Some of you are familiar with the Advertising Standard. Among other things, it prohibits endorsements, testimonials, superlatives and anything that could be interpreted as promoting a demand for unnecessary services.
I know some of you hate it. I have heard from you that it is not fair that you must compete with unregulated clinic owners who freely use these very advertising tools. I understand that. When the College is publishing standards it is important to know that the standards are based on feedback that we receive from the profession as to what the expectations should be. In the fall of 2013 we advised the profession that the advertising standard was up for review and we sought feedback from all of you. The feedback we received was that the expectations defined in the standard were reasonable. So unless new evidence arises, it seems as though the standard is set at the right place. In addition, the government has been requiring the new Colleges to have advertising regulations (a higher level of accountability) that address just these issues.
The goal of the advertising standard is to ensure that members of the public can rely on the information provided by physiotherapists to make a decision when they are choosing a physio. We, as a society, expect to be able to trust our care providers. We all know that there is enough information out there to suggest that you shouldn’t believe everything that you see or hear but patients in pain or family members seeking care for loved ones may not be as skeptical of advertising by health care providers as they would be if they were looking at a used car ad. The nature of self-regulation is to protect the public from undesirable or unprofessional behaviours by those few members who might engage in them. These are the reasons that physiotherapists are held accountable to an advertising standard.
So I don’t want to talk too much about what’s wrong with the standard. I would rather talk about how we should apply it. You are the profession. These are your standards. Tell me what you think.
Scenario One
On its website, a physio-owned clinic has a beautifully produced video done by a well-known television personality talking about how the clinic keeps him active. This meets the definition of advertisement in the standard. Seems like an endorsement, or do you disagree?
Scenario Two
A WagJagTM (or LivingSocial or Groupon) promotion offers 10 physio sessions and a 50% discount on orthotics for a low, low price. The advertisement doesn’t say anything about what happens if the first assessment does not demonstrate that physio is clinically indicated.
Do you think this intends to promote unnecessary services?
I would love to hear from you about whether these situations breach the standard. Are they professionally appropriate? Do they mislead the public? What other advertisements have you seen or used that you want to talk about?
Tell me – tell your colleagues – what you think.
Shenda’s Blog 
Please regulate the clinics. We physiotherapist can’t do anything about this kind of practice ,because we don’t have any control over clinic owners. I am sure you know this is a serious issue,but on your website says it may take year’s to change legislation. Why cant we act now? . This is a real serious issue affecting all physiotherapist working in out patient clinics. we are tried of this lax regulation/loop holes let owners to abuse us and our patients.
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Please appoint Rob Ford as our OPA or college president. Regardless of what, he will make impossible things to possible. He contracted out garbage collections. Now we don’t need to worry about garbage strikes in Toronto any more lol .
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So, we sould all be laid off, pensions stolen and rehired at lower wage. Good plan. Let’s start with you.
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The level of care received by a client is centric to the actual PT who delivered the program of care and not the company or it’s owner(s) therefore anyone who is paying a personality to suggest that his or her personal experience speaks to the physio company as a whole is misleading.
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Perfectly said. These ads should be taken down immediately.
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For scenario one, if the television personality was indeed the clinic’s patient, then that would be an endorsement and not allowed by our standard. If it was simply a hired actor, then I imagine that there should be a disclaimer stating that the person claiming such great results was not a real patient. I guess that would then resemble ads and posters by professional associations include our own OPA showing “patients” receiving care and regaining their function. As for the package promotion in scenario two, our standard does allow for this, however, there needs to be a mechanism for how billing is handled if the person doesn’t require services or doesn’t require all ten sessions. I personally wouldn’t put an ad out like that, but if done, the details need to be part of the ad. I think there is some potential for unnecessary services being accessed. In general, price wars between clinics and these types of ads are probably neither good for the profession, nor are they good for the public due to the potential for sub-optimal care being delivered. Has anyone every noticed dentists competing on price for routine examinations, x-rays and cleanings? I do see it happening for certain cosmetic procedures, but generally they have a provincial fee schedule and stick to it for standard care. PTs should be doing the same thing. We should set a reasonable fee schedule/guideline with an hourly rate (this would be the OPA’s job, of course, and not the College) and everyone should stick to it just like the dentists do. “Competition” would then be based on quality of care and service and not on price. This fee schedule should be adjusted annually based on inflation. The OPA’s recommended fee schedule of $150/hour was set in 1999 and hasn’t been adjusted since. As a practice owner, I can tell you that the cost of doing business has gone up since 1999!
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I think we should be allowed to use endorsements and testimonials. Physiotherapists offer an amazing service to the public and many don’t even know we exist. If we are to compete with other professions we need the public to be aware of the quality of our services and the outcomes. People today look to the internet for answers and I think it is a disservice the public that we are not allowed to toot our horns and let them know how successful we as physiotherapists are at treating many physical ailments across the lifespan. I work and own a niche clinic and have patients tell me daily that they didn’t know there was a solution to their problem. Having testimonials would greatly help people to know that we can help them. In terms of your scenario, I think it is great that a high profile celebrity is getting physiotherapy. I think this speaks volumes to the public that we are an essential service, and when a member of the public can identify with a celebrity it increases awareness. In scenario 2, I think groupons cheapen our profession and hope none of my colleagues ever stoop to such a low level.
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I strongly agree. I am very proud of the work we do and sadly many in the community have no idea what we do! If our college and association are not going to EFFECTIVLY advertise out profession as a whole, then it is our job to educate the public. Many people don’t know where to turn when hurt and how much we really can help……. Everyone know what a chiropractor does…. they have a much better global marketing approach. I think anyone offering cheap / reduced fee services (or like my competitors – free assessments to get people in the door…. when they are not doing an assessment up to clinical standard – just a look to say that YES that person needs to book for Rx) It disgusting and cheapens our professional worth as a whole and is detrimental to our reputation and the level of education we have and service we provide.
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Re Scenario 1. This is inappropriate and one of the main issues is client confidentiality. I am sure this well-known television personality thinks he consented (? was paid???) but it opens up the casualness of bragging about clients. This happens constantly in some clinics, with signed jerseys etc of athletes. Clients want to go where the famous people go. I am really not sure this television personality understands how he has tested the boundaries of our standard of practice. Has he really given informed consent? Does he really want to be in the centre of this discussion?
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Shenda. (or anyone else).
Have there been any recent instances where the College has actually taken action against those that have violated the Advertising Standards?
As far as I can see, many physiotherapy clinics in downtown Toronto use website text such as “The Best Physiotherapy clinic”, “most trusted multidisciplinary clinic”, “xxxxxx Physiotherapy brings to Toronto what no other clinic in the city provides”. Many more include patient testimonials imbedded in their webpages and in youtube videos (as presented in the original post) as well.
Or perhaps there are too many cases for the College to keep up with?
??
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I personally do not agree with discount packages. I think it degrades the value of the profession.
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Regarding scenario 2 it shows how our profession has been down graded due to unethical and unhealthy competitions and non professionals trying to run business . Hope fully we will see some changes and regulations in future to prevent the downfall of our valid profession.
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I am pretty sure there is enough work out there for physiotherapists that having to resort to the level of competing against other professionals is not really necessary. The marketing world has fooled us into believing that and the profession itself has fallen victim. A good physiotherapist doesn’t need testimonials and celebrities. A good reputation will speak for itself. If more of our members would focus on providing quality therapy, we wouldn’t need to feel threatened by other professionals. We allow ourselves to become downgraded when we play those games. Physiotherapy does stand alone as a profession and I hope we can regain some of the ground we have lost over the past few years. I’d like to see the college do their job and protect the public against those therapists or individuals who are taking advantage of our clients. I’d like the OPA to do their job and protect physiotherapy jobs in the hospitals as well as in the community. That’s where we are losing ground.
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well said.
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In regard to scenario 1: I too think that we should be able to use testimonials/ endorsements. We as physio’s do great work and the public should be able to hear it from others that have experienced it! If a clinic and it’s providers are really doing the great job they say they are then their satisfied clients should be able to tell others, this also increased our commitment to providin this service because our reputation relies on it! As far as the celebrity endorsement is concerned, assuming this fellow was a real client and is telling his true experience/thoughts and has willingly consented to do so and to be identified, I don’t see any problem with it and in fact looks great on that clinic. In this competitive age we need all the help we can get-as a clinic owner, I know it is not easy running a successful health care business.
As for scenario 2: I too think groupon packages reduce the value of our services which is something we are striving to raise but if you did do this you would need to be clear about how the coupon was to be used and various a scenarios-complicated and another reason not I do it!
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Silliness. Healthcare professionals are expected to do right by all of their patients and positive results are part of a proper program of care and outcomes. Where do the clients go to publicly share their discontent? The minute someone like a “celebrity type” is paid for a testimonial is the minute that the testimonial is self-serving and falsely bestows kudos to the company that cut him or her a cheque.
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I do not agree with scenario 2.
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I don’t agree with scenario 2 but with scenario 1 if the client doesn’t have a problem in sharing their views about a clinic nobody else should as we all know that running a clinic is tough and when hospitals can advertise why not clinics. recently I heard on the radio some great eye hospital performing eyes surgeries successfully and asking the listeners to choose them over others.
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I agree that Scenario 2 cheapens our expertise, the many years we spent in school and does not look good on the profession period. Physiotherapists are more qualified than other primary health care providers at providing exceptional care and referring on for more serious conditions. Regarding advertising, what does the CPO think about chiropractors advertising they do “physical therapy”, “physiotherapy” as a part of their service – I thought these were protected words/titles in Ontario, but I could be wrong. Lately, I have seen quite a few chiropractors advertise they do “physical therapy” to gain clients, which seriously greys the line between our professions.
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In regards to regulation of clinics versus just physiotherapists I believe that we are adequately regulated now. Shenda admits that there are problems trying to define what a ‘clinic’ is. Please stop this process, we have HCAI having to regulate (and charge us significantly) and I have not seen the evidence that we as a profession are egregious in our practices. Further layers for our profession will not help, use the framework in place. Where is the evidence that it does not work and who suggested that it might be thus?
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“Physical therapy” and “physiotherapy” are not regulated and the College has done huge campaigns on this but no one understands. (I have 2 brochures in my clinic – one with a baby saying “anyone can say they do physiotherapists etc) and one with an older woman looking thoughtful “my title is your protection”.
Still, no one gets it. And about the chiropractors offering physiotherapy – that is where the Colleges need to step in. The public thinks they are being treated by a PT.
On the topic of regulation then, is the term “adjustment” or “chiropractic” protected? Can I offer “chiropractic” treatment and adjustments at the clinic (meaning manual therapy, manipulations) without having a chiropractor?
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Once apatient told me, I dont believe in physio!!, all they do is TENs and hotpack !! . I embarrassed in behalf of my physio colleges. Then I realized he had been seen by PTA!!dont you think presence of PTA in our profession is responsible for poor image of society toward us?
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How is it in the best interest of the public when physiotherapists who provide quality & professional services (not just TENS & hot pack) and build a reputation for the profession are not allowed to have testimonials by their real patients (not paid TV personalities and high profile athletes) on their website or let their prospective patients know what a difference they can make in the life of their patients? Afterall, word of mouth can go so far when a physiotherapist decides to build a practice only by offering good quality care.
How are we supposed to compete with the chiro owned clinics claiming that they provide the best physiotherapy service in the city when the physiotherapist only provides initial assessment for the patient? While I am all for preventing unethical practices and false claims, the current limitations imposed by the college makes Physiotherapists who work very hard and spend a lot of their hard earned money on promoting their services to the community a target for their competitors.
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