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Physical therapists (PTs) have a broad scope of practice treating across all organ systems, and patients are seen by physical therapists across the entire lifespan. Physical therapist assistants (PTAs) have an equally broad scope of work. In addition, the venues in which physical therapy is delivered are only limited by the imagination. PTs and PTAs practice in traditional settings such as hospitals and private practices and less traditional settings such as industry and the space program. Regardless of setting the responsibilities of the physical therapist are guided by the standards of the profession such as the Code of Ethics and the Guide to Ethical Conduct. Practice settings are not necessarily subject to professional standards, but PTs and PTAs that practice in those settings are most definitely subject to professional guidance and this guidance goes across all practice settings. The PT and the PTA ultimately hold the license and have the professional responsibility to uphold the integrity of that license. They may find themselves working in an environment that challenges their professional values and integrity. They ultimately have to determine if they can work in that environment and maintain their integrity or they must seek to effect change to make it possible to remain or they must consider the professional guidance in Principle 7 that cautions against remaining in a setting that prevents a physical therapist from fulfilling professional obligations to patients/clients.
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Case 7 CAN YOU “SEE” ME NOW?
Workplace dictating a service delivery model
Advances in technology are changing the face of healthcare, but there are limits to what it can achieve—particularly if it is applied inappropriately. Consider this scenario, in which a physical therapist (PT) is asked to do something he strongly feels is ethically and clinically wrong.
Sam has been a PT for more than 30 years, practicing in a variety of settings. Two months ago, when he moved from the East Coast to live closer to his aging mother and father, he signed on at a private practice named Active Corps. There, he has enjoyed the patients, his work, and his colleagues—with one exception. His supervisor, Becky, who is not a PT, often gives him a hard time for what she calls his “old-school” ways, and sometimes questions whether he’s a “team player.”
As Sam sees it, “old-school” means “slow” and sometimes “less-profitable” to Becky, whereas it means “cautious,” “deliberate,” and “patient-centered” to him. He thinks of himself as a team player—with the patient at quarterback, as the reason that the team exists. In most contexts, Sam takes pride in being called old-school. But Becky clearly ...