Workplaces, including those in a health care environment, often include a variety of personalities that are not always complementary. Interpersonal difficulties with colleagues can arise in any workplace, but for regulated professionals, there is always a risk that these difficulties can lead to the regulator’s involvement – either through a complaint or mandatory report following disciplinary action. It is important, therefore, to address these difficulties before they lead to College proceedings. A recent case before the Health Professions Appeal and Review Board (the Board) involved such a scenario.
The matter involved a physiotherapist who worked in a long-term care home. The physiotherapist supervised and was professionally responsible for the work of the Physiotherapist Assistants (PTAs) at the home.
The physiotherapist had a particularly difficult relationship with one of the PTAs. She had concerns about the PTA’s language and behaviour, including that he was often insubordinate, did not chart properly, and did not comply with her instructions. Because of the difficult relationship the physiotherapist notified her employer that she was resigning. Her employer responded by initiating the termination of the PTA’s employment. However, individuals at the home intervened on the PTA’s behalf and his employment resumed.
In 2016 the physiotherapist and the PTA had a “very tense” meeting at the home where they raised their voices and the Director of the home asked both of them to leave the building. The physiotherapist began to work elsewhere.
The Complaint and Investigation
The daughter of one of the residents of the home (who was also a supporter of the PTA) filed a complaint with the College of Physiotherapists of Ontario regarding the physiotherapist’s behaviour. The complaint alleged that the physiotherapist would frequently yell at the PTA while pointing her finger in his face, would not let him leave during lunch, and forbade him from speaking with other staff and residents’ family members.
The College investigated the complaint and identified some concerns, one being that she behaved unprofessionally, particularly with regard to the PTA.
After the investigation was deemed complete, the Inquiries, Complaints and Reports Committee (the Committee) assessed the information and decided to require the physiotherapist to complete a Specified Continuing Education or Remediation Program (a SCERP) requiring that she review the College’s standards and professional competencies, meet with a coach, and write a reflective paper.
The physiotherapist requested that the Board review the decision.
The Board’s Decision
After confirming that the investigation was adequate (there was considerable information obtained from various sources) the Board went on to examine the reasonableness of the decision.
The Board confirmed that physiotherapists are “expected to identify and proactively manage situations and behaviours that may possibly interfere with a safe, respectful and professional interaction.” There was no question that the dynamics of the relationship with the PTA were difficult and challenged the physiotherapist professionally as his supervisor. There was also no question that the tensions in the working relationship had been witnessed by others, and at times had a “disruptive quality”. The Board accepted that the record supported the Committee’s observations that the interaction between the physiotherapist and the PTA in 2016 undermined the principles of professionalism and mutual respect and had the potential to disrupt the “therapeutic environment of the home”.
The Board accepted the Committee’s view that, even if a relationship is challenging, a registered health professional must still be able to act in accordance with standards of professionalism. The Board agreed that the physiotherapist’s approach in managing challenging interpersonal situation could benefit form requiring her to meet a coach and successfully compete an educational course as part of a SCERP. The Board concluded that this met the objective of being a remedial tool intended to educate a member about professional expectations.
The key message from this case is to conduct oneself in a professional manner and to take steps to try to resolve interpersonal workplace issues before they result in a complaint.
If you have any questions about this particular case or health professionals’ regulatory proceedings in general, please contact us.
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