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Can I Get a Do-Over? 11 Business Practice Regrets from Real PTs

Aug 14, 2019

We all have regrets in life… you might regret eating that third piece of pizza, staying up too late or even some of your career choices.

Reflection is important but by identifying areas of potential regret, and getting ahead of them, you may avoid some mistakes all together.

A group of physiotherapists recently chatted with the College’s Practice Advisor about their own professional regrets and shared 11 important lessons that they learned along the way.

Background

The Registrar was concerned about the business practices of seven physiotherapists who worked at the same (now closed) practice and invited them to the College to meet with the Practice Advisor to discuss the concerns and what good practice looks like.

The session covered the following standards and resources:

  • Working with Physiotherapist Assistants Standard
  • Fees, Billing and Accounts Standard
  • Record Keeping Standard
  • Consent
  • Starting a New Job Checklist
  • Leaving a Practice Checklist

The physiotherapists discussed many professional regrets and offered to share them with others so they could benefit from their learnings.

Before starting a new job:

"I should have checked with PT peers about the clinic’s reputation. I didn’t know any other PTs in Ontario, but I could have called and talked with people who worked at the clinic to get an idea of what it was like. Knowing what I know now, PTs came and went pretty fast."

"I wish I had looked at the clinic advertising on their website or researched the clinic before starting. Their online presence suggested their low level of commitment to professionalism and I would have been able to spot bad business practices before I started."

"I wish I had clearly communicated with the employer around the terms and conditions of billing using my name and registration number. I could have shown the employer (who was not a PT) a copy of the College standard and explained that I must meet those expectations."

"I wish I had reviewed the contract and had in writing an agreement from the employer that I need to have routine access to any billing and accounts using my registration number and that any errors or billing irregularities will be corrected. I should have been concerned that I was only going in for assessments twice a month."

"I was new to practice and it took me a few weeks to realize that I was not meeting my professional obligations, particularly the supervision requirements for working with physiotherapist assistants. I lost my autonomy to decide what to assign and when to reassess patients. I was encouraged to keep patients on too long."

"I hope others take time to discuss the employer’s expectations for PTs when working with assistants and ensure you maintain the ability to make patient-led decisions for quality care. There may be a power imbalance if the PTA is also the clinic owner or manager. It should have been a red flag when the employer insisted that all patient care was assigned to assistants and they would not allow a reassessment until three months had passed."

Once you have started your position:

"I regret not starting a peer group to review the standards and discuss concerns. I was so socially isolated and scared. Support from PTs in a group is social and fun. It keeps you engaged and motivates you to continuously meet the standards."

"I know now to routinely check a selection of invoices for physiotherapy care or products billed using my registration number. I know to keep a written record of the reviews, any errors I discovered and how they were corrected."

Other general advice:

"Ask about mentorship opportunities. The benefit of peer mentorship to career development and professional satisfaction cannot be stressed enough. If these opportunities don’t exist it may be an indicator of the type of employer they are. I worked alone, no mentorship and ended up making mistakes."

"Carve time in your day for proper record keeping. If an assessment and treatment plan is properly documented, it reflects quality physiotherapy care. If the care (who did what and when) is not recorded, a College Committee or lawyer is likely to argue that the care was NOT provided."

"If you decide to leave a practice, tell the employer (verbally and in writing) to stop using your registration number after you leave. You can check if any automobile insurance is billed using your information by emailing the College and requesting a report."

Protect Yourself Against Bad Business Practices

Remember to always Google a clinic before you start working there and if you’re being offered an overly generous salary to do assessments only, it’s probably too good to be true. Don’t get caught up in the money and essentially sell your name and registration number to the facility owner.

And keep in mind that once you get delisted by an insurance company it’s almost impossible to reverse that decision.

Questions or Need to Talk?

Contact the Practice Advice team for free, confidential advice at 1-800-583-5885 ext. 241 or advice@collegept.org.

Ask the Practice Advisor

Leave a comment
  1. Joanne Olsen | Aug 17, 2019
    Having been a Registered PT in this province for42 years, it too saddens me to read of these situations.  I have been proud to call myself a PT and have continued to strive for excellence in delivery of quality, clien-centred care.  I have earned a decent living and enjoyed a comfortable lifestyle.  This is what was presented to us when we entered the program.  I cannot wonder if perhaps the admission criteria to the PT programs now need to be reviewed.   Are we attracting the right individuals?   Why are PT’s being lured into these work environments?
  2. Cathy C | Aug 15, 2019
    I am disheartened that physiotherapists, even a new graduate, would not immediately recognize a problem with any clinic who allowed them to do only assessments and would set limitations on when the re-assessment could be done. I cannot believe that any PT trained in Canada would not have immediately recognized poor business practises with this. I think the issue is that as professionals we need to find the integrity to do what is right and in the best interests of the patient, not what we as individuals need to do to earn a living. If you act with caring and integrity you will always have enough patients!
  3. William | Aug 15, 2019
    How did seven different physios all make the same mistakes, particularly when the infractions mentioned would have been obvious to any physiotherapist in the province from day one?  Do they regret their communal acceptance of the clinic’s practice’s, or that ultimately the clinic got found out?
  4. Cassie | Aug 15, 2019
    Good lessons for a new graduate, I hope my fellow students would read that too!
  5. Jack Nolan | Aug 15, 2019
    Loved this blog piece! Great job. As an individual who is interested in starting a business one day, I found your writing very insightful. 
  6. Helen | Aug 15, 2019
    Great blog! Learned something new today! But it was difficult to find the blog and how to leave a comment. 

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    advice@collegept.org or 647-484-8800 or 1-800-583-5885 ext. 241