An important part of Physiotherapy Board’s role is receiving and processing complaints. We are the statutory body which sets standards, monitors and promotes competence, continuing professional development and proper conduct for the practice of physiotherapy in the interests of public health and safety. 

The physiotherapy profession is highly respected and consists of 4521 physiotherapists with an Annual Practising Certificate. Our profession’s average age is 40, and 74.8% of practitioners are female.

Rising numbers of Complaints and Notifications

Complaints and notifications are lodged with the Board by a number of sources including the public, physiotherapists, other health practitioners, the courts, Health and Disability Commissioner’s office, health provider organisations or entities such as ACC. The majority of complaints are received from patients (see Table One).

Although the number of complaints is small, it is increasing at a greater rate than can be expected with the profession’s growth. It could be suggested there was under-reporting in the past, nevertheless this increase is concerning.

Another trend is the increase in complaints related to conduct issues – which has grown significantly compared to competence-related complaints (see Table 1). The complaints data showed men were over three times more likely to be the source of complaints, allowing for the ratio of men to women in the profession.

On the positive side a large number of the competence complaints end with no further action being required, though some progress to competence reviews. On the negative side all boundary issues tend to result in Professional Conduct Committee (PCC) investigations, which has led to a number of practicing sanctions, including conditions being imposed on practice.

 Chart 1: Complaints and notifications by source for the 2015/2016 practising year

What is the cost?

All recent fraud complaints were referred to a PCC, with one forwarded to the police. Complaints are resource and time intensive so this process may take over a year from time the initial complaint is laid, and the cost of processing complaints for PCC and Health Practitioners Disciplinary Tribunals (HPDT) are covered by the Disciplinary Reserve, built up via the Disciplinary Levy. Other processes are covered by the APC fee.

The average cost of PCC and HPDT hearings are $16,500 and $64,500 respectively, so the increase of complaints will necessitate replenishment of the Disciplinary Reserve – and we will be consulting on how this should be done in the coming weeks.

What can I do?         

The fundamental of all good physiotherapy practice is education.

Firstly, ensure the patient is educated and understand their condition, treatment and prognosis. This encompasses the necessity of patient consent to evaluate and treat with every appointment. It also covers the need to appropriately undress and drape the patient. A number of complaints have been related to miscommunication, which might have been avoided with good education.

If patients are being treated for conditions involving the pelvic or breast areas, chaperones provide legal protection to the clinician and ensure patient safety. This is also a consideration for select populations like children under the age of 18. Chaperones also need consent from the patient and this with the chaperone identity should be documented. Note that a support person provides support for the patient but is not legal protection for the clinician.

Professionalism involves looking out for our colleagues. If you have any concerns about a colleague, a patient or a treatment make sure you speak up and seek guidance from a peer, mentor or supervisor.

There is a responsibility for continuing registration to meet ‘The Physiotherapy Practice Thresholds’. The Board, and in some cases in conjunction with Physiotherapy New Zealand, have developed Position Statements to assist in your practice as a physiotherapist. Finally, in practice it is important to ensure that the Aotearoa New Zealand Physiotherapy Code of Ethics and Professional Conduct is upheld. 

Table 1: Profile of new complaints from 2013 to 2017 (first four months)