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Physiotherapy Ethical Issues: Transparency to Patients and the Public

Oct 16, 2014

How much information about their health care providers should patients and other members of the public be able to see? Where’s the line between the public’s right to know and the professional’s right to privacy?

All of the health care professions in Ontario have Public Registers on their websites. These Registers all have some information about health care providers. For example, you can find out where your doctor went to university or whether your dentist has been disciplined by the College. But should these Registers go farther?

As a member of the public, should you be able to see exactly why your optometrist was referred to a Discipline hearing? Should you have the ability to find out whether the Ontario College of Pharmacists’ Inquiries, Complaints and Reports Committee ordered your pharmacist to take training courses or work under supervision? Should you be able to look up whether there are criminal charges outstanding against your mom’s favourite nurse?

You may have read in the news recently that the Minister of Health told all the Colleges to make transparency a priority. It is Dr. Eric Hoskins’ opinion that we need to ensure that as much information as possible is shared with the public. View the Minister’s letter and the College’s reply to it.

As it turns out, our College has been considering these important issues in partnership with the professions mentioned above for more than a year. All of these Colleges have been taking steps to make more information about our members available to the public. In September 2013, our Council approved Transparency Principles and at its last meeting, Council tentatively approved changes to the by-laws that will add information to the Find a Physiotherapist feature of the website such as criminal findings, bail conditions, the status of hearings for PTs referred to the College’s Discipline Committee and whether physiotherapists use support personnel.

We are asking for your input about these changes, please provide your thoughts. Once Council has received your feedback, they will make a final decision about whether to publish these pieces of information on the Public Register.

But that is only phase one. The second phase of the transparency project will consider what other types of information should be made public – in particular, criminal charges and Inquiries, Complaints and Reports Committee decisions. You’ll be asked for your opinion again about those things in the new year.

If these changes are approved at all the Colleges, you’ll see more information about health care professionals which may help you choose between practitioners. On the other hand, if you are a physiotherapist, it also means that the public may soon have additional information about you.

This is important.

Tell your friends to check it out and have your say. In the world post WikiLeaks, are there barriers to the amount of information that should be available about health professionals? Where is the line between the public’s right to know and the professional’s right to privacy?

I’m listening…

 

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  1. Anonymous | Nov 11, 2014

    I went and check college of chiropractors of Ontario and college of massage therapists of Ontario first time, when I read about the new changes. I tried searching for discipline hearing on chiropractor’s college for about two to three minutes. I could not find any. I gave up. I searched massage therapist website for the same. Found the disciplinary hearing cases BUT they were not posted on first page as what CPO website has. One has to go through the tabs on CMTO’s website to find the tab of disciplinary hearing. On CPO website, it is readily available. How much more transparent we have to be?
    There is something interesting, I would like to share with all of you. Try going to any nearest police station. Ask them for details of crime committed by any criminal. This criminal can be anyone who you know. It can be someone you have heard about. Police will not release it. The reason is that there are some laws of privacy in Canada. Police cannot release anybody’s crime details without permission from that person. That is why either we or the employer has to apply for police clearance with our signature on it. So… the people who have committed the crimes like murders can hide their deeds under the law of privacy but a physiotherapist who might not wrote few files, up to college’s expectation, will be humiliated not only in front of Canada but also in front of whole world!!!!
    Why don’t college realize that if a physiotherapist will work exactly as college expect; either the physiotherapist will loose the job or will have to spend money out of their own pocket to sustain their own practice.

  2. Anonymous | Nov 03, 2014

    Not sure CPO’s approach is out of line with what’s going on in regulation in Ontario. As a PT, I’ve been reading the media coverage and there is a real push on for all regulators to be more transparent. As a fellow citizen of Ontario and Canada, I’m glad to have emigrated to a country where the public protection is strong.Who cares if patients can read about my professional history online? I have nothing to hide!

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  3. Anonymous | Nov 02, 2014

    I think it is a sad situation when the head of a governing body, Shenda, will do whatever it takes to publicly humiliate another human and seems to have no conscious whatsoever in doing so. The greater responsibility is to not become ” power hungry” with your position and look at all sides of the equation. It is pathetic that she can not do anything but bully the members and claims it is in the public interest. This is a prime example of an abuse of authority and power over the members. Why do other colleges have much more civilized outcomes to situations that happen to it’s members. The CPO has taken the hardess approach on all matters when it comes to governing the physiotherapists in Ontario. Perhaps having a former lawyer at the head of the CPO isn’t the best idea. Members are real people with families and friends and lives. Physios don’t expect to have every aspect of their lives open for public review and perhaps Shenda has forgotten that aspect of being a citizen of Ontario and Canada regardless of what our chosen occupation is.

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  4. Anonymous | Oct 30, 2014

    As a member of the public I am already appalled at the amount of information that the CPO publishes on its website. What is reasonable for me to know is that my physio went to school, graduated and is now registered to practice physiotherapy in Ontario. If a member has had their license retired, resigned, or revoked, I don’t need to know why, they are no longer practicing. When will this glut of “information sharing” stop? If a member’s activities don’t directly impact their ability to treat me well I don’t need to know about it. Often lapses in judgment cause enough personal embarrassment to members and their families, they do not need to be publicly humiliated as well.
    Until just recently I didn’t even know the CPO website existed and I could look someone up. I can tell you how I know if the therapist is competent…my issue is resolved or it is not. Public humiliation and embarrassment is not any way to treat members and it is not anyway to set an example as a self regulating body. Shame, shame CPO.

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  5. Anonymous | Oct 27, 2014

    Mind you, I can be treating clients (eg: Acupuncture or DBE’s) who chose not to disclose to the team that they have communicable diseases. If i end up getting ill, could they be guilty of treason?

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  6. Anonymous | Oct 24, 2014

    I commend this post and kudos to those who are against public humiliations to us professionals. Yes, we are HCP’s and we have to be role models but we are humans who have human rights like everyone else. Which public ministry website should I go and see a list of its government employees or officials who were found guilty of illegal activities except for the news? How do I get to know know about the disturbing details of the wrongdoings of the specific hearings? and if they were in the news, we should be able to revisit the public shame for two decades in a website as well, right?

    I cannot harass a patient and likewise, a patient should not harass me. Anyone of us may end up in a shameful situation but sadly some may be framed-up. While most of us are innocent, these kinds of public humility may either put a stigma to our profession or make us a target to the real evil-doers of society (like some rehabilitation clinics which have illegal practices).

    However, I don’t think that the college would be able to publicize our health info. I am unsure if it is allowed to say that a practitioner is demented or suffering from anxiety when a malpractice was committed.

    I think that we should not complicate things and focus on the essentials of the issue here by not exaggerating what the college might do one day: publish your hobbies, parking tickets, etc., but I need to know if a physiotherapist has stole a health info, identity, narcotics, etc., Mike.

    Cheers!

    Struggling HCP

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  7. Anonymous | Oct 19, 2014

    Agree-where does our right to privacy start. Your name, roster items and standing with the college is enough.

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  8. Anonymous | Oct 19, 2014

    It is a tough balancing act! I agree with the many posts that privacy is important but if our members have been convicted/found guilty of offences that impact their professional life and put the public in harm’s way then the public should know. The dilemma, as Mike has eloquently written, is exactly what information…and I would add when… should that information be shared? Is it shared during the investigation phase or only when there is real evidence of wrong doing? I read this story in the Hamilton Spectator this weekend; although as a female member of the public I would appreciate being aware of the allegations against this doctor, as a practitioner the concern that your reputation would be ruined prior to any conviction is worrying. http://www.thespec.com/news-story/4921198-burlington-doctor-ordered-not-to-treat-female-patients/
    In addition recent news items that speak to the kind of havoc that can occur when someone deliberately sets out to ruin another’s online reputation by posting false information leaves one feeling vulnerable; would those false allegations lead to restrictions on our practices during the investigation and would that be publically displayed.
    That said, the CPO would need to have very clear guidelines regarding what can, and should be shared, and when, so that there is a level of transparency for all. Members then practice knowing the consequences that will arise if that practice or behaviour isn’t in line with professional guidelines. I personally have a high level of trust in the CPO and recognize nothing is done lightly!
    Great discussion so far.

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  9. Anonymous | Oct 17, 2014

    I support your desire to regulate physiotherapy clinics but the price to pay for gaining this right from the Ministry may be too high if the privacy of our members is overly compromised. It is the nature of government relations to give in order to get. If we are going to be involved in this type of horse trading we need to be cautious of what we barter away.

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  10. Anonymous | Oct 17, 2014

    I think we need to be careful of the slippery slope between and individual’s right to privacy and the public’s need/wish/desire to know. Like the first comment, I agree that professional information only should be public; schooling, standing and rostered activities, and disciplinary information. They do not have a right to know about a therapist’s actions and activities once they step outside the door of their professional environs. This has potential to endanger a member. Personal health and demographics? No way. The College cannot ignore that its members are still a female majority; there is a personal safety issue at hand. I also think that the College needs to re-explore protection of “physiotherapy” and “physical therapy”. Protection of this would enhance the public trust…people are always surprised when I advise them that any Tom Dick or Harry can hang a shingle and advertise physiotherapy services. There’s certainly no transparency there, is there?

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  11. Mike | Oct 17, 2014

    I think personal privacy is one thing. Professional is another. If something you do in your personal life will have a direct effect on your professional life, then I think the public should know. Drug trafficking? Yes. It points to ethics, morals and decision making. All things I would expect a professional to have. But if they don’t have it personally, then they don’t have it professionally, and I should be able to know that as an informed user of health care. Sexual offences, yes. But I don’t need to know how many parking tickets she got, whether she stole something 5 years ago or whether her favourite past-time is shooting squirrels with a pellet gun…

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  12. Anonymous | Oct 16, 2014

    And again, although we are reviewing serious issues of transparency and clinic regulation, we still do not have protection of the word “physiotherapy”. The College’s reply talks about “physiotherapy clinics”. If we significantly care about public choice and safety, we and the Ministry will address this issue, because a high school student is providing unregulated, non-transparent physiotherapy care at a “physiotherapy clinic” (or athletic facility, or chiropractic clinic) down the street for half the price.

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  13. Anonymous | Oct 16, 2014

    I have already noticed a big difference in College websites – some Colleges publish more than others. I appreciate the public’s right to know essential information, and I very much believe in an individual’s right to privacy.

    I think putting a lot of information on the website is like public shaming – reminds me of the old town squares where people would hang by their wrists in front of city hall. And we don’t publicly shame our children anymore. No dunce hats, standing in the corner. I think, if something like this happened to me, it would be difficult to move forwards with this public viewing. What do our experts in the field of healing and forgiveness have to say about this?

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  14. Anonymous | Oct 16, 2014

    Let’s get the ball rolling…..where will this all end? As a citizen I expect a certain level of personal privacy. It is easy for the government to constantly want more transparency, but the reality is, there are “nutters” and genuinely bad people out there who would just love to know more about us. At one point will the College list our home addresses, phone numbers, sexual orientation and even medical information i.e. do I have hepatitis, AIDS etc. Again where does this “transparency” end? I believe the College should provide my name, roster items and whether or not I am in good standing with the College. That’s it, End of story. It is time for physios to start speaking out about our personal rights…nobody else is standing for up for us if we don’t do it ourselves.

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