Funding Changes to Physiotherapy—Where’s CPO in all of this?

Thanks for stopping by to read my first blog. I am hopeful that you’ll stay long enough to leave a comment and tell me what you think about this issue. The purpose of Shenda’s Blog is to generate discussion around things that matter to patients, the public, physiotherapists and anyone touched by the regulatory world, so don’t be shy.

This summer there’s been lots of conversations about the government’s announced funding changes for physiotherapy. One of the conversation threads in an article that ran in the Toronto Star suggested that the College should take action against those people who had been allegedly billing OHIP excessively up until now.

Here’s how that conversation unfolded. On July 25, the Toronto Star reported, “Letters aimed at recovering $104,600 were couriered to 45 clinics Wednesday after a three-month OHIP audit found more than half of the records did not support claims…”

In the comments section on the Star website, jimmydgp wrote: “I will call the College of Physiotherapist’s [sic] of Ontario today and enquire as to why all of the PT’s who have contributed to this scheme are not suspended…”

And then on July 26, james58 wrote, “Why isn’t the College of Physiotherapists who are supposed to protect the public investigating these bogus clinics?“

On July 27, Dave U. randomly emailed me directly to ask, “Where is the CPO on this? Why are they so quiet?”

Where are we indeed?

Personally, I stand in the ranks of the outraged, if as the Star reported, 58% of billings made by designated OHIP clinics were unsupported. (Please be clear, I don’t know if that’s true, I am only quoting what the paper said).

What do you think?

Were the billings appropriate if the government had created a loophole that permitted them to flow the way they did? Should we accept that individual physiotherapists were merely employees and not responsible for the way the companies for which they worked billed OHIP? Do group exercise classes really equal physiotherapy? Do you think that the OHIP billing allegations, together with the Auto Insurance Anti-Fraud investigation from last year, have irrevocably tarnished the professional reputation of physiotherapists?

It seems to me that many of you are likely uncomfortable with the old funding model and the billing activities it led to. Let me tell you why I think this.

Last fall and winter, I went around the province with John Spirou, College President and a practicing physiotherapist. We spoke with groups of physiotherapists about a day in the life of the College. We presented a couple of real life scenarios of cases where PTs had inappropriately billed insurance companies. John would always ask the assembled group of PTs, “How does this make you feel? Are you embarrassed that a physiotherapist would do this?” The physiotherapists we met with were universally appalled by this conduct. In fact, in many of the examples that we shared, PTs thought the College response was far too lenient.

I formed the impression that the majority of physiotherapists have pretty strict ideas of what’s appropriate in terms of billing. If that’s correct, how are PTs feeling about the newspaper coverage of this issue?

And, back to the question of where is the College on the allegedly inappropriate OHIP billings?

We are not like the police force. We cannot undertake investigations without receiving a formal complaint or having solid evidence that an individual has committed an act of professional misconduct. And we don’t have the power to investigate clinics or businesses, only individuals—but let’s talk about that in a future blog post.

So where is the College on all of this?

We’re watching and waiting—just like you are.

By the way, jimmydgp, you never called!