Ethics for Physiotherapists

I Really Should Do Something About This

As regulated professionals, we have an ethical responsibility to take steps to ensure safety and excellence in caring for our clients.

Be professionally and morally responsible for addressing incompetent, unsafe, illegal, or unethical practice of any health care provider and legally responsible for reporting conduct that puts the client at risk to the appropriate authority/ies. (CPM Code of Ethics)

What is our obligation when we feel that our client’s care is being negatively impacted by other involved health providers?  The parameters and thresholds for obligatory reporting of another regulated professional are often not clearly defined.

This question is being explored by the CPM Ethics Committee and we would greatly appreciate the insights of our members as we work through this.

The following is a short fictional story created by the committee.  It is followed by some questions relating to how the physiotherapist could or should address this concern.

You have just finished an initial assessment of a client who is three weeks post total knee arthroplasty. During the assessment they present with increased swelling, pain and a slightly warm joint. Their symptoms raise a few red flags with you, so you decide that you want them to see their physician ASAP. You decide to call their physician in advance with your concerns.

Their physician is no stranger to you.  You have often communicated with this person and have been told that “It is not your role to suggest treatments or investigations that are not within your scope”.  Despite your past experiences, you make the decision to call the referring physician to discuss your findings and concerns. To no surprise, you are told, “You do your job and I’ll do mine”. 

A few days later the client returns to see you for a follow up appointment. The client has increased pain, a fever and their surgical incision is oozing. You end up sending them to the Emergency Department for further follow up.

You feel “fed up” with this practitioner and cannot shake this nagging feeling that you did not do enough for your client.   You ask yourself if there are any avenues available to me to address my concerns with this physician. 

  1. Do you feel that you have an obligation to escalate the concern regarding the physician’s inaction?
  2. Can another regulated health professional make a complaint to the licensing body of the physician?
  3. Do your concerns meet the threshold of “incompetent, unsafe, illegal, or unethical practice”?
  4. Does the client need to be willing to support this complaint?
  5. Should you have tried to suggest/encourage the client to seek another medical opinion?

As is often the case when confronted with ethically charged situations, there are no clear Right or Wrong answers.

We invite members to provide their insights and feedback relating to the story and/or the included questions.

Consent will be sought prior to any inclusion of responses in follow up submissions.

Please send feedback to

This article was created by physiotherapists who have an interest in ethics in a variety of practise areas.  The topics that are chosen to discuss and submit are reviewed at the regular meetings of the CPM Ethics committee.  If this type of College involvement interests you, we invite you to consider putting your name forward to become an Ethics Committee member.