Professionalism in Physical Therapy

1
Professionalism in Physical Therapy

• Tara Jo Manal PT, DPT, OCS, SCS
• Director of Clinical Services
• Director of Orthopedic Residency
• University of Delaware
• Department of Physical Therapy

2
What makes a job a Profession?

• A professional body, (Law, Accountancy, Medicine
  etc)controls the entry qualifications of
  applicants, their training, sets the examinations
  they must pass before being accepted as a member,
  ensures that members comply with appropriate
  professional standards whilst a member, and may
  disqualify a member by removing him/her as a
  practitioner, and ensures that members continue
  with ongoing professional training to ensure that
  they are kept up to date. A member of such an
  organization could be regarded as a true
  professional.

3
Wikipedia def.

• A profession is an occupation, vocation or career
  where specialized knowledge of a subject, field,
  or science is applied.1 It is usually applied
  to occupations that involve prolonged academic
  training and a formal qualification. It is
  axiomatic that "professional activity involves
  systematic knowledge and proficiency."2
  Professions are usually regulated by professional
  bodies that may set examinations of competence,
  act as a licensing authority for practitioners,
  and enforce adherence to an ethical code of
  practice.

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Characteristics of a Profession

• Skill based on theoretical knowledge
• Professional association
• Extensive period of education
• Testing of competence
• Institutional training
• Licenced practitioners
• Work autonomy
• Code of professional conduct or ethics
• Self-regulation
• Public service and altruism

• Exclusion, monopoly and legal recognition
• Control of remuneration and advertising
• High status and rewards
• Individual clients
• Middle-class occupations
• Offer reassurance
• Legitimacy
• Inaccessible body of knowledge
• Indeterminacy of knowledge
• Mobility

5
Vision 2020

• Doctor of Physical Therapy
• Evidence Based Practice
• Autonomous Based Practice
• Direct Access
• Practitioner of Choice
• Professionalism

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Need for Professionalism

• At all times you are being judged by someone
• Need to create a positive experience for the
  consumers of physical therapy
• Scenario

7
Issues in Professionalism

• Who is unprofessional?
• Who is being judged?

8
7 Core Values

• Accountability
• Altruism
• Integrity
• Compassion/Caring
• Professional Duty
• Excellence
• Social Responsibility

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Accountability

• Acceptance of Responsibility for the diverse
  roles, obligations, and actions of the physical
  therapist including self regulation of other
  behaviors that positively influence patient
  outcomes, the profession and the health needs of
  society

10
Accountability

• Responding to Patient goals
• Seeking feedback from multiple sources
• Acknowledging and accepting consequences of
  actions
• Adhering to code of ethics, standards of practice
  and policies/procedures in health care
• Communicating accurately to others (payors,
  patients, other providers re profession)

• Participating in health goals of patients and
  society
• Seeking continuous improvement in quality of care
• APTA membership and other organizations
• Educating Students to facilitate the pursuit of
  learning

11
Altruism

• Altruism is the primary regard for or devotion to
  the interest of patients, thus assuming the
  fiduciary responsibility of placing the needs of
  the patient ahead of the physical therapists
  self interest.

12
Altruism

• Placing patients needs above the physical
  therapists
• Providing pro-bono services
• Providing physical therapy services to
  underserved and underrepresented populations
• Providing patient services that go beyond
  expected standards of practice
• Completing patient care and professional
  responsibility prior to personal needs

13
Compassion/Caring

• Compassion is the desire to identify with or
  sense something of anothers experience a
  precursor of caring.
• Caring is the concern, empathy, and consideration
  for the needs and values of others

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Compassion/Caring

• Understanding the socio-cultural, economic, and
  psychosocial influences on the individuals life
  in their environment
• Understanding an individuals perspective
• Being an advocate for patients needs
• Communicating effectively, both verbally and
  non-verbally with others taking into
  consideration individual differences in learning
  styles, language, and cognitive abilities, etc.

• Designing patient programs that are congruent
  with patient needs
• Empowering patients to achieve the highest level
  of function possible and to exercise
  self-determination in their care
• Focusing on achieving the greatest well-being and
  the highest potential for a patient
• Recognizing and refraining from acting on ones
  social, cultural, gender, and sexual biases

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Compassion/Caring cont

• Embracing the patients emotional and
  psychological aspects of care
• Attending to the patients personal needs and
  comforts
• Demonstrating respect for others and considers
  others as unique and of value

16
Excellence

• Excellence is physical therapy practice that
  consistently uses current knowledge and theory
  while understanding personal limits, integrates
  judgment and the patients perspective,
  challenges mediocrity, and works toward
  development of new knowledge

17
Excellence

• Demonstrating investment in the profession of
  physical therapy
• Internalizing the importance of using multiple
  sources of evidence to support professional
  practice and decisions
• Participating in integrative and collaborative
  practice to promote high quality health and
  educational outcomes
• Conveying intellectual humility in professional
  and personal situations
• Using evidence consistently to support
  professional decisions

• Demonstrating high levels of knowledge and skill
  in all aspects of the profession
• Demonstrating a tolerance for ambiguity
• Pursuing new evidence to expand knowledge
• Engaging in acquisition of new knowledge
  throughout ones professional career
• Sharing ones knowledge with others
• Contributing to the development and shaping of
  excellence in all professional roles

18
Integrity

• Integrity is the steadfast adherence to high
  ethical principles or professional standards
  truthfulness, fairness, doing what you say you
  will do, and speaking forth about why you do
  what you do

19
Integrity

• Abiding by the rules, regulations, and laws
  applicable to the profession
• Adhering to the highest standards of the
  profession (practice, ethics, reimbursement,
  Institutional Review Board IRB, honor code)
• Articulating and internalizing stated ideals and
  professional values
• Using power (including avoidance of use of
  unearned privilege) judiciously
• Resolving dilemmas with respect to a consistent
  set of core values
• Being trustworthy

• Taking responsibility to be an integral part in
  the continuing management of patients
• Knowing ones limitations and acting accordingly
• Confronting harassment and bias among ourselves
  and others
• Recognizing the limits of ones expertise and
  making referrals appropriately
• Choosing employment situations that are congruent
  with practice values and professional ethical
  standards
• Acting on the basis of professional values even
  when the results of the behavior may place
  oneself at risk

20
Professional Duty

• Professional duty is the commitment to meeting
  ones obligations to provide effective physical
  therapy services to individuals patients, to
  serve the profession, and to positively influence
  the health of society

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Professional Duty

• Demonstrating beneficence by providing optimal
  care
• Facilitating each individuals achievement of
  goals for function, health, and wellness
• Preserving the safety, security and
  confidentiality of individuals in all
  professional contexts

• Involved in professional activities beyond the
  practice setting
• Promoting the profession of physical therapy
• Mentoring others to realize their potential
• Taking pride in ones profession

22
Social Responsibility

• Social responsibility is the promotion of a
  mutual trust between the profession and the
  larger public that necessitates responding to
  societal needs for health and wellness

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Social Responsibility

• Advocating for the health and wellness needs of
  society including access to health care and
  physical therapy services
• Promoting cultural competence within the
  profession and the larger public
• Promoting social policy that effects function,
  healthy, and wellness needs of patients

• Ensuring that existing social policy is in the
  best interest of the patient
• Advocating for changes in laws, regulations,
  standards, and guidelines that affect physical
  therapy service provision
• Promoting community volunteerism
• Participating in political activism

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Social Responsibility

• Participating in achievement of societal health
  goals
• Understanding of current community wide,
  nationwide, and worldwide issues and how they
  impact societys health and well-being and the
  delivery of physical therapy
• Providing leadership in the community
• Participating in collaborative relationships with
  other health practitioners and the public at
  large
• Ensuring the blending of social justice and
  economic efficiency of services

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How to Communicate Professionally

• At all times you are being judged by someone
• Put nothing in e-mail, voicemail, text, writing,
  etc. that you do not want to see on the front
  page of the paper
• Choose your words carefullly

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How to Communicate Professionally

• Simple rules
• Dont should all over yourself (Could)
• Someone cant make you
• You make me so frustrated
• When you , I feel statements
• When you forget the instructions I just gave you,
  I feel frustrated
• Never assume
• When you come late to clinic, it appears you
  dont value the patients time or the time the
  other staff loses wondering if you are coming or
  when and how to reach you

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Negotiation Guidelines

• Express feeling with I messages
• Balance compliments and constructive criticism
• Allow time for other person to respond
• Show mutual respect with body language and
  positive regard

• State perceived problem clearly with examples
• Request other persons point of view
• Present suggested solutions
• Achieve consensus on solution
• Share responsibility in managing outcomes

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Medical Communication

• Treat each opportunity to communicate as
  professional
• Written communication to other health care
  providers
• Home programs
• Messages
• Charts!

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E-mail Guidelines

• Spell check
• Use punctuation
• Create paragraphs and structure
• Be concise but clear
• Need response or action by a specific date
• Consider the value of replying in-line with
  previous communications
• Evaluate your signature line, wallpaper, links
  and quotes for consideration in professional
  communication

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Cell Phone Guidelines

• Never take a personal mobile call during business
  activity
• Keep a 10 foot zone in public areas related to
  work
• No loud or annoying ring tones

• Warn callers you are on a mobile so they can
  anticipate distractions or disconnections
• Keep cell calls brief and to the point
• Use earpieces if you are too loud

NO CELL PHONES IN THE CLINIC- EVER
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HIPAA and Communication

• Do not discuss patients even away from the
  clinical setting using any identifying
  information

32
APTA Conference Etiquette

• Dress
• Business casual for attendance
• Business dressy for presentations
• Minimums
• Follow cell phone guidelines
• If cell does not have vibrate- turn it off

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APTA Conference Etiquette

• Meeting types
• Educational sessions
• Longer and larger objectives
• Platforms
• 15 minute
• Clustered by topic
• Research, innovation, cases
• Posters
• Free to wander at will
• Scheduled time for presenters to be there for
  questions

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APTA Conference Etiquette

• Scheduling your day
• Prepare ahead by reviewing the registration
  material
• It is acceptable to quietly leave a session and
  go to another session at will
• Plan ahead if you can an try to sit in areas that
  allow for mobility
• Arrive early for popular sessions, they can be
  closed due to large numbers
• If a session is closed and you are on-time- they
  will offer you a free audio of the session instead

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APTA Conference Etiquette

• Practice critical thinking
• Relate new information to information you have
  learned
• If information contradicts information you have
  read or been taught recheck your original
  information, ask for clarification during the
  talk, or seek out the appropriate professor for a
  discussion
• Seek more information on the topic