Sometimes a physiotherapist will find themselves in a social situation that involves their patients. As a PT, your children may attend the same school as your patient, your patient might live in your neighbourhood, or attend the same gym that you do. In these circumstances socializing may be unavoidable. What is important is how you manage the situation and the potential for a boundary crossing. Physiotherapists must set limits (boundaries) when they see a person both inside and outside of the clinical environment. This creates a safe place for the patient and prioritizes their care.
Boundaries are limits that establish identity, maintain privacy, avoid entanglement and allow for safe and professional interactions. Boundaries are the invisible lines that are drawn to help define roles and interactions in relationships. When these lines are crossed, negative consequences may result. According to the College’s Boundaries and Sexual Abuse Standard, the physiotherapist’s responsibility is to always act in the patient’s best interest and manage the boundaries within the therapeutic relationship.
One of the important risks to note when providing services to a person you interact with both professionally and in-person is that your clinical objectivity may be affected when you assess or treat that person. In this case, knowing this person’s family for example may make the patient feel less comfortable sharing sensitive information with you. Or because of your familiarity with them, you could be tempted to take shortcuts with record keeping or discussing consent for example. Patient confidentiality must be carefully protected as there is risk of accidently breaking confidentiality is higher when you interact with someone both personally and professionally.
Tips:
- Do not discuss patient care topics in non-clinical settings
- Develop strategies to redirect treatment-related questions to the clinic setting and social questions to a personal setting.
For example:
If the patient's injury or condition comes up at the park or a party, be prepared to say something like "I am happy to look at the injury in the clinic at our next treatment session." And if a patient starts to discuss something personal when you are treating them, be prepared to say something like “Let’s chat more about that when I see you at the hockey game on the weekend.”
"I know exactly where my professional boundaries are; they are the four walls of my clinic, and outside of them, I don’t discuss client care, and inside of them, I don’t have personal conversations."
-Reference "Where's the Line" Professional Boundaries in a Therapeutic Relationship.