Dear Colleagues,

Happy New Year.

I hope 2026 has begun with health and optimism for you, your teams, and your patients. For the Ontario Society of Chiropodists, the start of the year has been anything but slow. We have been deeply engaged in several important regulatory matters including the upcoming vote this Thursday on the revised Patient Relations Standard. Because this standard directly affects how every chiropodist interacts with patients, including expectations around communication, boundaries, documentation, and professional conduct, I want to ensure all practitioners (whether OSC members or not) understand what is happening and why it matters.

COCOO Patient Relations Standard

What Is the Patient Relations Standard?
The Patient Relations Standard outlines expectations for how chiropodists and podiatrists maintain professional boundaries, communicate with patients, and prevent misconduct or abuse. It is one of the most important standards in our regulatory framework because it shapes how everyday interactions are interpreted and how concerns or complaints may be assessed.

What Is Happening Now?
COCOO is currently reviewing all its standards. As part of this process, the Patient Relations Standard was updated to modernize language, remove redundancies, and expand expectations around communication, confidentiality, and boundaries.

Here is the timeline:
1. Draft Approved “In Principle” in October 2025 and was sent for a 60-day consultation

2. Consultation Feedback Submitted- feedback from registrants and stakeholders (including OSC’s detailed submission) is included in the Council meeting package.

3. Critical Issue
The version being recommended for approval does not incorporate any of the consultation feedback, including OSC’s recommendations.
Council is being asked to approve the same draft that was circulated months ago, without revisions based on practitioner input.

What Concerns Did OSC Raise?
OSC submitted a comprehensive, evidence‑based response identifying several areas where the draft standard may create confusion or unintended risk for practitioners.

Examples include:

• Ambiguous definitions

• Issue: The draft uses terms like personal relationship and dual relationship without defining them.
• Day‑to‑day impact: A chiropodist treating a neighbour, a parent from their child’s school, or someone they know casually from the community may be unsure whether this is allowed, requires disclosure, or could be viewed as a boundary concern.

• Overly broad prohibitions that could capture normal clinical interactions

• Issue: The draft does not distinguish between normal rapport‑building and boundary‑crossing behaviour.
• Day‑to‑day impact:
  Simple gestures — such as offering a compliment, acknowledging a patient’s milestone, or engaging in brief personal conversation could be interpreted inconsistently.

• Unclear documentation expectations

• Issue: The draft suggests documenting certain interactions but does not specify when documentation is required or what level of detail is expected.
• Day‑to‑day impact:
  If a patient shares personal information casually, expresses emotion, or discloses something unrelated to treatment, practitioners may be unsure whether this must be documented — increasing administrative burden and inconsistency.

• Trauma‑informed language needing refinement

• Issue: Some sections use clinical or punitive language rather than supportive, trauma-informed phrasing.
• Day-to-day impact: Practitioners may feel uncertain about how to respond to patient disclosures or emotional reactions in a way that aligns with the standard’s expectations.

• Disproportionate Impact on Small, Rural, and Culturally Diverse Practices

Practitioners, particularly those practicing in small or rural communities may face unavoidable overlapping relationships that are difficult to interpret under undefined terms like “personal relationship” or “dual relationship.” Solo practitioners may struggle to meet expectations that assume multiple staff. Those serving culturally diverse communities may be more vulnerable to misinterpretation under subjective language such as “may be perceived” as inappropriate. Without clearer definitions and context‑sensitive guidance, the standard may create uneven risk exposure across the profession, particularly for small clinics, community‑based practices, and those working with culturally diverse or marginalized populations.

These concerns are not theoretical. They affect how practitioners navigate everyday interactions and how the College may interpret conduct in the future.

OSC’s Role and Our Spirit of Partnership
OSC approached this consultation in a spirit of partnership with COCOO. Our submission was designed to be constructive, practical, and aligned with regulatory best practices across Ontario. Our goal has always been to support a Patient Relations Standard that protects the public while remaining clear, fair, and workable for practitioners.

Ontario has seen similar challenges before. When the College of Physicians and Surgeons of Ontario revised its own patient‑relations expectations several years ago, the initial draft was later withdrawn and rewritten after feedback revealed concerns about clarity and proportionality. That experience demonstrated the importance of incorporating stakeholder input before final approval.
COCOO now has the same opportunity to strengthen the Patient Relations Standard by integrating the feedback it has received.

To Our Current Members of OSC
Thank you. Your membership makes this advocacy possible. Every submission, every meeting, and every consultation response is strengthened by your support.

To Practitioners Who Are Not Yet Members
If you have been following this process from a distance, I encourage you to consider joining OSC now.

Moments like this when standards are being shaped and decisions are being made that directly affect your practice are exactly why a strong, unified professional association matters.

Membership is an investment in:

• A clearer, fairer regulatory landscape
• A stronger professional voice
• Better tools and supports for your practice
• A community committed to excellence in patient care

Your participation strengthens our ability to advocate effectively on behalf of the profession.

Looking Ahead
Regardless of Thursday’s outcome, OSC will continue working collaboratively with the College to ensure that standards reflect both patient safety and the realities of clinical practice. We remain committed to advocating for transparency, fairness, and regulatory modernization, and to supporting every chiropodist in Ontario through clear communication, practical resources, and a unified professional voice.

With appreciation for your dedication and with a shared commitment to strengthening our profession,

Sasha Kozera‑Faye, B.Sc., D.Ch.
Chiropodist
Interim President
Ontario Society of Chiropodists