The Case

A patient arrived 30 minutes late for their appointment. Strict infection control policies were in place due to COVID-19 restrictions, limiting the number of persons in the clinic. The physiotherapist explained that due to these restrictions, they could not provide treatment that day but could see them the following day.

The patient was agitated and insisted on attending the appointment. The patient yelled, slammed the desk and used abusive language towards the front desk staff. 

The PT noted that they responded calmly and repeated they were sorry, but due to the pandemic and restrictions, they could not see the patient. They would be happy to see them the following day instead.

The physiotherapist also asked the patient to refrain from insulting any staff member, and to lower their voice. The PT explained that if the patient continued to raise their voice and insult staff, they would not continue any care and would recommend alternative physiotherapy clinics.

The patient's behaviour didn't change. As a result, the PT provided a list of alternative clinics in the area and discharged the patient. The physiotherapist documented the interaction in the patient's file.  

The Standards 

Many physiotherapists may have experienced a similar situation, where a patient is angry or upset and behaving inappropriately. Whether the patient is upset about the physiotherapy care they have received, an experience or something that was said to them, physiotherapists should ensure that they know how to respond to challenging behaviours in the moment. In this case, the physiotherapist remained calm, was apologetic and offered an alternative solution.

The Providing or Refusing Care Standard outlines the circumstances where a physiotherapist may discontinue care. As per the standard, the physiotherapist discontinued physiotherapy care after the patient became verbally abusive. The PT also made sure they provided information for other physiotherapy clinics where the patient could continue care.

The Outcome

The Committee considered the patient's side of the story, reviewed the patient's file, and received a written version of events from the physiotherapist. In the end, they confirmed that the PT managed the situation professionally and in accordance with the Providing or Refusing Care Standard. As a result, they decided to take no action.

Have you experienced a similar situation and need some support? Reach out to the Practice Advice team at any time: advice@collegept.org or 1-800-583-5885 (extension 241).

Resources:

Providing or Refusing Care Standard 

Managing Challenging Situations — College of Physiotherapists of Alberta

Six Tips for Dealing with Difficult Patients – Jordan Stone, Lawyer