On 15 and 16 April 2021, the Health Practitioners Disciplinary Tribunal (the Tribunal) considered a charge laid by a Professional Conduct Committee (PCC) against Mr Regan Wigg, registered physiotherapist of Auckland (the Physiotherapist).
The charge was laid under the Health Practitioners Competence Assurance Act 2003 (HPCA Act). There were six particulars to the charge. All the charges related to the Physiotherapist’s record keeping.
It was alleged that the Physiotherapist failed to maintain adequate and/or appropriate clinical records. In some cases, allegedly no records were kept at all. In other cases, records that were kept were either not sufficiently contemporaneous with the consultation recorded, and/or did not include information that ought to have been included.
In 2014, the Physiotherapist’s business began a process of transitioning from a manual system of record keeping to the use of a computerised system called Gensolve. The Physiotherapist initially struggled with the new system.
In 2016, ACC developed concerns about the businesses’ billing practices generally, and those of the Physiotherapist in particular. A meeting took place between Ms Brown (an engagement and performance manager with ACC) and the Physiotherapist.
Ms Brown asked to see patient records for treatments that had been billed to ACC. The Physiotherapist was not able to provide all of the records for his consultations, as he had still been handwriting his notes and had taken them home to enter into Gensolve.
It appeared that Ms Brown believed that the Physiotherapist had no records for these consultations and was intending to create records well after the event. It seemed that Ms Brown did not realise that the Physiotherapist did have these records at his home.
The Physiotherapist subsequently transcribed his notes into Gensolve. He then destroyed the handwritten notes. He did not advise ACC of what he had done, and did not volunteer to send the information that was then in Gensolve to ACC.
ACC investigated the matter further. ACC identified 29 instances in which the Physiotherapist was unable to find a clinical record of treatments for which the Physiotherapist had billed ACC. The total amount paid by ACC for services during the relevant period had exceeded the amount owed to the business by $1,305.47.
The Tribunal dismissed the charge in its entirety.
The first particular that the Physiotherapist did not have clinical records for 27 treatments was not established. The Tribunal was satisfied that the Physiotherapist had handwritten notes which were subsequently entered into Gensolve.
The second and fourth particulars that the Physiotherapist failed to document outcome measures and treatment goals were not established. The Tribunal was satisfied by evidence that the Physiotherapist did record outcome measures. Though there were cases where the Physiotherapist failed to record treatment goals, this was not sufficient to establish professional misconduct.
The third and fifth particulars that the Physiotherapist used cut and paste to duplicate notes, without individualising the records of patients, or checking if the records were accurate, were not established. It was found that the notes differed. The Tribunal held that what occurred fell short of establishing professional misconduct.
The sixth particular that the Physiotherapist failed to keep contemporaneous records was not established. While it is not good practice to take more than three days post-appointment to make notes, it could not be determined which notes were late for around 40 possible patients. The evidence fell short of supporting this particular.
Though the charge was dismissed in its entirety, the Tribunal did not grant permanent name suppression of the Physiotherapist. The Tribunal did not consider that the suggested elements of prejudice to the practitioner in this case outweighed the public interest.