A health-care professional is in a position of power over a patient, by virtue of having professional knowledge and skill that a patient must rely on for their well-being. In addition, they have access to patients' personal health information. Health-care professionals must maintain professional boundaries with their patients at all times. They are prohibited from engaging in any form of sexual abuse or sexual misconduct as defined by law in the Health Professions Act with a patient.
Sexual Abuse is defined in the Health Professions Act, and means “the threatened, attempted or actual conduct of a regulated member towards a patient that is of a sexual nature and includes any of the following conduct:
- Sexual intercourse between a regulated member and a patient of that regulated member;
- Genital to genital, genital to anal, oral to genital or oral to anal contact between a regulated member and a patient of that regulated member;
- Masturbation of a regulated member by, or in the presence of, a patient of that regulated member;
- Masturbation of a regulated member’s patient by that regulated member;
- Encouraging a regulated member’s patient to masturbate in the presence of that regulated member;
- Touching of a sexual nature of a client’s genitals, anus, breasts or buttocks by a regulated member.”1,2
Sexual Misconduct as defined in the Health Professions Act, means “any incident or repeated incidents of objectionable or unwelcome conduct, behaviour or remarks of a sexual nature by a regulated member towards a patient that the regulated member knows or ought reasonably to know will or would cause offence or humiliation to the patient or adversely affect the patient’s health and well-being but does not include sexual abuse.”1,2
Each college that regulates a health profession must define who constitutes a “patient” in their Standards of Practice. The College of Physiotherapists of Alberta has defined a patient as the following:
An individual is a patient of a physiotherapist when they are a recipient of physiotherapy services and a therapeutic relationship is formed. This occurs when a physiotherapist has engaged in one or more of the following activities:
- Gathered clinical information to assess an individual
- Contributed to a health record or file for the individual
- Provided a diagnosis
- Provided physiotherapy advice or treatment
- Charged or received payment from the individual or third party on behalf of the individual for physiotherapy services provided
- Received consent from an individual for recommended physiotherapy services
A patient is deemed discharged and no longer a patient if there have been no physiotherapy services provided for one year (365 days).
For the purposes of sexual abuse and sexual misconduct provisions in the Health Professions Act, an individual is not considered a patient:
- If a current sexual, spousal, or adult interdependent partner relationship exists between the individual and the physiotherapist at the time the physiotherapist provides physiotherapy services,
- If the physiotherapist has provided episodic care to a patient where neither the physiotherapist nor the patient has the expectation of an ongoing care relationship AND 48 hours have elapsed between the episode of care and the start of the sexual relationship or communication for the purpose of starting the sexual relationship.
Note: If the health-care provider is not a member of a regulated profession, they are not subject to the authority of any regulatory college. Should you have a complaint or concern about their conduct or the care they provided, please contact the employer of the unregulated provider and/or the police.
Complaints of a sexual nature may involve:
- Privacy and respect: This could include a physiotherapist not providing enough privacy while putting on a gown or getting dressed after a treatment.
- Inappropriate comments or gestures: This could include saying something sexually suggestive or seductive to you, commenting unnecessarily about sexual relationships or sexual orientation, making sexually insulting or offensive comments or jokes, or giving unwanted attention (like kissing).
- Sexual contact or assault: This encompasses everything from inappropriate touching to sexual assault. It also includes any sexual contact between a physiotherapist and patient that would otherwise be considered consensual.
Do you think a physiotherapist violated a boundary or otherwise engaged in sexual misconduct or abuse?
Did your physiotherapist do something to make you feel uncomfortable? Maybe they touched you in a way that was not medically necessary or appropriate or perhaps they said something sexually suggestive. We recognize that coming forward with a complaint about sexual abuse or misconduct can be very difficult; however, we urge you to discuss your concerns with our Complaints Director.
Coming forward about a sexually inappropriate encounter you’ve experienced with a physiotherapist can be incredibly difficult and there are many reasons why you may choose not to do so. There are, however, good reasons for reporting:
- Public protection: Incidents of sexual abuse are often not isolated. By coming forward, you could help us act to ensure what happened to you does not happen to someone else.
- Awareness: The regulatory body won’t know otherwise. We rely on individuals to make us aware when things aren’t right. We can only learn about sexual abuse from people who make complaints.
- Your own well-being: If you’ve been sexually abused by a physiotherapist, knowing there is an investigation and potential consequences may play a role in your healing process.
We recognize that coming forward with a complaint about sexual abuse or sexual misconduct can be very difficult. When you call for assistance or to make a complaint, you will speak to the College of Physiotherapists of Alberta’s Conduct Coordinator. This person is very familiar with the complaint process and can give you an idea of what to expect. You can speak to this person on the phone by calling 780.438.0338 ext 360. At this time, you may remain anonymous or use an alias. If you later decide to make a formal complaint, it must be submitted in writing, identify your true name and be signed.
After your complaint is received, the appointed investigator will contact you to obtain additional information. If you prefer, you may bring someone with you for support. The investigator will ask you to explain what happened as clearly and in as much detail as you can possibly provide.
The investigator will contact other individuals or institutions who may have relevant information as part of the investigation.
Legislation requires us to notify the physiotherapist of your complaint, and the physiotherapist is given the opportunity to respond to it.
Your complaint is handled with the utmost seriousness and will be fully investigated. When the investigation is complete, all the materials gathered by the investigator are given to the Complaints Director who reviews the information and decides what should happen.
The Complaints Director may decide to refer the concerns about the physiotherapist for a hearing or may determine no further action is needed if the conduct or care was appropriate.
What happens if my complaint is referred for a hearing?
Your complaint may be referred for a hearing. Hearings are much like proceedings in a court of law. If the Complaints Director refers your complaint for a hearing, the College will present evidence before a panel, called a Hearing Tribunal, consisting of three regulated physiotherapists and one member of the public whose role is like that of a jury. They will hear the evidence presented by both parties and make a ruling based on that evidence.
You may be asked to testify at the hearing and you are encouraged to bring someone with you for support. If you must testify, you may be questioned by the legal representatives for the College and the physiotherapist.
If the Hearing Tribunal decides the conduct of the physiotherapist constitutes unprofessional conduct based, in whole or in part, on sexual abuse or sexual misconduct you will have the opportunity to present a written or oral impact statement before the tribunal determines the penalty.
The physiotherapist’s registration will be cancelled, and they will not be allowed to practice for life if the Hearing Tribunal finds the allegations of sexual abuse are proven. A finding of sexual misconduct requires the Hearing Tribunal to suspend the physiotherapist’s practice permit; timelines imposed will depend on the circumstances of the case.
The decisions of the Hearing Tribunal are subject to an appeal process whereby the physiotherapist or the Complaints Director, on behalf of the College, may appeal the Hearing Tribunal’s decision.
Hearings are open to the public and the media may attend unless the Hearing Tribunal orders the hearing be held in private or an application is submitted for the hearing to be held in private. The media can publish the name of the physiotherapist, but in cases involving misconduct of a sexual nature the Hearing Tribunal is required, by law, to order a publication ban on information that could identify you if you request such an order.
Additional Complaint Process Information
For more information, refer to the Complaints Process section.
Who to Contact
Therapy & Counselling
The Health Professions Act Bill 21 requires the College of Physiotherapists of Alberta to provide funding for treatment and/or counselling for patients who have experienced sexual abuse or sexual misconduct by a physiotherapist while they are a patient. For more information, refer to the Funds for Therapy and Counselling section.
Community resources may also be available. Contact the Association of Alberta Sexual Assault Services for services in your area.