Although there is no specific rule related to incentives, it is imperative that you make your decisions after having reviewed the Advertising Standard, Fees, Billing and Accounts Standard and Conflict of Interest Standard when considering business models and introducing incentives into your practice. 

While the College does not have a list of specific incentives that may be appropriate or inappropriate you should be aware that third party payors may have different positions regarding the use of incentives. Any decision made by a third-party payor to delist a clinic or a physiotherapist based on the use of incentives is made independent of the College.