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Professionals are granted the privilege of monitoring themselves. This is in exchange for the safe and effective administering of the duties and responsibilities that are inherent in the care of patients. Self-monitoring is not just the responsibility of the regulatory authority; it is a duty every licensee has. Most physical therapy practice acts have within them a “duty to report.” Our code of ethics also addresses this requirement to self-regulate Stating in principles 5D and 5E the requirement to assist colleagues with any type of impairment that impacts patient care and if necessary contact authorities. So why is this particular responsibility so difficult for licensees to actually “do”? As a close knit professional community it is hard to report a colleague. Many of us are raised “not to tattle,” but the stakes in those childhood encounters are significantly less than the stakes we now encounter with the central focus on the well-being of the patient. The way to report is not restricted to just one specific manner. The act that is of concern must be evaluated to determine the root cause so those observing the behaviors can determine the best way to address the problem. A physical therapist (PT) or physical therapist assistant (PTA) with substandard skills raises different concerns than the clinician who has a substance abuse problem or some cognition issues. There are several reasons why self-regulation is so important. The origin of the concept is based on trust. Our actions based on the foundational ethical principles demonstrate respect for the patient (autonomy), we promise to use our knowledge and skills to “do good” for the patient (beneficience) and we promise not harm our patients (non maleficence), we ensure patients they can rely on us, we are honest (veracity) and finally we treat all entrusted to our care fairly (Justice). We further promise not to harm a patient (non-maleficence) and we ensure patients that we are honest (veracity) and will treat all entrusted to our care fairly (justice). This relationship is built and sustained on trust. The trust given to us to “keep our own house in order” is what we have to keep in mind when confronted with practitioners who have negated this trust in some way.

Each of the cases presented in this section speaks in a different way regarding the duty to report requirement.

Cases in this section:

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Who Are You? Responsibility to report
Where Is the Evidence? Exceeding responsibility
An Education on Staff Behavior Stopping poor practice

Case 16 WHO ARE YOU?

Responsibility to report

A physical therapist (PT) develops a personal relationship not just with the patient but with the family as well. This relationship is built on trust. When there is a minor or adult who is not competently involved, this relationship becomes more complicated.

Sarah is a PT. She works in an outpatient pediatric ...

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