The control framework reveals that a physical therapist in Canada must navigate complex ethical and regulatory landscapes when managing patient information. This scenario is professionally challenging because it requires balancing the patient’s right to privacy and confidentiality with the need for effective communication and collaboration within the healthcare team, all while adhering to provincial/territorial privacy legislation (such as Ontario’s Personal Health Information Protection Act, 2004 or Alberta’s Health Information Act) and the Canadian Physiotherapy Association (CPA) Code of Ethics. Careful judgment is required to determine the appropriate level of detail and the most secure method for sharing information. The best approach involves the physical therapist directly contacting the referring physician via a secure, encrypted communication channel (e.g., secure email, secure patient portal, or a direct phone call) to discuss the patient’s progress and any new findings. This approach is correct because it prioritizes patient confidentiality by using a secure method of communication and ensures that only relevant, necessary information is shared directly with the physician who initiated the referral. This aligns with the principles of privacy legislation that mandate the protection of personal health information and the CPA Code of Ethics, which emphasizes professional responsibility and maintaining patient trust. Sharing the detailed progress notes by simply attaching them to a general clinic fax without specific confirmation of receipt or secure transmission is professionally unacceptable. This method poses a significant risk of unauthorized disclosure of personal health information, violating privacy legislation and the ethical duty of confidentiality. Leaving a detailed voicemail on the physician’s general office answering machine is also professionally unacceptable. Voicemails can be overheard by unauthorized individuals, and the information may not be considered secure, thus breaching privacy regulations and the ethical obligation to protect patient information. Forwarding the patient’s entire electronic health record to the physician’s personal email address is a severe breach of privacy and ethical standards. Personal email accounts are generally not considered secure for transmitting sensitive health information, and this action would likely violate multiple privacy laws and the CPA Code of Ethics regarding the safeguarding of patient data. Professionals should employ a decision-making framework that begins with identifying the core ethical and legal obligations (confidentiality, privacy, informed consent). They should then assess the risks and benefits of each potential communication method, prioritizing secure and direct channels for sensitive information. When in doubt, consulting with a supervisor, privacy officer, or relevant professional body is a crucial step in ensuring compliance and ethical practice.

Scenario Analysis: This scenario presents a professional challenge because the physiotherapist must balance the need for accurate diagnosis and treatment planning with the patient’s right to privacy and informed consent, especially when dealing with potentially sensitive neurological findings. The physiotherapist’s duty of care extends to ensuring that any information shared is relevant, necessary, and communicated appropriately, respecting the patient’s autonomy and confidentiality. Correct Approach Analysis: The best professional approach involves obtaining explicit, informed consent from the patient to share specific, relevant information with their family physician. This approach respects the patient’s autonomy and right to privacy. By clearly explaining the purpose of the communication, the information to be shared, and the potential benefits, the physiotherapist empowers the patient to make an informed decision. This aligns with ethical principles of informed consent and confidentiality, as well as professional practice guidelines that mandate patient-centered care and the protection of personal health information. The physiotherapist’s role is to facilitate communication that supports the patient’s overall health management, not to unilaterally disclose information. Incorrect Approaches Analysis: Sharing detailed neurological findings with the family physician without first obtaining the patient’s explicit consent is a breach of confidentiality and patient privacy. This violates ethical obligations and potentially regulatory requirements regarding the protection of personal health information. The physiotherapist assumes the patient would want this information shared, which is a paternalistic approach and undermines patient autonomy. Discussing the patient’s symptoms and potential diagnoses in a general manner with the family physician without specific consent, even if not sharing all details, still risks overstepping boundaries. While the intent might be to seek collaborative care, the lack of explicit consent for the specific information being discussed makes it unprofessional and potentially a breach of privacy. The physiotherapist should not initiate such discussions without a clear mandate from the patient. Contacting the family physician to request a referral for further diagnostic testing based on the physiotherapist’s findings, without informing the patient or obtaining their consent for this communication, is also inappropriate. The physiotherapist’s role is to provide assessment and treatment within their scope of practice. Initiating contact with other healthcare providers to facilitate further investigations without patient knowledge or consent bypasses the patient’s role in their own healthcare decisions and can be seen as an unauthorized disclosure of information or an overreach of professional boundaries. Professional Reasoning: Professionals should employ a decision-making framework that prioritizes patient autonomy, informed consent, and confidentiality. When faced with a situation requiring communication with other healthcare providers, the first step is always to determine if patient consent is required. If it is, the professional must clearly explain the purpose, scope, and potential implications of the communication to the patient, allowing them to make an informed decision. If consent is granted, the communication should be limited to the information explicitly authorized by the patient and be relevant to the purpose of the communication. If consent is denied, the professional must respect that decision and explore alternative strategies for patient care that do not involve unauthorized disclosure.

Scenario Analysis: This scenario is professionally challenging because it requires the physiotherapist to balance the immediate need for patient care with the long-term implications of their exercise prescription, particularly concerning cardiovascular and respiratory health. The audit findings highlight a systemic issue that could impact patient safety and the clinic’s reputation. The physiotherapist must demonstrate sound clinical judgment, adherence to professional standards, and effective communication to address the situation appropriately. Correct Approach Analysis: The best professional practice involves a thorough, individualized assessment of the patient’s current cardiovascular and respiratory status, considering their exercise history, any pre-existing conditions, and the specific demands of the prescribed exercise program. This assessment should inform a tailored exercise prescription that gradually progresses intensity, duration, and frequency, incorporating appropriate monitoring strategies (e.g., heart rate, perceived exertion, symptom reporting) and clear patient education on warning signs. This approach aligns with the Canadian Physiotherapy Association (CPA) Code of Ethics and Standards of Practice, which emphasize patient-centered care, evidence-informed practice, and the physiotherapist’s responsibility to ensure the safety and efficacy of interventions. It also reflects the principles of risk management by proactively identifying and mitigating potential cardiovascular or respiratory complications. Incorrect Approaches Analysis: One incorrect approach would be to dismiss the audit findings as a minor administrative issue and continue with the existing exercise prescription without further investigation. This fails to acknowledge the potential for patient harm and violates the ethical obligation to provide safe and competent care. It also disregards the importance of quality assurance and continuous improvement, which are implicitly expected within professional practice. Another incorrect approach would be to immediately halt all exercise for the patient without a comprehensive reassessment. While caution is warranted, an abrupt cessation of exercise, especially if the patient is benefiting from it, can have negative consequences for their overall health and rehabilitation progress. This approach lacks the nuanced clinical judgment required to differentiate between appropriate exercise and potentially harmful exertion, and it fails to consider the patient’s individual needs and response to exercise. A third incorrect approach would be to delegate the assessment and modification of the exercise program to an unregulated assistant without direct supervision or clear protocols. This constitutes a failure to uphold professional responsibility and scope of practice. Physiotherapists are accountable for the care provided under their purview, and delegating critical assessment and prescription tasks without appropriate oversight can lead to errors, compromised patient safety, and a breach of professional standards. Professional Reasoning: Professionals facing such a situation should employ a systematic decision-making process. First, they must acknowledge and investigate the audit findings, recognizing their potential implications for patient care. Second, they should prioritize patient safety by conducting a thorough, individualized assessment of the patient’s cardiovascular and respiratory systems in relation to the prescribed exercise. Third, they must apply evidence-informed practice principles to develop or modify an exercise program that is safe, effective, and tailored to the patient’s needs, incorporating appropriate monitoring and education. Fourth, they should document all assessments, interventions, and patient communications meticulously. Finally, they should consider how to address the systemic issues identified by the audit to prevent future occurrences, potentially through staff education or protocol review.

Scenario Analysis: This scenario presents a professional challenge due to the potential for misinterpreting complex anatomical variations and their impact on patient presentation and treatment. A physiotherapist must rely on a robust understanding of normal anatomical structures and their common variations to accurately assess a patient, differentiate between pathology and normal variation, and develop an effective, individualized treatment plan. Failure to do so can lead to misdiagnosis, inappropriate interventions, and potentially harm to the patient. The challenge lies in integrating theoretical anatomical knowledge with practical clinical observation and diagnostic reasoning. Correct Approach Analysis: The best professional practice involves a systematic approach that begins with a thorough patient history and physical examination, focusing on the presenting symptoms and functional limitations. This is followed by a critical analysis of the findings in the context of known anatomical structures and their common variations. The physiotherapist should then formulate a differential diagnosis, considering both pathological conditions and anatomical variations that could explain the patient’s presentation. Treatment planning should be based on this comprehensive assessment, prioritizing interventions that address the underlying impairments and functional deficits, while acknowledging any identified anatomical variations that may influence the treatment approach or prognosis. This aligns with the College of Physiotherapists of Ontario (CPO) Standards of Practice, which emphasize the importance of accurate assessment, evidence-informed practice, and patient-centred care. Incorrect Approaches Analysis: One incorrect approach involves immediately attributing all unusual findings to a pathological condition without first considering common anatomical variations. This can lead to unnecessary investigations, anxiety for the patient, and a delay in addressing the actual cause of their symptoms, which might be benign anatomical variation. This fails to meet the CPO’s standard of thorough and accurate assessment. Another incorrect approach is to dismiss unusual findings as insignificant anatomical variations without a proper differential diagnosis. While anatomical variations are common, some can mimic or predispose individuals to certain pathologies. Failing to investigate further could mean missing a serious underlying condition, which is a breach of the CPO’s duty of care and professional responsibility to rule out significant pathology. A third incorrect approach is to rely solely on imaging reports without correlating them with the patient’s clinical presentation and physical examination findings. Imaging can reveal anatomical variations, but its interpretation must be integrated with the patient’s subjective and objective data to form a complete clinical picture. Over-reliance on imaging without clinical correlation can lead to misinterpretations and inappropriate treatment decisions, contravening the CPO’s emphasis on holistic patient assessment. Professional Reasoning: Professionals should employ a clinical reasoning framework that integrates knowledge, experience, and critical thinking. This involves gathering information (history, examination), generating hypotheses (differential diagnosis), testing hypotheses (further assessment, imaging if indicated), and developing a plan (treatment). When faced with anatomical variations, the process requires a heightened awareness of the spectrum of normal, a systematic approach to differential diagnosis, and a commitment to evidence-informed practice and patient safety, as mandated by regulatory bodies like the CPO.

Scenario Analysis: This scenario presents a common challenge in physiotherapy practice: managing patient expectations and ensuring informed consent when a patient’s subjective experience of pain and functional limitation does not align with objective findings. The professional challenge lies in balancing the patient’s perception of their condition with evidence-based assessment and treatment, while maintaining a therapeutic alliance and adhering to professional standards of care. Careful judgment is required to avoid dismissing the patient’s experience, over-treating, or under-treating, all of which can have negative consequences for patient outcomes and professional reputation. Correct Approach Analysis: The best professional practice involves a comprehensive reassessment that integrates the patient’s subjective report with objective findings, followed by a collaborative discussion to establish a shared understanding and treatment plan. This approach prioritizes patient-centred care by acknowledging the patient’s experience while grounding interventions in evidence. It aligns with the principles of informed consent and professional accountability, ensuring that treatment is both necessary and appropriate. This approach involves a thorough re-examination of the musculoskeletal system, including range of motion, strength, palpation, and special tests, to identify any subtle changes or missed findings. The therapist then communicates these findings clearly to the patient, explaining the rationale for the treatment plan and addressing any discrepancies between subjective and objective data in a non-judgmental manner. This fosters trust and empowers the patient to participate actively in their rehabilitation. Incorrect Approaches Analysis: One incorrect approach involves proceeding with the previously planned, more aggressive treatment without further investigation. This fails to acknowledge the patient’s current subjective experience and may lead to unnecessary or even harmful interventions if the underlying cause of the discrepancy has changed or was initially misidentified. It disregards the importance of ongoing assessment and adaptation of treatment based on patient response, potentially violating the ethical principle of beneficence and non-maleficence. Another incorrect approach is to dismiss the patient’s subjective report as inaccurate or exaggerated and to discontinue treatment. This invalidates the patient’s experience, erodes trust, and can lead to patient dissatisfaction and a breakdown in the therapeutic relationship. It also fails to explore potential reasons for the discrepancy, such as psychosocial factors or subtle physiological changes that may not be immediately apparent through standard objective measures. This approach neglects the holistic nature of patient care. A third incorrect approach is to solely rely on the objective findings and to prescribe a treatment plan that does not adequately address the patient’s reported pain and functional limitations. While objective findings are crucial, they must be interpreted in the context of the patient’s subjective experience. Ignoring or downplaying the patient’s reported symptoms can lead to a treatment plan that is not perceived as relevant or effective by the patient, potentially resulting in poor adherence and suboptimal outcomes. This can also be seen as a failure to adequately assess the patient’s functional status from their perspective. Professional Reasoning: Professionals should employ a systematic approach to patient assessment and management. This includes: 1) Active listening and validation of the patient’s subjective report. 2) Thorough and repeated objective assessment, considering the entire musculoskeletal system and relevant functional movements. 3) Critical analysis of discrepancies between subjective and objective findings, exploring potential contributing factors. 4) Collaborative goal setting and treatment planning with the patient, ensuring shared understanding and informed consent. 5) Ongoing monitoring of patient response and adaptation of the treatment plan as needed. This decision-making process emphasizes patient-centred care, evidence-based practice, and ethical responsibility.

Scenario Analysis: This scenario presents a professional challenge because it requires the physiotherapist to apply their knowledge of muscle anatomy and physiology to a patient’s functional deficit, while also adhering to the ethical and professional standards of practice in Canada. The challenge lies in accurately identifying the primary muscle group responsible for the observed weakness and then selecting the most appropriate intervention strategy based on that understanding, ensuring patient safety and efficacy of treatment. Careful judgment is required to differentiate between primary muscle dysfunction and secondary compensatory patterns, and to avoid oversimplification of complex biomechanical issues. Correct Approach Analysis: The best professional practice involves a systematic assessment that begins with identifying the primary muscle group responsible for the observed deficit. This approach is correct because it directly addresses the root cause of the patient’s functional limitation. By understanding the specific anatomy and physiology of the muscles involved in the movement, the physiotherapist can then design a targeted and effective treatment plan. This aligns with the Canadian Physiotherapy Association (CPA) Code of Ethics, which emphasizes providing competent and evidence-informed care, and the Standards of Practice for Physiotherapists in Canada, which mandate accurate assessment and diagnosis as the foundation for treatment. This approach ensures that interventions are specific, goal-oriented, and maximize the potential for patient recovery. Incorrect Approaches Analysis: Focusing solely on compensatory movements without identifying the primary weak muscle group is professionally unacceptable. This approach fails to address the underlying pathology, potentially leading to ineffective treatment or even exacerbation of the problem as the body continues to rely on inefficient movement patterns. It deviates from the principle of evidence-informed practice by not targeting the source of the dysfunction. Assuming the weakness is due to a general lack of conditioning without a specific muscle assessment is also professionally flawed. While conditioning is important, a precise diagnosis of muscle involvement is crucial for developing a tailored rehabilitation program. This approach lacks the specificity required for optimal patient outcomes and may not address any underlying anatomical or physiological issues contributing to the weakness. Applying a generic strengthening protocol without considering the specific muscle group’s function and potential injury is ethically and professionally problematic. This can lead to inappropriate exercise selection, potentially causing further harm or failing to elicit the desired therapeutic response. It disregards the fundamental principle of individualized care and the need for a thorough understanding of muscle biomechanics. Professional Reasoning: Professionals should employ a problem-solving framework that begins with a comprehensive subjective and objective assessment. This includes understanding the patient’s history, observing their movement patterns, and performing specific muscle tests to identify the primary muscles involved in the functional deficit. Based on this accurate diagnosis, the physiotherapist should then develop a treatment plan that directly addresses the identified impairments, utilizing evidence-based interventions. Regular reassessment and modification of the treatment plan based on patient response are also critical components of effective practice. This systematic approach ensures that care is safe, effective, and aligned with professional standards and ethical obligations.

Scenario Analysis: This scenario presents a professional challenge due to the need to accurately interpret complex neurophysiological findings in the context of a patient’s functional limitations. The physiotherapist must synthesize information from various sources, including diagnostic imaging and patient history, to formulate an effective and safe treatment plan. Misinterpretation can lead to inappropriate interventions, delayed recovery, or even harm to the patient. The challenge lies in bridging the gap between theoretical neuroanatomy and practical application in a clinical setting, ensuring that treatment aligns with the underlying pathophysiology. Correct Approach Analysis: The best professional approach involves a comprehensive review of all available diagnostic information, including the MRI report detailing the extent and location of the spinal cord lesion. This is coupled with a thorough clinical assessment of the patient’s current motor, sensory, and proprioceptive deficits. By integrating these two data sets, the physiotherapist can develop a targeted treatment plan that addresses the specific neurophysiological impairments identified. This approach is ethically sound and aligns with the principles of evidence-based practice, ensuring that interventions are both safe and effective, and directly address the patient’s unique presentation as dictated by their neurological condition. This aligns with the College of Physiotherapists of Ontario (CPO) Standards of Practice, which emphasize the importance of a thorough assessment and the development of individualized treatment plans based on a comprehensive understanding of the patient’s condition. Incorrect Approaches Analysis: One incorrect approach would be to solely rely on the MRI report without a detailed clinical assessment. While the MRI provides structural information, it does not fully capture the dynamic functional impact of the lesion on the patient’s movement and sensation. This could lead to assumptions about the patient’s capabilities that are not accurate, potentially resulting in an ineffective or even harmful treatment plan. This fails to meet the CPO’s requirement for a comprehensive assessment that considers the patient’s functional status. Another incorrect approach would be to focus treatment solely on gross motor retraining without considering the specific neurophysiological deficits indicated by the MRI, such as potential sensory pathway involvement. This generalized approach may not adequately address the underlying neurological issues, leading to suboptimal outcomes and a failure to maximize the patient’s recovery potential. It neglects the detailed understanding of neuroanatomy and neurophysiology required for targeted rehabilitation. A further incorrect approach would be to proceed with a treatment plan based on the patient’s pre-injury functional level without accounting for the new neurological deficits. This ignores the fundamental impact of the spinal cord lesion on the nervous system’s ability to control movement and sensation, potentially leading to frustration for the patient and a lack of progress. It demonstrates a failure to adapt treatment to the current neurophysiological reality. Professional Reasoning: Professionals should employ a systematic approach that begins with understanding the patient’s presenting problem and relevant medical history. This is followed by a comprehensive physical assessment, integrating findings from diagnostic imaging and other investigations. The physiotherapist must then synthesize this information to identify the underlying neuroanatomical and neurophysiological impairments. Based on this synthesized understanding, an individualized, evidence-based treatment plan is developed, with clear goals and regular reassessment to monitor progress and adjust interventions as needed. This iterative process ensures that care is patient-centered, safe, and effective, adhering to professional standards and ethical obligations.

This scenario is professionally challenging because it requires the physiotherapist to balance the patient’s immediate desire for symptom relief with the need for a comprehensive diagnostic process to ensure accurate identification and management of a potentially serious neurological condition. Rushing to treatment without adequate assessment risks misdiagnosis, delayed appropriate care, and potential harm to the patient. The best approach involves a systematic and thorough neurological assessment, including detailed history taking, observation, and specific neurological tests relevant to the reported symptoms. This approach is correct because it aligns with the fundamental principles of physiotherapy practice as outlined by the Canadian Alliance of Physiotherapy Regulators (CAPR) competency profile, which emphasizes the importance of a comprehensive assessment to establish a diagnosis and develop an evidence-based treatment plan. Ethical obligations to the patient, including beneficence and non-maleficence, necessitate a diagnostic process that minimizes risk and maximizes the likelihood of effective intervention. This systematic approach ensures that all potential contributing factors are considered, leading to a more accurate diagnosis and safer, more effective treatment. An incorrect approach would be to immediately initiate a treatment plan based solely on the patient’s subjective report of pain and stiffness. This fails to acknowledge the potential for underlying neurological pathology that may not be directly addressed by symptomatic treatment and could be exacerbated by inappropriate interventions. This approach violates the professional responsibility to diagnose accurately and could lead to a delay in identifying a serious condition, thus breaching the duty of care. Another incorrect approach would be to refer the patient to a physician without conducting any preliminary neurological assessment. While physician referral is often a necessary part of interprofessional collaboration, a physiotherapist has the skills and responsibility to perform an initial assessment to gather relevant information that can aid the physician’s diagnosis. Abrogating this responsibility entirely without any preliminary assessment is a failure to utilize the full scope of physiotherapy practice and may delay the diagnostic process. A further incorrect approach would be to focus exclusively on musculoskeletal assessments, such as range of motion and palpation of soft tissues, without incorporating specific neurological screening. While musculoskeletal factors may contribute to the patient’s symptoms, neglecting the neurological system when symptoms suggest potential involvement is a significant oversight. This could lead to a missed diagnosis of a primary neurological disorder, resulting in inappropriate treatment and potential progression of the underlying condition. The professional reasoning framework for such situations involves a cyclical process of assessment, diagnosis, planning, intervention, and re-evaluation. It begins with gathering subjective information, followed by objective assessment, formulation of a differential diagnosis, selection of appropriate diagnostic tests, implementation of a treatment plan, and continuous monitoring of the patient’s response to guide further interventions and adjustments. This iterative process ensures that patient care is evidence-based, safe, and effective.

The assessment process reveals a patient presenting with symptoms suggestive of a fracture. The challenge lies in accurately identifying the affected bone and understanding its structural integrity to guide appropriate physiotherapy interventions. Misinterpreting bone structure or function can lead to ineffective treatment, delayed healing, or even iatrogenic injury. The best approach involves a comprehensive assessment that integrates patient history, physical examination findings, and diagnostic imaging. This allows for a precise identification of the bone involved, the nature of the injury (e.g., fracture type, displacement), and the impact on surrounding structures. Understanding the specific biomechanical role of the affected bone and its relationship to adjacent joints and soft tissues is crucial for developing a safe and effective rehabilitation plan. This aligns with the College of Physiotherapists of Ontario’s (CPO) Standards of Practice, which emphasize the importance of accurate diagnosis and evidence-based practice, requiring physiotherapists to gather sufficient information to make informed clinical decisions. An approach that relies solely on palpation without considering diagnostic imaging is insufficient. While palpation can provide clues, it is not definitive for diagnosing fractures and can be misleading, especially in cases of subtle fractures or significant soft tissue swelling. This failure to utilize available diagnostic tools represents a deviation from best practice and could lead to an incorrect diagnosis, violating the CPO’s requirement for thorough assessment. Another unacceptable approach would be to proceed with aggressive mobilization techniques based on a presumptive diagnosis without confirming the fracture and its stability. This disregards the fundamental principles of bone healing and the potential for exacerbating the injury. The CPO’s standards mandate that physiotherapists practice within their scope and ensure patient safety, which includes avoiding interventions that could compromise bone integrity or impede healing. A further inappropriate response would be to delegate the interpretation of diagnostic imaging to a less qualified individual without direct supervision or verification. The responsibility for interpreting diagnostic findings and integrating them into the clinical picture rests with the physiotherapist. This delegation would contraindicate the CPO’s expectations regarding professional accountability and the competent use of diagnostic information. Professionals should employ a decision-making framework that begins with a thorough subjective and objective assessment. This includes obtaining a detailed patient history, performing a targeted physical examination, and critically reviewing any available diagnostic imaging. The physiotherapist must then synthesize this information to formulate a differential diagnosis, confirm the diagnosis with appropriate investigations if necessary, and develop a treatment plan that is tailored to the specific bone structure, injury, and functional goals of the patient, always adhering to the CPO’s Standards of Practice and ethical guidelines.

Scenario Analysis: This scenario is professionally challenging because it requires the physiotherapist to balance the client’s desire for continued participation in a desired activity with the potential risks associated with a common skin condition. The physiotherapist must accurately assess the condition, understand its implications for physical activity, and communicate effectively with the client and potentially other healthcare providers, all while adhering to professional standards of care and ethical obligations. The challenge lies in making an informed decision that prioritizes client safety and well-being without unduly restricting their functional goals. Correct Approach Analysis: The best professional approach involves a thorough assessment of the client’s skin condition, including its stage, severity, and any signs of infection or inflammation. This assessment should inform a risk-benefit analysis regarding the proposed physical activity. The physiotherapist should then engage in a collaborative discussion with the client, clearly explaining the findings, potential risks (e.g., exacerbation of the condition, spread of infection, pain), and benefits of participation. Based on this discussion and the assessment, the physiotherapist should provide evidence-based recommendations, which may include modifying the activity, recommending specific precautions, or advising against participation until the condition improves. This approach aligns with the ethical principles of beneficence (acting in the client’s best interest), non-maleficence (avoiding harm), and client autonomy (respecting the client’s right to make informed decisions). It also adheres to professional practice standards that mandate comprehensive assessment and informed consent. Incorrect Approaches Analysis: Recommending immediate cessation of all physical activity without a thorough assessment of the specific skin condition and its impact on the proposed activity fails to consider the client’s functional goals and may be overly restrictive. This approach neglects the principle of proportionality and could lead to unnecessary deconditioning or psychological distress for the client. Proceeding with the activity without any modifications or precautions, despite the presence of a potentially contagious or aggravating skin condition, demonstrates a failure to uphold the duty of care and the principle of non-maleficence. This could lead to the spread of infection to others, exacerbation of the client’s condition, or delayed healing, all of which are professionally unacceptable outcomes. Referring the client to a physician without conducting an initial physiotherapy assessment of the skin condition and its implications for therapy is inefficient and may delay appropriate physiotherapy intervention. While physician consultation is important for diagnosis and medical management, the physiotherapist has a role in assessing the functional impact of the condition and guiding safe participation in therapy and activity. Professional Reasoning: Professionals should employ a systematic approach to client care. This begins with a comprehensive assessment to gather all relevant information. Following assessment, a clinical reasoning process should be used to analyze the findings, identify potential risks and benefits, and formulate a plan of care. This plan should be developed collaboratively with the client, ensuring they understand the rationale behind the recommendations and are empowered to participate in decision-making. Ongoing monitoring and re-assessment are crucial to adapt the plan as the client’s condition evolves.