Unwritten Standards

What are unwritten standards and why do they matter? 

All colleges have written standards. Yet many issues that come before the Inquiries, Complaints and Reports Committee (ICRC) and Discipline Committee at the College have to do with disregarding other rules – the unwritten standards that establish expectations for the profession.

Consider the Working with Physiotherapist Assistants Standard. When determining an appropriate level of supervision, you should factor in things like risk to the patient, caseload and treatment complexity. The standard doesn’t provide a limit for how many people you can supervise, or at how many locations. It doesn’t describe every risk. You, the professional, must fill in the unwritten part using your professional judgement.

A written standard is a signpost not a how-to manual. It lays out the basis for practice and describes a level of professional performance considered to be acceptable. 

As a physiotherapist you are constantly using unwritten standards – things such as asking a patient for permission before you touch them, giving the person privacy when they change, or not being late for appointments. 

Following unwritten standards comes from experience, seeking advice from peers about practice situations, reviewing cases, being lifelong learners of the profession, and running decisions through an ethical filter.

The College could never codify everything in written standards, even if it wanted to. Standards can’t cover every situation – and are often purposely written not to). 

If you’re unsure about an unwritten standard, refer to this grounding principle: put the interests of patients above all else. 

Some of unwritten standards PTs follow every day:

- Being nice and polite to patients

- Greeting patients when they arrive

- Introducing yourself to patients, families, caregivers, colleagues

- Knocking before entering a patient’s room

- Doing what you said you would do

- Being on time for appointments

- Making eye contact

- Responding to patients questions and concerns

- Being truthful

- Listening

- Being empathetic

- Asking permission before you touch

- Giving a patient privacy when they are changing

- Apologizing when you are wrong or make a mistake