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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 that in Principles 5D and 5E, there is the requirement to provide assistance 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. Reporting is not restricted to one way in which to report. 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. We say to the public through our principle-based ethical actions, we demonstrate respect for the patient (autonomy) we promise to use our knowledge and skills to do good for the patient (beneficence). 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

Independent or set adrift?

Responsibility to know your practice requirements.

Case Example 21 Who are You?

Responsibility to report

A physical therapist (PT) develops a personal relationship not just with the patient but with the family. 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 clinic and loves the opportunities she has to really get to know her patients and their families. Her caseload includes the children she sees at home through early ...

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