It seems like with every day that passes, RTs are having new responsibilities added to their roles. While most – including the CRTO – view this evolution of the profession as a positive thing, RTs sometimes express concerns about what could happen if they embark on a new endeavour and something goes wrong. One comment we hear most often in these circumstances is, “but I could lose my license!” I think this is an important concern to address because an RT’s practice should be based first and foremost on their personal scope of practice and the best interest of their patients – not on fear.
It is true that all health regulatory College’s Discipline Committees have the option to revoke a Member’s certificate of registration. However, it’s important to note that this is only likely to occur in situations where it is determined to be the best means of safeguarding patient care. In fact, no RT in Ontario has had their certificate of registration revoked since the CRTO’s inception in 1994. This is because the issues that have arisen regarding RTs thus far have been most appropriately dealt with through remediation or other measures aimed at ensuring the Member provides safe, competent and ethical patient care.
As an example, in the 2013-2014 fiscal year, there were four (4) complaints, 17 reports (Registrar reports, employer reports and Members’ self-reports) lodged about Ontario RTs. In the case of one complaint, the Inquiry, Complaints and Reports Committee (ICRC) recommended that the Member revise his practice to ensure he is complying with the CRTO Standards of Practice, including the Professional Practice Guideline on Conflict of Interest. Further, in two of the mandatory employer reports, it was the decision of the ICRC to require the Members to complete specified continuing education or remediation programs (SCERPs). In only one case was it the decision of the ICRC to refer the matter to the Discipline Committee for a hearing, which is to be held later in 2014.
It’s also important to mention that a discipline hearing is required to revoke a Member’s certificate of registration – and the bar for referring allegations to a hearing is fairly high. This means that the nature of the concerns has to be quite serious, or there’s a pattern of behaviour that remediation has not been able to address. Additionally, there must be sufficient evidence to support the allegations (i.e., witnesses, documentation, etc.). The interest of patients in Ontario is usually best served by the CRTO focusing its resources on ensuring Members receive the education and remediation support they need in order to meet the highest possible practice standards.
Losing one’s licence is always a possibility; however it should not be the reason that an RT decides to decline taking on new roles and responsibilities. The most relevant concerns when presented with an opportunity to expand one’s professional practice are:
- Is it clinically appropriate, i.e., in the best interest of the patient?
- Is it within the scope of practice of Respiratory Therapy?
- Is it within my individual scope of practice, i.e., do I have the requisite competencies (knowledge, skills & abilities) to undertake the activity?
These and other considerations are provided in the CRTO’s position statement on Scope of Practice & Maintenance of Competency.