Health Practitioners Disciplinary Tribunal, 1033/Phys/420D, (5 August 2019)
The Director filed a charge of professional misconduct against registered physiotherapist, Peter Chum (“Mr Chum”), in the Health Practitioners Disciplinary Tribunal (“the Tribunal”) concerning the treatment he provided to a female patient (“the patient”) who was experiencing voice and swallowing difficulties.
The charge against Mr Chum related to a breach of professional boundaries during a treatment session with the patient. In particular, that Mr Chum: advised the patient to take off all of her clothes and/or failed to ask the patient to put some clothing back on when he realised she was naked; proceeded to massage the patient’s lower back, pelvic, upper and inner thigh areas despite the fact she was naked; failed to adequately drape the patient during the massage; asked if he could massage the patient’s clitoral region; and engaged in a conversation with the patient, which was of a sexual nature.
The charge also concerned a departure from professional standards of care in the treatment provided by Mr Chum, specifically: the treatment provided was not appropriate treatment at a first consultation for the conditions Mr Chum stated he was treating (being suspected muscle tension dysphonia (“MTD”) and breathing pattern disorder (“BPD”)). This included the allegation that soft tissue massage to the inner thigh was not an appropriate treatment for suspected MTD and BPD, that Mr Chum focused on muscle groups that were not the dominant muscle groups he ought to have been focusing on, and that he proceeded to soft tissue massage for those muscle groups despite his patient’s vulnerability.
In 2016, the patient suffered a traumatic brain injury requiring surgery. As a result of the injury, she experienced, amongst other things, changes to her voice and difficulty swallowing and was referred to Mr Chum for assessment. By agreement, Mr Chum went to the patient’s home to assess her and was alone with the patient during the assessment. Mr Chum first carried out therapy to the patient’s vocal chords which the patient found beneficial. Following a discussion about a previous lower back injury which had been aggravated by the patient’s stay in hospital, Mr Chum advised the patient that there was a connection between the lower back and the diaphragm and voice, and that a lower back massage might be helpful, to which the patient agreed.
The Tribunal found that at this time, Mr Chum asked the patient to “take all of her clothes off”. The patient questioned this, and Mr Chum confirmed that she was to remove all of her clothing, and put on a bathrobe. The patient changed as requested. Mr Chum then asked the patient to remove her bathrobe and lie face down on a plinth. The patient covered herself with a towel provided by Mr Chum.
Mr Chum proceeded to massage the patient’s lower back and the top of her buttocks, moving the towel so that he could massage directly onto her skin. Mr Chum then advised the patient that, if she agreed, he would massage her “other side” and asked the patient to roll over so she was lying on her back. Mr Chum draped the patient with a towel from her shoulders to just below her crotch and began to massage the patient’s outer, middle, and inner thighs which made the patient feel uncomfortable. The Tribunal found that as Mr Chum massaged the patient he moved the towel, leaving intimate areas of the patient exposed. Further, that Mr Chum continued to massage higher up the patient’s thigh and then asked if he could massage her clitoral region, to which the patient said no, and the massage ended. While Mr Chum was packing up, he and the patient engaged in a conversation about Mr Chum’s treatment of other patients. The patient understood Mr Chum to be advising her that he massaged other patient’s clitoral regions, and gave them orgasms.
Mr Chum did not attend the Tribunal hearing but asked the Tribunal to take into consideration a number of statements written by him and several other potential witnesses.
The Tribunal found that the particulars of the charge (separately and cumulatively) were established and constituted malpractice, negligence, and conduct bringing discredit to the physiotherapy profession with the exception of the particular relating to the conversation between Mr Chum and the patient at the conclusion of the treatment session. The Tribunal concluded that on that aspect of the charge, the ambiguity in the exchanges that occurred meant that it could not conclude that Mr Chum had engaged in a conversation which was of a sexual nature. The Tribunal was satisfied that each of the particulars proved warranted disciplinary sanction and amounted to professional misconduct.
In determining penalty, the Tribunal concluded that Mr Chum had taken advantage of the situation and of the patient’s trust, and caused the patient significant distress. The Tribunal stated Mr Chum’s behavior “became increasingly more concerning” and that he was “testing the boundaries as events unfolded to see how far he could go in his predatory conduct”. The Tribunal cancelled Mr Chum’s registration and put in place a number of conditions that Mr Chum would be required to fulfil before he could re-apply for registration.
The Tribunal’s decision can be found at: https://www.hpdt.org.nz/portals/0/1033Phys18420D.pdf