Understanding Professional Misconduct

Updated: Recently Updated July 1, 2024
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In addition to complying with Standards of Practice and the Code of Ethics, Registered Massage Therapists (RMTs or MTs) are expected to practise according to certain regulations. One of these regulations is the General Regulation under the Massage Therapy Act, 1991. Part VIII of the General Regulation – Professional Misconduct – outlines RMT actions and behaviours that the College of Massage Therapists of Ontario (CMTO) considers to be a failure to meet minimum expectations (i.e., it amounts to professional misconduct). Acts of professional misconduct may be investigated by CMTO, and in serious cases, may result in disciplinary proceedings.

CMTO’s Professional Misconduct Regulations were updated in 2024 and will take effect July 1, 2024. Below is a summary of the provisions, and examples to help RMTs understand some areas of expected conduct. This Guide only provides an overview and RMTs should review the regulation for more detail.

Being a regulated health professional means that RMTs:

  • act in accordance with the Regulated Health Professions Act, 1991, the Massage Therapy Act, 1991, and the regulations under those statutes.
  • act in accordance with federal and provincial/territorial laws and by-laws.
  • comply with any terms, conditions or limitations of their registration with CMTO, including not practising when they are suspended.
  • practise in accordance with CMTO’s Standards of Practice and Code of Ethics.
  • do not engage in any conduct that could be seen by other RMTs as disgraceful, dishonourable, unprofessional or unbecoming of an RMT. Examples of this include discriminating against others, intentionally spreading false information online or engaging in fraud outside of work.

For records, RMTs must:

  • keep appropriate records and provide copies to clients as requested.
  • ensure personal health information is kept confidential unless the client consents to disclosure or disclosure is required by law.
  • arrange with the client to transfer the client’s record in certain situations (e.g., when the RMT retires or moves practices, when the client requests it, etc.).
  • not falsify records, or sign or issue records that they know, or ought to know, are false or misleading.

For more information on records, please see CMTO’s Guide to Record Keeping Requirements.

When it comes to providing services and interacting with clients, RMTs must:

  • advertise their practice in a way that does not contravene the regulations under the Massage Therapy Act, 1991. CMTO’s guide to advertising helps RMTs understand their obligations.
  • use appropriate terms, titles or designations. RMTs cannot use a restricted title (e.g., doctor, physiotherapist, etc.) that they are not authorized to use, or a title that may imply that they are qualified to practise a specialty.
  • use only their name as it appears on the Public Register when providing Massage Therapy care or services, and when requested by the client or another health professional to identify themselves.
  • not allow, support or help anyone to present themselves as an RMT if the person is not an RMT (i.e., “holding out”).
  • only practise when they are not impaired or negatively affected by any substance, condition or dysfunction they are aware of that could affect their ability to practise safely.
  • not practise Massage Therapy while in a conflict of interest.
  • fulfill agreements with clients in terms of services and fees.
  • only perform a service or treatment that they have the knowledge, skill or judgment to perform.
  • only perform therapeutic, preventative, palliative, or other health-related treatments to a client with the client’s informed consent.
  • refer the client to a qualified medical practitioner when appropriate.
  • maintain a safe and sanitary practice setting. Learn more by reviewing the Practice Standard: Infection Prevention and Control and the Practice Standard: Safety and Risk Management.
  • reveal ingredients of a product if the client requests, and only make claims about the effectiveness of a product, treatment, device or procedure that can be supported by a reasonable professional opinion.
  • never abuse a client sexually.
  • never abuse a client verbally, physically, psychologically or emotionally. Examples of this may include harassing, demeaning, or intimidating a client. More detailed definitions of abuse can be found in CMTO’s Code of Ethics Glossary of Terms.
  • take reasonable steps to prevent sexual abuse of clients by any person working under their direction or supervision. Reasonable steps include [1]:
    • providing sexual abuse prevention training to staff;
    • having a workplace policy around sexual abuse; and
    • taking action to address inappropriate behaviour as soon as you see it.
  • only discontinue providing care if:
    • treatment is no longer needed;
    • the client requests the discontinuation;
    • alternative services are arranged by the RMT or the client;
    • the client is given a reasonable opportunity to arrange alternative services; or
    • the client is abusive or threatening and the RMT has made all reasonable attempts to arrange alternative services.

Improper business practices can hurt clients, so RMTs must:

  • post their fees in a readily visible location at the practice setting, and not charge outside the posted fees without a client’s consent.
  • actively disclose fees before beginning services or treatment.
  • not charge or accept a fee that is excessive or unreasonable in relation to the services provided.
  • take reasonable steps to ensure that receipts, accounts or charges are fair and accurate.
  • not submit an account or charge for services that they know or ought to know are false or misleading.
  • not charge for services that were not provided.
  • only issue receipts for services provided. For example, a gift card receipt is a proof of purchase and should not indicate services were provided.
  • itemize an account or receipt if a client or another party responsible for payment (e.g., an insurance provider) requests it.
  • not sell or assign debt the RMT is owed for services. This does not prohibit the use of credit cards to pay for professional services.

Learn more by reviewing the Standard of Practice: Fees and Billing.

When interacting with CMTO, RMTs must:

  • take reasonable steps to ensure that information provided to CMTO by or on behalf of the RMT is not false or misleading.
  • reply appropriately and in a timely manner to a written request from CMTO that requires a response.
  • comply with orders or directions issued by a CMTO committee or a panel of a committee.
  • permit entry to, and cooperate with, any authorized representative of CMTO, including to conduct an investigation, assessment, inspection or examination of the RMT’s office, records, equipment or practice.
  • carry out or abide by undertakings or agreements in which they enter with CMTO.
  • not verbally or physically abuse CMTO staff, agents, officer or other representatives of CMTO.
  • pay money owed to CMTO.

 

[1] Note: not adopting CMTO’s proposed reasonable steps may or may not constitute professional misconduct depending on the specific circumstances.

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