Shhh! The Registrar’s TOP SECRET FORMULA for Avoiding Complaints!

Amanda is a young woman in pain. Mr. McBean is an experienced physiotherapist who achieves excellent clinical outcomes. So how come she’s complained about him?

  1. Because he reached his arm across her chest, coming into contact with her breast
  2. Because it really hurt when he moved her arm through the full range of motion
  3. Because she didn’t get better after two treatments
  4. Because she found out that Ms. Lee, who was providing her treatments, was a PTA when she thought Ms. Lee was a physiotherapist who worked in partnership with Mr. McBean

If you answered all of the above, you got it right.

So what went wrong for Mr. McBean?

  1. Amanda was surprised by the physical contact with her breast, which she did not expect. Without an explanation of what the injury was and what the treatment would look like, she interpreted the events as intimate violations. She complained about sexual abuse.
  2. Amanda was surprised by the pain. She didn’t tell Mr. McBean it was OK to move her arm and he didn’t tell her what to expect. She complained that he assaulted her.
  3. Only a miracle would have resolved Amanda’s issue after two treatments, but she didn’t know that. She didn’t know that she should expect to go for six. She complained that he was a bad clinician.
  4. Amanda booked an appointment with a physiotherapist. She assumed that the person touching her was a physiotherapist filling in for Mr. McBean. Nobody told her that she could or was receiving physiotherapy from an assistant. She complained that Mr. McBean lied to her and provided her with inferior care.

The bottom line is that in each and every case, Amanda did not give consent.

There is no science to this, my friends. Informed consent means that you talk to your patient. You give them all the information that THEY might think relevant and you let them decide if the next step is OK with them. And if you aren’t sure how much information to give them, give them a little extra to be on the safe side.  If something changes along the way, talk to them about the change and what you propose for next steps and let them decide if that’s OK. And for Pete’s sake, before you start treatment, tell them what you think is wrong, how you propose to address it and how many visits it might take…AND ASK THEM IF IT IS OK TO PROCEED.

Don’t take shortcuts when you discuss treatment and don’t assume you know best. Sincerely ask every one of your patients for permission to proceed.

The secret formula for staying out of trouble? Talk to your patients. Start immediately and never stop.

Video: Did You Get Consent?

Additional Resources
7 Things You Should Know About Consent
Briefing Note: Health Care Consent Act
The Health Care Consent Act (HCCA)


3 thoughts on “Shhh! The Registrar’s TOP SECRET FORMULA for Avoiding Complaints!

  1. I think that you interpreted the different scenarios very very well. An excellent illustration of the situations that could be encountered.


  2. Great article Shenda, you clearly identify what Physiotherapist can do every time / all of the time to avoid not only complaints against them but also to help clients achieve the best outcomes. Communication is critical. The ‘informed’ part of ‘informed consent’ is just as important as the ‘consent’ part 🙂


  3. Consent is an important issue and I strive to educate in a manner generally consistent with the above. Excellent overview.

    Recently I had occasion to consult with the Royal College of Dental Surgeons of Ontario as a dentist performed a procedure on me as I was ‘frozen’ that I had specifically asked him not to do. The Royal College of Dental Surgeons of Ontario post investigation response was simply that I did not stop him so that was enough to grant consent and that the Dentist in question did not need to get more consent as I was ‘in his chair’ which implied consent to any ‘necessary’ procedures.

    Because I agree that consent and education is an essential component of accountable care I do strive to act as you suggest.

    As a regulator my question is why we are judged differently than other providers in Ontario?


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