Guide for Conduct of the PTA
I am going to pick on the APTA for this session. I rarely question the APTA and I am not a member of the organization so I can do this with an "outsider's" point of view. In November 2010, a guide for conduct of the PTA was issued by the Ethics and Judicial Committee. I read it then but decided not to question some of the standards; today is different. I may paraphrase or abbreviate for space but the essence of what the APTA conveys is here.
Altruism, 2A. PTAs shall act in the best interest of patients/clients over the interest of the PTA. The example used for this was when a patient comes in 15 minutes late and the PTA may have to stay later than the scheduled hours. Fine, no problem; however, the APTA does not pay my salary and if my boss says no overtime without prior approval, there is no overtime if I am unable to get approval. Where is the patient/client responsibility to me as a health professional? My time with my family is more valuable than anything else in the world.
Reporting, 4C. PTAs shall discourage misconduct by health care professionals and report illegal or unethical acts to the relevant authority, when appropriate. When clarifying this, the APTA went on to say "... keep in mind not all allegedly illegal or unethical acts should be reported immediately to an agency/authority." I believe being a mandated reporter supersedes the clarifying point. If my supervisor is the one who is inappropriate (allegedly), then I should be obligated to report the behavior to an agency and allow the authority to determine ethics.
Colleague Impairment, 5E. PTAs who have knowledge that a colleague is unable to perform his professional responsibility with reasonable skill and safety shall report this information to the appropriate authority. This, along with 5D, discusses colleagues' physical, psychological or substance-related impairments that could affect their responsibilities. I am encouraged to report a colleague if he may be impaired but not if he might be unethical or doing something illegal. I find contradiction in this.
Clinical Competence, 6A. PTAs shall achieve and maintain clinical competence. I think the APTA forgot to check with the rules and regulations with all 50 states. Some states have no regulations stating therapists have to attend CEUs, and when looking at violations of practice acts, there are more PTs in violation of their respective state acts than PTAs.
Support - Health Needs, 8A. PTAs shall support organizations that meet the health needs of people who are economically disadvantaged and underinsured. In the clarifying point, to achieve this I can have conversations with colleagues about the work but I am not allowed to actually do anything because I must "comply with applicable laws and be under the direction and supervision of a PT." As we read in an earlier blog by me, this is not always possible when trying to help another person.
Also, it is easy to throw money at non-profits or send equipment to other countries for their health needs. When one actually assists with the feeding of homeless folks more than once a year, or consistently volunteers their time week after week in the United States, then a better perspective on health care needs can be affirmed for us. I could go on about being underinsured and the cost of services because I deal with it frequently with my children. Maybe the APTA will pay my bill the next time my child sees the neurologist and has an EEG. Or maybe they will simply have a conversation about it and call it good.