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Toni Talks about PT Today

We Must Be Professionals

Published June 11, 2009 10:30 AM by Toni Patt
I learned something interesting today. Only APTA members are bound by its Code of Conduct and Code of Ethics. No disciplinary action can be taken against a non-member for violation of either code. That made me sit back and think. Just about every conversation I've had on those topics centers on what the APTA has determined as the gold standard. When debating if a behavior is ethical the Code of Ethics posted on the APTA website is always used. In Texas we must take 2 CEU hours of ethics that are based on the APTA Code of Ethics. I don't know the exact numbers but I'm certain the majority of therapists in Texas aren't APTA members.

One could argue that ethics are universal and based on common sense. Everyone should have an idea of what is ethical and what isn't.   Physical Therapists learn what is ethical during their training. They are taught to behave ethically. The same argument can be made for the Code of Conduct. PTs are taught that in school.  They know they must abide by it. The APTA also has a section describing professional behavior. It is based on the Codes of Ethics and Conduct. Until recently, when I researched it for class, I didn't know it existed.  I'm probably not the only one.

I accept the argument that PTs learn ethical behavior. I also accept that they learn how to conduct themselves for the most part. Obviously no one will harm a patient. When providing treatment a PT decides on the best available treatment.  Things start getting a little fuzzy when we get to appropriate charging, altruism and social issues.  In Texas we charge in 15 minute units based on the 8 minute rule.  Anything treatment greater than 8 minutes is counted as an additional unit.  I'm sure that gets fudged occasionally.  I'm also sure there are those who consistently round their units up to look more productive.  I worked with an OT who did. She would indicate she did 40+ units in an 8 hours day.  That's just not possible.

Altruism refers to putting the pt. first.  I can't count the number of PTs who put themselves first.  They schedule times based on their convenience not the pt's.  They do the same thing with everyone no matter what.  I worked with a PT who was salaried.  He never worked a full 8 hour day in the year I worked with him.  He arrived late.  Usually left early and always managed to get a full hour for lunch.  He never offered to help anyone.  He never took a patient that wasn't on "his floor".  He considered himself a good, patient oriented therapist.  He's not alone.  Granted things aren't black and white, but the majority of the time should fall in favor of the patient.

What I find sad is that the very therapists I'm describing wouldn't see the problem if they read those documents.  It wouldn't strike them that their behavior is unprofessional to say the least.  They're worse than those who refuse to accept evidence based practice.  At least those therapists are trying to do the best for the patient.   I admit I make mistakes sometimes.  Everyone does. The difference is I don't make those mistakes intentionally and always try to correct them in the future.

Professional behavior is becoming more and more important.  PTs want to be taken seriously.   Vision 2020 states the DPT is equivalent to an MD, DVT, etc.  The APTA has run into a lot of trouble trying to get that point across.  One reason is the lack of professional behavior by some therapists.  I work with many residents.  I see what gets beaten into their heads.  They are taught professional behavior and responsibility from the beginning.  Until PTs consistently demonstrate the same level of professionalism the DPT won't be taken as seriously.  There's a big difference between developing a friendly relationship with a patient and being unprofessional.  A therapist who is only concerned with how many units she can generate in one day isn't acting in a professional manner. Neither is a therapist who skips a beneficial treatment because he would actually have to put his hands on a patient. 

 We all know these people. Nothing will change until they realize their behaviors are unacceptable. I consider everyone I work with to be professional. If I saw something I didn't like they would list to my concern and possibly correct the behavior.  Someone who doesn't care will not listen to my opinion much less change a behavior. Since we can't change them we have to change the environment by modeling what is acceptable and what isn't. That might make a difference. It might not. What it will do is demonstrate professionalism on a larger scale so that others will take us seriously.

All three documents I mentioned can be found at http://www.apta.org/.  Go to the main page and type the document title in the search box.

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