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Speakers: Jody Prohar and Leanne Loranger
At their September meeting, Council voted to approve the updated Standards of Practice for Alberta Physiotherapists. These updated standards will be in effect as of January 1, 2025. On this episode of College Conversations, Jody and Leanne provide listeners with an update about the Standards of Practice including:
· The process the College used to develop standards that were right-touch and risk-based (and what those terms mean to regulators), and
· Highlights of the major changes, including standards that are being retired and new standards added.
It is up to each physiotherapist to meet the performance expectations established in the standards. Being unaware of the standards of practice is not an acceptable explanation if a professional conduct matter arises related to your practice.
The revised Standards will be available on the College’s website in November 2024 and will take effect on January 1, 2025.
As that date approaches, Alberta physiotherapists are encouraged to review the standards to make sure they understand what is required of them. If you do not understand the performance expectations, check the College’s website, or contact the College’s Practice Advisor for more information.
Links:
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Speakers: Jody Prohar and Leanne Loranger
On this episode of College Conversations, Jody and Leanne ask Alberta physiotherapists ‘are you engaged in a risky business?’ Listen to the episode to learn more about risky business arrangements that the College has become aware of in recent years.
What does it mean to put the client’s interests first? How can physiotherapists identify and avoid conflicts of interest in which their own financial or personal interests are prioritized ahead of the client’s interests? How does this discussion relate to the rules in place related to provision of professional services and the role of the most responsible physiotherapist?
Listen to the episode for answers to these questions and more.
Resources:
· Good Practice: Is your business keeping your client’s best interests at heart?
· Good Practice: What makes it physiotherapy?
· AHPRA: Concerns raised over emerging models of care.
Links:
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Over the last couple of years, there has been a steady increase in the public discourse about artificial intelligence or AI. Since the release of the generative AI tool ChatGPT4 in spring of 2023 we have seen the emergence of AI tools designed to support charting of health care services and platforms to support clinical decision making in health care, including those designed for or applicable to physiotherapy practice.
What does this all mean for Alberta physiotherapists? Can physiotherapists use AI in clinical practice? What are the risks they should be aware of? Check out this episode to learn more about regulatory considerations of consent, privacy, quality and accuracy; and the physiotherapist’s responsibilities if they choose to use AI tools in their practice.
While it’s easy to get caught up in the hype about these tools, physiotherapists need to take the time to understand the AI tools they use and what they do and don’t offer.
Resources:
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Links:
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Speakers: Amanda Gould and Leanne Loranger
Amanda Gould, Indigenous Knowledge Keeper, and Cultural Advisor to the College joins Leanne on this special, extended episode, of College Conversations. We discuss the sharing circles the College engaged in earlier this year, bringing Indigenous people and physiotherapists together, and the key learnings that arose from the sharing circles.
Listen to this episode to learn more about what sharing circles are, what the College learned from the sharing circles held in early 2024, and the College’s next steps towards addressing Indigenous cultural safety and health equity.
Resources:
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Links:
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Speakers: Sean FitzGerald and Leanne Loranger
In this episode, Sean and Leanne discuss video recording in physiotherapy practice settings, including video surveillance, generating recordings of virtual visits, and creating videos of patient instructions or home exercise programs as part of in-person visits.
Physiotherapists usually provide lots of information to clients, and there can be benefits to providing video summaries of information. However, physiotherapists need to consider the privacy, record keeping, and consent issues that arise if they create videos in their practice settings and take steps to proactively address these issues.
Physiotherapists should also consider the potential that a client may record a clinical interaction, either with their knowledge and consent or not.
Resources:
· Office of the Information and Privacy Commissioner of Alberta. Video Surveillance in the Private Sector.
· Office of the Information and Privacy Commissioner of Alberta. Bring Your Own Device (BYOD) Programs.
Links:
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Speakers: Jody Prohar and Leanne Loranger
Physiotherapists adhere to the legislation that applies to their practice. That responsibility is enshrined in the Code of Ethical Conduct. But what legislation, exactly, is included when we say that?
In this episode, Jody and Leanne review some of the often-overlooked legislation that applies to practice and its relevance to physiotherapists, including the:
· Radiation Protection Act
· Protection for Persons in Care Act
· Child, Youth and Family Enhancement Act
· Occupational Health and Safety Act, and
· Public Health Act
We begin with a discussion of the Radiation Protection Act, which was repealed in 2021, and the legislation established in its place to regulate lasers.
Later in the episode, we discuss the practice setting inspections enabled by the Occupational Health and Safety and Public Health Acts. Are you aware that inspectors have the legislated authority under both Acts to perform practice site inspections? What can we learn from physiotherapists who have had their practice settings inspected?
What are our legislated responsibilities as physiotherapists? Listen to this episode to learn more!
Resources:
· Legislation related to Practice – CPTA. https://www.cpta.ab.ca/for-physiotherapists/resources/legislation-related-to-practice/
· Occupational Health and Safety Act Act https://www.canlii.org/en/ab/laws/stat/sa-2020-c-o-2.2/latest/sa-2020-c-o-2.2.html
· Public Health Act https://www.canlii.org/en/ab/laws/stat/rsa-2000-c-p-37/latest/rsa-2000-c-p-37.html#Part_2_Administration_32475
· IPC Guide CPTA - https://www.cpta.ab.ca/docs/67/IPC_Guide-Revised_Human_Rights_11.30.23.pdf
Links:
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Speakers: Sean FitzGerald and Leanne Loranger
“A bystander is a person who is present at an event or incident but does not take part.” What does bystander intervention mean and why does bystander intervention matter for physiotherapists?
In late 2023 and early 2024, the College highlighted trends in allegations of sexual abuse and sexual misconduct received by the College of Physiotherapists of Alberta. One of the College’s messages is that we need the help of all physiotherapists to disrupt these trends by intervening when they see conduct that is either clearly sexual misconduct or is tipping in the direction of becoming inappropriate. Further, the Standards of Practice and Code of Ethical Conduct call upon physiotherapists to act when they observe others acting in a racist or discriminatory manner towards others.
In short, physiotherapists need to shift from witness to intervenor when they observe an incident or conduct in the practice setting that is not consistent with professional norms and expectations. In this podcast we discuss highlights and take away messages from the February 2024 Introduction to Bystander Intervention webinar the College hosted with the Sexual Assault Centre of Edmonton.
Do you know the 4Ds of bystander intervention and how to apply them? Check out this episode to learn more!
Resources:
· Webinar: https://www.cpta.ab.ca/news-and-updates/webinars/an-introduction-to-bystander-intervention/
Links:
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Speakers: Jody Prohar and Leanne Loranger
When you think about the College’s past messaging about its role – that it exists to safeguard and serve the public interest and receives its mandate from the Government of Alberta, on some level it’s understandable that physiotherapists might ask, “if that’s the case, why am I footing the bill?”
In this conversation, Jody and Leanne address the age-old question of “what’s in it for me?” when it comes to regulation. Along the way, they discuss the contract that exists between government and regulated health professionals, different regulatory models, and the concept of co-regulation. They touch on the benefits physiotherapists gain through regulation and what could potentially occur if the profession was not regulated.
Being a regulated health professional offers benefits but it also demands that we work to continually raise the bar for ourselves and those around us. Albertans deserve a physiotherapy profession that is accountable and that serves the public’s interests.
Listen to this episode to learn more about the benefits and obligations of being a regulated health professional.
Resources:
· Webinar: What does it mean to be a member of a self-regulating profession in 2021?
Links:
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Speakers: Jody Prohar and Leanne Loranger
All physiotherapists need a basic awareness of the rules of practice and professional expectations for physiotherapists in Alberta. The College uses many tools to get that information into your hands, to make you aware of and help you understand and meet your regulatory responsibilities. You can’t fulfill a responsibility if you don’t know about it or don’t understand what it means, but we need you to meet us halfway,
At the end of 2023, the College engaged in a review of its communications practices. In this episode, Jody and Leanne discuss the findings of the communications review and actions the College is planning to address the feedback received and to try to make our communication efforts more effective. If you have ever asked yourself why the College spends time and resources on communications, or wondered what resources are available to help physiotherapists understand the rules of practice, this episode is for you.
Listen to the episode to learn more about the resources the College creates, the feedback received during the review, and some of the changes we are working on.
Resources:
Links:
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Speakers: Sean FitzGerald and Leanne Loranger
The Consent Standard of Practice and Consent Guide for Alberta Physiotherapists both refer to the importance of ensuring that a physiotherapist has ongoing informed consent when providing physiotherapy services. The College often hears from physiotherapists and others who have questions about the College’s expectations related to ongoing consent. Does ongoing informed consent mean that the physiotherapist must engage in an extensive discussion of the risks, benefits, and options for care at every visit? Can a physiotherapist ensure that the patient continues to consent to treatment at subsequent visits by asking a few simple questions and being alert to the patient’s replies? Does a patient’s attendance at an appointment mean that ongoing informed consent is in place?
In this episode Sean and Leanne answer these questions and more and highlight the risks that can arise if express ongoing informed consent is not sought and received. What does this look like in clinical practice? Listen to the episode to learn more.
Resources:
· Consent Standard of Practice
· Consent Guide for Alberta Physiotherapists
Links:
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Speakers: Jody Prohar and Leanne Loranger
On this episode of College Conversations Jody and Leanne continue the discussion of trends in complaints related to allegations of sexual abuse and sexual misconduct, highlighting one of the underlying themes identified from the review of these complaints – communication.
They discuss the comments highlighted in the #WordsMatter infographic and why they are problematic. They connect the concerning comments back to the concept of professional boundaries, the importance of maintaining therapeutic relationships, and the difference between therapeutic relationships and personal relationships.
They also discuss the important roles that context, non-verbal and para-verbal communication play when it comes to how a comment is received, highlighting that how a comment is received depends on both the person speaking and the person on the receiving end of the comment. Towards the end of the episode, they touch on trauma-informed practice and highlight some tips for integrating a trauma informed approach into daily patient interactions.
Communication is one of the hardest skills to master and one that physiotherapists can spend their entire careers developing. Check out this episode to learn more.
Resources:
· Sexual Abuse and Sexual Misconduct Standard of Practice
· Words Matter: Comments & Sexual Misconduct Infographic
Links:
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Speakers: Jody Prohar, Sean FitzGerald, and Leanne Loranger
In this episode, Jody, Sean, and Leanne discuss common questions and issues related to physiotherapy business practices.
· Is it appropriate for a physiotherapist to continue to sell their services without demonstrable progress towards the patient’s goals, or is that a conflict of interest?
· Where does demonstrable progress fit into decisions about providing ongoing care or discharging a patient?
· What about maintenance plans for patients with chronic conditions?
· Are there rules or requirements to keep in mind when selling physiotherapy equipment or products?
· What about incentive contracts that see physiotherapists receive a bonus based on volume of product sales?
· What are the risks of accepting pre-payment for physiotherapy services?
We address all these questions in this episode.
Resources:
· Conflict of Interest Standard of Practice
· Fees and Billing Standard of Practice
· Code of Ethical Conduct
Links:
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Speakers: Leanne Loranger, Jody Prohar, and Joyce Vogelgesang
On this episode of College Conversations Jody, Joyce, and Leanne talk about concerning trends in the number and nature of complaints received by the College during the 2022-2023 registration year. The College has seen an increase in the number of complaints received, and the number of complaints pertaining to sexual abuse particularly.
Four years have passed since the Sexual Abuse and Sexual Misconduct Standard of Practice came into force. In this episode, Jody, Joyce, and Leanne review the key components of the Standard of Practice and discuss some of the actions by health professionals that have led to complaints of sexual abuse or sexual misconduct.
Find out how recent complaints data from the College of Physiotherapists of Alberta compares to that of other “hands on” health professions in Alberta. The College is concerned about these statistics and physiotherapists should be too.
Listen to this episode to understand why the College is calling on all registrants to revisit the performance expectations established in the Standard and to reflect on their current practice and interactions with patients.
Resources:
· Sexual Abuse and Sexual Misconduct Standard of Practice
· College of Physiotherapists of Alberta - Complaints
Links:
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Speakers: Leanne Loranger and Sean FitzGerald
Being a member of a small community poses some unique challenges for regulated health professionals. There is the potential for conflicts of interest and risks related to the ability to set and maintain appropriate professional boundaries with patients.
What does the College mean when it says that physiotherapists should refrain from providing services to an individual with whom they have a close personal relationship? Which relationships are considered to be a close personal relationship?
What are some recommendations if you do need to treat someone with whom you also have a personal relationship?
What about the challenges of navigating a small community and informal interactions with past or current patients occurring outside of the practice setting?
How can physiotherapists also have a life outside of work as a member of a small community?
What about making friends in town or developing a network of peer health professionals with whom to discuss challenging situations?
We address the College’s perspective on these questions and more in this episode.
Resources:
· Conflict of Interest Standard of Practice
· Therapeutic Relationships Guide for Alberta Physiotherapists
· Good Practice – Conflict of Interest
Links:
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One of the most common topics of the questions brought to the College is that of privacy and the legislative and regulatory requirements that physiotherapists must meet in relation to patient privacy. With physiotherapists subject to as many as four different pieces of privacy legislation depending on their area of practice and patient population, it’s easy to understand why.
In this episode of College Conversations, Sean and Leanne complete a brief review of privacy legislation in Alberta, the core principles that they share, and the differences between different pieces of legislation. In the second half of the episode, they answer some frequently asked and recent challenging questions that the College has received.
Leanne and Sean also highlight the many resources available, both through the College of Physiotherapists of Alberta and from the Office of the Information and Privacy Commissioner of Alberta, to help physiotherapists navigate the complicated world of privacy in physiotherapy practice.
Resources:
· Privacy Standard
· Privacy Guide
· Leaving a Practice Guide
· OPIC Video Surveillance in the Private Sector
· OPIC Bring Your Own Device Resources
Links:
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Speakers: Leanne Loranger and Sean FitzGerald
Physiotherapist support workers are an essential element to a functioning health system. In this episode, Leanne and Sean discuss the range of backgrounds, educations and experiences people working as physiotherapist support workers may possess and the implications of physiotherapist support workers being unregulated health providers.
They review the performance expectations that physiotherapists must adhere to when supervising physiotherapist support workers and the importance of understanding the skills and knowledge of the physiotherapist support workers you work with.
Toward the end of the episode, they discuss the College’s perspective on the importance of establishing when a supervision relationship exists between a physiotherapist and an unregulated health provider and touch on the different methods of supervision physiotherapists can employ when supervising physiotherapist support workers.
Resources:
· Supervision Standard of Practice
· Supervision Guide for Alberta Physiotherapists
Links:
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Speakers: Jody Prohar and Leanne Loranger
Over the last few months, there has been a near constant stream of media coverage related to health workforce labour shortages and actions taken by governments, regulators, and other organizations to address the issue.
In this episode, Jody and Leanne discuss actions taken by the provincial governments in Ontario and Nova Scotia and recent changes to Alberta legislation that are all intended to attract health professionals to the respective provinces.
They provide an overview of the Fair Registration Practices Act and the Labour Mobility Act - two pieces of legislation which apply to the physiotherapy workforce. These pieces of legislation establish specific timelines and responsibilities for the College of Physiotherapists of Alberta related to registering physiotherapists who are moving to Alberta from other jurisdictions – both from within Canada and from other countries.
What does it all mean for Alberta physiotherapists? Listen to the episode to find out more.
Resources:
· Government of Alberta. Fair Registration Practices Code.
· Government of Alberta. Labour Mobility Within Canada.
Links:
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Speakers: Jody Prohar and Leanne Loranger
The College of Physiotherapists of Alberta has had provision of professional services rules in place for several years. The rules stem from the College’s legislated authority to “approve practice settings where physiotherapists provide services.” In this episode, Jody and Leanne discuss the rationale behind the rules, policy updates that were implemented in 2023, and what those updates mean for physiotherapists and business owners.
Do you have questions about:
· The role of the designated owner of a practice setting?
· The mandatory learning modules in place for Most Responsible Physiotherapists (MRPTs) and some business owners?
· The agreement that MRPTs enter into with the College?
· The transition to online applications?
If so, this is the episode for you!
Resources:
Episode 37: Thinking About Opening a Physiotherapy Business? Start Here! College of Physiotherapists of Alberta. Provision of Professional Services.Links:
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Physiotherapists have fundamental obligations to provide safe, competent, effective care to their clients, and to provide for continuity of care whenever a therapeutic relationship has been established. The concept of a duty of care underlies long standing professional norms and expectations.
In this episode we discuss recurring challenges that physiotherapists may encounter related to the duty of care that they have towards their clients, including:
· The physiotherapist’s responsibility to maintain the therapeutic relationship and take responsibility for conflict resolution.
· Challenges related to discharging patients who still require treatment, but with whom the physiotherapist is unable to maintain a therapeutic relationship, and the physiotherapist’s responsibility to arrange for continuity of care.
· Expectations related to informed consent and shared decision making such as the requirements of avoiding providing inappropriate or ineffective treatment and respecting the patient’s right to make decisions about their own care. We also discuss how to navigate the challenging situations that can arise when a patient declines or refuses treatment and the physiotherapist thinks the patient’s choice of action is unsafe.
The Standards of Practice and Code of Ethical Conduct set out the expectations for physiotherapists related to duty of care. In this episode we elaborate on those expectations and discuss real world scenarios that physiotherapists may encounter from time to time.
Resources:
Code of Ethical Conduct https://www.cpta.ab.ca/for-physiotherapists/regulatory-expectations/code-of-ethics/ Standards of Practice https://www.cpta.ab.ca/for-physiotherapists/regulatory-expectations/standards-of-practice/Links:
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Speakers: Jody Prohar, Joyce Vogelgesang, and Leanne Loranger
To be eligible to renew their College of Physiotherapists of Alberta practice permit each year, physiotherapists are required to meet currency of practice requirements. The most common way to meet these requirements is to have engaged in the practice of physiotherapy for at least 1200 hours in the 5 registration years immediately preceding the application for permit renewal. Each year the College of Physiotherapists of Alberta receives many questions from regulated physiotherapists regarding practice hours and currency of practice requirements.
Have you ever wondered
· How many hours a registrant must work to meet the currency of practice requirements?
· What types of hours count towards meeting the currency requirements?
· Whether a physiotherapist is required to count their hours of practice?
· When to report physiotherapy practice hours and what information to include? And
· What happens if the physiotherapist does not meet the currency requirement?
If so, this episode is for you!
Resources:
Practice Permit Renewal. https://www.cpta.ab.ca/for-physiotherapists/registration-information/practice-permit-renewal/Links:
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