Messages an osteopath sent to a client "frequently discussed personal and sexual matters", according to a Health and Disability Commission decision. File photo. Photo: 123rf.com
An osteopath who exchanged hundreds of personal messages with a client - some of an explicit sexual nature - has been found by the Health and Disability Commission to have crossed professional boundaries.
In a decision released today, Deputy Health and Disability Commissioner Dr Vanessa Caldwell found the osteopath - who had recently arrived in New Zealand when he began treating the woman - had breached the Code of Health and Disability Services Consumers' Rights.
The case will now be referred up for consideration if further action is warranted.
Caldwell said the osteopath's conduct, specifically sending inappropriate text and social media message communications, providing a free service at the woman's home, conducting longer appointments than necessary, and kissing her following an appointment, breached professional boundaries. She was also critical of the osteopath's standard of documentation.
She did not accept the osteopath's explanation that their communication never went beyond a friendly level, as the content of the messages "frequently discussed personal and sexual matters".
Caldwell said the commission had previously stated that an inherent power imbalance exists between a consumer and a healthcare provider and trust was fundamental to the relationship Trust was fundamental to the relationship, to ensure the consumer could be assured that the provider was acting with the consumer's best interests in mind.
"It is critical that relationships between health professionals and their clients stay within the professional realm, to avoid any exploitation or abuse of power."
Personal text messages, a home visit and allegations of assault
The woman had suffered an injury in June 2021 and had problems with chronic pain that led her to seek treatment from an osteopath.
She had weekly treatments from in the second half of 2021, which she attended with her young child. For the first year, the woman had no concerns about the osteopath's behaviour.
The appointments were initially in the morning, but came to be scheduled for the end of the day, so the osteopath could offer her longer treatments.
He said the woman's health issues were complex and she would often open up to him about her past and the issues she was facing. The treatment time was often extended as the standard allocation of 30 minutes was not adequate.
About a year after the first appointment, the osteopath contacted the woman directly by text message and the two became friends on social media.
The messages were initially about the osteopathy treatments, but then began to canvas personal and sexual matters.
In one, the osteopath asked the woman about sex, to which she replied "any sexual behaviour was reserved for her future husband".
She said he also offered her free treatments at home, which she declined, until she sought a urgent appointment due to chronic pain and asked to be put on the osteopath's cancellation list, after which he offered to visit her at home.
The woman continued to visit the clinic until an appointment in June 2023, when she said the man indecently assaulted her. She said she asked him to stop touching her inappropriately, but he continued to do so before realising she was not interested and the normal treatment resumed.
That October, she made a complaint to police setting out the allegations of indecent assault during the home visit and her final treatment at the clinic. The osteopath denied indecently assaulting the woman.
He left New Zealand in November 2023 after he was contacted by police and has not returned.
The osteopath accepted the messages he exchanged with the woman were inappropriate, that it was unprofessional for him to have provided her with free treatment at her home and that such behaviour contravened professional boundaries, and that in doing so, he breached the Code of Health and Disability Services Consumers' Rights.
Follow up actions
Caldwell made two adverse comments - that the osteopath had disclosed the personal information of other clients in sharing screenshots of his appointment calendar with the woman, which breached their privacy and that the clinic took no action after being advised of the allegations and the HDC complaint in October 2023; and that the osteopath continued to practise until he left New Zealand the following month.
The matter has now been referred to the Director of Proceedings to decide if any further action is warranted.
The osteopath told the HDC he had engaged two mentors to provide support and guidance in his osteopathy practice and was also undertaking appropriate continuing education courses in respect of ethics and professional boundaries.
Caldwell also recommended the osteopath return to New Zealand to work and that the Osteopathic Council of New Zealand undertake a competence assessment of him.
She also recommended the clinic develop a policy that outlines steps to be taken when a patient makes a complaint about staff with a copy of the policy to be sent to HDC within six months.
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