Complaint,Tribunal,Discipline ......!!!

[emad]

Hi all :

I know that i am on that forums with physios of long experience ,

Bernard :arrow: 24 years experience
Diand :arrow: 25 experience
Takao :arrow: :?:
Nari :arrow: :?:
Rin :arrow: :?:
Me :arrow: :!:
others :arrow: :?: :?:

Tell me any one hasbefore exposed/subjected to be complained by a pateint , or was subjected to hearing :?: :?:

i like to read those stories , is thus legal for us to discuss :idea: :idea:

cheers
emad :D :D

[emad]

Hi Bernard:

It is okay ,it is ver good to speak generally ,i put that topic as i have read a complaint against one physio in nz , it was like clinical reasoning process , the commissionar give the case to two independant expert physio to say their views , one of them said that the responsible physio had to use a certain test to detect the case ,
thus only what encouged me to put that topic , if i am reminding other physios on that forum of bad moments , i find no problem to remove the topic :wink:

cheers
emad

[Diane]

Emad,
I see no problem with this topic. It is a woeful moment when some individual is called to task on some perceived issue of wrongdoing, but it is fine to discuss it in my opinion.

I've actually been practicing since 1971, which gives me...33 years, not 25 ...

Here there is a College of Physiotherapy, which regulates the profession, hears complaints from the public, issues warnings, fines and suspends liscences to practice. They are quite active. And in a newsletter they publish their activities and findings. Any PT can be a whistleblower on any other PT. It helps improve the standards of practice.

Over the years there have been infractions that range from sexual impropriety, actual and alleged, issues about proper draping of patients, that sort of modesty concern. There are always issues over whether charts are being properly kept and files maintained. This one always makes me smile..over whether ultrasound was being applied by a real liscenced PT or an assistant. This seems to make the college go nuts!

Whenever there has been a true transgression and a PT found in violation, their lisence is removed and their name is published where all other PTs can read it, in the College newsletter, which comes out 3 or 4 times/year. If the allegation has been found to be bogus, they report (without mentioning the name of the PT involved,) the nature of the complaint and the outcome of their investigation. It works. There has to be some sort of system in place and it has to be seen as fair and functional, or we lose the right to call ourselves professionals.
Diane

[nari]

Our system (which sounds very similar to Canada's) deals primarily with complaints from patients, and rarely with litigation. Some years ago a clinician was brought to court to face a fraud charge, found proven, rapped on the knuckles, prevented from practice for a while, then cleared.

Yes, there is always great consternation if it appears that a non-PT has been asked to deliver US, eg a receptionist or PT assistant. I heard of one assistant who was wise enough to refuse to apply US; she was cluey enough to know the implications, even though she would be theoretically blameless in a court case. Another cause for concern for the board is the removal of cervical traction by non-PTs, and application of heat packs.

One litigation incident I remember was the case of a woman suing because the physio had 'made her fall off the plinth' when she was asked to stand up from lying down. It was remarkably unsuccessful, fortunately for the physio; because the physio had asked if she required help and was told quite firmly 'no'.

I think this is a good topic to discuss, because we are in the firing line for litigation, we pay each year a substantial amount for indemnity, and although court cases are rare, we need to be reminded that it can happen, rather like the Earth being hit by an asteroid.

Nari

[Diane]

Bernard, I admire your nonchalance.

Documentation is so important. In a dispute it is really one's only protection. I have never (touch wood) had any complaints raised against me by any member of the public or any other therapist. A PT friend of mine was once accused by a vindictive patient of hurting him by correcting an upslip, and made a complaint to the college. The PT had documented everything done, and it turned out the patient couldn't even remember which leg had been treated...he got the leg wrong! so my friend was exonerated after investigation showed that the patient was clearly a crank who was out to take advantage if he could.
Cheers,
Diane

[emad]

Hi All ;

thanks ,the topic went so successfully

Great knowledge , lovely topic .

Diane ,Even there in Canada they Touch wood,
i was thinking it is a culture here only , really attracted my attention .

I respect your experince of 33 years

Me

I graduated with bachelor in 1998 , then a year of internship.

I think the topic gone in a lovely manner , thanks friends .
i will write more comment then.

cheers
emad

[Diane]

Hi Emad,
You are still freshly out of the egg, yet have grown so much! :)
So you have "touch wood" in Egypt? Wow, that must either be a very ancient practice, originating there or nearby in the cradle of civilization, or else it's an import from further west...
Cheers,
Diane

[emad]

Hi Diane :

I swear ,before ,i told you that i am graduated in 1998 ,you have not detect thus through our discussions ,
Here they say touch wood , when one is afraid of other s eyes to look in his things ,for example , when one person buys a new car , his friend comes to him saying WOW it is lovely,excellent car , the first replies very fast saying TOUCH WOOD.

You said
documentaion is imporatnt , i agree with you completely documents are so essential through our work to reason legally our management,Then you have mentioned another problem the assistant wotk performing could be a source of trouble , Is not there a clear ,precise ,accurate law regarding what to be delegated and what not :?:

Bernard:
you have mentioned a women patient , you applied around perineum , what was her problem to treat like thus :?: :idea: :arrow:

cheers
emad :D

[Diane]

Here, "touch wood" is an action based on a superstition about luck. One makes a statement, and touches something made of wood in the hope that the fates will support the assertion or the intention. I always thought it stemed from pagan nature type beliefs, that the earth/cosmos was the supreme being, and wood was tangible earth, usually growing somewhere within arm's reach. Like reaching out to check that your mother is still beside you as you gather courage to venture forth.
No, I didn't know before when you had graduated...
Cheers, Diane

[nari]

To 'touch wood' is an expression probably inherited from the UK 200 years ago; it is rather out of vogue now, and can be hard to find something made of wood anyway - certainly in the workplace.

Bernard, if someone can't find any wood to touch, they immediately touch their head, or, sometimes another person's head. We love 'taking a rise out of someone' at every opportunity; and we are generally very good at laughing at our and others' stupidity. Australians are famous for 'ribbing'; which includes direct criticism - eg if someone forgets to do something important, he/she is likely to be told: 'You're a dickhead/an idiot aren't you?' and the result is laughter all round.

I fortunately have not had a formal complaint lodged against me in 25 years of actual physio practice; the exception to that in a mild way was another colleague ( a junior)who told the boss/leader in an exit review that I was not interested in doing a good job. When it was discussed with me, it turned out that I was so tired of the silly hospital system that I needed to get out, but had not recognised it fully. So he did me a good turn, as my boss then went on a hunt to suggest alternatives, and I came into the health centre. A good move.
Sometimes we need a wake-up call, even if at the time we don't like it!!


Nari :idea:

[emad]

Hi friends
:D :D :D happy weekend

Glad to know that most of you have not gone under a formal complaint :)


Let us change the topic to discuss what are the most common mistakes could lead to putting the physiotherapist in a difficult position formally.

cheers
emad

[nari]

I think there are quite a few 'red flags' for risk management.

1) not warning the patient before applying ANY sort of electrotherapy or heat treatment.
2) not warning the patient about major flare-ups if given homework that involves neurodynamic mobilisation, if the number of repetitions is not followed.
3) mobilising the cervical spine and impingeing on the vagus or, in the case of subacute neck pain, causing vomiting, etc.
4) not following protocols with post-surgical patients
5) not performing VAT prior to strong mobilisations with the neck flat and rotated. (EVEN THOUGH the test can show false positives and negatives)
6) not documenting red flags noted during assessment and not following up with medical advice......

There are many more, and in a vast number of cases, there is no real problem if we transgress..

BUT it only takes one loopy person who is out to blame everyone but him/herself... :oops:


Nari

[emad]

Hi nari :
thank you very good knowledge for me :idea:

i ashamed to speak about that topic here , here all people do illegal issues ,destroying the nature and human being , so we do every thing we want to do , the is thing called ethics through our work , so easly we are not threatened to be complained.
for them here , not advising the patient about the possible side effects of number increasing of neural mobilisation is no thong as they suffer many many problems , i do not think there is a physiotherapist here in a country of at least 75 millions has been complained by a patient , i can tell you here the nurses performing the physio ,they use infra red leading to burn patients , with no problems.

sometimes , i think illetracy is of benefit :idea:
cheers
emad :)

[nari]

emad -
Yes. it does seem unfair that the nurses can get away with much more than we can; their protection by hospitals is not failproof, but as they are seen as only following orders, they can defer blame more easily.

There is a price for us to pay by being independent in practice.

Nari

[emad]

Hi Nari:

Independant practice seems more better , usually i say ,i can work all alone with no help ,and i feel usually more better , particularly gentle hand working needs who apply the work be oriented well thinker ,understand well all our work back grounds .

cheers
emad

[nari]

It certainly is frustrating to have someone who believes that pain must be present during or after treatment in order to get better.

It is an indication of the attitude of some of the general public - perhaps, back to the magic of the 'click' of manipulation. Audible verification of 'something is back in place, and of course it will hurt because it has become used to the misaligment'... or similar.

Not all chiros are so territorial; but some physios are - I guess it comes down to a lot of factors, one of which is power play.

It is good to remember the patients who left happy and painfree!

Nari