Does it have to be this way?
I think that the difference between a health care profession and a business is simple: it’s in your motive. If you do this for a living to take care of patients, you are a professional. If your top priority is profit, you are a business person.
Before you post angry comments—I don’t mean that health care professionals can’t make a profit. Of course I don’t! I am talking about your primary reason for going to work in the morning. I hope that your first goal is to help patients and the gorgeous consequence of your good work is a healthy income.
The problem arises when patient care is secondary to the bottom line.
When Council was brainstorming business practices that are unacceptable, they quickly came up with the following examples: sales of products or services that do the PT’s profit line more good than the patient; advertising that is misleading or false; using too many support personnel to adequately supervise; using support personnel who aren’t properly trained; telling patients they need care or devices that won’t really do them any good; offering services that are not really physiotherapy but billing patients or third party payors for physio; inadequate, false or incomplete records; false billing. The list went on from here.
Last year Council adopted a policy of zero tolerance for inappropriate business practices. That means that if you are engaged in one of the practices listed above (or something not listed but equally offside) then you are doing a disservice to your profession and to your patients and the College will not accept it.
When the College learns about such a situation, the appropriate College Committee will consider it (that is, you will be evaluated by your peers and appointed members of the public—not by staff, and never by me) and the outcome could be anything from a meeting with the Committee, to compulsory education or could lead to a revocation of your certificate of registration.
We have heard from you: You deplore businesses that put profit before patients and Council agrees with you.
Physiotherapy CAN be a profession and a business—it’s just a matter of putting first things first.
Shenda’s Blog 
I would argue that putting patients first IS good business…. Most sustainable businesses outside of Healthcare understand that if you do not provide a customer/client with a good product/service your business will eventually fail due to the lack of repeat business.
I think we have a unique problem with physiotherapist owned clinics in that they often put the needs of the patient above ALL else including all thoughts of gaining enough profit to sustain the business. I have seen many ethical private clinics that have failed where the clinician could not pay the rent or paid themselves LESS then their employees because of this.
Therefore balance is the key….put patients first but pay attention to the fundamentals to keep your business sustainable!
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Can the College or the registrar please provide an example of what “offering services that are not really physiotherapy” means. Thank you.
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While I agree that training by personal trainers in a gym is not physiotherapy, I would argue that “exercise programs are not physiotherapy” when application of TENS & heat pack by PTAs is considered to be physiotherapy.
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I’d argue that exercise with a personal trainer is more beneficial to the patient than ultrasound by a PTA. Large physio ‘businesses’ and corporations live off the later. Maybe the college should go after them and then read some currenn literature.
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This type of practice is going on from decades. NOT YEARS… DECADES. Nothing has happened till now to stop it. Don’t even have any expectation anymore.
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how about delegate soft tissue release technique to RMT or delegate acupunture to acupunturist but bill under physiotherapy treatment in the insurance invoice? is this ethical?
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Guys, you are wasting time in here writing comments. The college…. if it was concerned about getting proper physiotherapy to public, it would first find ways and means to stop the mushroom growth of ‘rehab clinics’ owned and operated by non-professionals and non-physios…..I think THAT Is the root cause of all the problems and i feel physios are generally very ethical and concerned about their patients.
So better spend time in something useful than writing comments here….!
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100 percent correct!!!! All this is show off by College. If they were really concerned about public safety, they would have controlled all these shady businesses.
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Great comment…… What is the college and the CPTA doing about COPS and POPS (Chiro and Physician owned clinics) ?
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I agree with Mark C’s post. All health professionals are in the business of health care and providing good care is good business.
Finding the balance between providing care, running the business, and proper compensation is key to sustainability.
Regardless of environment – public or private – ethical practice, efficiency, innovation, collaboration, goodwill, and customer service are essential business practices in maintaining and growing our presence in the health environment.
Anonymous makes a good point. The College can monitor the business practices of its registrants. However, not in all instances but more likely, non-PT owned clinics pose a greater liability to the profession. I think exercising protection of the term “Physiotherapy” through the Trademark Act and allowing only PT owned clinics to use the term would be one possible strategy in allowing the College to more directly monitor and enforce good business practices.
Wheter we talk about PT clinics, medical practices, hospitals, or even the College, there is a business side to consider. It’s how we provide our services that will affect how we are judged and perceived.
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“telling patients they need care or devices that won’t really do them any good” – this happens all the time in medicine. Doctors and pharmacists have secured themselves sustainability all in part of lobbying and marketing from the pharmaceutical…here it comes…business! Meanwhile PTs are scared off to sell anything to their patients.
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We are professionals that definitely put our clients first, but delivering PT services is not voluntary work. I am sure, no matter how good a PT is, he/she would not want to work for free !!
At the end of the day, job satisfaction is directly proportional to the income that particular job generates 🙂
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I agree entirely with Shendas concerns. Don’t let’s kid ourselves. Physiotherpist owned clinics are in many cases no better than those owned by others. I was let go (not for cause) with my two weeks notice and Record of employment because I was not getting patients to book three times a week, regardless of their condition, coverage or ability to pay. I was also not encouraging them to book two massage appointments a week or selling enough orthotics/soft goods. The owners frank mission statement was to make as much money as possible for as little work and to ensure the patients EHC was exhausted before discharge.
My last position, from which I have recently resigned because of similar practices was not owned by a physio but regional managers were physiotherapists and even included part-time lecturers at PT programmes at a couple of local universities, and we’re only concerned with minimum three times a week bookings for physiotherapy and two massage visits a week regardless of assessment findings. A lot of things were done properly such as outcomes measures and satisfaction surveys. These were redundant as the only priorities were numbers of visits per new assessment. There was a disincentive to ever discharge anyone.
It’s business and we are glorified retail workers. Not good!
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physiotherapy businesses doing wrong, new grads with dangerous dream, support person hurting patients, stories of failed consent… these are all very important and good things to be aware of as a practitioner or patient. Though I do notice a trend here of focus on negative and poor aspects in physiotherapy, most physio clinics I’ve been to follow regulations, care about patient care first and for most. I wish I’d see a light shined on these positive examples, I’m sure you could think of a clinic somewhere in Canada that does a good job?
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we all need to be reasonable and realistic here. The college’s expectations seem to be ideal in a “perfect” world or even better- a “fairy tale” world
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I think the biggest issue with PT in ontario is the CPO itself. I have gotten very vague advice on how to handle improper practices in clinic. I think it is time we ask if the CPO is billing physios improperly. That 650 registration fee is ridiculous. Im not paying for someone to write blogs and send out magazines (that are designed to profit from ads, i hope at least). The college does a horrendous job in terms of regulating clinics. The practice has become chaos. There are very few clinics that do things perfectly according to college guidelines, at least within Toronto. There is one company in particular that has had numerous fraudulent cases and has been caught multiple times yet this mediical company continues to operate. If the college really truly cared about it’s physiotherapists, then it would take action or at least let PT’s know what companies have had issues such as insurance fraud. As long as the college is making money and their salaries are paid, they care very little. Again, the company that I referred to is built for scamming, and this is the message that the owner himself instills in his franchisees.
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charging for services they don’t need? doesn’t the alliance already do that to international applicants?
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For those who work in clinics that follow unethical practices, it would be best to let the College know of the names of the clinics that practice that way. It is the only way to get those fraudulent clinics to shut down! I hear this so often from would be patients who come in to the clinic and actually demand services & ‘gifts’ in exchange for their insurance information. When we deny they actually get upset stating the ‘clinic nearby’ does it, why not us!! Problem is, getting the names of those clinics is the tough part.
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