InSpirou v College of Physiotherapists of Ontario, the Divisional Court considered whether the action of four physiotherapists concerning the management of their co-owned clinic could fall under theCollege of Physiotherapists of Ontario’s (College) jurisdiction.
The four physiotherapists co-owned and directed a clinic with four locations that offered physiotherapy and multidisciplinary health services. After receiving a complaint from an insurance company, the College launched an investigation into the conduct of the four physiotherapists to ascertain whether they may have committed acts of professional misconduct regarding conflicts of interest, billing practices, consent, record keeping, and patient assessment and treatment practices.
The investigation revealed that the clinics had either failed to collect or had waived co-payment amounts for a number of products and services but billed the insurance company for the full amount of the product or service. Of note is that, under the regulations, any health college can find professional misconduct when a member has failed to take reasonable steps “to ensure that any accounts submitted in the member’s name or billing number are fair and accurate.” Here, the four physiotherapists, through their clinic, were submitting accounts that were not accurate.
At the conclusion of its investigation, the Inquiries, Complaints and Reports Committee (ICRC) released its decisions cautioning each of the four physiotherapists to ensure they submit accurate invoices for their services. In so doing, the ICRC stated:
“the College does not regulate physiotherapy clinics per se and in general, the College only regulates physiotherapists themselves. Nonetheless, the College may hold registered physiotherapists accountable, where appropriate, for systemic issues in the practices of clinics or businesses in which these physiotherapists participate in the ownership or management.”
The four physiotherapists sought judicial review of the ICRC’s decision. The physiotherapists’ main argument on judicial review was that the college lacked the statutory jurisdiction to regulate the business practices of the clinic.
The Divisional Court dismissed the physiotherapists’ argument, noting:
“It would be nonsensical for the College to have jurisdiction to regulate fees and billings of individual members, but no jurisdiction to regulate fees and billings over members that operate their practice through their own business. This would allow members to easily avoid oversight by the College by running their practice through a business.”
The takeaway here is that regulated health professionals cannot subvert regulatory oversight by using a business entity. So long as the regulated health professional is the operating mind of the business, they will be responsible for the business practices. If those business practices are at odds with the regulated health professional’s duties and the College’s standards of practice, then it can result in findings of professional misconduct.
Note: The team at Wise Health Law has extensive experience in navigating investigations and other college proceedings. Our blog is not intended to replace legal advice. Please contact us to see if we are able to assist.
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