Factors Influencing the Multiplication of Physiotherapy Treatments: A Thematic Analysis of Quebec Case Law

Abstract

Physical therapy is affected by a problem of multiplication of treatments; the frequency and the length of treatments can be inappropriate or disproportionate in the face of a patient’s needs. The multiplication of treatments can have financial, physical, psychological and social consequences. To explore the factors that influence the frequency and the total treatment duration in situations where there is a multiplication of treatments, a thematic analysis of the jurisprudence was conducted. Clinical and non-clinical factors influencing the frequency and the treatment duration were identified. Clinical factors mean that resource allocation is guided by the condition and the evolution of the patient. Non-clinical factors can include: pressure from the employer, requests of other health professionals or financial conflict of interests. This thematic analysis of the jurisprudence is a first step to understanding what motivates the clinical decisions of physical therapists regarding the allocation of physical therapy resources. This approach is essential to establishing policies and standards of practice that are attentive to the context of practice and the ethical, deontological and legal standards that shape the profession.