Discipline Case Summary

The following is a summary of a matter placed before a four-member panel of the Discipline Committee of the College of Physiotherapists of Ontario on Wednesday, November 29, 2006. 

In this matter, the panel considered and accepted an Agreed Statement of Facts filed by the College and Ms. Thawer, and found the registrant guilty of professional misconduct in relation to professional standards of practice and unprofessional conduct. 

The Allegations

The Discipline Panel found that the conduct alleged in the statement of agreed facts and joint submission on finding constitutes professional misconduct as defined in paragraphs 2 (standards of practice), 8 (conflict of interest), 23 (act inconsistent with legislation by using the title “Dr.” contrary to s.33 of the Regulated Health Professions Act) and 25 (unprofessional conduct ) of Ontario regulation 861/93 as amended. 

Summary of Agreed Upon Facts

Ms. Thawer graduated with a Bachelor of Science degree in 1997 and has been a duly registered physiotherapist since September 1997. In 1999, she obtained a Master of Science degree. In August 2002, she obtained a Doctorate in Rehabilitation Science. 

Ms. Thawer was hired as a physiotherapist at the CBI Physiotherapy and Rehabilitation Centre in London, Ontario (the “clinic”) in 1998. From that date until her promotion to clinic manager in July 2002, she was well regarded. Commencing in about August 2002 and progressing until she left the clinic in February 2003, Ms. Thawer struggled with management of the clinic, finding the experience very stressful. Conflicts arose with staff arising from her management style. In particular, many of the staff perceived her comments to be rude and inappropriate. Ms. Thawer acknowledges that she ought to have taken better care to communicate respectfully with clinic staff. Ms. Thawer was sometimes late, leaving clients waiting or to be treated by other staff who were not expecting them. On one of these occasions, the client's file could not be located as they were in Ms. Thawer's locked office. 

From August 2002 to about April 2004, Ms. Thawer, while under the mistaken belief that it is permissible because she has a doctorate in Rehabilitation Science, referred to herself as “doctor”, (while also identifying herself as a physiotherapist) and put “Dr. Thawer” on her office door. Ms. Thawer was paid at an hourly rate for the services she provided to the clinic. She did not receive any bonuses arising from profits of the clinic. 

Facts pertaining to the complainant Ms. G

From about October/November of 1999 to about August/September of 2000, Ms. Thawer had a romantic and sexual relationship with Ms. G. Ms. Thawer did not provide physiotherapy services to Ms. G during this period. From about January 2002 to January 2003, Ms. Thawer and Ms. G shared an apartment. From January 15, 2002 to June 17, 2002, Ms. Thawer and Ms. G had a joint bank account, which they used for the purpose of sharing joint expenses. Thereafter, Ms. Thawer permitted Ms. G to use Ms. Thawer's personal credit card and Ms. G reimbursed her in cash. Ms. Thawer purchased a dog and Ms. G shared in the care of the dog. Ms. Thawer acknowledges that their prior history and the living arrangements could cause others to reasonably believe that the relationship continued to be romantic during this period. 

From about June 24, 2002 to about November 29, 2002 Ms. Thawer provided physiotherapy treatment to Ms. G for her foot. This was in accordance with a treatment plan that was preapproved by the insurer, Federation Insurance, at a cost of $3,218. The treatment plan specified that the treatment would be provided by a physiotherapist, kinesiologist and a massage therapist. Ms. Thawer acknowledges that she ought to have informed Federation Insurance that she was friends and shared an apartment with Ms. G and that she failed to do so. 

Ms. G established businesses, called ACG Enterprises and All About Rehab Medical Supply Division, through which she provided services and supplies to various CBI clinics including the one where Ms. Thawer was manager. Ms. Thawer authorized payments for these services and supplies, which were paid for by CBI. Ms. Thawer did disclose to CBI that she was friends with Ms. G but acknowledges that she also ought to have disclosed that they shared an apartment. 

The friendship between Ms. G and Ms. Thawer ended in January 2003. Ms. G filed a complaint with the College on August 9, 2004, in which she stated that there were other clients of Ms. Thawer, as well as former co-workers of Ms. Thawer, who experienced Ms. Thawer's behaviour as rude and inappropriate. 

Facts pertaining to other clients

Upon receipt of Ms. G's complaint, the College investigator conducted interviews with Ms. Thawer's former co-workers and reviewed the files of Ms. Thawer's former clients. The investigator's findings with regard to Ms. Thawer's former co-workers have been set out above. The investigator further determined that there were four other clients who felt that Ms. Thawer's behaviour towards them was inappropriate: Ms. Z, Ms. S, Ms. K and Mr. M. All of these were cases where the client was involved in litigation or a disputed insurance claim. Ms. Thawer acknowledged she ought to have realized that these circumstances made the clients particularly vulnerable to stress and she ought to have taken better care to ensure good rapport and to communicate appropriately with them. 

In February 2004, while working at a Designated Assessment Centre ("DAC") in Ottawa, Ms. Thawer conducted an assessment of Ms. H. Ms. H did not file a formal complaint with the College, but in April 2006 she informed the College that she found Ms. Thawer to be rude and inappropriate and further that Ms. Thawer had referred to herself as "Dr." on her report. Ms. Thawer acknowledges that at that time, she did use the title "Dr." She further acknowledges that Ms. H's perception of her behaviour may be due in part to Ms. Thawer's failure to adequately explain the role of a DAC assessor. 

Order on Penalty and Costs

The Discipline Committee delivered the following orders as to Penalty: 

1. Ms. Thawer will receive a reprimand, the fact of which shall be recorded on the College register.
2. Ms. Thawer's certificate of registration will be suspended for four months, to be served on a date to be set by the Registrar.
3. There will be a term, condition and limitation imposed on Ms. Thawer's certificate of registration requiring her to successfully complete an ethics and boundaries course, approved by the Registrar, at Ms. Thawer's own cost, within six months of the date the Discipline Panel's order becomes final.
4. A term, condition and limitation will be imposed on Ms. Thawer's certificate of registration requiring Ms. Thawer to be monitored by a representative appointed by the College. The representative will meet once with Ms. Thawer to develop a learning contract and then conduct an evaluation up to four times over a period of two years from the date the Discipline Panel's order becomes final. The representative will monitor Ms. Thawer's ability to engage in ethical practice and to establish and maintain appropriate therapeutic relationships. The representative will also review Ms. Thawer's patient and billing records at Ms. Thawer's expense, to a maximum of $500 per visit.
5. Ms. Thawer will pay $7,500 in costs to the College in 35 monthly installments of $208.33 and one last installment of $208.45, the first installment being paid no later than the 15th day of the first month after the Discipline Panel's order becomes final.  

The Panel's Reasons

In assessing the proposed penalty order, the Panel considered those audiences with a vested interest in this matter – the public, the registrant and the profession. The College, which governs the self-regulating physiotherapy profession, is charged with the responsibility of protecting the public. 

The Panel concluded that Ms. Thawer cooperated with the College and, by agreeing to the facts and a proposed penalty, Ms. Thawer accepted responsibility for her actions. The Panel was satisfied that that the penalty reflected the severity of the allegation of professional misconduct. 

Through Ms. Thawer's agreement to successfully complete an ethics and boundaries course and participate in a regime to monitor her practice over a period of two years, the public interest is served and Ms. Thawer is provided with mechanisms for rehabilitation. She is also provided with general deterrence through a reprimand and a four-month suspension of her certificate of registration.