• Why has my natural therapist touched me there?

    Guild Insurance sees numerous allegations against natural therapists where the patient claims the practitioner has behaved in a sexually inappropriate manner during treatment.

    These claims may involve allegations regarding the way the practitioner has touched them, or they may relate to what’s been said during the consultation. These are incredibly serious allegations that cause a great deal of stress for both the practitioner and the patient.

    Case example 1

    The patient alleged that during treatment the practitioner moved and undid items of the patient’s clothing without the patient’s consent, leaving the patient feeling exposed and uncomfortable.

    Case example 2

    The patient complained about what they perceived to be excessive and unnecessary physical contact during treatment that left them feeling uncomfortable. The patient stated they’d received this type of treatment before and had never been touched in this manner.

    How can these allegations be avoided?

    Be mindful of patient clothing

    If treatment would be easier with the patient’s clothes removed or adjusted, this should be clearly explained to the patient, while seeking their consent. Being even partially undressed can leave patients feeling exposed and vulnerable. Adhere to the following tips regarding patients and their clothing:

    • Consider making patients aware prior to their appointment that they may be asked to remove or adjust clothing, if they’re comfortable doing so. This allows the patient to consider what clothing might be most suitable and practical to wear.
    • Be sure you explain to patients why you would like them to remove or adjust their clothing, keeping in mind it may not be obvious to them.
    • Provide the patient with clean towels and/or gowns to keep the parts of their body not being treated covered. These must be of a sufficient size to adequately cover all patients.
    • If moving or adjusting the patient’s clothing once treatment has begun, seek the patient’s consent first, and ensure you offer to re-position the clothes afterwards.
    • Be very clear about what you want patients to remove and what they should leave on. Simply asking them to undress is likely to cause confusion and apprehension.
    • Give patients privacy when undressing and dressing by either having a screen for them to go behind, or by leaving the room.
    • Remember that patients can decline to consent to adjusting or removing clothes; don’t assume they’re ok with it.

    Gender is irrelevant

    It’s easy to think that allegations of inappropriate touching are predominately issues when treating patients of the opposite gender. However, this isn’t the case. Regardless of the patient’s or your gender, there’s always a possibility for the patient to feel uncomfortable. The way you explain treatment to patients and seek their informed consent should not differ based on the patient’s gender.

    Informed consent

    All health professionals would be aware of their professional obligation to ensure a patient has given their informed consent prior to assessment and treatment beginning. For a patient to be able to give informed consent, they need to have had the assessment and treatment explained to them in a manner they understand. This means avoiding clinical language which may be confusing while providing the risks and benefits to what you’re proposing and allowing time for the patient to ask questions.

    When treatment involves touching the patient, it’s important to clearly explain to patients where you’re proposing to touch them, and why. It may even require you to demonstrate on yourself exactly where you’re referring to. Remember that in some cases you won’t directly touch the patient where they feel pain or discomfort, so the treatment area may not be obvious to them. Keep in mind that even after treatment has commenced, patients can withdraw consent at any time if they don’t feel comfortable.

    Record keeping

    Record keeping is a professional requirement which serves several purposes. Detailed and accurate clinical notes allow for continuity of patient care. They also provide evidence of what took place during a consultation, and why.

    If a patient alleges they’ve been touched inappropriately, the practitioner’s clinical record will be examined for evidence of what treatment was provided and the clinical justification for this. The clinical record should also contain evidence of the patient consenting to the treatment. Without this information in the clinical record, it becomes very difficult for the practitioner to defend their actions.

    Don’t make assumptions

    As with any professional, practitioners can become overly familiar with what they know and do every day. However, they must remember that patients won’t have that level of familiarity when it comes to treatment. Regardless of how many times a practitioner has treated a patient, they should never make assumptions about what the patient will understand about treatment, be comfortable with and be willing to consent to. Treatment always needs to be explained to patients, even if they’ve received that treatment before.

    Consider the patient’s demeanour

    While it isn’t expected that a practitioner can be sure of what a patient is thinking and feeling just by their body language, we all have some ability to gauge when a person is feeling uncomfortable with a situation. If you have a patient who appears to not be comfortable with the treatment being suggested or carried out, stop what you’re doing and assess the situation. You may need to further explain the treatment so it’s better understood. You may need to reposition clothing or gowns so the patient is more adequately covered. Or you may need to remind the patient that they don’t have to consent to treatment being proposed and discuss other treatment options. It’s also worth informing patients that they can bring a support person, such as a friend or relative, into the treatment room with them if that would make them feel more comfortable.

    Talking while treating

    Being a personable and friendly health professional can be beneficial in terms of building relationships with patients, but it can also have its downside. While having non-treatment related chats with a patient during treatment is acceptable, there will be occasions when the chatting should cease so further information about treatment can be discussed. It’s far too easy to forget what has and hasn’t been explained, and consented to, when continually chatting during treatment.

    Don’t go it alone

    1800 810 213
    guildinsurance.com.au

    Guild Insurance Limited ABN 55 004 538 863, AFS Licence No. 233 791. This article contains information of a general nature only, and is not intended to constitute the provision of legal advice. Guild Insurance supports your Association through the payment of referral fees for certain products or services you take out with them. NAT575998 Risk Article - Why Have I Been Touched There Natural Therapists 05/2026

  • Why has my physiotherapist touched me there?

    Guild Insurance sees numerous allegations against physiotherapists where the patient claims the practitioner has behaved in a sexually inappropriate manner during treatment.

    These claims may involve allegations regarding the way the practitioner has touched them, or they may relate to what’s been said during the consultation. These are incredibly serious allegations that cause a great deal of stress for both the practitioner and the patient.

    Case example 1

    The patient alleged that during treatment the practitioner moved and undid items of the patient’s clothing without the patient’s consent, leaving the patient feeling exposed and uncomfortable.

    Case example 2

    The patient complained about what they perceived to be excessive and unnecessary physical contact during treatment that left them feeling uncomfortable. The patient stated they’d received this type of treatment before and had never been touched in this manner.

    How can these allegations be avoided?

    Be mindful of patient clothing

    If treatment would be easier with the patient’s clothes removed or adjusted, this should be clearly explained to the patient, while seeking their consent. Being even partially undressed can leave patients feeling exposed and vulnerable. Adhere to the following tips regarding patients and their clothing:

    • Consider making patients aware prior to their appointment that they may be asked to remove or adjust clothing, if they’re comfortable doing so. This allows the patient to consider what clothing might be most suitable and practical to wear.
    • Be sure you explain to patients why you would like them to remove or adjust their clothing, keeping in mind it may not be obvious to them.
    • Provide the patient with clean towels and/or gowns to keep the parts of their body not being treated covered. These must be of a sufficient size to adequately cover all patients.
    • If moving or adjusting the patient’s clothing once treatment has begun, seek the patient’s consent first, and ensure you offer to re-position the clothes afterwards.
    • Be very clear about what you want patients to remove and what they should leave on. Simply asking them to undress is likely to cause confusion and apprehension.
    • Give patients privacy when undressing and dressing by either having a screen for them to go behind, or by leaving the room.
    • Remember that patients can decline to consent to adjusting or removing clothes; don’t assume they’re ok with it.

    Gender is irrelevant

    It’s easy to think that allegations of inappropriate touching are predominately issues when treating patients of the opposite gender. However, this isn’t the case. Regardless of the patient’s or your gender, there’s always a possibility for the patient to feel uncomfortable. The way you explain treatment to patients and seek their informed consent should not differ based on the patient’s gender.

    Informed consent

    All health professionals would be aware of their professional obligation to ensure a patient has given their informed consent prior to assessment and treatment beginning. For a patient to be able to give informed consent, they need to have had the assessment and treatment explained to them in a manner they understand. This means avoiding clinical language which may be confusing while providing the risks and benefits to what you’re proposing and allowing time for the patient to ask questions.

    When treatment involves touching the patient, it’s important to clearly explain to patients where you’re proposing to touch them, and why. It may even require you to demonstrate on yourself exactly where you’re referring to. Remember that in some cases you won’t directly touch the patient where they feel pain or discomfort, so the treatment area may not be obvious to them. Keep in mind that even after treatment has commenced, patients can withdraw consent at any time if they don’t feel comfortable.

    Record keeping

    Record keeping is a professional requirement which serves several purposes. Detailed and accurate clinical notes allow for continuity of patient care. They also provide evidence of what took place during a consultation, and why.

    If a patient alleges they’ve been touched inappropriately, the practitioner’s clinical record will be examined for evidence of what treatment was provided and the clinical justification for this. The clinical record should also contain evidence of the patient consenting to the treatment. Without this information in the clinical record, it becomes very difficult for the practitioner to defend their actions.

    Don’t make assumptions

    As with any professional, practitioners can become overly familiar with what they know and do every day. However, they must remember that patients won’t have that level of familiarity when it comes to treatment. Regardless of how many times a practitioner has treated a patient, they should never make assumptions about what the patient will understand about treatment, be comfortable with and be willing to consent to. Treatment always needs to be explained to patients, even if they’ve received that treatment before.

    Consider the patient’s demeanour

    While it isn’t expected that a practitioner can be sure of what a patient is thinking and feeling just by their body language, we all have some ability to gauge when a person is feeling uncomfortable with a situation. If you have a patient who appears to not be comfortable with the treatment being suggested or carried out, stop what you’re doing and assess the situation. You may need to further explain the treatment so it’s better understood. You may need to reposition clothing or gowns so the patient is more adequately covered. Or you may need to remind the patient that they don’t have to consent to treatment being proposed and discuss other treatment options. It’s also worth informing patients that they can bring a support person, such as a friend or relative, into the treatment room with them if that would make them feel more comfortable.

    Talking while treating

    Being a personable and friendly health professional can be beneficial in terms of building relationships with patients, but it can also have its downside. While having non-treatment related chats with a patient during treatment is acceptable, there will be occasions when the chatting should cease so further information about treatment can be discussed. It’s far too easy to forget what has and hasn’t been explained, and consented to, when continually chatting during treatment.


    Guild Insurance Limited ABN 55 004 538 863, AFS Licence No. 233 791. This article contains information of a general nature only, and is not intended to constitute the provision of legal advice. Guild Insurance supports your Association through the payment of referral fees for certain products or services you take out with them. PHY576006 Risk Article - Why Have I Been Touched There Physios 05/z2026

  • Learnings from dental prosthetist claims.

    Guild Insurance spends time analysing claims and/or complaints relating to treatment provided by dental prosthetists. This involves complaints made directly to the practitioner or practice as well as complaints to a regulatory body, such as Ahpra. This analysis helps Guild better understand several key details such as:

    • what the complaint or allegation is about
    • the factors that may not be mentioned in the complaint yet have contributed to the incident and therefore the complaint occurring
    • what could have been done differently to possibly avoid the complaint from occurring

    This information is then used to develop risk messages for the profession, which are tips and strategies to reduce the likelihood of complaints being received. It’s important to understand that risk management can’t guarantee a poor outcome or complaint won’t ever occur. However, by adhering to the following messages, dental prosthetists are taking positive steps to reduce the likelihood.

    Key risk messages

    1. Ensure you make communication a key feature of your work

    Guild’s claims analysis suggests that poor communication is a feature in almost all treatment-related complaints. Patients don’t often complain specifically about poor communication. However, when an incident is investigated, poor communication is quite often a factor. Practitioners must continually focus on their communication with patients, patient’s families where relevant, colleagues and other health professionals. Good clinical skills alone aren’t enough to make someone a safe and effective practitioner.

    2. Manage patient expectations

    It’s common to hear from patients who are unhappy with the look, feel and comfort level of a denture. It’s therefore important that patients have realistic expectations, as unrealistic expectations are rarely met. Unmet expectations will often lead to patients being dissatisfied and more likely to complain. It’s the responsibility of the practitioner to support the patient to have realistic expectations. Practitioners must remember that in most cases, patients won’t have the clinical knowledge and understanding they have. They should never assume a patient’s understanding regarding wearing a denture; there must be a conversation to ensure this.

    3. Ensure assessments are thorough and treatment plans are appropriate

    Thorough assessments seem like an obvious step. However, it’s not uncommon to see claims where the assessment hasn’t been thorough enough, leading to a treatment plan and prosthesis that isn’t ideal. Assessments shouldn’t be rushed, and details of the assessment, findings and treatment plan are to be recorded in the clinical record. Practitioners must be sure they don’t make assumptions or fall into routines. Remember, poor assessment usually leads to poor outcomes.

    4. Be sure patients have given their informed consent to treatment

    Patients must be given the opportunity to provide their informed consent to treatment. Informed consent requires a conversation between the treating practitioner and patient about recommended and alternate treatment options as well as the benefits and risks for each of those options. Informed consent should include informed financial consent which is a discussion about the expected costs of treatment. Details about the consent discussion need to be recorded in the clinical record.

    5. Maintain adequate clinical records

    Clinical records are a history and evidence of what took place, and they serve numerous purposes. They assist with ongoing clinical care, as no practitioner can remember how they’ve treated every patient in every consultation. They also assist as evidence, if a practitioner’s treatment is questioned by a patient, regulator, or private health insurer. And finally, they’re necessary for meeting the expectations of the Dental Board of Australia.

    6. Know and adhere to all Ahpra requirements

    As a health professional registered with Ahpra, it’s a dental prosthetist’s responsibility to make themself aware of what’s required. This means making the time to seek out and read the numerous codes and guidelines found on the Ahpra website (ahpra.gov.au). Some of these documents detail what’s considered best practice, while some information refers to the law. Not knowing this information is no excuse for not adhering to it.

    7. Behave in a professional and appropriate manner

    Complaints don’t always focus on clinical outcomes; they can also relate to the behaviour of the practitioner. These complaints include, among others, allegations of speaking rudely to patients, not listening to the concerns of a patient and blurring professional boundaries by having inappropriate conversations or interactions with patients. Practitioners must always be very mindful of their professional behaviour. They also need to understand, and adhere to, the professional standards set out in their Code of Conduct, which can be found at ahpra.gov.au/Resources/Code-of-conduct/Shared-Code-of-conduct.

    8. Adhere to advertising requirements

    Ahpra’s expectations regarding advertising are explained in the Guidelines for Advertising Regulated Health Services document which can be found at ahpra.gov.au/Resources/Advertising-hub. There are numerous complaints continually being lodged with Ahpra alleging health professionals are breaching these guidelines. Practitioners need to be aware that these guidelines specify what’s required under the National Law and non-compliance is a criminal offence for which hefty fines can be imposed.

  • Learnings from dental claims

    Guild Insurance spends time analysing claims and/or complaints relating to treatment provided by dentists. This involves complaints made directly to the dentist or practice as well as complaints to a regulatory body such as Ahpra. This analysis helps Guild better understand several key details such as:

    • what the complaint or allegation is about
    • the factors that may not be mentioned in the complaint yet have contributed to the incident and therefore the complaint occurring
    • what could have been done differently to possibly avoid the complaint from occurring

    This information is then used to develop risk messages for the profession, which are tips and strategies to reduce the likelihood of complaints being received. It’s important to understand that risk management can’t guarantee a poor outcome or complaint won’t ever occur. However, by adhering to the following messages, dentists are taking positive steps to reduce the likelihood.

    Key risk messages

    1. Ensure you make communication a key feature of your work

    Guild’s claims analysis suggests that poor communication is a feature in almost all treatment-related complaints. Patients don’t often complain specifically about poor communication. However, when an incident is investigated, poor communication is quite often a factor. Dentists must continually focus on their communication with patients, patient’s families where relevant, colleagues and other health professionals. Good clinical skills alone aren’t enough to make someone a safe and effective dentist.

    2. Ensure there’s been an adequate assessment prior to treatment

    Assessment before treatment seems like an obvious step. However, it’s not uncommon to see claims where the assessment hasn’t been thorough enough, leading to treatment that’s inappropriate or ineffective. The assessment shouldn’t be rushed, and details of the assessment and findings are to be recorded in the clinical record. Dentists must be sure they don’t make assumptions or fall into routines. Remember, poor assessment usually leads to poorly selected treatment.

    3. Manage patient expectations

    It’s important that patients have realistic expectations regarding their likely treatment outcomes. Unrealistic expectations are rarely met. Unmet expectations will often lead to patients being dissatisfied with treatment and more likely to complain. It’s the responsibility of the dentist to be sure a patient’s expectations are realistic before treatment begins. Dentists must remember that in most cases, patients won’t have the clinical knowledge and understanding they have. They should never assume a patient understands their treatment or what’s likely to happen post-treatment; there must be a conversation to ensure this understanding.

    4. Be sure patients have given their informed consent to treatment

    Patients must be given the opportunity to provide their informed consent to treatment before being treated. Informed consent requires a conversation between the treating dentist and patient about recommended and alternate treatment options as well as the benefits and risks for each of those options. Informed consent should include informed financial consent which is a discussion about the expected costs of treatment. Details about the consent discussion need to be recorded in the clinical record. Signing a generic form at reception prior to seeing the dentist is not informed consent.

    5. Maintain adequate clinical records

    Clinical records are a history and evidence of what took place, and they serve numerous purposes. They assist with ongoing clinical care, as no dentist can remember how they’ve treated every patient in every consultation. They also assist as evidence if a dentist’s treatment is questioned by a patient, regulator, or private health insurer. And finally, they’re necessary for meeting the expectations of the Dental Board of Australia (the Board).

    6. Only treat within your individual scope of practice

    All dentists should understand their own individual scope of practice. This isn’t just based on practitioner divisions within dentistry, but also an individual’s education and experience. According to the Board’s Guidelines for Scope of Practice document, “You must only perform dental treatment that you have been educated and trained in, and that you are competent in”. Therefore, when a clinical situation is outside a dentist’s scope of practice, they need to refer the patient to someone suitably qualified.

    Dentists are expected to use their professional judgement to assess their scope of practice. To assist with this, the Board has created a reflective practice tool. This tool, and the Scope of Practice document, can be found at dentalboard.gov.au/Codes-Guidelines/Policies-Codes-Guidelines

    7. Don’t be coerced into treating against your better judgement

    There’ll be occasions when a dentist is asked to do something they don’t believe is in the best interests of the patient, such as when a patient is asking for a particular type of treatment which isn’t clinically indicated. Dentists need to be sure they use their professional judgment when deciding on treatment and not allow themselves to be convinced to do something that isn’t appropriate. They must remember that they’re responsible for, and need to be able to justify, their clinical decisions and actions.

    8. Maintain infection control standards

    Guild regularly sees complaints alleging a dental practice’s infection control standards are below the standard they should be. And what might be surprising is that these complaints are often lodged by patients, not just health professionals. Dentists and their colleagues must be sure they understand and adhere to the guidance provided by the Board. It’s also vital to ensure their knowledge and practice is current.

    9. Adhere to advertising requirements

    Ahpra’s expectations regarding advertising are explained in the Guidelines for Advertising Regulated Health Services document which can be found at ahpra.gov.au/Resources/Advertising-hub. There are numerous complaints continually being lodged with Ahpra alleging health professionals are breaching these guidelines. Dentists need to be aware these guidelines specify what’s required under the National Law and non-compliance is a criminal offence for which hefty fines can be imposed.

    10. Know and adhere to all Ahpra requirements

    As a health professional registered with Ahpra, it’s a dentist’s responsibility to make themself aware of what’s required. This means making the time to seek out and read the numerous codes and guidelines found on the Ahpra website (ahpra.gov.au). Some of these documents detail what’s considered best practice while some information refers to the law. Not knowing this information is no excuse for not adhering to it.

    Download PDF

    Guild Insurance Limited ABN 55 004 538 863, AFS Licence No. 233 791. Guild Insurance supports your Association through the payment of referral fees. This article contains information of a general nature only, and is not intended to constitute the provision of legal advice. For more information call 1800 810 213. DEN575825 Learnings from Dental Claims RA 05/2026

  • Maintaining personal and practice safety in podiatry

    All employers, business owners, contractors and employees have an obligation to create and maintain a safe working environment. And to do this, we all need to think about what makes our workplace unique in terms of the risks and the strategies needed to keep it safe.

    There are a few ways in which podiatry practices can pose risks to the personal safety of practitioners, other people who work there and patients. One-on-one consultations mean that the practitioner is always alone with a patient. Small practices can lead to practitioners being the only worker present in a clinic. And the varied hours of clinics will often see practitioners working late at night.

    Below are some tips to help you create a safe workplace for everyone who comes into your practice.

    • When booking in a new patient who you know nothing about, consider booking them in during a busy time of the day when there are other staff around, rather than when the practitioner will be in the practice alone.
    • If you have a patient who, for any reason, raises some red flags in terms of the practitioner’s comfort levels, only allow them to book in when there are others in the practice.
    • If a practitioner is practicing in the evening and is the only person working at that time, consider locking the front door to the practice. If you do this, explain to patients inside what you’re doing and why. And consider your process for other patients who’ll be arriving. Will you let them know the door will be locked and that they’re to wait outside until you’re ready for them? Maybe you’ll only lock the door once the final patient for the day has arrived.
    • Installing a buzzer on the front door notifies you when it’s been opened, thereby allowing you to be sure when people are entering your practice.
    • Consider installing a reception area camera and post clear signage so anyone who enters understands they’re being filmed and will be identifiable. Don’t use cameras in treatment rooms.
    • Consider walking patients and colleagues to their cars when it’s late, however be sure to consider your own safety when doing this. Provide patients with advice on safe places to park.
    • Always lock your car doors as soon as you get in, and keep in mind criminals can approach from varying angles, so they may be in your blind spot.
    • If the practice is in the home of the practitioner, have processes in place to separate the living space from the practice to protect the privacy and safety of the practitioner and their family members, especially children. And be aware, family members may also breach a patient’s privacy or modesty, so ensure everyone in your household understands the rules.
    • Keep records of any uncomfortable, challenging or threatening behaviours from patients, and be sure to save anything that’s received via text or email. This information is to be recorded in the patient record. The details on what occurred can be brief, but must be professional, keeping in mind records can be seen by others.
    • Don’t contact patients via your personal email or mobile phone or provide these details to them. If you need to contact them while off-site, put your phone on “No Caller ID” so they don’t have access to your phone number. If you leave a voicemail message, ask the patient to call the clinic phone, not your mobile.
    • Have a practice policy that advises against practitioners connecting with patients on social media as these connections can contribute to the blurring of professional boundaries. And be sure to understand the privacy settings of any social media platforms used.
    • Discuss any challenging or awkward situations with your colleagues or other healthcare professionals, while maintaining patient confidentiality. This not only provides support when dealing with challenging situations, it can also provide additional tips for how to manage these situations.

    It’s important to remember that workplace safety laws apply to everyone in the business, including contractors, not just the business owner. A safe work environment is in everyone’s best interest so open communication about any concerns is the best way to protect all staff members.

    Download PDF Here

  • Maintaining personal and practice safety in Chinese medicine

    All employers, business owners, contractors and employees have an obligation to create and maintain a safe working environment. And to do this, we all need to think about what makes our workplace unique in terms of the risks and the strategies needed to keep it safe.

    There are a few ways in which Chinese medicine and acupuncture practices can pose risks to the personal safety of practitioners, other people who work there and patients. One-on-one consultations mean that the practitioner is always alone with a patient. Small practices can lead to practitioners being the only worker present in a clinic. And the varied hours of clinics will often see practitioners working late at night.

    Below are some tips to help you create a safe workplace for everyone who comes into your practice.

    • When booking in a new patient who you know nothing about, consider booking them in during a busy time of the day when there are other staff around, rather than when the practitioner will be in the practice alone.
    • If you have a patient who, for any reason, raises some red flags in terms of the practitioner’s comfort levels, only allow them to book in when there are others in the practice.
    • If a practitioner is practicing in the evening and is the only person working at that time, consider locking the front door to the practice. If you do this, explain to patients inside what you’re doing and why. And consider your process for other patients who’ll be arriving. Will you let them know the door will be locked and that they’re to wait outside until you’re ready for them? Maybe you’ll only lock the door once the final patient for the day has arrived.
    • Installing a buzzer on the front door notifies you when it’s been opened, thereby allowing you to be sure when people are entering your practice.
    • Consider installing a reception area camera and post clear signage so anyone who enters understands they’re being filmed and will be identifiable. Don’t use cameras in treatment rooms.
    • Consider walking patients and colleagues to their cars when it’s late, however be sure to consider your own safety when doing this. Provide patients with advice on safe places to park.
    • Always lock your car doors as soon as you get in, and keep in mind criminals can approach from varying angles, so they may be in your blind spot.
    • If the practice is in the home of the practitioner, have processes in place to separate the living space from the practice to protect the privacy and safety of the practitioner and their family members, especially children. And be aware, family members may also breach a patient’s privacy or modesty, so ensure everyone in your household understands the rules.
    • Keep records of any uncomfortable, challenging or threatening behaviours from patients, and be sure to save anything that’s received via text or email. This information is to be recorded in the patient record. The details on what occurred can be brief, but must be professional, keeping in mind records can be seen by others.
    • Don’t contact patients via your personal email or mobile phone or provide these details to them. If you need to contact them while off-site, put your phone on “No Caller ID” so they don’t have access to your phone number. If you leave a voicemail message, ask the patient to call the clinic phone, not your mobile.
    • Have a practice policy that advises against practitioners connecting with patients on social media as these connections can contribute to the blurring of professional boundaries. And be sure to understand the privacy settings of any social media platforms used.
    • Discuss any challenging or awkward situations with your colleagues or other healthcare professionals, while maintaining patient confidentiality. This not only provides support when dealing with challenging situations, it can also provide additional tips for how to manage these situations.

    It’s important to remember that workplace safety laws apply to everyone in the business, including contractors, not just the business owner. A safe work environment is in everyone’s best interest so open communication about any concerns is the best way to protect all staff members.

    Download PDF Here

  • Why has my Chinese medicine practitioner touched me there?

    Guild Insurance sees numerous allegations against Chinese medicine practitioners and acupuncturists where the patient claims the practitioner has behaved in a sexually inappropriate manner during treatment.

    These claims may involve allegations regarding the way the practitioner has touched them, or they may relate to what’s been said during the consultation. These are incredibly serious allegations that cause a great deal of stress for both the practitioner and the patient.

    Case example 1

    The patient alleged that during treatment the practitioner moved and undid items of the patient’s clothing without the patient’s consent, leaving the patient feeling exposed and uncomfortable.

    Case example 2

    The patient complained about what they perceived to be excessive and unnecessary physical contact during treatment that left them feeling uncomfortable. The patient stated they’d received this type of treatment before and had never been touched in this manner.

    How can these allegations be avoided?

    Be mindful of patient clothing

    If treatment would be easier with the patient’s clothes removed or adjusted, this should be clearly explained to the patient, while seeking their consent. Being even partially undressed can leave patients feeling exposed and vulnerable. Adhere to the following tips regarding patients and their clothing:

    • Consider making patients aware prior to their appointment that they may be asked to remove or adjust clothing, if they’re comfortable doing so. This allows the patient to consider what clothing might be most suitable and practical to wear.
    • Be sure you explain to patients why you would like them to remove or adjust their clothing, keeping in mind it may not be obvious to them.
    • Provide the patient with clean towels and/or gowns to keep the parts of their body not being treated covered. These must be of a sufficient size to adequately cover all patients.
    • If moving or adjusting the patient’s clothing once treatment has begun, seek the patient’s consent first, and ensure you offer to re-position the clothes afterwards.
    • Be very clear about what you want patients to remove and what they should leave on. Simply asking them to undress is likely to cause confusion and apprehension.
    • Give patients privacy when undressing and dressing by either having a screen for them to go behind, or by leaving the room.
    • Remember that patients can decline to consent to adjusting or removing clothes; don’t assume they’re ok with it.

    Gender is irrelevant

    It’s easy to think that allegations of inappropriate touching are predominately issues when treating patients of the opposite gender. However, this isn’t the case. Regardless of the patient’s or your gender, there’s always a possibility for the patient to feel uncomfortable. The way you explain treatment to patients and seek their informed consent should not differ based on the patient’s gender.

    Informed consent

    All health professionals would be aware of their professional obligation to ensure a patient has given their informed consent prior to assessment and treatment beginning. For a patient to be able to give informed consent, they need to have had the assessment and treatment explained to them in a manner they understand. This means avoiding clinical language which may be confusing while providing the risks and benefits to what you’re proposing and allowing time for the patient to ask questions.

    When treatment involves touching the patient, it’s important to clearly explain to patients where you’re proposing to touch them, and why. It may even require you to demonstrate on yourself exactly where you’re referring to. Remember that in some cases you won’t directly touch the patient where they feel pain or discomfort, so the treatment area may not be obvious to them. Keep in mind that even after treatment has commenced, patients can withdraw consent at any time if they don’t feel comfortable.

    Record keeping

    Record keeping is a professional requirement which serves several purposes. Detailed and accurate clinical notes allow for continuity of patient care. They also provide evidence of what took place during a consultation, and why.

    If a patient alleges they’ve been touched inappropriately, the practitioner’s clinical record will be examined for evidence of what treatment was provided and the clinical justification for this. The clinical record should also contain evidence of the patient consenting to the treatment. Without this information in the clinical record, it becomes very difficult for the practitioner to defend their actions.

    Don’t make assumptions

    As with any professional, practitioners can become overly familiar with what they know and do every day. However, they must remember that patients won’t have that level of familiarity when it comes to treatment. Regardless of how many times a practitioner has treated a patient, they should never make assumptions about what the patient will understand about treatment, be comfortable with and be willing to consent to. Treatment always needs to be explained to patients, even if they’ve received that treatment before.

    Consider the patient’s demeanour

    While it isn’t expected that a practitioner can be sure of what a patient is thinking and feeling just by their body language, we all have some ability to gauge when a person is feeling uncomfortable with a situation. If you have a patient who appears to not be comfortable with the treatment being suggested or carried out, stop what you’re doing and assess the situation. You may need to further explain the treatment so it’s better understood. You may need to reposition clothing or gowns so the patient is more adequately covered. Or you may need to remind the patient that they don’t have to consent to treatment being proposed and discuss other treatment options. It’s also worth informing patients that they can bring a support person, such as a friend or relative, into the treatment room with them if that would make them feel more comfortable.

    Talking while treating

    Being a personable and friendly health professional can be beneficial in terms of building relationships with patients, but it can also have its downside. While having non-treatment related chats with a patient during treatment is acceptable, there will be occasions when the chatting should cease so further information about treatment can be discussed. It’s far too easy to forget what has and hasn’t been explained, and consented to, when continually chatting during treatment.

    Download PDF Here

  • Maintaining personal and practice safety in physiotherapy

    All employers, business owners, contractors and employees have an obligation to create and maintain a safe working environment. And to do this, we all need to think about what makes our workplace unique in terms of the risks and the strategies needed to keep it safe.

    There are a few ways in which physiotherapy practices can pose risks to the personal safety of practitioners, other people who work there and patients. One-on-one consultations mean that the practitioner is always alone with a patient. Small practices can lead to practitioners being the only worker present in a clinic. And the varied hours of clinics will often see practitioners working late at night.

    Below are some tips to help you create a safe workplace for everyone who comes into your practice.

    • When booking in a new patient who you know nothing about, consider booking them in during a busy time of the day when there are other staff around, rather than when the practitioner will be in the practice alone.
    • If you have a patient who, for any reason, raises some red flags in terms of the practitioner’s comfort levels, only allow them to book in when there are others in the practice.
    • If a practitioner is practicing in the evening and is the only person working at that time, consider locking the front door to the practice. If you do this, explain to patients inside what you’re doing and why. And consider your process for other patients who’ll be arriving. Will you let them know the door will be locked and that they’re to wait outside until you’re ready for them? Maybe you’ll only lock the door once the final patient for the day has arrived.
    • Installing a buzzer on the front door notifies you when it’s been opened, thereby allowing you to be sure when people are entering your practice.
    • Consider installing a reception area camera and post clear signage so anyone who enters understands they’re being filmed and will be identifiable. Don’t use cameras in treatment rooms.
    • Consider walking patients and colleagues to their cars when it’s late, however be sure to consider your own safety when doing this. Provide patients with advice on safe places to park.
    • Always lock your car doors as soon as you get in, and keep in mind criminals can approach from varying angles, so they may be in your blind spot.
    • If the practice is in the home of the practitioner, have processes in place to separate the living space from the practice to protect the privacy and safety of the practitioner and their family members, especially children. And be aware, family members may also breach a patient’s privacy or modesty, so ensure everyone in your household understands the rules.
    • Keep records of any uncomfortable, challenging or threatening behaviours from patients, and be sure to save anything that’s received via text or email. This information is to be recorded in the patient record. The details on what occurred can be brief, but must be professional, keeping in mind records can be seen by others.
    • Don’t contact patients via your personal email or mobile phone or provide these details to them. If you need to contact them while off-site, put your phone on “No Caller ID” so they don’t have access to your phone number. If you leave a voicemail message, ask the patient to call the clinic phone, not your mobile.
    • Have a practice policy that advises against practitioners connecting with patients on social media as these connections can contribute to the blurring of professional boundaries. And be sure to understand the privacy settings of any social media platforms used.
    • Discuss any challenging or awkward situations with your colleagues or other healthcare professionals, while maintaining patient confidentiality. This not only provides support when dealing with challenging situations, it can also provide additional tips for how to manage these situations.

    It’s important to remember that workplace safety laws apply to everyone in the business, including contractors, not just the business owner. A safe work environment is in everyone’s best interest so open communication about any concerns is the best way to protect all staff members.

    Download PDF Here

  • Maintaining personal and practice safety in natural therapy

    All employers, business owners, contractors and employees have an obligation to create and maintain a safe working environment. And to do this, we all need to think about what makes our workplace unique in terms of the risks and the strategies needed to keep it safe.

    There are a few ways in which natural therapy practices can pose risks to the personal safety of practitioners, other people who work there and patients. One-on-one consultations mean that the practitioner is always alone with a patient. Small practices can lead to practitioners being the only worker present in a clinic. And the varied hours of clinics will often see practitioners working late at night.

    Below are some tips to help you create a safe workplace for everyone who comes into your practice.

    • When booking in a new patient who you know nothing about, consider booking them in during a busy time of the day when there are other staff around, rather than when the practitioner will be in the practice alone.
    • If you have a patient who, for any reason, raises some red flags in terms of the practitioner’s comfort levels, only allow them to book in when there are others in the practice.
    • If a practitioner is practicing in the evening and is the only person working at that time, consider locking the front door to the practice. If you do this, explain to patients inside what you’re doing and why. And consider your process for other patients who’ll be arriving. Will you let them know the door will be locked and that they’re to wait outside until you’re ready for them? Maybe you’ll only lock the door once the final patient for the day has arrived.
    • Installing a buzzer on the front door notifies you when it’s been opened, thereby allowing you to be sure when people are entering your practice.
    • Consider installing a reception area camera and post clear signage so anyone who enters understands they’re being filmed and will be identifiable. Don’t use cameras in treatment rooms.
    • Consider walking patients and colleagues to their cars when it’s late, however be sure to consider your own safety when doing this. Provide patients with advice on safe places to park.
    • Always lock your car doors as soon as you get in, and keep in mind criminals can approach from varying angles, so they may be in your blind spot.
    • If the practice is in the home of the practitioner, have processes in place to separate the living space from the practice to protect the privacy and safety of the practitioner and their family members, especially children. And be aware, family members may also breach a patient’s privacy or modesty, so ensure everyone in your household understands the rules.
    • Keep records of any uncomfortable, challenging or threatening behaviours from patients, and be sure to save anything that’s received via text or email. This information is to be recorded in the patient record. The details on what occurred can be brief, but must be professional, keeping in mind records can be seen by others.
    • Don’t contact patients via your personal email or mobile phone or provide these details to them. If you need to contact them while off-site, put your phone on “No Caller ID” so they don’t have access to your phone number. If you leave a voicemail message, ask the patient to call the clinic phone, not your mobile.
    • Have a practice policy that advises against practitioners connecting with patients on social media as these connections can contribute to the blurring of professional boundaries. And be sure to understand the privacy settings of any social media platforms used.
    • Discuss any challenging or awkward situations with your colleagues or other healthcare professionals, while maintaining patient confidentiality. This not only provides support when dealing with challenging situations, it can also provide additional tips for how to manage these situations.

    It’s important to remember that workplace safety laws apply to everyone in the business, including contractors, not just the business owner. A safe work environment is in everyone’s best interest so open communication about any concerns is the best way to protect all staff members.

    Download PDF

  • You said what? Appropriate conversations in massage therapy

    Complaints of wrongdoing against massage therapists aren’t always about the treatment provided or the clinical outcome. Guild Insurance sees numerous cases annually which relate to professional behaviour and conduct. This sort of complaint may initially seem less serious than those relating to poor clinical outcomes, however, having your professional conduct questioned and issues raised about inappropriate behaviour towards clients can be incredibly distressing.

    Some of these professional conduct complaints relate to conversations, both during and outside of the treatment session. Once investigated, it’s usually found that the practitioner in no way intended to breach any professional boundaries or make the client feel uncomfortable. However, this is what’s occurred. The information below has been created to help massage therapists understand what they should be doing and saying differently to avoid facing complaints similar to the following examples.

    Examples of inappropriate conversations

    • A client complained alleging the practitioner made them feel uncomfortable by asking questions about them moving in with their partner. The practitioner claimed it was only intended to be a friendly chat during treatment, however the client felt judged when the practitioner made a comment about them living with their partner while not married.
    • A client complained of feeling uncomfortable as the practitioner lowered the client’s pants during treatment without consent. Following investigation, it was found the treatment provided and lowering the client’s pants was, in this instance, clinically justified. However, distracted by a chat they were having about weekend activities, the practitioner forgot to continually talk to the client about treatment and didn’t seek the client’s informed consent before moving their clothing.
    • A client complained about questions the practitioner asked about dating. The practitioner claimed the conversation was just intended as a friendly chat; however, the client felt the practitioner was trying to initiate an intimate relationship.

    Tips about professional conversations

    Don’t become too friendly with your clients.

    While it’s clinically beneficial to build a rapport with clients, professional boundaries need to be maintained. And this means there are conversations you would have with a friend or family member which you shouldn’t have with a client. Conversations should be had in a professional manner to avoid becoming too casual, relaxed, or jokey when talking to clients. Often comments made in light humour, or to build rapport, can lead to difficult situations and potentially embarrassing accusations. What may be funny to you may not be to someone else. The relationship with a client should always remain a professional one; keeping in mind the client is paying for a healthcare consultation, not a social conversation.

    Limit non-professional or non-treatment related conversations.

    These types of conversations can easily complicate and confuse a professional situation. When a practitioner asks personal questions of their client, this is most likely intended to just be a friendly chat. However, clients often report being confused and uncomfortable and don’t understand why they’re being asked questions not related to treatment. While some conversations may be fine, such as asking how a person’s weekend was, things can easily change when more questions are asked, such as about the partner they spent the weekend with.

    Explain to clients why questions are being asked.

    If you need to ask some personal or lifestyle questions to assist with history taking or to better understand an injury or pain, be careful to explain why you’re asking. This is particularly important when asking about partners, sexual activity, or sensitive body parts.

    Don’t forget to keep talking about treatment.

    When non-treatment related discussions are had, this detracts from time which should be spent discussing treatment. The discussion about treatment shouldn’t just be had at the beginning of the session, it’s an ongoing conversation throughout. Not only can chats about something other than treatment make a client feel uncomfortable, but they may also mean the client isn’t fully informed about their treatment.

    Consider the situation of the client during a conversation.

    During treatment, clients are often sitting or lying in positions which may make them feel vulnerable or exposed, particularly if they aren’t fully clothed. Personal conversations had during this time are likely to compound the uncomfortable feeling. It doesn’t mean to say that when the client is fully clothed sitting at your desk it will be okay to ask about a personal matter. However, keep in mind that a client could easily misinterpret the intentions behind your questions or conversation if they’re already feeling uneasy.

    Consider the method of communication.

    SMS, email, and other forms of electronic communication encourage brief messages and don’t often adequately convey the full intent or tone of the message. Therefore, if communicating in this way, practitioners need to be mindful that clients may easily misinterpret the message and make assumptions. Also, don’t forget that electronic communication, as with all communication with a client, needs to form part of the clinical record.

    Download PDF

  • You said what? Appropriate conversations in physiotherapy

    Complaints of wrongdoing against physiotherapists aren’t always about the treatment provided or the clinical outcome. Guild Insurance sees numerous cases annually which related to professional behaviour and conduct. This sort of complaint may initially seem less serious than those relating to poor clinical outcomes, however, having your professional conduct questioned and issues raised about inappropriate behaviour towards patients can be incredibly distressing.

    Some of these professional conduct complaints relate to conversations, both during and outside of the consultation. Once investigated, it’s usually found that the practitioner in no way intended to breach any professional boundaries or make the patient feel uncomfortable. However, this is what’s occurred. The information below has been created to help practitioners understand what they should be doing and saying differently to avoid facing complaints similar to the following examples.

    Examples of inappropriate conversations

    • A patient complained alleging the practitioner made them feel uncomfortable by asking questions about them moving in with their partner. The practitioner claimed it was only intended to be a friendly chat during treatment, however the patient felt judged when the practitioner made a comment about them living with their partner while not married.
    • A patient complained of feeling uncomfortable as the practitioner lowered the patient’s pants during treatment without consent. Following investigation, it was found the treatment provided and lowering the patient’s pants was, in this instance, clinically justified. However, distracted by a chat they were having about weekend activities, the practitioner forgot to continually talk to the patient about treatment and didn’t seek the patient’s informed consent before moving their clothing.
    • A patient complained about questions the practitioner asked about dating. The practitioner claimed the conversation was just intended as a friendly chat; however, the patient felt the practitioner was trying to initiate an intimate relationship.

    Tips about professional conversations

    Don’t become too friendly with your patients.

    While it’s clinically beneficial to build a rapport with patients, professional boundaries need to be maintained. And this means there are conversations you would have with a friend or family member that you shouldn’t have with a patient. Conversations should be had in a professional manner to avoid becoming too casual, relaxed, or jokey when talking to patients. Often comments made in light humour, or to build rapport, can lead to difficult situations and potentially embarrassing accusations or reputation damaging conditions on your registration. What may be funny to you may not be to someone else. The relationship with a patient should always remain a professional one; keeping in mind the patient is paying for a healthcare consultation, not a social conversation.

    Limit non-professional or non-treatment related conversations.

    These types of conversations can easily complicate and confuse a professional situation. When a practitioner asks personal questions of their patient, this is most likely intended to just be a friendly chat. However, patients often report being confused and uncomfortable and don’t understand why they’re being asked questions not related to treatment. While some conversations may be fine, such as asking how a person’s weekend was, things can easily change when more questions are asked, such as about the partner they spent the weekend with.

    Explain to patients why questions are being asked.

    If you need to ask some personal or lifestyle questions to assist with history taking or to better understand an injury or pain, be careful to explain why you’re asking. This is particularly important when asking about partners, sexual activity, or sensitive body parts.

    Don’t forget to keep talking about treatment.

    When non-treatment related discussions are had, this detracts from time that should be spent discussing treatment. The discussion about treatment shouldn’t just be had at the beginning of the consultation, it’s an ongoing conversation throughout. Not only can chats about something other than treatment make a patient feel uncomfortable, but they may also mean the patient isn’t fully informed about their treatment.

    Consider the situation of the patient during a conversation.

    During treatment, patients are often sitting or lying in positions which may make them feel vulnerable or exposed, particularly if they aren’t fully clothed. Personal conversations had during this time are likely to compound the uncomfortable feeling. It doesn’t mean to say that when the patient is fully clothed sitting at your desk it will be okay to ask about a personal matter. However, keep in mind that a patient could easily misinterpret the intentions behind your questions or conversation, if they’re already feeling uneasy.

    Consider the method of communication.

    SMS, email, and other forms of electronic communication encourage brief messages and don’t often adequately convey the full intent or tone of the message. Therefore, if communicating in this way, practitioners need to be mindful that patients may easily misinterpret the message and make assumptions. Also, don’t forget that electronic communication, as with all communication with a patient, needs to form part of the clinical record.

    Download PDF

    Physiotherapist working on patient
  • You said what? Appropriate conversations in Chinese medicine

    Complaints of wrongdoing against Chinese medicine practitioners and acupuncturists aren’t always about the treatment provided or the clinical outcome. Guild Insurance sees numerous cases annually which related to professional behaviour and conduct. This sort of complaint may initially seem less serious than those relating to poor clinical outcomes, however, having your professional conduct questioned and issues raised about inappropriate behaviour towards patients can be incredibly distressing.

    Some of these professional conduct complaints relate to conversations, both during and outside of the consultation. Once investigated, it’s usually found that the practitioner in no way intended to breach any professional boundaries or make the patient feel uncomfortable. However, this is what’s occurred. The information below has been created to help practitioners understand what they should be doing and saying differently to avoid facing complaints similar to the following examples.

    Examples of inappropriate conversations

    • A patient complained alleging the practitioner made them feel uncomfortable by asking questions about them moving in with their partner. The practitioner claimed it was only intended to be a friendly chat during treatment, however the patient felt judged when the practitioner made a comment about them living with their partner while not married.
    • A patient complained of feeling uncomfortable as the practitioner lowered the patient’s pants during treatment without consent. Following investigation, it was found the treatment provided and lowering the patient’s pants was, in this instance, clinically justified. However, distracted by a chat they were having about weekend activities, the practitioner forgot to continually talk to the patient about treatment and didn’t seek the patient’s informed consent before moving their clothing.
    • A patient complained about questions the practitioner asked about dating. The practitioner claimed the conversation was just intended as a friendly chat; however, the patient felt the practitioner was trying to initiate an intimate relationship.

    Tips about professional conversations

    Don’t become too friendly with your patients.

    While it’s clinically beneficial to build a rapport with patients, professional boundaries need to be maintained. And this means there are conversations you would have with a friend or family member that you shouldn’t have with a patient. Conversations should be had in a professional manner to avoid becoming too casual, relaxed, or jokey when talking to patients. Often comments made in light humour, or to build rapport, can lead to difficult situations and potentially embarrassing accusations or reputation damaging conditions on your registration. What may be funny to you may not be to someone else. The relationship with a patient should always remain a professional one; keeping in mind the patient is paying for a healthcare consultation, not a social conversation.

    Limit non-professional or non-treatment related conversations.

    These types of conversations can easily complicate and confuse a professional situation. When a practitioner asks personal questions of their patient, this is most likely intended to just be a friendly chat. However, patients often report being confused and uncomfortable and don’t understand why they’re being asked questions not related to treatment. While some conversations may be fine, such as asking how a person’s weekend was, things can easily change when more questions are asked, such as about the partner they spent the weekend with.

    Explain to patients why questions are being asked.

    If you need to ask some personal or lifestyle questions to assist with history taking or to better understand an injury or pain, be careful to explain why you’re asking. This is particularly important when asking about partners, sexual activity, or sensitive body parts.

    Don’t forget to keep talking about treatment.

    When non-treatment related discussions are had, this detracts from time that should be spent discussing treatment. The discussion about treatment shouldn’t just be had at the beginning of the consultation, it’s an ongoing conversation throughout. Not only can chats about something other than treatment make a patient feel uncomfortable, but they may also mean the patient isn’t fully informed about their treatment.

    Consider the situation of the patient during a conversation.

    During treatment, patients are often sitting or lying in positions which may make them feel vulnerable or exposed, particularly if they aren’t fully clothed. Personal conversations had during this time are likely to compound the uncomfortable feeling. It doesn’t mean to say that when the patient is fully clothed sitting at your desk it will be okay to ask about a personal matter. However, keep in mind that a patient could easily misinterpret the intentions behind your questions or conversation, if they’re already feeling uneasy.

    Consider the method of communication.

    SMS, email, and other forms of electronic communication encourage brief messages and don’t often adequately convey the full intent or tone of the message. Therefore, if communicating in this way, practitioners need to be mindful that patients may easily misinterpret the message and make assumptions. Also, don’t forget that electronic communication, as with all communication with a patient, needs to form part of the clinical record.

    Download PDF Here

  • Maintaining personal and practice safety in massage therapy

    All employers, business owners, contractors and employees have an obligation to create and maintain a safe working environment. And to do this, we all need to think about what makes our workplace unique in terms of the risks and the strategies needed to keep it safe.

    There are a few ways in which massage therapy practices can pose risks to the personal safety of practitioners, other people who work there and clients. One-on-one consultations mean that the practitioner is always alone with a client. Small practices can lead to practitioners being the only worker present in a clinic. And the varied hours of clinics often mean practitioners work late at night.

    Below are some tips to help you create a safe workplace for everyone who comes into your practice.

    • When booking in a new client who you know nothing about, consider booking them in during a busy time of the day when there are other staff around, rather than when the practitioner will be in the practice alone.
    • If you have a client who, for any reason, raises some red flags in terms of the practitioner’s comfort levels, only allow them to book in when there are others in the practice.
    • If a practitioner is practising in the evening and is the only person working at that time, consider locking the front door to the practice. If you do this, explain to clients inside what you’re doing and why. And consider your process for other clients who’ll be arriving. Will you let them know the door will be locked and that they’re to wait outside until you’re ready for them? Maybe you’ll only lock the door once the final client for the day has arrived.
    • Installing a buzzer on the front door notifies you when it’s been opened, thereby allowing you to be sure when people are entering your practice.
    • Consider installing a reception area camera and post clear signage so anyone who enters understands they’re being filmed and will be identifiable. Don’t use cameras in treatment rooms.
    • Consider walking clients and colleagues to their cars when it’s late, however be sure to consider your own safety when doing this. Provide clients with advice on safe places to park.
    • Always lock your car doors as soon as you get in, and keep in mind that criminals can approach from varying angles, so they may be in your blind spot.
    • If the practice is in the home of the practitioner, have processes in place to separate the living space from the practice to protect the privacy and safety of the practitioner and their family members, especially children. And be aware, family members may also breach a client’s privacy or modesty, so ensure everyone in your household understands the rules.
    • Keep records of any uncomfortable, challenging or threatening behaviours from clients, and be sure to save anything that’s received via text or email. This information is to be recorded in the client record. The details of what occurred can be brief yet must be professional, keeping in mind that records can be seen by others.
    • Don’t contact clients via your personal email or mobile phone or provide these details to them. If you need to contact them while off-site, put your phone on “No Caller ID” so they don’t have access to your phone number. If you leave a voicemail message, ask the client to call the clinic phone, not your mobile.
    • Have a practice policy that advises against practitioners connecting with clients on social media as these connections can contribute to the blurring of professional boundaries. And be sure to understand the privacy settings of any social media platforms used.
    • Discuss any challenging or awkward situations with your colleagues or other healthcare professionals, while maintaining client confidentiality. This not only provides support when dealing with challenging situations, it can also provide additional tips for how to manage these situations.

    It’s important to remember that workplace safety laws apply to everyone in the business, including contractors, not just the business owner. A safe work environment is in everyone’s best interest, so open communication about any concerns is the best way to protect all staff members.

  • Learnings from physiotherapy claims

    Guild Insurance regularly analyses claims and/or complaints relating to treatment provided by physiotherapists. This involves complaints made directly to the practitioner or practice, as well as complaints to a regulatory body, such as Ahpra. This analysis helps Guild better understand several key details such as:

    • what the complaint or allegation is about
    • the factors that may not be mentioned in the complaint, yet have contributed to the incident, and therefore the complaint occurring
    • what could have been done differently to possibly avoid the complaint from occurring

    This information is then used to develop risk messages for the profession, which include tips and strategies to reduce the likelihood of receiving complaints. It’s important to understand that risk management can’t guarantee that a poor outcome or complaint won’t ever occur. However, by adhering to the following messages, physiotherapists are taking positive steps to reduce the likelihood.

    Key risk messages

    1. Ensure you make communication a key feature of your work

    Guild’s claims analysis suggests that poor communication is a feature in almost all treatment-related complaints. Patients don’t often complain specifically about poor communication. However, when an incident is investigated, poor communication is quite often a factor. Practitioners must continually focus on their communication with patients, patient’s families where relevant, colleagues and other health professionals. Good clinical skills alone aren’t enough to make someone a safe and effective practitioner.

    2. Ensure there’s been an adequate assessment prior to treatment

    Assessment before treatment seems like an obvious step. However, it’s not uncommon to see claims where the assessment hasn’t been thorough enough, leading to treatment that’s inappropriate or ineffective. The assessment shouldn’t be rushed, and details of the assessment and findings are to be recorded in the clinical record. Practitioners must be sure not to make assumptions or fall into routine. Remember, poor assessment usually leads to poorly-selected treatment.

    3. Manage patient expectations

    It’s important that patients have realistic expectations regarding their likely treatment outcomes. Unrealistic expectations are rarely met. Unmet expectations will often lead to patients being dissatisfied with treatment and more likely to complain. It’s the responsibility of the practitioner to be sure a patient’s expectations are realistic before treatment begins. Practitioners must remember that in most cases, patients won’t have the clinical knowledge and understanding that they have. They should never assume a patient understands their treatment or what’s likely to happen post-treatment; there must be a conversation to ensure this understanding.

    4. Be sure patients have given their informed consent to treatment

    Patients must be given the opportunity to provide their informed consent to treatment before being treated. Informed consent requires a conversation between the treating practitioner and patient about recommended and alternate treatment options, as well as the benefits and risks for each of those options. Informed consent should include financial consent, which involves discussing the expected costs of treatment. Details about the consent discussion need to be recorded in the clinical record. Signing a generic form at reception prior to seeing the practitioner is not informed consent.

    5. Be mindful of treatment around sensitive areas

    Guild Insurance sees numerous claims each year where a patient has accused a practitioner of touching them inappropriately during treatment. In most of these cases, the treatment has been appropriate and clinically indicated. However, the practitioner’s communication about the treatment has been lacking, leaving the patient confused about where and how they’ve been treated and why. Never assume a patient’s understanding or comfort level. Be sure they understand the treatment and the reason for it before you proceed, particularly when treating around sensitive areas. It’s a practitioner’s responsibility to explain the treatment in simple, non-clinical language, so the patient understands. And be sure to always use appropriate coverings, such as towels, to ensure patient modesty is protected.

    6. Maintain adequate clinical records

    Clinical records are a practitioner’s history and evidence of what took place, and they serve numerous purposes. They assist with ongoing clinical care, as no practitioner can remember how they’ve treated every patient in every consultation. They also assist as evidence if a practitioner’s treatment is questioned by a patient, regulator, or private health insurer. And finally, they’re necessary for meeting the expectations of the Physiotherapy Board of Australia.

    7. Refer to another practitioner when required

    Physiotherapists play a key role in the Australian healthcare system; however, it’s important to remember that other health professionals do too. There’ll be occasions when a patient presents for treatment, but physiotherapy won’t be the most suitable treatment. Practitioners must recognise those occasions and be sure they refer those patients to the appropriate professional. Sometimes, the most appropriate treatment provided is no treatment at all.

    8. Don’t allow yourself to be coerced into doing things against your better judgment

    There’ll be occasions when a practitioner is asked to do something they don’t believe is in the patient’s best interests. This may be when a patient is asking for a particular type of treatment that isn’t clinically indicated. Or when a practitioner has decided against treating a patient, yet the patient insists on some form of treatment. Practitioners need to be sure they aren’t convinced to do something they don’t believe is appropriate. They must remember that they’re responsible for, and need to be able to justify, their clinical decisions and actions.

    9. Know and adhere to all Ahpra requirements

    As a health professional registered with Ahpra, it’s a physiotherapist’s responsibility to make themself aware of what’s required. This means making the time to seek out and read the numerous codes and guidelines found on the Ahpra website (ahpra.gov.au). Some of these documents detail what’s considered best practice while some information refers to the law. Not knowing this information is no excuse for not adhering to it.

    10. Adhere to advertising requirements

    Ahpra’s expectations regarding advertising are explained in the Guidelines for Advertising Regulated Health Services document which can be found at ahpra.gov.au/Resources/Advertising-hub. There are numerous complaints continually being lodged with Ahpra alleging health professionals are breaching these guidelines. Practitioners need to be aware these guidelines specify what’s required under the National Law and non-compliance is a criminal offence for which hefty fines can be imposed.

    Download PDF Here

  • Are you sure your professional indemnity insurance is current?

    While making your way through emails one evening, you come across one from Ahpra (Australian Health Practitioner Regulation Agency). It informs you that they’ve received a notification about you from one of your patients, alleging your treatment has caused harm. You’re shocked and confused; this has never happened to you before. You immediately notify Guild Insurance, knowing they’re there to support you during moments like this. However, the situation becomes more concerning when Guild informs you that your policy lapsed five months earlier.

    Could this happen to you? It’s easy to think not. However, Guild Insurance has noticed a worrying trend of practitioners failing to maintain instalment payments during the policy period, or to renew their policy.

    Ahpra’s registration standards

    Being covered by a professional indemnity insurance (PII) policy is a registration standard for all health professionals registered with Ahpra. This means that every practitioner must be covered by either their own PII policy or a third party arrangement. Section 129 of the Health Practitioner Regulation National Law states that:

    “A registered health practitioner must not practise the health profession in which the practitioner is registered unless appropriate professional indemnity insurance arrangements are in force in relation to the practitioner’s practice of the profession.”

    Section 130 of the National law details relevant events where, if they occur, a practitioner is required to notify their relevant Board within seven days after becoming aware of the event. PII arrangements no longer being in place is one of these events.

    It’s recommended that all practitioners review their Board’s Professional Indemnity Insurance Registration Standard which can be found on the Ahpra website: www.ahpra.gov.au.

    Implications of having no PII

    No cover for an investigation or complaint

    Most PII policies provide cover on a claims-made basis. This means that, regardless of when the alleged event occurs, if the practitioner doesn’t have a policy at the time they become aware of the complaint, they won’t be covered for that claim. Without a PII policy, the practitioner won’t have the support of a claims manager or lawyer, instead having to respond to the claim or complaint themselves, or pay a lawyer to do this for them. By not having a PII policy, this would also mean the practitioner has to self-fund any compensation payable to the patient, which can be quite costly.

    Breach of professional requirements

    As already mentioned, not being covered by a PII policy is a breach of Ahpra’s registration standards. Further to this, it can lead to practitioners making a false declaration at the time of registration renewal. At renewal, practitioners are asked to declare that they won’t practice without PII. If they continue practicing when there’s no longer a PII policy in place, this may mean they’ve made a false declaration. There are possible registration consequences for practicing without PII. This can include conditions placed on the registration, refusal of an application for registration renewal or suspension of registration.

    What can be done to prevent this?

    The team at Guild do all they can to make customers aware when their policy is due for renewal, or if the policy is going to be lapsed or cancelled due to non-payment of the premium. However, ultimately, the responsibility for maintaining PII cover sits with each individual practitioner.

    PolicyHub – Guild Insurance has an online self-service platform called PolicyHub where customers can access their insurance information. If you aren’t sure when you last paid your insurance premiums and you want to check when it’s due, logging onto PolicyHub is an easy way to keep yourself informed. This can be accessed via Guild’s website – guildinsurance.com.au/policyhub.

    Reliance on a third party – if a practitioner doesn’t hold their own PII policy and is instead covered by a third party’s policy (e.g. your employer’s), this doesn’t mean the practitioner isn’t responsible for ensuring they’re appropriately covered. Practitioners should discuss the policy with the third party to ensure, first and foremost, that they have a policy, but also that the level of cover is appropriate for the practitioner’s requirements.

    Set reminders – a common explanation for not maintaining insurance is that the practitioner has a poorly-managed inbox and doesn’t stay up-to-date with reading emails, meaning some are missed. If this might happen to you, think about how else you can be sure you won’t miss that renewal date. Setting a reminder in a calendar is one simple way to do this.

    Setting a reminder in your calendar is one simple way to help not miss your insurance renewal.

    Download PDF Here

    Don’t go it alone
    guildinsurance.com.au

  • Navigating locum veterinary work.

    As a locum, you essentially operate as a one-person veterinary practice; it’s your responsibility to be organised and set up to practice both legally and safely. With this in mind, here are some important tips for locums or vets considering becoming one.

    Ensure that you have the appropriate insurance

    If you’re employed by a veterinary practice and undertake independent locum work elsewhere for up to a maximum of 5 hours per week, you may find having your own professional indemnity insurance to be sufficient. But make sure to confirm in advance with clinics that their practice insurance will cover you.

    However, if you are engaged as an independent locum for more than 5 hours per week, or you run your own practice, you’ll also need appropriate insurance to ensure you’re covered.

    Understand state-specific registration requirements

    Before starting work in a new state or territory, verify that you hold all necessary registrations and licenses, including those related to radiation and microchipping.

    Create a standard contract

    Develop a contract that specifies your fees, obligations, responsibilities, and compensation terms.

    Don’t rely on verbal agreements

    Always request and keep a written record of the clinic’s agreement to the terms of your contract.

    Be adaptable

    No two clinics operate the same, so remember to keep an open mind and embrace challenges as learning opportunities.

    By keeping these tips in mind while considering locum work, you can set yourself up for success. For more risk management tips, visit guildinsurance.com.au/riskhq

    Managing your own insurance can be intimidating, but with Guild, you don’t have to go it alone. Call 1300 810 213 or visit guildne.ws/AVACGIL to discuss your insurance needs.

    Download PDF Here

  • Considerations for internal treatment

    Those familiar with the broad range of osteopathy treatment will understand that internal treatments (anal and vaginal) may be recognised aspects of osteopathy, when clinically indicated. However, this isn’t necessarily well known to the general population who make up your patients.

    Unfortunately, Guild Insurance has seen claims regarding internal treatment; these claims often feature allegations of treatment being inappropriate or unnecessary as well as allegations the patient has been sexually assaulted. These claims can have a devastating impact on both the patient and the osteopath.

    While the potential for a complaint may be less likely for practitioners or clinics with a particular focus on women’s health issues, it does exist for all osteopaths. Due to this risk, Osteopathy Australia and Guild Insurance believe that special consideration should be given to patient communication and clinical processes for prior assessment and treatment. Therefore, the following information has been created to provide you with an opportunity for reflection. If you respond to any of the statements with a no, this is an opportunity to consider changes to the way you practice.

    It’s important to note that the following statements aren’t regulatory requirements. Rather, they’re recommendations for consideration, based on complaints against osteopaths.

    Assessment/treatment consideration/planning

    Yes

    No

    I've undertaken what I consider to be appropriate training for internal treatment to ensure I'm skilled, competent and that it's within my scope of practice.

     

     

    Before proposing or providing internal assessment or treatment, I ensure it's clinically justified and appropriate for the patient, their condition and individual circumstances.

     

     

    I document my decision making and the clinical reasoning for proposed assessment and treatment options in the clinical record.

     

     

    I understand trauma-informed practice and apply this clinical reasoning when considering if an internal assessment or treatment is appropriate or not.

     

     

    I am aware of my own personal biases and limitations which could retraumatise a patient.

     

     

    Discussion with patient

    Yes

    No

    When proposing internal assessment and treatment to a patient, I'm mindful that patients may not be aware this is a recognised treatment within osteopathy, so I explain it accordingly.

     

     

    I have very detailed conversations about internal treatment due to the sensitive and uncommon nature of the treatment.

     

     

    I explain to patients the evidence-informed clinical reasoning for internal treatment, so they understand why it's being proposed.

     

     

    I don't use clinical language when discussing internal assessment and treatment with a patient to better help them understand.

     

     

    I utilise anatomical models and diagrams, that use plain English, to assist the patient to understand their anatomy and therefore the assessment and treatment being proposed.

     

     

    I explain the assessment and treatment in detail to allow the patient to give their informed consent - this conversation covers what both the assessment and treatment will entail, as well as the benefits and risks.

     

     

    I am fully aware of what informed consent entails.

     

     

    I inform patients that they can withdraw their consent at any time, including once assessment or treatment has commenced.

     

     

    I discuss with the patient the assessment and treatment options for them to consider so they know internal treatment isn't their first or only option. This includes providing an option of doing nothing (education only, no hands on at all) and the option to change their mind at any time.

     

     

    I understand that consenting once does not mean assumed consent for future internal assessments and treatment and future consultations will follow the same presentation of options and decision making for the patient.

     

     

    I ensure the patient is provided ample time to ask questions; both before and after assessment or treatment.

     

     

    I have written information available for patients to take away and read to support them to better consider and understand the assessment and treatment, and I record in the clinical record when this information is provided.

     

     

    I inform patients that they can choose to undergo this assessment and treatment with another osteopath, if they would prefer.

     

     

    All discussions regarding the proposed assessment and treatment, treatment options, the clinical reasoning for the treatment and the patient's questions are documented in the clinical record as evidence of what's been explained.

     

     

    Providing assessment/treatment

    Yes

    No

    An appropriate internal assessment is conducted prior to any internal treatment, with diagnosis and treatment plans clearly explained to the patient.

     

     

    If patients are unsure about the proposed assessment or treatment, they're given information to take away and consider, and are advised to book in later should they wish to proceed. I acknowledge that it won't always be appropriate to provide internal assessment or treatment at an initial appointment.

     

     

    I encourage patients to have a support person with them, should they choose. This may be someone they bring with them or someone from the clinic.

     

     

    I ensure the clinical record contains detailed information about the assessment performed and the treatment provided (if any), the patient's response to assessment and treatment and what education and management recommendations were provided.

     

     

    I maintain appropriate and professional conversation during treatment.

     

     

    I pay close attention to non-verbal cues like tension or discomfort and adjust the approach accordingly.

     

     

    I pay close attention to signs of patient dissociation or disconnection, cease assessment or treatment immediately if signs are noticed and follow this with appropriate discussion with patient.

     

     

    I have knowledge of, and apply infection control practices, including considerations in the patient history which could raise concerns for potential infection.

     

     

    I have knowledge of and apply appropriate hand hygiene practices.

     

     

    Patient positioning options are discussed for selection of a position they're most comfortable in for assessment and treatment.

     

     

    The patient is asked to remove or adjust only those clothes which is necessary for that assessment or treatment.

     

     

    I always provide the patient with a towel, sheet or gown for draping, so they're suitable covered.

     

     

    I only assist in the removal or adjustment of clothes if requested.

     

     

    I always leave the room while patients are undressing and redressing.

     

     

    Download PDF Here

    clinical-records
  • Clinical Records Checklist

    Maintaining appropriate and detailed clinical records is a core requirement for all health professionals. Unfortunately, when managing claims against health professionals, Guild Insurance sees too many cases where the records haven’t been kept to the standard expected. It’s the responsibility of all health professionals to make themselves familiar with their regulator’s codes and guidelines regarding record keeping as well as other areas of professional behaviour and conduct.

    Responding to the statements on this checklist will help you evaluate your record keeping practice. ‘No’ answers are opportunities for reflection on and improvement of your processes.

    Download PDF Here

  • Neurotoxins and Dermal Fillers in Dentistry

    The use of neurotoxins, such as Botox, and dermal fillers is on the rise in dental practice. Practitioners who are considering offering these treatments to patients should ensure they have a good grasp of their related professional obligations and are able to comply with all relevant laws.

    I’m thinking about doing a course to expand my scope – what do I need to know?

    First, practitioners must ensure they have taken out an appropriate professional indemnity insurance policy. This means being sure your policy will respond in the event of a treatment complication or adverse event arising. Guild Insurance’s professional indemnity policy has always covered dentists for claims related to the practice of dentistry within the practitioner’s scope of practice, including the use of neurotoxin and dermal fillers. Non-Guild members should consult their provider regarding the extent of their policy cover.

    Next, ensure you are familiar with all regulatory requirements. This means having a good understanding of the expectations of the Dental Board of Australia (DBA): The use of botulinum toxin and dermal fillers by dentists.

    The DBA expects dentists to practise in a manner that is consistent with:

    • The definition of dentistry:

      “Dentistry involves the assessment, prevention, diagnosis, advice, and treatment of any injuries, diseases, deficiencies, deformities or lesions on or of the human teeth, mouth or jaws or associated structures.”

    • The DBA’s Standards, Codes and Guidelines by:
      • Performing only those procedures that fall within their scope of practice; that is, procedures for which the practitioner has been educated and trained and is competent to provide.
      • Maintaining a high level of professional competence, including obtaining informed consent.

    The DBA expects dentists to adhere to all relevant state drugs and poisons legislation relating to the storage, use and supply of medicaments and by using scheduled medicines ‘for dental therapeutic use’ only. This means the prescription of medicaments must follow a dental diagnosis. It’s recommended that dentists clearly state their diagnosis and reason for prescription in the clinical record.

    The DBA expects dentists to refer patients:

    • When the treatment required by the patient is outside the personal scope of the individual dentist, but still within the definition of dentistry, to another dentist or dental specialist; or
    • When the proposed treatment is outside the definition of dentistry, to a medical practitioner.

    What does the “Practice of Dentistry” and “Associated Structures” mean?

    The definition of dentistry is designed to be flexible with advances in knowledge, materials, techniques and community views constantly evolving. Although the DBA does not define “associated structures”, it is expected that practitioners exercise their professional judgement as to which anatomical structures are included in their care.

    New Ahpra guidelines for cosmetic procedures

    The new Australian Health Practitioner Regulation Agency guidelines for practitioners performing non-surgical cosmetic procedures came into effect in September 2025. Ahpra has also developed additional resources to help practitioners comply with the guidelines, including FAQs, dos and don’ts and guidance on specifics such as patient assessment for Body Dysmorphic Disorder (BDD).

    The new guidelines require:

    • Patient welfare before profit.
    • Training and education to be completed before performing cosmetic procedures.
    • Better protection for younger Australians.
    • No more airbrushed photos or misleading advertising.

    Management of adverse events

    As with all clinical procedures, the application of neurotoxins and dermal fillers by dentists can include risks. Proper patient care requires dentists to be familiar with all common and easily resolved post-operative issues, such as redness, swelling and pain, in order to provide appropriate patient education, reassurance and support. Dentists engaging in advanced cosmetic treatments should also be familiar with the more serious or major complications, such as infection, stroke, blindness and scarring, which require prompt recognition and immediate medical management.

    Which is the correct item code for injection of botulinum toxin and dermal fillers?

    The Australian Dental Association (ADA) publication The Australian Schedule of Dental Services and Glossary – Thirteenth Edition includes the following relevant item codes and descriptors:

    • 929 – Provision of neuromodulator therapy #
      Injection of neuromodulators for the treatment of oral and maxillofacial diseases and disorders.
    • 987 – Recontour tissue – per appointment #
      Recontour of oral and associated tissue not described elsewhere in the Thirteenth Edition, such as the injection of dermal fillers.

    Will private health insurers pay a benefit for treatment that includes botulinum toxin and dermal fillers?

    Private health insurers have different rules and different policies when it comes to the treatments for which they will pay a benefit. Patients should be encouraged to contact their health fund to ascertain this information.

    Download PDF

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  • Nurturing minds: building mentally healthy workplaces in early learning services.

    Early learning educators play a pivotal role in the development and well-being of young minds. As you prioritise the mental health of the children in your care, it’s equally important to create an environment that supports the mental well-being of the dedicated educators in your service.

    Mental health is integral to overall well-being, and creating a mentally healthy workplace is crucial for the happiness, productivity, and job satisfaction of staff. A positive work environment not only benefits individuals but also enhances the quality of the service provided.

    Strategies for mentally healthy workplaces

    • Open communication: foster an environment where open communication is encouraged. Staff should feel comfortable discussing their concerns, ideas, and feelings with supervisors and colleagues.
    • Training and education: provide mental health training and resources to staff members. This includes workshops on stress management, coping strategies, and recognising signs of mental health issues. Check companies in your area that can provide this or access free resources from organisations such as SafeWork Australia, whose resources can be found at safeworkaustralia.gov.au/safety-topic/managing-health-and-safety/mental-health/resources
    • Work-life balance: encourage a healthy work-life balance by setting realistic expectations for work hours and breaks. Avoid overloading staff with excessive responsibilities.
    • Team building: promote a sense of camaraderie among staff through team-building activities and events. Strong interpersonal relationships contribute to a positive work atmosphere.
    • Recognition and appreciation: regularly acknowledge and appreciate the hard work and dedication of staff members. Recognition boosts morale and fosters a positive work culture.
    • Flexible schedules: offer flexible scheduling options when possible. This can help staff manage personal commitments and reduce stress associated with rigid work hours.
    • Mental health support services: provide access to mental health support services, such as counselling or employee assistance programs. Ensure that staff members know how to access these resources confidentially.
    • Training on child development and behaviour: equip staff with the knowledge and skills to understand and manage children’s behaviour effectively. This can reduce stress and frustration in the workplace. One option is to access the free resources available from ACECQA at acecqa.gov.au/resources/resource-finder
    • Designated break areas: create designated space where staff can relax and recharge during their breaks. These spaces should be comfortable and conducive to relaxation.
    • Conflict resolution procedures: establish clear procedures for resolving conflicts in the workplace. Encourage open communication and provide mediation services if needed.
    • Regular check-ins: conduct regular check-ins with staff members to gauge their well-being and address any concerns they may have.
    • Workplace surveys: periodically conduct surveys to assess the overall well-being and job satisfaction of staff. Use the feedback to make improvements to the work environment.
    • Mental health awareness: organise awareness activities to reduce the stigma associated with mental health. Provide educational materials and resources to promote understanding. One place to find this information is at ruok.org.au
    • Leadership support: demonstrate leadership support for mental health initiatives. Leaders should be approachable and actively participate in creating a positive workplace culture.

    Timely notification to our claims team
    Should an employee experience a mental health condition that may result in a workers compensation claim, it’s crucial to notify us as soon as possible at our website guildinsurance.com.au/claims/workers-compensation-claims. Early notification helps us provide prompt support and allows us to work with you to manage the claim efficiently, ensuring both your organisation and the employee receive the assistance needed.

    Information about your reporting obligations is available at sira.nsw.gov.au/workers-compensation/what-to-do-if-a-worker-is-injured

    In summary…
    Creating mentally healthy workplaces in early learning services is a shared responsibility that benefits staff and the children. By implementing these strategies, early learning services can cultivate environments that support the mental well-being of their dedicated staff, ultimately contributing to the overall success and quality of care provided to the children. Remember, a mentally healthy workplace is the foundation for nurturing both the minds of the staff and the young minds under their care.

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