REP 19 - Is practicing without a licence really worth the risk?
I’ve recently been marathon watching Suits on Netflix. If you’re one of the few who haven’t yet seen the show, it’s a fast-paced legal drama set in New York City. The characters are complex, the actors are attractive, and the story lines are interesting, but it’s the premise of the show that I find most provocative.
Without giving too much away, Suits revolves around the professional and personal life of Mike Ross. Despite having a brilliant mind and a photographic memory, Mike never graduated from College. And it’s hard to get into Harvard Law when you’ve been expelled from your undergrad for selling answers to a math test.
Having given up on his dream of becoming a lawyer, Mike makes a series of bad decisions, but somehow ends up exactly where he wants to be – practicing law as an associate in a top New York firm.
“But how could that be?” you might be asking. “Wouldn’t he have to go to law school and pass the bar exam to be able to work as a lawyer?”
The answer is: of course he would.
Just like a Canadian physiotherapist must graduate from a recognized University program and pass the Physiotherapy Competency Examination*, a lawyer must follow a similar licensing process.
And it doesn’t stop there.
Once a lawyer qualifies for licensure, he or she must complete the process by being called to the bar in the province or territory in which they intend to practice law.
As physiotherapists, our “call to the bar” is registration with a provincial Regulatory College (the “College”).
Under no circumstance are we to call ourselves physiotherapists (or physical therapists) or practice physiotherapy until we have applied to the College, submitted all required supportive documents, paid our registration fee, and received confirmation of registration.
For newly licensed physiotherapists, this means receiving a unique registration number that you will use when issuing invoices for the services you provide.
So what happens to someone when they don’t check off one (or all) of those registration boxes?
What if, as Mike does with the law, someone claims to be a physiotherapist and provides patient care without being properly licensed?
You might think this is an unlikely scenario – something you’d only see on TV. But actually, variations of this situation happen across many regulated professions, including physiotherapy.
In addition to being a physiotherapist, I also work in insurance.
As the broker for the Canadian Physiotherapy Association (CPA)’s professional liability insurance program, our brokerage is privy to details of insurance claims made to the CPA program, including civil actions, criminal claims, and regulatory complaints made against physiotherapists.
Over the past few years, I’ve seen a number of claims related to individuals practicing without a license – nothing quite as extreme as on Suits, but considered serious enough to warrant a College investigation.
For instance, there was the claim that involved “Alison”, who graduated with a Master’s degree in physiotherapy, but started working as a physiotherapist before receiving confirmation of her provisional practice registration from the College.
Alison used her CPA member number on her receipts instead of her College registration number. When Alison’s patients submitted their receipts for re-imbursement, the unusual billing number raised a red flag with the insurance companies.
They reported their concerns to the College, which prompted an investigation into Alison’s practice, which included sending an undercover College investigator into Alison’s place of work to pose as a patient.
And then there’s “Chelsea”, who was registered and working as a physiotherapist for a few years before taking time off to have a baby. Chelsea decided to resign her registration with the College while she was on maternity leave, but didn’t re-apply for registration before returning to work.
The College investigated and Chelsea was formally reprimanded and required to pay a fine.
These situations are nowhere near as worrying to me as the deliberate deception taking place on Suits. I can easily imagine something similar happening, due to ignorance or forgetfulness.
But that’s not to say the potential consequences of these behaviours - ranging from reprimands, to fines, mandated participation in professional education courses, and even the chance of having your license revoked (or not granted) - aren’t serious.
A College investigation can be costly and stressful, especially when your license is on the line.
I’m only on Season 3 of Suits, so I don’t know if Mike is ever held accountable for his deception. Presumably, he could face criminal and/or civil charges for practicing law without a license. And what about all the “real” lawyers who know that Mike is a fraud but have failed to report him?
They risk being found guilty of professional misconduct, with all the various consequences this may have on their license, reputation, and ability to practice.
The licensing process should never be taken lightly in any regulated profession. Forgetfulness and ignorance probably aren’t going to cut it as excuses, and willful disregard of College legislation and standards is even worse.
So what do you think?
- Is there ever a good reason for practicing without a license?
- What’s the best way to educate physiotherapists and new graduates about licensing requirements?
- Should I keep watching Suits or cut my losses before I get too far into the series?
Check your regulatory College’s registration guidelines and practice standards on use of restricted title.
*Note that the process is slightly different for internationally-educated physiotherapists and Quebec licensure.
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