Responding to Complaints at the College of Physiotherapists of Ontario: What Physiotherapists Need to Know
Physiotherapists are susceptible to formal complaints made to their regulator, the College of Physiotherapists of Ontario. Navigating the complaint process is a potentially stressful experience for physiotherapists, as these proceedings can result in professional consequences. Physiotherapists may feel even more pressure when they are unfamiliar with the process. To assist, we have prepared this basic guide to responding to complaints at the College of Physiotherapists of Ontario.
In a letter to the physiotherapist, the College of Physiotherapists of Ontario encloses the complaint and, when applicable, a summary of the physiotherapist’s other complaint history. After the initial investigation concludes, the physiotherapist’s complaint file is reviewed by a panel of the Inquiries, Complaints and Reports Committee (ICRC), which in some cases may decide that further investigation is required. Consisting of four physiotherapists and two government appointed members of the public, the ICRC panel determines how to most appropriately dispose of the matter.
Generally, the College of Physiotherapists of Ontario must address all formal complaints against physiotherapists. It is the physiotherapist’s professional obligation to cooperate with the complaint process, which may include participating in interviews with the College of Physiotherapists of Ontario’s investigator. Whether or not the physiotherapist considers the complaint worthwhile, they typically should prepare a response.
The ICRC generally does not see the physiotherapist in person, as it operates the complaint process through exchanging and reviewing documents rather than through a hearing. This means that physiotherapists can typically only respond in writing, and cannot otherwise explain their decision making or expand upon their reasons for providing care. In consideration of this limitation, physiotherapists should ensure that, prior to submitting their response, they have addressed each and every one of the complainant’s concerns.
Within 30 days of notifying the physiotherapist, the College of Physiotherapists of Ontario expects a written response to the complaint. Physiotherapists may find the time and effort required to craft a response demanding, and the stress from the complaint process can be challenging. Retaining legal counsel with experience in professional regulation can often assist physiotherapists through this potentially difficult experience, as the lawyer typically assumes the responsibility of submitting the response, and becomes the primary contact with the College of Physiotherapists of Ontario.
While drafting the response, the physiotherapist should pay attention to the unique aspects of their case, including when they provided the care, the complexity of the care, and the possibility that another party might initiate a civil lawsuit. In our experience, it is often helpful for physiotherapists to organize their response as a chronological account of any events that are relevant to the allegations.
In some cases where a complaint has merit, it is prudent for the physiotherapist to acknowledge their shortcomings and assume responsibility. Acquiring further education and taking corrective action, and detailing such efforts in the written response, may help portray the physiotherapist more favourably at the College of Physiotherapists of Ontario. When the right circumstances are present, the ICRC may feel more confident in the physiotherapist’s capacity to improve their practice and maintain the lessons obtained from their experience.
In finalizing their response for submission to the College of Physiotherapists of Ontario, the physiotherapist or, when applicable, their legal representative should generally enclose the patient chart and any other relevant records or information. Physiotherapists should always maintain their records in compliance with the Physiotherapy Act, 1991 guidelines, as the ICRC is entitled to evaluate the quality of the records regardless of its disposition on the specific complaint.
An investigator assigned to the physiotherapist’s case receives the finalized response and determines what, if any, further investigation is required. The investigator encloses all of their findings in a report to the ICRC. When enough data is available to inform the ICRC’s decision, it reviews the file and may do any of the following: take no further action; caution the physiotherapist in person before the ICRC; inquire into the physiotherapist’s professional capacity; refer the matter to the Discipline Committee; or take any other appropriate action. Apart from cases in which the physiotherapist is referred to discipline or to the Fitness to Practice Committee, the ICRC typically supplies written reasons for each of its decisions.
In addition to the professional consequences that may potentially result from regulatory proceedings, complaints against physiotherapists may also lead to unwanted public exposure. Findings at the College of Physiotherapists of Ontario are becoming increasingly transparent, with details of the following ICRC dispositions now posted on the Public Register: Specified Continuing Education or Remediation Programs (SCERP); oral cautions; undertakings; and referrals to discipline. This information is available on the physiotherapist’s public profile.
Early in the complaint process, before it is ready to dispose of a matter, the ICRC may feel that it is necessary to impose an interim order. Interim orders may apply for complaints of a more serious nature, where the physiotherapist’s alleged conduct exposes or is likely to expose their patients to harm or injury. Potentially lasting for the duration of the investigation, interim orders may take the form of terms, limitations, conditions, or even licence suspension. In such serious complaints, the Registrar may also appoint a special investigator who, under section 75 of the Health Professions Procedural Code, has much broader powers of investigation than in the standard process.
Generally, the physiotherapist or the complainant is entitled to request a review of the ICRC’s decision before the Health Professions Appeal and Review Board (HPARB). At the review, the HPARB panel considers whether the College of Physiotherapists of Ontario’s investigation was adequate and whether the ICRC’s decision was reasonable. The HPARB panel bases its review on the documents and material that were available to the ICRC, which are typically provided, in their entirety, to the physiotherapist and the complainant.
Dealing with a complaint at the College of Physiotherapists of Ontario is an important process. Retaining the services of a lawyer is a worthwhile consideration for physiotherapists, as legal counsel can help craft a response and work through the complaint process. With potentially serious implications for the physiotherapist’s career and reputation, a complaint merits a thoughtful and proactive approach.
Josh Koziebrocki, is the principal lawyer and founder of Koziebrocki Law. He represents physiotherapists and has extensive experience dealing with regulatory issues. He can be reached at 416-925-5445.
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