Miscellaneous advice – workplace, ethics and practice

Frequently asked questions

Can I provide a sick certificate?
What information do I include on a sick certificate?
Can I email or text a patient? - matters related to privacy
Can I take clients with me if I move practices?
Can I stop treating a patient?
Can I sell or supply medicines?
Can I sell supplements?
Can I treat friends or family?
Registering and protecting a business name.
Where can I get advice about employment contracts?
My employment has been terminated; what are my rights?
How do I become a credentialled diabetes educator?
Can I ask for or offer a payment for a referral?
How do I maintain professional boundaries with patients? Can I have an intimate relationship with a patient?
Do I need a working with children or police record check?
How do I create a child safe environment, or comply with the Victorian Child Safe Standards?
Where can I get interpreter or translator services?
What do I need to know about protecting my patient’s confidentiality?
What should I know about franchising?
Do my staff need CPR and first aid training?

Can I provide a sick certificate?

Physiotherapists may provide sickness or fitness for work certificates.

The Fair Work Act 2009 - Subdivision D—Notice and evidence requirements S107 (3) states that an employee who has given his or her employer notice of the taking of (sick) leave must, if required by the employer, give the employer evidence that would satisfy a reasonable person that the paid sick leave is taken because the employee is not fit for work because of a personal illness, or personal injury, affecting the employee. (S97)

Physiotherapists must also ensure they adhere to the PhysioBA code of conduct (8.8 Reports, certificates and giving evidence) when writing such certificates and so provide sick certificates related to their scope of practice.

Some workplaces have policies related to the length of absence covered by a sick certificate they will accept. This is frequently for one week at a time. While not bound by the workplace policies of other organisations, physiotherapists may consider providing certificates for a maximum length of one week’s absence, with review after that time. This may ensure patient adherence to treatment and physiotherapist management of the condition.

Workers Compensation or Motor Accident Authorities in each state or territory may have specific criteria about sickness or fitness for work certificates. You should refer to these authorities if relevant.

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What information do I include on a sick certificate?

The following information should be contained in the sick leave certificate:

  • Name and address of the physiotherapist issuing the certificate
  • Name of the patient
  • Date on which the certificate was issued
  • Date(s) on which the patient is or was unfit for work
  • A diagnosis is not usually required and the physiotherapist should inform the patient if it will be included on the certificate
  • Sick leave certificates should be issued on practice letterhead

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Can I email or text a patient? - matters related to privacy

The sending of electronic messages – which includes email, SMS, MMS – is regulated by the Spam Act 2003. It prohibits the sending of electronic messages except under limited circumstances.

You should refer to the Australian Communications and Media Authority, their information on the Spam Act 2003 and their page on anti-spam for more detailed information or seek independent legal advice from a person qualified to provide advice on this matter.

You must obtain consent from the person you are contacting, you must identify yourself and you must make it easy for that person to unsubscribe:


1. You must have the recipient’s express or inferred consent. We advise you to ensure you have express consent.

Express consent comes in many ways—filling in a form, ticking a box on a website, over the phone, face-to-face or by swapping business cards—as long as the recipient is aware they may receive commercial messages.

Inferred consent can occur:

  • via an existing business or other relationship, where there is reasonable expectation of receiving commercial electronic messages
  • via conspicuous publication of a work-related electronic address because it is accessible to the public, or a section of the public
  • if the address is not accompanied by a statement saying no commercial messages are wanted
  • the subject of the message is directly related to the role or function of the recipient.

2. You must identify yourself:

  • clearly and accurately identify the individual or organisation who authorised the sending of the message. For example if your organisation gets a third party to send out messages on its behalf, the message must clearly identify the organisation on whose behalf the message is being sent—the correct legal name of the organisation or individual, and an Australian Business Number, where applicable.
  • include accurate information about how the recipient can contact your organisation, or you as an individual sender

You must make it easy to unsubscribe

Examples of unsubscribe facilities that are clearly worded and easy to use include:

  • Email—'Unsubscribe: if you no longer want to receive messages from us, simply reply to this email with the word "unsubscribe" in the subject line.'
  • Email—'If you no longer want to receive these messages, please click the "unsubscribe" button below.'
  • SMS—'Unsub: reply NO' or 'Unsub: (1800-number).’

An unsubscribe facility may also be a link to a website where the person can easily click a button to remove themselves from a mailing list. Unsubscribe facilities must always be easily accessible, must not require the payment of a fee to the sender of the original message or a related person, and must not cost more than the usual cost (if any) of using such addresses.

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Can I take clients with me if I move practices?

It is common for employees to move practices, or set up their own practice. However, a client’s relationship is with a particular practice, rather than with a particular employee of that practice. Unless provided for in a contract, clients remain a client of a practice unless they choose to move.

It is entirely appropriate for an employee to inform a patient that they will no longer be working at a practice and if asked, to provide further details.

This is a complex matter which may depend on the nature of any employment contract in place and other factors. If you believe an employee is “poaching” clients, you should seek independent legal advice from a lawyer with expertise in the related field of law.

Premium Principal and Business Affiliate Members of the APA’s Physiotherapy Business Australia (PBA) group can access our HR in Practice service. This service provides members with free HR and industrial advice. Additional services are available for a fee. HR in Practice on 1300 138 954.

You may also consider speaking to AHPRA, or the Health Care Complaints Commission (HCCC) if you are in NSW, or the Office of the Health Ombudsman (OHO) if you are in Queensland to discuss whether it is a matter they should investigate.

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Can I stop treating a patient?

You do not have to treat, or continue the treatment of, a patient. You do not have to give a reason for stopping treatment but you should provide the patient with alternative treatment options, for example the details of another practitioner.

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Can I sell or supply medicines?

This is general advice. You should also seek independent legal advice, and seek the advice of your insurer.

For the purposes of this advice, and in accordance with the Medicines, Poisons and Therapeutic Goods Act 2008:

a person deals with a regulated substance if the person does 1 or more of the following:


(a) manufactures the substance;

(b) obtains the substance;

(c) possesses the substance;

(d) supplies the substance;

(e) administers the substance;

(f) discards the substance;

(g) issues a purchase order for the substance;

(h) if the substance is a medicine— (i) prescribes the medicine; or (ii) issues a requisition or standing order for the medicine;


Possess includes the following:

(a) receive or obtain possession of the substance;

(b) have control over the disposition of the substance (whether with or without custody of the substance);

(c) have joint possession of the substance.


Sell includes the following:

(a) offer or expose for sale;

(b) dispose of by any method for value (or offer or expose for disposal by any method for value);

(c) possess for sale or disposal for value.

Supply includes the following:

(a) sell (or offer or expose for sale);

(b) dispense; Note Dispense means supply on prescription.

(c) supply under a requisition or standing order;

(d) dispose of by any method for free (other than by discarding).

The dealing of scheduled medicines is controlled by legislation and regulation in each state or territory. Legislation varies in each state or territory. You should refer to the legislation in your state or territory. The Therapeutic Goods


Administration provides more information about drugs schedules, which may also vary in each State or Territory.

Regardless of your practice setting, legislation and regulation are clear:

  • Physiotherapists must not deal with any scheduled medicine. Those permitted to deal with medicines are provided for in state and territory legislation.
  • Physiotherapists must not deal with scheduled medicines under the direction of any person – including a medical practitioner, or any person legally able to supply
  • The APA advises members not to supply unscheduled medicines to avoid any medico-legal risk. Unscheduled medicines may include forms of medicines, like aspirin or paracetamol that are commonly available at supermarkets, for example.
  • Physiotherapists must not provide advice about medicines and should always refer the consumer to a pharmacist or medical practitioner for advice about the suitability of a product. Pharmacists are qualified to provide advice about pharmacokinetics, indications, contraindications, precautions, dosage, over-dosage signs, interactions, side effects, and whether there could be adverse interaction with the client’s other medicines or medical conditions.

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Can I sell supplements?

There are no controls on the sale of supplements; however you must be aware of the additional weight and status of the advice you provide because of your position of trust as a health professional.

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Can I treat friends or family?

Your liability insurance may exclude the treatment of members of your family or friends. You should refer to your insurance company and your policy for more information.

The APA Combined Liability Insurance provided by Insurance House will not indemnify you for:

6.22 Any Claim:

(a) made against You by any Related Persons, unless originally emanating from an independent third party; or

(b) by any Employee for Personal Injury, unless the Personal Injury is caused by the negligent acts, errors or omissions of You while the Employee is a patient of Yours.

Related Persons means any person or entity covered by this Policy, any Subsidiary, trustee or nominee of the Insured, or any spouse, domestic partner, parent, parent-in-law, domestic partner of parent, sibling, or child of the Insured or any spouse or domestic partner of the Insured’s sibling or child.

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Registering and protecting a business name.

Registering a business name does not give you exclusive trading rights over that name. ASIC provides information about how to protect your business name.

The Business Names Registration Act 2011 regulates words and expressions that can be used to register a business. The Business Names Registration (Availability of Names) Determination 2012 sets out the criteria ASIC uses in terms of the

Act to decide whether a word or expression can be used in a business name. ASIC can refuse to register a name if it uses a restricted word or expression.

A business name is available to an entity if:

(a) the name is not identical or nearly identical to: (i) a business name registered to another entity; or (ii) a name that is reserved or registered under the Corporations Act 2001 for another body

How ASIC decides whether a name is identical or nearly identical, is addressed in the same 2012 determination:


Matters to be disregarded When comparing a business name with another name:

(a) the use article (a/the);

(b) the use of ‘Association’, ‘Co-operative’, ‘Incorporated’, ‘Limited’, ‘Ltd’, ‘No Liability’, ‘NL’, ‘Proprietary’ or ‘Pty’ in one or both names;

(c) plural or singular;

(d) the size of characters, punctuation;

(e) the order of words in the names;

(f) ‘www’ or a domain extension such as ‘net’, ‘org’ or ‘com’.


Matters to be considered when comparing a business name with another name

despite the characters used in the name, it may be pronounced the same as the other name. e.g. K8’s Physio, Kate’s Fizio

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Can I treat friends or family?

The APA or its employees cannot offer legal advice. We advise you seek independent legal advice related to employment or contract law.

Premium Principal and Business Affiliate Members of the APA’s Physiotherapy Business Australia (PBA) group can access our HR in Practice service. This service provides members with free HR and industrial advice. Additional services are available for a fee. Contact HR in Practice on 1300 138 954.

You should also refer to the Fair Work Ombudsman for information and advice about your workplace rights and obligations, including award rates.

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My employment has been terminated; what are my rights?

You should always have a contract in writing. Most employment contracts will have clauses relating to termination of employment.

You should seek independent legal advice and seek advice from the Fair Work Ombudsman and your Trade’s Union, if you are a member of one.

Premium Principal and Business Affiliate Members of the APA’s Physiotherapy Business Australia (PBA) group can access HR in Practice. This service provides members with free HR and industrial advice. Additional services are available for a fee. Contact HR in Practice on 1300 138 954

Members of the APA who are insured through Insurance House may access 30 minutes free legal advice and should call 1300 305 834 for more information.

The Australian Small Business Commissioner provides information about legal assistance in each state or territory.

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How do I become a credentialled diabetes educator?

Physiotherapists can apply for an accredited post-graduate certificate in diabetes education and management courses. Completion of this course leads to accreditation as a diabetes educator.

To gain recognition as a credentialed diabetes educator, physiotherapists must meet minimum criteria in diabetes education, participate in mentoring partnership registered with the ADEA and have a referee report addressing the criteria of the

National Core Competencies for Credentialed Diabetes Educators (CDE). All CDE’s must apply to the ADEA to retain their CDE status every three years.

It will enable patients to receive Medicare benefits for group physiotherapy sessions they attend – for five sessions per year under items 81100 to 81125 when the group is run by a CDE physiotherapist.

http://www.adea.com.au/credentialling/credentialled-diabetes-educators/ for info about how to qualify as credentialed diabetes educators

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Can I ask for or offer a payment for a referral?

This practice may be against the AHPRA Code of Conduct for the registered professions related to conflicts of interest.

The Code states:

Patients or clients rely on the independence and trustworthiness of practitioners for any advice or treatment offered. A conflict of interest in practice arises when a practitioner, entrusted with acting in the interests of a patient or client, also has financial, professional or personal interests or relationships with third parties which may affect their care of the patient or client. Multiple interests are common. They require identification, careful consideration, appropriate disclosure and accountability. When these interests compromise, or might reasonably be perceived by an independent observer to compromise the practitioner’s primary duty to the patient or client, practitioners must recognise and resolve this conflict in the best interests of the patient or client.

Good practice involves:

g) not offering inducements to colleagues or entering into arrangements that could be perceived to provide inducements.

We advise members NOT to offer inducements to colleagues or enter into arrangements that could be perceived to provide inducements.

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How do I maintain professional boundaries with patients? Can I have an intimate relationship with a patient?

Professional boundaries are addressed in the AHPRA Code of Conduct 8.2 Professional boundaries.

A clear separation should exist between professional conduct to meet the health needs of patients, and a practitioner’s own personal views, feelings and relationships which are not relevant to the therapeutic relationship.


AHPRA states that good practice involves:

  • maintaining professional boundaries
  • never using a professional position to establish or pursue a sexual, exploitative or otherwise inappropriate relationship with anybody under a practitioner’s care; this includes those close to the patient or client, such as their carer, guardian, spouse or the parent of a child patient or client
  • recognising that sexual and other personal relationships with people who have previously been a practitioner’s patients or clients are usually inappropriate, depending on the extent of the professional relationship and the vulnerability of a previous patient or client, and
  • avoiding the expression of personal beliefs to patients or clients in ways that exploit their vulnerability or that are likely to cause them distress.
  • Practitioners need to be aware of and comply with any guidelines of their National Board in relation to professional boundaries.

 

 

Do I need a working with children or police record check?

Your employer may require you to have a valid working with children check as a condition of employment. There is no single national framework setting out the requirements for obtaining Working With Children Checks or Police Checks. Each state and territory has their own procedures and it is necessary to fulfil the requirements in the jurisdiction in which you are working.

Read detailed information here and check with the relevant agency in your state or territory:

Australian Capital Territory  
Working with Vulnerable People Check

The Office of Regulatory Services
Ph: (02) 6207 3000
Email: wwvp@act.gov.au

National Police Check Australian Federal Police
Ph: (02) 6140 6502
New South Wales
Working with Children Check Office of the Children’s Guardian
Ph: (02) 9286 7219
Email: check@kidsguardian.nsw.gov.au
Northern Territory  
Working with Children Clearance Northern Territory Government
Ph: 1800 72 33 68
Email: safent.police@pfes.nt.gov.au
Queensland  
Working with Children Check Blue Card Services
Freecall: 1800 113 611
Ph: (07) 3211 6999
South Australia
Child-related employment screening Department for Communities and Social Inclusion
Ph: 1300 32 15 92
Email: screening@dcsi.sa.gov.au
National Police Check South Australia Police
Ph: (08) 7322 3347
Tasmania
Working with Children Registration Department of Justice
Ph: 1300 13 55 13
National Police Check Tasmanian Police Department
Ph: (03) 6173 2928
Email: workingwithchildren@justice.tas.gov.au
Victoria
Working for Children Check Department of Justice and Regulation
Ph: 1300 652 879
Email: workingwithchildren@justice.vic.gov.au
National Police Certificate Victoria Police
Ph: 1300 88 15 96
Western Australia  
Working with Children Check Department of Child Protection
Freecall: 1800 883 979
Ph: (08) 6217 8100
Email: checkquery@cpfs.wa.gov.au
National Police Certificate Western Australia Police

 

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How do I create a child safe environment, or comply with the Victorian Child Safe Standards?

If you believe a child is in immediate danger, call the Police on 000

You do not need to be absolutely certain that abuse or neglect of a child has occurred to call the child protection authority in your state or territory. If you suspect a child is at risk of harm, call the authority.

You can also find information , or refer people to:

  • Kids Helpline: http://www.kidshelpline.com.au/ 1800 55 1800
  • Lifeline: https://www.lifeline.org.au/ 13 11 14

Child Safe Standards

The Victorian Government is introducing compulsory minimum child safe standards to help keep children safer. While these standards are mandatory for some organisations over the next two years, the Department (DHS) intends them to apply to all organisations that provide services to children in the near future.

The DHS would also like as many organisations to apply the standards voluntarily so children are as safe as possible no matter where they receive services.


The new standards apply to all in scope organisations that provide services for children. The standards will start applying to organisations from 1 January 2016 in phases:

Phase 1: Organisations that provide services for children that are government funded and/or regulated will be required to work towards compliance from 1 January 2016

Phase 2: Other organisations that provide services for children will be required to comply from 1 January 2017

The Overview of the Victorian Child Safe Standards provides valuable guidance and examples of how to meet the standards. The self-audit tool designed, which accompanies the overview, will help organisations assess their progress in becoming a child safe organisation.

For more information on child safety, go to the APA landing page

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Where can I get interpreter or translator services?

You may need to access the services of an interpreter or translator services when you provide healthcare to people whose first language is not English, including for people who use Auslan. Interpreters provide real-time translation in person or by telephone, for example. Translators translate text into different languages.

The Translating and Interpreting Service (TIS National) is an interpreting service provided by the Department of Immigration and Border Protection for people who do not speak English and for agencies and businesses that need to communicate with their non-English speaking clients.

TIS National provides:

  • Immediate phone interpreting.
  • ATIS Voice automated voice-prompted immediate phone interpreting.
  • Pre-booked phone interpreting.
  • On-site interpreting.

The majority of TIS National interpreting services are free for non-English speakers. Generally the organisation being contacted accepts the charges for the service. Some organisations and medical practitioners are eligible for free interpreting through TIS National.

Allied Health Professionals are not eligible for the Free Interpreting Service through TIS National. You can view our interpreting service fees and charges . If you would like to register to become a TIS National client please complete the online client registration form.


NDIS consumers:

People who are receiving services under the NDIS and whose plan identifies a need for interpreting will be funded for those services through their NDIS plan.


Auslan users:

NABS is the National Auslan Interpreter Booking and Payment Service. NABS is funded by the Australian Government to provide Interpreters FREE of charge to people who use sign language to communicate and would like to book an interpreter for private health care appointments.

Please refer to NABS to book an Auslan interpreter

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What do I need to know about protecting my patient’s confidentiality?

This is general advice. It is not legal advice. You should seek independent legal advice and speak to your insurer.

In most cases in healthcare practice, maintaining patient confidentiality is paramount. This means that any information a patient gives to you about their health status or private circumstances in the course of a professional consultation should be regarded as confidential and not passed on to other people except with the patient’s consent. Patients expect all communications between themselves and health professionals to remain private. Most medical consultations are also protected by a statutory or common law requirement of confidentiality.

However, there are some exceptions to this requirement for strict adherence to patient confidentiality. It is lawful for a health professional to disclose information if:

  • some other law requires disclosure – for example reporting cases of suspected child abuse under chapter 4 of the Children, Youth and Families Act 2005 (Vic); or
  • you receive a subpoena from a court; or
  • it can be argued that the person has provided express consent to disclose information; or the consent for disclosure is implied– for example, in situations where the practitioner is giving information to another health provider as part of the referral process to another practitioner, and reports provided for the purpose of insurance where the person has been examined at the request of the insurer. In situations where consent is implied the APA advises members to inform the patient and record this; or
  • it may be in the public interest for the information to be disclosed, for example where there is a serious risk to the patient or another person.

You should call the Police if in your professional judgement there is a serious and immediate risk of harm to a patient or another person.

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What should I know about franchising

We advise members who are considering franchises to seek independent legal advice.

APA Members can access complementary independent legal advice from a lawyer with expertise in the legal area you seek advice on e.g. employment, contract or privacy law.

  • Insured members can access 30 minutes free legal advice per annum for any matters related to their business or employment in a physiotherapy business - not for personal matters. Call Insurance House on 1300 305 834
  • PBA (Premium Principal) members receive 60 minute consultation with William Buck included with PBA membership. William Buck refer PBA members to TressCox lawyers, who have experience in the health industry. PBA-PP members may call Andrew Rumsey on 03 9824 8555 or email Andrew.Rumsey@williambuck.com
  • All members have up to 60 minutes preliminary verbal advice & a written report from Maurice Blackburn included in membership. Maurice Blackburn provide advice on a wide range of legal matters. For more information and to access this benefit, contact Olivia Tanner on (03) 9605 2654 or email OTanner@mauriceblackburn.com.au

Members can also seek advice from other industry associations, like the Franchise Council of Australia which has its own member standards and complaints process, and the ACCC which regulates the Franchising Code of Conduct, and consider the Competition and Consumer (Industry Codes—Franchising) Regulation 2014.

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Do my staff need CPR and first aid training?

A person conducting a business or undertaking must ensure that an adequate number of workers are trained to administer first aid at the workplace, or that workers have access to an adequate number of other people who have been trained to administer first aid.

Given the risk in a health practice our position is that all staff should have up to date first aid and CPR training.

First aid training is usually repeated every two years. CPR training is usually repeated each year.

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