The Situation

Between January and November 2013, inclusive of the time period he was promoted to the position of Chief Clinical Officer for a group of clinics in the Greater Toronto Area, a physiotherapist engaged in professional misconduct with 27 patients.

These clients, referred for physiotherapy, were handled as if they were everyday attendees of a fitness gym. Their treatment took the form of general exercise routines directed one-on-one by assistants without a physiotherapist’s supervision.

The patients’ workout programs were not tailored to their specific pain or injuries, did not include goals to help them transition toward self-management and independence, and in some cases continued past the point of efficacy or necessity.

From initial assessment through reassessment, the charting for these ill-served patients lacked the necessary detail to establish concrete objectives and measure success against meaningful milestones. Courses of treatment were not personalized.

These activities were improperly invoiced as physiotherapy services. In addition, Clinio Health Centres’ advertising practices came under scrutiny for providing incentives to Clinio attendees who received ‘physiotherapy’ services in-house.

The Standard

Physiotherapy should be condition-specific and reflect a patient’s stage of recovery. That means taking precautions and acknowledging contraindications respective to each case. Rehabilitation is then adjusted, by degree, to the acuity of impairment. And without quantifiable goals in the charting, you cannot properly track results.

The Consequence

The PT admitted that he failed to maintain the standards of the profession with respect to his assessments, reassessments and treatment plans. He’d formulated clinical impressions, conclusions and diagnoses that were not supported by the recorded data. He’d failed to supervise his physiotherapy assistants, permitting (or not preventing) their developing, evaluating, interpreting and altering treatment plans. The College withdrew allegations related to advertising.

Found guilty of Professional Misconduct, the PT received:

- a reprimand
- a suspension of 15 months
- practice enhancement activities including completion of an Ethics program
- restrictions related to potential employment as a physiotherapist assistant during the suspension period
- practice enhancement coaching for a period of three years
- restrictions related to supervising physiotherapy students or assistants
- costs payable to the College in the amount of $17,000

A copy of the decision and justification is available on CanLII.