Good Practice: Good Business

  •   December 2, 2015


To a large extent, Physiotherapy Alberta does not get involved in the business practices of members. The philosophy of Council has been to allow members to pursue their business interests with a minimum of regulatory impediments. However, this should not be construed to mean that we don’t care about ethical business practices.

There are several Standards of Practice that directly relate to the business practices of members including Advertising and Promotional Activities, Fees and Billing, Conflict of Interest, and Human Resources Standards. In addition, our Code of Ethics contains several statements about how physiotherapists and physiotherapy businesses should seek to uphold in their daily activities including:

  • Engaging in organizational and business practices that benefit clients and the community.
  • Being honest and truthful, so clients and the public have confidence in them as professionals and in the services they provide.
  • Conducting themselves in such a manner as to reflect the highest standard of professional integrity and responsibility.1

As with all activities, it is the member’s responsibility to be aware of and follow the Standards of Practice that relate to conducting your business. With that said, each month Physiotherapy Alberta receives a number of calls from members seeking advice about various aspects of self-employment that don’t relate to the standards.

They may be planning on opening a clinic, or considering seeing a patient in the community as a one-time event. Callers can be at any stage of planning their business, from simply pondering the idea to making formal plans. While the questions may not directly relate to the Standards of Practice or Code of Ethics, they are still fundamental considerations. Here is our best advice on what you need to keep in mind:

  1. No matter where you practice, or what type of practice you engage in, as a regulated member the Standards of Practice apply to your practice at all times.2, 3
  2. While your malpractice insurance covers your professional liability, it’s important to talk to your insurance provider(s) to ensure that your other liabilities are covered. For example, do you need additional automobile insurance because you are using your car for business purposes? Do you need business insurance to protect against a claim if a patient trips while entering your business location?
  3. How will you protect your personal assets and keep these separate from your business assets? Do you need to incorporate? These are questions for your lawyer. We strongly recommend that you invest in having a qualified person walk you through the process of establishing your business entity so that your interests are protected.
  4. Do you need a GST number? How should you best manage the financial affairs of your business? How do you set up the bookkeeping practices for your business? Speak to an accountant about this early on, to avoid a tax headache later.

Some other issues that you may not have thought of:

Privacy and record keeping

If you go out on your own you are responsible for the privacy and security of your patient records. If you are operating from a home office, it is not enough to lock your home, you need to have your records secured within your home in addition to having your home secure. You are also required to ensure that your patients know how they can get access to their records for the duration of the ten year retention period.2,4

Personal security

If you are planning to operate from your home, how will you ensure your own safety? Did you realize that this is also required under the Safety Standards of Practice?5 You will now have patients entering your home, knowing where you live. While most patients have positive relationships with their physiotherapists, how will you feel if you have a therapeutic relationship that ends poorly? What will your strategy be to protect yourself? How can you avoid getting into a difficult situation to begin with?

Professionalism

While there is nothing that stops a physiotherapist from operating from their home, keep in mind the Code of Ethics does require that you conduct yourself in such a manner “as to maintain public confidence in the integrity and dignity of the profession.”1 How will you achieve this objective if your patient is coming to your home and enters directly into your personal living space?

Physiotherapists should also carefully consider what services are appropriate for delivery in a less-formal environment, or one where you have no other staff present. For example, is it appropriate to do women’s health-related work in a home environment? What sorts of potential misunderstandings could a less-formal environment give rise to? How will you manage a critical event if there is no one present that you can call on for help? Do you have a crisis management plan that is feasible for your environment?

The Canadian Physiotherapy Association also offers a number of business resources for members.

Regardless of whether you are contemplating a change, or are in the midst of planning a move to self-employment; whether you plan to see one patient in the next month, or one hundred; whether this is your primary employment or not, the bottom line is that this is business and should only be entered into after careful consideration of the legal, financial and professional ramifications of doing so. 


References:

  1. Physiotherapy Alberta – College + Association. Code of Ethics. (n.d.) Available at: https://www.physiotherapyalberta.ca/physiotherapists/what_you_need_to_know_to_practice_in_alberta/code_of_ethics. Accessed on November 16, 2015.
  2. Physiotherapy Alberta – College + Association. Practice Standard: Legislative Compliance. 2012. Available at: http://www.physiotherapyalberta.ca/physiotherapists/what_you_need_to_know_to_practice_in_alberta/standards_of_practice/legislative_compliance. Accessed on November 16, 2015.
  3. Province of Alberta. Health Professions Act. 2015. Available at: http://www.qp.alberta.ca/documents/Acts/h07.pdf. Accessed on November 16, 2015.
  4. Physiotherapy Alberta – College + Association. Practice Standard: Record Keeping and Management. 2012. Available at: https://www.physiotherapyalberta.ca/physiotherapists/what_you_need_to_know_to_practice_in_alberta/standards_of_practice/record_keeping_and_management.  Accessed on November 16, 2015.
  5. Physiotherapy Alberta – College + Association. Practice Standard: Safety. 2012. Available at: http://www.physiotherapyalberta.ca/physiotherapists/what_you_need_to_know_to_practice_in_alberta/standards_of_practice/safety. Accessed on November 16, 2015.