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Proactively Enforcing Advertising Requirements in Physiotherapy Practice

For physiotherapists working in private settings advertising and related activities to promote one’s skills and services are a fact of life, whether working as a small, solo provider of mobile physiotherapy services, as part of a stand-alone physiotherapy clinic, or as part of a large network of multidisciplinary clinics.

The Health Professions Act establishes that regulated members of a college “shall not engage in advertising that is untruthful, inaccurate or otherwise capable of misleading or misinforming the public.” (Section 102) The Advertising Standard of Practice of the College of Physiotherapists of Alberta establishes the performance expectations related to advertising for all regulated physiotherapists. Every day in Alberta, many physiotherapists market their services in a manner that is professional and in alignment with the expectations articulated in the Standards of Practice and legislation.

However, the topic of advertising of physiotherapy services and the issues that stem from failures to fulfill professional responsibilities related to advertising take up a considerable amount of College time and resources. The College of Physiotherapists of Alberta strives for regulatory actions that proactively address emerging trends and issues. To that end, Council has decided to take a new approach to advertising and the enforcement of the Advertising Standard of Practice.

In 2023, the College is introducing an initiative to proactively monitor physiotherapy advertising, rather than waiting to be contacted by individuals expressing concerns. The goal of this initiative is to make sure that physiotherapists know and adhere to the expectations found in the Standards of Practice.

Advertising Compliance Verification Tool

At their September meeting, Council voted to implement an advertising compliance verification tool that will screen websites and social media accounts where physiotherapy services are promoted to verify that advertisements and promotional activities are in alignment with legislation and college requirements.

When an issue is identified with a website or social media account, the College will contact the registrant about the issue and advise them of the necessary changes to bring the website/account into alignment with regulatory requirements. The tool will also be able to check that changes have been made to correct the issue identified.

Why is the College taking this approach?

Each month the College receives a considerable number of concerns and complaints related to the advertising of physiotherapy services. Often when the College has contacted the registrant to address the issue identified, their response has included a list of websites of their peers and competitors identifying the same issue.

This led the College to conclude:

  • That we were only hearing about a portion of advertising issues
  • That past efforts to educate registrants and ensure compliance with the performance expectations of the Advertising Standard were not having the desired effect

A core function of regulatory colleges is to “establish, maintain, and enforce standards of practice of the regulated profession.” With evidence that past efforts were not having the desired effect, the College decided to take a new approach to fulfilling its mandate.

What does this mean for me?

Now is the time to review every website and social media account where your physiotherapy services are promoted. Review the Standards of Practice that are currently in force. Talk to your peers, employer, and those you hire to engage in marketing and promotion of your services to address any issues.

Over the years the College has published many articles on the topic of advertising and social media use for promotional purposes. There are also podcasts available that speak in greater detail about the issues the College encounters and this new initiative. Registrants with questions about the performance expectations in the Standards can look to these articles for further information.

In the coming weeks, the College will be running a pilot test of the tool. We are committed to sharing preliminary findings of that testing with registrants to support their understanding of the advertising Standard of Practice performance expectations. However, this tool will not be used to “approve” advertisements. The College expectation is that physiotherapists know the performance expectations related to their practice and ensure that advertisements are appropriate before they are implemented.

When the pilot period is over, a first incidence of an issue will have the physiotherapist receive a message from the College. However, a second occurrence will result in a fine. Importantly, a third occurrence could lead to a conduct process as it may be viewed as disregard for the Standards of Practice.

What issues will be flagged?

The Advertising Standard of Practice states that “the physiotherapist advertises in a manner that is truthful, accurate, verifiable, not misleading to the public, and in compliance with regulatory requirements.” Among other expectations, the standard includes a list of common marketing activities that physiotherapists are expected to avoid.

Some of the most frequent advertising concerns brought to the College relate to the marketing activities that physiotherapists are expected to abstain from, including advertisements that:

  • Offer free services
  • Use comparative or superlative statements such as “best” or “number 1” to refer to the services offered or the physiotherapists working at a practice site
  • Offer other types of incentives or other inducements

In addition to actions that directly disregard these expectations, the College frequently observes language which is inconsistent with the requirements of the Use of Title Standard of Practice which specifies that “the physiotherapist uses her/his title, credentials, and other designations to clearly identify her/himself to clients, other health providers, and the public.

The most common issues related to title use in advertising include use of the title “Doctor” or prefix “Dr.” in ways that are inconsistent with regulatory requirements, and the use of language indicating or implying that a physiotherapist is a clinical specialist when they have not met the criteria for use of that title and have not received authorization from the Registrar to use it.

Who is responsible?

Some physiotherapists may want to argue that they are not the ones generating advertisements for their practice location and, therefore, should not be held accountable for the advertisements and other marketing materials or initiative generated to promote their services. However, the Advertising Standard of Practice clearly articulates practice expectations and identifies the physiotherapist as the individual who must fulfill the performance expectations.

Fulfilling the requirements of physiotherapy governing legislation in Alberta including the performance expectations articulated in the Standards of Practice are requirements for ongoing registration with the College.

In instances where a physiotherapist outsources advertising of their services, either directly by hiring another party to complete marketing and promotional activities on their behalf, or indirectly, by allowing an employer to advertise the physiotherapist’s services, they retain the responsibility to fulfill their professional obligations. It is the individual physiotherapist who is accountable to meet or exceed the expectations articulated in the Standards.

The regulated physiotherapist is ultimately responsible for advertising about themselves and the services they provide.

Each physiotherapist is expected to review advertisements about their services regularly, and to address instances where advertisements are not in line with the performance expectations articulated in the Standards of Practice with their employer or marketing company.

Next steps

As we work through implementing this new initiative, we encourage all physiotherapists to monitor the College newsletter and website for updates. We expect to have this tool in place and to begin reviewing physiotherapist websites and social media accounts in the spring of 2023.

The College’s long-term goal is to complete a scan of physiotherapy websites and social media accounts and find nothing. We genuinely hope that this initiative will serve to reinforce the importance of how a registrant’s physiotherapy services are advertised and lead to improved practice for all College registrants.

Page updated: 03/02/2023