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Conduct Matters: Prolonged Treatment Not in the Best Interest of the Patient

The complaint

The College of Physiotherapists of Alberta received a complaint from a patient detailing several concerns with the quality of care provided by a physiotherapist. The patient was referred to the physiotherapist by an insurance adjuster following an MVC, the primary area of injury being the neck. The patient complained that after nine months of weekly physiotherapy treatments, with the physiotherapist doing the same thing, that their neck symptoms were worse, not better. The patient stated that they attempted to discuss the lack of progress with the physiotherapist, adding that the physiotherapist could have been a better listener.

The investigation

The patient attended 57 physiotherapy treatments over nine months. Treatment primarily consisted of manual therapy, specifically passive neck stretches and grade 4 spinal mobilizations. The treatment record did not reflect reasonable objective evaluation of the patient over the course of care. It was difficult to evaluate the clinical reasoning process, and progression of treatment outcomes. Objective findings were noted on 6 of the 56 chart entries. Exercises were referred to in seven entries, however; the exercises were not described in any significant detail. Overall, treatment notes were scant. Many entries reference the patient’s subjective reports of pain, however; these were rarely specific regarding location, intensity, duration of increase or decrease of symptoms.

The investigation revealed there was clear evidence to support two allegations:

  • Allegation #1: Prolonged course of treatment provided, not in the best interest of the complainant
  • Allegation #2: Poor communication

The outcome

Under the authority of s. 55(2)(a.1) of the Health Professions Act, the Complaints Director resolved this matter through facilitated resolution.

The physiotherapist worked cooperatively with the Complaints Director on the following terms of an Agreement and Undertaking.

  • Pay a portion of the investigation in the amount of $1000
  • Review the following the College of Physiotherapists of Alberta documents in their entirety:
  • Complete an E-learning module on informed consent
  • Complete an E-Learning education on documentation
  • Enter into a mentorship agreement with a regulated member to participate in a chart simulated recall interview once a month for the first six months and once every second month for the last six months.

All conditions of the Agreement and Undertaking were met by the physiotherapist over 18 months and the conduct file was closed.

Page updated: 20/04/2022