Are you at risk in public practice?

By Michael Woger, Risk Manager, Guild Insurance Limited

Physiotherapists in public practice experience a range of issues that can place their professional reputation at risk. The complex operating dynamics of the public healthcare system, especially in hospital settings, creates particular challenges for physiotherapists. Below are four risks that warrant consideration from public practitioners.

1. Dissenting opinions

Your opinion on the readiness of a patient for ‘safe discharge’, for example, may not be consistent with the views of others. If you do have concerns about the implications for your patient, record your clinical view. When keeping records ensure that the information is accurate and that any commentary remains objective. In the event of an allegation of patient mismanagement, thorough records provide evidence to support your decisions and actions and help to demonstrate your professional care.

2. Broadening practice scope

In the United States and the United Kingdom the role of physiotherapy can extend to include emergency department triage, injection therapies and non-invasive ventilation services. In Australia, the scope of physiotherapy practice is also extending. This presents additional risk in that, if you are not careful, you may be seen to be practising outside of the scope of physiotherapy practice.

Ensure therefore that there is a clinical justification for the techniques applied in the care of your patients. This means acting within your levels of training and competency, and the constraints of the relevant Physiotherapy Act. Could the techniques you are applying in the care of a patient, be outside of your scope of expertise or knowledge? If the outcome of the treatment is poor, you may be exposed.

3. Practising out-of-hours

‘Off-the-cuff’ advice, services at a sports club or even in a social setting, has the potential to result in legal action against you. It is a risk to assume that any services you deliver in your private time will remain covered by your organisation of employment. Any physiotherapy you provide out-of-hours needs to be treated in a professional manner and any services and advice you give should be documented for future reference. Only provide your professional services if you know your interests are protected.

4. Not having your own professional indemnity insurance

There are a number of reasons why physiotherapists in public practice are at risk by not having their own professional indemnity insurance:

(1) There are circumstances where the ‘law of vicarious liability’ will not protect practitioners in the employ of others.

(2) The broad defence mounted by your employer may not safeguard your specific professional interests. Funding your own independent legal representation could be very expensive.

(3) An action brought against you, for which you have no insurance cover, places your assets, reputation and professional standing at risk, even if eventually you are found not to be liable. Your insurer can assist you in getting the support you need to defend your reputation and provide the financial support to cover to defend your interests.

(4) A hospital’s cover is there first and foremost to protect the hospital, transferring the risk associated with their provision of care. This is not a criticism of such covers but simply raises the question, who will look after your interests, and reputation in an adverse event?

Consider the above when seeking to protect your professional reputation..

By addressing these four key risks I’ve outlined, physiotherapists in the public sector maximise their opportunities to achieve positive outcomes and defend their professional reputation in the event of an allegation.

For more guidance on managing risks in physiotherapy visit www.riskequip.com.au/physiotherapists

Key features of Guild’s Liabilities Insurance for Physiotherapists incorporating professional indemnity include:

• Cover for up to 15 hours per week of work performed outside of your principal place of employment (eg voluntary work at your local sporting club).
• Access to free telephone legal advice from a team highly experienced in defending liability claims against physiotherapists.
• $100,000 cover for legal expenses associated with disciplinary inquiries by a health profession board or coronial inquiries.
• Cover for the full scope of physiotherapy treatments.

For more information on professional indemnity insurance for physiotherapists in public practice contact Guild Insurance on 1800 810 213