A few years ago the British Parliament was considering how they could improve patient safety after a series of crushing hospital incidents. And here is what the members of parliament said, “Doctors could risk losing their licence if they fail to report fitness to practise concerns about their colleagues.” Do you think about that for physiotherapy? Do you wonder about your obligation to report your colleagues?
Maybe you watched while Susan, who was teaching Mrs. Hall to climb the stairs on crutches after hip surgery, left her alone to take a phone call. Or you think that Claire may be showing signs of age-related cognitive decline. Perhaps you know that Joe down the hall sometimes asks his pretty patients on lunch dates. Maybe you heard your boss offering patients invoices for PT services when the service was really personal training.
Here’s the thing: if self-regulation is built on the belief that physiotherapists are in the best position to set the standards for physiotherapy, then physiotherapists are also in the best position to identify when those standards have been breached.
I am sure that most of you believe that if a PT’s functioning is impaired due to substance abuse, mental health problems or incompetence, patients may be put to risk. And your feedback to the College has been clear—you hate dishonest business dealings. And yet most health professionals do not report their colleagues. In one study only 37% of nurses who have experienced working with impaired colleagues reported them. It’s no different for physiotherapists: in a study from Australia, only 19% of the participants indicated they would report to the Board if they were aware of sexual misconduct by a colleague.
Your partnership with your colleagues and your membership in the profession creates bonds of loyalty that can make it very difficult for you to step forward. We understand that. Maybe it would help you to know that we will never take any action without proof and where there are health concerns we will always take great care over the well-being of the physio.
But if you believe in physiotherapy as a true self-regulating profession, you can’t turn your back. Sure, there are legal obligations to report in some cases, but I am talking about more than that. I am talking about making sure that the people that you work with meet your own expectations for your profession. And when they don’t, I am talking about taking action. First line might be to speak with your colleague directly, but in cases of true patient risk or legal responsibility you will need to take stronger action. Tell your supervisor. Call the College. Call the police or Children’s Aid if you need to. Because as much as offering therapeutic care, monitoring your colleagues is part of being a physio.
What do you think: Should physiotherapists be investigated for failing to report concerns? Have you ever reported a concern? What happened?
 Helen Jaques, “Doctors should to be held to account for behaviour of colleagues, say MPs,” BMJ 2011;343:d4794.
 J.W. Beckstead, “Modeling attitudinal antecedents of nurses’ decisions to report impaired colleagues,” Western Journal of Nursing Research, 2002 Aug;24(5):537-51.
 I. Cooper and S. Jenkins, “Sexual boundaries between physiotherapists and patients are not perceived clearly: an observational study”, Australian Journal of Physiotherapy 2008;54(4):275-9.