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 October 26, 2009. 

Allegations

In December 2008 the College received information concerning certain aspects of Mr. Patel’s practice. At the conclusion of the investigation the Executive Committee of the College referred the matter to the Discipline Committee for a hearing. 

The Facts as Agreed to by the Parties

Record Keeping

In 2008 and 2009, Mr. Patel regularly failed to maintain appropriate physiotherapy records by failing to document and maintain financial records, records of assessments, records of treatments, and records of attendances in relation to his patients. 

Falsification of Patient Records

In 2008 and 2009, Mr. Patel regularly created false patient records and facilitated the submission of those records to insurers to support the patient’s claim when the claim was questioned by the insurer. 

Providing False Invoices to Patients

In 2008 and 2009, Mr. Patel regularly provided invoices to patients indicating that they had fully paid for orthotics or other devices when they had not done so. It is further agreed that in 2008 and 2009, in relation to patients with insurance coverage, Mr. Patel would regularly not bill those patients for every second visit the patient made but would provide invoices to the patient that indicated Mr. Patel had received payment from the patient for all visits.

Offering Incentives to Patients

In 2008 and 2009, in relation to patients with insurance coverage, Mr. Patel would regularly offer to bill the insurer for the services he rendered and then reimburse the patient 50% of the amount that Mr. Patel received from the insurer.  
The Member’s Plea 
At the hearing, Mr. Patel admitted to the allegations and the fact that his actions constituted professional misconduct. 

Decision

The Panel agreed that Mr. Patel’s conduct constituted professional misconduct. This finding was made in accordance with paragraphs 2, 16, 18 and 25 of section 1 of O.Reg.861/93 (Professional Misconduct Regulation), as amended under the Physiotherapy Act, 1991.  

• 2. Failing to maintain the Standard of practice of the profession
• 16. Signing or issuing a document containing a statement that the member knows or ought to know contains a false or misleading statement
• 18. Submitting an account or a charge for services that the member knows or ought to know is false or misleading
• 25. Engaging in conduct or performing an act that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional

Penalty and Costs

The panel ordered the following. 

1. Mr. Patel shall be required to appear before the panel to be reprimanded, the fact of which shall appear on the College register.
2. The Registrar shall be directed to suspend the certificate of registration of Mr. Patel for a period of thirteen (13) months, to commence on a date to be set by the Registrar.
3. Four (4) months of the suspension referred to in paragraph 2 herein shall be suspended if Mr. Patel complies with paragraphs 4 and 5 of this Order within the deadlines set out therein.
4. Mr. Patel shall be required to pay a fine of $4000.00.
5. Mr. Patel shall be required to review all of the College’s Standards of Practice and submit to the Registrar a written acknowledgement of having done so.
6. The Registrar shall be directed to impose a term, condition and limitation on Mr. Patel’s certificate of registration requiring Mr. Patel to successfully complete approved courses on ethics and record keeping.
7. The Registrar shall be directed to impose a term, condition and limitation on Mr. Patel’s certificate of registration prohibiting him from supervising provisional practice certificate holders or students.
8. The Registrar shall be directed to impose a term, condition and limitation on Mr. Patel’s certificate of registration prohibiting Mr. Patel from working in a private practice where he is the sole physiotherapist for two (2) years following the suspension.
9. The Registrar shall be directed to impose a term, condition and limitation on Mr. Patel’s certificate of registration prohibiting Mr. Patel from working in a private practice unless it is owned by a regulated health professional or a health professional corporation for three (3) years following the suspension.
10. The Registrar shall be directed to impose a term, condition and limitation on Mr. Patel’s certificate of registration requiring him to undergo a remediation program overseen by the College for two (2) years following the suspension.
11. Mr. Patel is required to pay the College a portion of its costs in this matter in the amount of $7500.00.

The Panel’s Reasons

In determining the appropriate penalty, the Panel took into consideration the interest of the public and the serious nature of the offence(s) and determined that the registrant’s conduct demonstrated a serious disregard for his basic professional obligations. The panel also considered the mitigating circumstances; namely, that this will be his first finding of professional misconduct, that he had demonstrated a willingness to accept responsibility for his actions, that he had cooperated with the investigations of the College, and that in the panel’s view he has sincerely agreed to remediate his billing and practice methods. Nevertheless, the panel felt that its order must give notice to the profession at large that serious penalties will be imposed for failure to comply with these types of professional obligations so as to demonstrate to the public that the College views this type of professional misconduct seriously. The Panel concluded that the penalty was reasonable and in the public interest. The panel believed that this penalty order satisfied the intended mandate of public protection, deterrence to the profession as a whole and the individual member and that it would assist in the remediation of the member. The panel believed that the penalty would also convey an appropriate message to the membership as a whole that this type of conduct would be dealt with harshly.