An important professional regulation tool is the publication of standards of practice (or other types of advisory statements) guiding registrants. However, to be effective, standards must be clearly worded because ambiguity can undermine the ability of the regulator to enforce them. This point is illustrated in Sefcik v College of Podiatric Physicians of Alberta, 2025 ABCA 263 (CanLII).
A podiatrist had a consensual sexual relationship with an employee. A month or so before the sexual relationship began, the podiatrist referred the employee for an x-ray of their sore ankle. The discipline tribunals (both hearing and appeal) found that as a result, the employee was a patient when the sexual relationship began, resulting in a mandatory order revoking the podiatrist’s registration.
The finding of “patient” status was based on a published standard of practice mandated by the enabling statute. The standard defined a patient as a person to whom a podiatrist was “currently providing a health services [sic] and/or treatment”. The standard also had a glossary which defined: “Minor healthcare service – a situation that requires discrete procedural or episodic care for which the regulated member has no determination in the ongoing care of the person receiving the service.” Curiously, the phrase “minor healthcare service” was nowhere to be found in the standard; it likely originated with a previous, related standard.
The Court said that the glossary definition had to be considered when interpreting the standard:
The term “minor healthcare service” does not qualify or change the definition of patient but, as this case indicates, it logically informs the analysis of how that definition applies to the facts of a particular case, and in particular, how long the status of “patient” endures….
As the definition of “minor healthcare service” indicates, not all health services and treatments are the same. Where a podiatrist provides regular care to an individual over several years, even a long gap between appointments, on its own, may not be sufficient to change the recipient of that care’s status from current patient to former patient. Conversely, where a podiatrist sees an individual once for a non-recurring issue for which no follow-up is required or reasonably anticipated – i.e., where the podiatrist provides a minor healthcare service – the individual may cease to be a patient as soon as they leave the podiatrist’s office.
The Court determined that “… the only conclusion available on a proper interpretation and application of the Practice Standards is that [the employee] ceased to be a patient….” The Court returned the matter for a determination as to whether the employee qualified as a former patient of the podiatrist for the purposes of the sexual abuse provisions.
This case shows that ambiguity in the wording of a standard can have significant consequences for a regulator’s ability to enforce its professional expectations.
