What if Your Colleague Made a Mistake But You Got Punished?

A few years ago the British Parliament was considering how they could improve patient safety after a series of crushing hospital incidents. And here is what the members of parliament said, “Doctors could risk losing their licence if they fail to report fitness to practise concerns about their colleagues.”[1] Do you think about that for physiotherapy? Do you wonder about your obligation to report your colleagues?

Maybe you watched while Susan, who was teaching Mrs. Hall to climb the stairs on crutches after hip surgery, left her alone to take a phone call. Or you think that Claire may be showing signs of age-related cognitive decline. Perhaps you know that Joe down the hall sometimes asks his pretty patients on lunch dates. Maybe you heard your boss offering patients invoices for PT services when the service was really personal training.

Here’s the thing: if self-regulation is built on the belief that physiotherapists are in the best position to set the standards for physiotherapy, then physiotherapists are also in the best position to identify when those standards have been breached.

I am sure that most of you believe that if a PT’s functioning is impaired due to substance abuse, mental health problems or incompetence, patients may be put to risk. And your feedback to the College has been clear—you hate dishonest business dealings. And yet most health professionals do not report their colleagues. In one study only 37% of nurses who have experienced working with impaired colleagues reported them.[2] It’s no different for physiotherapists: in a study from Australia, only 19% of the participants indicated they would report to the Board if they were aware of sexual misconduct by a colleague.[3]

Your partnership with your colleagues and your membership in the profession creates bonds of loyalty that can make it very difficult for you to step forward. We understand that. Maybe it would help you to know that we will never take any action without proof and where there are health concerns we will always take great care over the well-being of the physio.

But if you believe in physiotherapy as a true self-regulating profession, you can’t turn your back. Sure, there are legal obligations to report in some cases, but I am talking about more than that. I am talking about making sure that the people that you work with meet your own expectations for your profession. And when they don’t, I am talking about taking action. First line might be to speak with your colleague directly, but in cases of true patient risk or legal responsibility you will need to take stronger action. Tell your supervisor. Call the College. Call the police or Children’s Aid if you need to. Because as much as offering therapeutic care, monitoring your colleagues is part of being a physio.

What do you think: Should physiotherapists be investigated for failing to report concerns? Have you ever reported a concern? What happened?

 

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[1] Helen Jaques, “Doctors should to be held to account for behaviour of colleagues, say MPs,” BMJ 2011;343:d4794.

[2] J.W. Beckstead, “Modeling attitudinal antecedents of nurses’ decisions to report impaired colleagues,” Western Journal of Nursing Research, 2002 Aug;24(5):537-51.

[3] I. Cooper and S. Jenkins, “Sexual boundaries between physiotherapists and patients are not perceived clearly: an observational study”, Australian Journal of Physiotherapy 2008;54(4):275-9.

15 thoughts on “What if Your Colleague Made a Mistake But You Got Punished?

  1. Can non- physiotherapist owned clinics be regulated by College of PT? or the role of college is to advocate for such regulation by MOHLC? College should focus on advocating for the ownership of a physiotherapy clinic being an exclusive right of a physiotherapist and making “physiotherapy” a service that can be only provided by a “physiotherapist” . After all, isn’t that in the best interest of public?

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  2. Don’t get why College funds coming directly from physiotherapists are used to support a “blog”?? A lot would be actually achieved if the college staff + management spend more time working on the issues the public and profession is facing, just my thoughts…

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    • LOL! @ July 16. Yeah, just now the whole admin @ my clinic is celebrating reading this blog, finding ways they can blame everything to the physiotherapist. I don’t think public should even read our conversations, just my thoughts too!

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  3. Your blog is very knowledgable and very useful but I am not sure how useful our comments are to you. Myself and many of us left feedback few months ago to regulate the PT clinics in a way PT clinics should be owned by PTs. It is possible in other provinces like Alberta. We aren’t sure what necessary action taken by you towards it. We all had registered our expectations and it is frustrating that nothing is changed. I hope our expectation is in the best interest of the Public and profession as well.

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    • Thank you for your comment. I want to reiterate that I do read every comment and I’m grateful that you take the time to share your thoughts. Currently, it is not within the College’s power to regulate clinics. Council has directed that we explore clinic regulation and we are doing so. Please understand that it’s a slow process, partly because we’ll need to create a regulatory solution that doesn’t cause more problems than it solves. You can read more here https://shendasblog.com/2014/05/20/clinic-regulation-now-what-2/

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  4. Shenda, I thank you for starting this conversation, but you need to understand the frustration physiotherapist face as the non-physiotherapist are cornering the market with sub standard treatment resulting in bad name for the physiotherapist. The government which can bring drastic change in ohip can also bring the change in clinic ownership rule as it will bring the cost of our Auto insurance down.

    One of the arguments i have been told is that they are not doing this because they (government) can end up getting sued by these clinics.

    Things you can do right away are

    1. Start conversation with college of physicians and upper society of law canada for stopping the practice of doctors and lawyers taking referral fees from non-physiotherapist for referring their clients
    2.Educate the payers including insurance company that they will not pay for any treatment if the bill is not counter signed by registered physiotherapist
    3. Make a targeted approach on the non-physiotherapist owned clinics to make surprise check .
    4 stop harassing physiotherapist based on frivolous complaints and support them during the process based on their past history.
    5.At Least prosecute one non-physio owned clinics and then see the results

    Let us see what will you do with my suggestion.

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    • July 22, I am in agreement with all your suggestions. I would also like to add that making physiotherapists responsible to report on colleagues can be misused tremendously. A disgruntled Physiotherapist employee may come up with something about his or her boss leading to a meaningless investigation & headache for all parties concerned. A conversation could be misconstrued, people lose things in translation, they perceive things the way they want, not knowing all the facts. I am not in agreement with this encouragement of tale-telling to be very honest.

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  5. @ Anonymous July 22

    Well said comment. PT’s are scared to practice direct patient care due to unrealistic rules and responsibilities created by CPO. Doctors and lawyers asking money for referrals OPA knows about it.. I called college of physician few times to report this issues but they are asking evidence.. I don’t have resources to find evidence for this kind of practice. Government/ college of physicians should ban physicians referring patients to specific clinics.

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  6. I wonder if any of us could withstand a list of our minor errors in an overloaded caseload crazy environment collected by peers we may or may not have good relationships with. We are now being driven to accept caseloads which make good care difficult, with divided concentration the norm.

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  7. As self-regulated professionals we are responsible for ensuring public safety. If a colleague is not acting responsibly and according to our professional standards bringing this behaviour to the attention of the College is imperative. The appropriate investigations will be conducted and action taken as needed. As members our responsibility is simply to call attention to the matter.

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    • I fully support that physiotherapist are to be accountable ,
      . But,i hope no one misuses this noble idea to take on personal vendetta. We need to have checks and balances in place to prevent physiotherapist being harassed by patients, colleagues and employers in the name of reporting them.

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  8. I am again disheartened by the “witch hunt” that is being promulgated by the CPO. Physiotherapists do not have the skills to determine if a colleague has cognitive dysfunction and they also lack the skills and means to diagnose a colleague’s health status. More importantly, making judgements of this nature is impulsive , unprofessional, may represent personality conflict issues and I think is best left to the experts. Federal laws do trump provincial when it comes to an individual’s right to make a living, Physiotherpists need to understand that if you report or make a complaint about a colleague, that the CPO will not defend you if you find yourself facing litigtion. CPO operates under a mandate from the provincial govenment. Physiotherpaist need to revive their historical roots and values.

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    • i definitely agree that a PT has no right to determine cognitive decline of a colleague. if, however, forgetfulness, let’s say, result in major safety issues, that has to be held in a meeting for investigation(s).

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  9. Why would a PT want to only be limited to working in a “physiotherapy-only-owned” clinic? This would limit the different job opportunities that exist in the private clinic or hospital sector that employs PTs.

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  10. I agree that physiotherapists are not “trained enough” to determine anybody’s mental status. What if a physiotherapist was wrong in determining the conduct of a colleague? Can the colleague sue the physiotherapist for putting wrong allegations on him and defaming him? We need to understand that physiotherapists are here to perform their work safely for people of Ontario and not to take over the job of college of physiotherapists of Ontario. Maintaining public safety is work of “college” not Physiotherapists. Physiotherapists job is to maintain patient/client safety while performing his job. It is long evident that college has failed to do their job by targeting at physiotherapists rather than non physiotherapy owned clinics. College should wake up now and step up towards non physiotherapist owned companies before physiotherapy services gets eliminated from both private insurances and government funding.

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