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
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. 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
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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
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
Issues in Professionalism
• Who is unprofessional?
• Who is being judged?
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7 Core Values
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Accountability
Altruism
Integrity
Compassion/Caring
Professional Duty
Excellence
Social Responsibility
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
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
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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 therapist’s self interest. Altruism
• Placing patient’s 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 Compassion/Caring
• Compassion is the desire to identify with or sense something of another’s 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 patient’s 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 one’s social, cultural, gender, and sexual biases
Compassion/Caring con’t
• Embracing the patient’s emotional and psychological aspects of care
• Attending to the patient’s personal needs and comforts
• Demonstrating respect for others and considers others as unique and of value
Excellence
• Excellence is physical therapy practice that consistently uses current knowledge and theory while understanding personal limits, integrates judgment and the patient’s perspective, challenges mediocrity, and works toward development of new knowledge
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Excellence
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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
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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 one’s professional career
Sharing one’s knowledge with others
Contributing to the development and shaping of excellence in all professional roles
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
Integrity
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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
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Taking responsibility to be an integral part in the continuing management of patients
Knowing one’s limitations and acting accordingly
Confronting harassment and bias among ourselves and others
Recognizing the limits of one’s 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 6
Professional Duty
• Professional duty is the commitment to meeting one’s obligations to provide effective physical therapy services to individuals patients, to serve the profession, and to positively influence the health of society
Professional Duty
• Demonstrating beneficence by providing optimal care
• Facilitating each individual’s 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 one’s profession
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
Social Responsibility
• Participating in achievement of societal health goals
• Understanding of current community wide, nationwide, and worldwide issues and how they impact society’s 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
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
– Don’t “should” all over yourself (Could)
– Someone can’t “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 don’t value the patient’s time or the time the other staff loses wondering if you are coming or when and how to reach you
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 person’s point of view
• Present suggested solutions
• Achieve consensus on solution
• Share responsibility in managing outcomes
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
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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
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
HIPAA and Communication
• Do not discuss patients even away from the clinical setting using any identifying information
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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
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
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
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