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REP 5 - Mandatory reports: what you don’t know can still hurt you


Last year, my brother-in-law got a new boss. After a few days of working with her, he became concerned about her behaviour. 

He noticed some red flags. 

After discussing it with a few of his colleagues, they all realized that they were all observing some clear signs of cognitive decline. My brother-in-law had just lost his grandmother to dementia and was familiar with her cognitive decline.

As they did not know what to do, he and his team brought this delicate issue to the attention of their vice-president.

As the leader of a large physiotherapy team, I started to wonder what I would do if faced with this situation.

I didn’t know. 

I started off with a visit to my regulator’s website, which led me to read up on mandatory reports. I was very familiar with the need to report sexual abuse, child abuse and elder abuse. 

I’m embarrassed to say that I was less familiar with my obligations as an employer to report if I believed that one of the PTs was incompetent or suffering from a health condition that was affecting their ability to practice physiotherapy safely. 

I even found out that failing to make a mandatory report could result in court proceedings and hefty fines.

I’m relieved that I didn’t have to deal with a situation like my brother-in-law’s. But I realized that if I had, then I would have been unprepared. I decided that it was time to review all of the standards of practice and to make this an annual review. 

I hope that sharing my story will inspire some of you to review your obligations with regards to mandatory reporting.


What do you think?

1. As an employer, were you aware that you have an obligation to report if you believe that one of your PTs was incompetent or suffering from a health condition that was affecting their ability to practice physiotherapy safely?

2. What else should physiotherapy team leaders know about that they might not think of?  



Check your regulatory body’s requirements about mandatory reporting.


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Being a physiotherapist in Ontario, our regulations make if very clear what needs to be reported. 

The "story" above has a beginning but no end. It would've been interesting to see how the "boss" was approached by the employer is this case. It would've been interesting to know if the "behavours" were correctable or whether it was part of a medical/pyschological problem. Also, I hope that appropriate attempts were made to correct the "behavour". I'm not certain in this case what the "clear signs of cognitive deterioration" were. I hope the writer knows their scope of practice and that any "behaviours" were assessed by an appropriate healthcare professional. Brian Lowe, PT

After working with my office manager for over 25 years I'd noticed a decline in her cognitive function and work output. After an annual appraisal I advised her to discuss these concerns with her medical doctor. Her doctor dismissed my concerns and instead stated that she was stressed out and needed 2 weeks of stress leave.

It is difficult to 'do the right thing' at times when no one wants to admit that the Emperor has no clothes! 



I too have the same issue with my office manager who is in her 70's and is really affecting our customer satisfaction with wrong appointments or just wrong information.


A great topic, but really avery hard situation I wish I would never be in it. 

But thanks for sharing it as it really keep our eyes open if we are in a semilier situation.

This could be a good scenario or a bad scenario.  It depends on how it is handled.  Done with sensitivity and caring it would be doing the individual a great service to assist them in negotiating their personal "minefield".  Done as an impersonal "responsibility"  puts it in a whole new light!

Thank you for joining the conversation. This is an important yet sensitive topic. You hit the nail on the head in that the way it is handled is extremely important. One thought to always keep in mind is: is the patient or public being put at risk? A call to your regulatory body for guidance may be warranted.


Mandatory reporting is not defined or standardized across Canada. The member who submitted this post was sharing her experience in Ontario. Please keep this in mind as you look for support and guidance documents. And contact your regulatory body to determine what your obligations are.

Very important topic you have brought up; it's got me thinking already. I would be reading up on my College's mandatory reporting standards for sure.


Hello - thanks for bringing up this issue and sharing your experience and thoughts.  It's important; we've likely all seen the stats on dementia increasing as our population it stands to reason that as our profession ages we will experience this situation.  I believe most physiotherapists are aware that they have a regulatory duty to report care that could potentially harm the public....after all, that is the hallmark of  a self-regulating profession and the reason we all have a  provinical College.  In response to your question about other things to think about as an employer and/or a team lead, I'd like to add that beyond the regulatory responsibility to report, there is an employer duty to accomadate in many situations.  If a persons level of ability dips below that required to perform their job, many employers ( of significant size and varability) have a duty to accomadate that worker in a role that they can safely perform.  As team leads / managers in physiotherapy we are often called upon to analyse job tasks and supervision levels against remaining capabilities for this purpose.  It's another layer, and another skill.....



 Thanks for bringing up this issue; I admire your proactive stance in investigating what you would do and how you would go about it.  You'll be better prepared when/if such an event arrises.





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