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3/18/2016APTA Guide for Conduct of thePhysical Therapist AssistantDeveloped by the APTA Ethics & Judicial Committeeas a companion document to the Standards of EthicalConduct for the PTA to: Serve PTAs in interpreting the Standards of EthicalConduct for the Physical Therapist Assistant inmatters of professional conduct Provide a framework to determine the propriety ofconduct Guide the professional development of PTA studentsPrinciple 1 & Standard 1Ways we show dignity and respect include: Recognizing our biases Acting respectfully regardless of age, gender,race, nationality, religion, ethnicity ,social oreconomic status, sexual orientation, healthcondition or disability.Principle 2 & Standard 2A physical therapist and physical therapistassistant shall be trustworthy and compassionatein addressing the rights and needs ofpatients/clients.Core Values: Altruism, Compassion, andProfessional DutyPrinciple 1 & Standard 1A physical therapist and physical therapistassistant shall respect the inherent dignity andrights of all individualsCore Values: Compassion and IntegrityPrinciple 1 & Standard 1The Bottom Line:Do your best to keep your personalbiases from affecting patient/clientcarePrinciple 2 & Standard 2Ways we demonstrate trustworthiness andcompassion Providing information in order to make informeddecisions Collaborating to empower patients/clients Providing services that incorporate individualand cultural differences Protecting patient confidentiality9

3/18/2016Principle 2 & Standard 2The Bottom Line:Empower patient autonomy byproviding collaborative andconfidential informationPrinciple 3 & Standard 3Principle 3 - Physical therapists shall be accountablefor making sound professional judgmentsStandard 3 - Physical therapist assistants shall makesound decisions in collaboration with the physicaltherapist and within the boundaries established bylaws and regulations.Core Values: Excellence and IntegrityPrinciple 3 & Standard 3Ways we demonstrate accountability Using objective information and evidence(literature & best practice) Judgments based on scope of practice,competency & expertisePrinciple 3 & Standard 3The Bottom Line:Use of evidence and collaboration withothers to make decisions in thepatient’s best interest Avoiding conflicts of interest Communicating effectively with othersPrinciple 4 & Standard 4Principle 4 & Standard 4A physical therapist and physical therapistassistant shall demonstrate integrity in theirrelationships with patients/clients, families,colleagues, students, other healthcare providers,employers, payers and the public.Ways we demonstrate integrity in relationships Ensure completely truthful information Do not exploit individuals over whom you haveauthority Discourage & report misconduct or abuseCore Value: Integrity Do not engage in sexual relationships withpatients/clients, supervisees or students Avoid verbal, physical, emotional or sexualharassment10

3/18/2016Principle 4 & Standard 4The Bottom Line:Protect vulnerable individuals fromharmful or potentially harmfulbehaviorsPrinciple 5 & Standard 5Ways we demonstrate legal and professionalobligations Comply with laws and regulations Recognize and respect supervisory roles andresponsibilities Protect research participantsPrinciple 5 & Standard 5The Bottom Line:Responsibilities may extend beyondwhat is required by the practice actinto the moral realm to protectpatients, colleagues and societyPrinciple 5 & Standard 5A physical therapist and physical therapistassistant shall fulfill their legal and professionalobligationsCore Values: Professional Duty andAccountabilityPrinciple 5 & Standard 5Ways we demonstrate legal and professionalobligations Report colleagues who are unable to performprofessional responsibilities skillfully and safely Do not abandon patients; provide notice andinformation about alternative care prior todischargePrinciple 6 & Standard 6Principle 6 - Physical therapists shall enhance theirexpertise through lifelong and refinement ofknowledge, skills, and professional behaviorsStandard 6 - Physical therapist assistants shallenhance their competence through the lifelongacquisition and refinement of knowledge, skills andabilities.Core Value: Excellence11

3/18/2016Principle 6 & Standard 6Ways we demonstrate excellence Maintain competence PT shall engage in critical self assessment andreflection on changes in PT practice Engage in lifelong learningPrinciple 6 & Standard 6The Bottom Line:Stay current in knowledge and skills tosupport patient/client care Cultivate and support practice environmentsthat foster professional developmentPrinciple 7 & Standard 7Physical therapists and physical therapistassistants shall promote organizational behaviorsand business practices that benefitpatients/clients and societyCore Values: Integrity and AccountabilityPrinciple 7 & Standard 7Ways we promote beneficial organizationalbehaviors/business practices Promoting and supporting practice environmentsthat encourage autonomous and accountableprofessional judgments Seek deserved and reasonable remuneration Do not accept gifts that appear to influenceprofessional judgmentPrinciple 7 & Standard 7Ways we promote beneficial organizationalbehaviors/business practicesPrinciple 7 & Standard 7The Bottom Line: Fully disclose any financial interests in productsor services recommended to clients Accurate and reflective documentation, codingand charges Refrain from employment arrangements thatAccept responsibility for all actions:support full disclosure; avoidemployment relationships that preventfulfilling responsibilities to patientsprevent fulfilling professional obligations12

3/18/2016Principle 8 & Standard 8A physical therapist and physical therapistassistant shall participate in efforts to meet thehealth needs of people locally, nationally, orglobally.Principle 8 & Standard 8Ways we demonstrate participation Support provision of pro bono services Advocate to reduce health disparities andimprove access to care Avoid over-utilization or under-utilization ofCore Value: Social Responsibilityphysical therapy services Provide public education about the benefits ofphysical therapy and the unique roles of thephysical therapistPrinciple 8 & Standard 8Moral DiscourseThe Bottom Line: Identify and discuss ethical values, differences inPromote services to individuals whoseaccess to healthcare is limited;promote responsible use of physicaltherapy services; educate publicregarding the value of physical therapyCommunication Tips Keep an open mind Accept and understand differences When in doubt, check it out Take the time to talk about talking Create an environment where people feelsafe sharing ideas/opinionsopinion, potential dilemmas and options for actionwith your colleagues, employers, administrators,physicians and others Differences in opinion don’t necessarily mean youare facing an ethical dilemmaReview of Ethical Analysis Gather all the facts Define the situation Who has an interest Identify values andobligations Review alternatives Consider theconsequences Make a decision Carry out the plan Evaluate theprocess Learn for the future13

3/18/2016Discussion of Ethical SituationsPTs and PTAs May FaceCase Discussion Realm(s) – individual, organizational, orsocietal – that are involved Which type of ethical situation is involved –conflict, dilemma, distress, temptation, silence Which PT Principle(s) and/or PTA Standard(s)relates to or assists with options for the case Core values and bioethical principles relevantto the case Offer several options or resolutions to the caseCase Discussion Appoint a spokesperson to give a 2 minutesummary of the case on the itemsdiscussed After reviewing the assigned case, move onto the next one as time permitsCase 2Sara works in a private practice in which there is a profitsharing plan. Her year-end bonus is directly related tomaximizing return visits as they are the most costeffective. Her boss has been heard to say to other staffmembers that they should treat patients to the maximumof their benefits; after all, you can always change thegoals so there is more therapy to do – it just requiresbeing a little creative. She has also been heard toencourage therapists to discontinue treatment early forthose patients with poor reimbursement. Sara isuncomfortable with this situation but is counting on heryear-end bonus.Case 1Rob, a morbidly obese disabled veteran, arrived at anoutpatient clinic, requesting PT services. His doctorreferred him to this clinic because of their greatreputation. Mary, a PT, working in the gym saw Robwalking into the clinic. She called the front deskrequesting they not assign her the patient. The patientwas scheduled two days later for another PT. Ellen, aPTA who works with Mary, overheard the conversationrequesting that the patient not be assigned to her. Ellenknows that Mary is a fitness fanatic and has heard hermake derogatory comments about people who areoverweight. Ellen feels very uncomfortable about thissituation and wonders if she should do anything.Case 3The PT Director of an outpatient clinic is attracted to astaff PTA. The PT and PTA are both married and workon a team treating patients together and typically cotreat the patients. They are observed in the clinicwhispering, flirting, and touching each other at varioustimes throughout the day. The PT and PTA teamcontinued throughout the year working together andmany of their coworkers have talked with each otherabout their displeasure working in the currentenvironment. Mark, a senior staff therapist is a goodfriend of the director and has been silent about thesituation so far. However, the discontent of the staff isincreasing and he wonders if he should do something.14

3/18/2016Case 4Case 5Jim, a PT, works at a private practice that hasa number of clinics throughout the region. Ithas a centralized management structure.One of the top managers calls Jim and askshim to call a previously scheduled new patientto re-schedule an initial evaluation since aVIP/shareholder has been referred to theclinic wants to be seen as soon as possible.Jim is uncomfortable with this request.Lauren, a PT, is the only witness to a patientfall in the clinic gym. The patient has balanceproblems and the PTA, Hal, working with herwas not guarding her. Lauren observes Halplace a gait belt on the patient after the falland before calling for assistance. Lauren isunsure what to do about this situation.Case 6Drew works for a national contract therapycompany and is currently working in a SNFand likes the patient population. He has apatient who is progressing well, but has notyet met all of her goals. Management ispressuring Drew to discharge the patient tohome prior to the time he feels discharge isappropriate. Drew is uncertain what to doabout this situation.How to Report Ethical ProblemsTennessee Department of Health nst-health-care-professionals Complete the downloadable form and submit You may call 1-800-852-2187 for additionalinstructionsHow to Report Ethical Problems TPTA – If the individual is a TPTA member: File a signed, written complaint with the TPTAPresident The president, in collaboration with the ChapterEthics Committee chair, will determine if thecomplaint has merit Complaints with merit are referred to the EthicsCommittee for investigationPost-test The TPTA president notifies APTA of thecomplaint15

PROFESSIONALISM IN PHYSICAL THERAPY:CORE VALUESSELF-ASSESSMENTAmerican Physical Therapy AssociationDepartment of Physical Therapy Education1111 North Fairfax StreetAlexandria, Virginia 22314Copyright 2013 American Physical Therapy Association.Educational institutions may convert this document to online formats without prior permission, but the copyright statement must remain on thedocument. For non-educational use, changes, alterations, commercial use, or CEU course use, written approval from APTA is required. Contactpermissions@apta.org for one of these uses.

2PROFESSIONALISM IN PHYSICAL THERAPY: CORE VALUESIntroductionIn 2000, the House of Delegates adopted Vision 2020 and the Strategic Plan for Transitioning to A Doctoring Profession (RC 37-01). The Planincludes six elements: Doctor of Physical Therapy, Evidenced-based Practice, Autonomous Practice, Direct Access, Practitioner of Choice, andProfessionalism, and describes how these elements relate to and interface with the vision of a doctoring profession. In assisting the professionin its transition to a doctoring profession, it seemed that one of the initiatives that would be beneficial was to define and describe the concept ofprofessionalism by explicitly articulating what the graduate of a physical therapist program ought to demonstrate with respect toprofessionalism. In addition, as a byproduct of this work, it was believed that practitioner behaviors could be articulated that would describewhat the individual practitioner would be doing in their daily practice that would reflect professionalism.As a part of the preparation for this consensus conference, relevant literature was reviewed to facilitate the development of the conferencestructure and consensus decision-making process. Literature in medicine3, 18, 19, 25, 27 reveals that this profession continues to be challenged todefine professionalism, describe how it is taught, and determine how it can be measured in medical education. The groundwork and advancesthat medicine laid was most informative to the process and product from this conference. Physical therapy acknowledges and is thankful formedicine’s research efforts in professionalism and for their work that guided this conference’s structure and process.Eighteen physical therapists, based on their expertise in physical therapist practice, education, and research, were invited to participate in aconsensus-based conference convened by APTA’s Education Division on July 19-21, 2002. The conference was convened for the purpose of:1) Developing a comprehensive consensus-based document on Professionalism that would be integrated into A Normative Model ofPhysical Therapist Professional Education, Version 2004 to include a) core values of the profession, b) indicators (judgments,decisions, attitudes, and behaviors) that are fully consistent with the core values, and c) a professional education matrix that includeseducational outcomes, examples of Terminal Behavioral Objectives, and examples of Instructional Objectives for the classroom andfor clinical practice.2) Developing outcome strategies for the promotion and implementation of the supplement content in education and, where feasible, withpractice in ways that are consistent with physical therapy as a doctoring profession.The documentation developed as a result of this conference is currently being integrated into the next version of A Normative Model of PhysicalTherapist Professional Education: Version 2004. The table that follows is a synopsis of a portion of the conference documentation thatdescribes what the physical therapist would be doing in his or her practice that would give evidence of professionalism.In August 2003, Professionalism in Physical Therapy: Core Values was reviewed by the APTA Board of Directors and adopted as a coredocument on professionalism in physical therapy practice, education, and research. (V-10; 8/03)We wish to gratefully acknowledge the efforts of those participants who gave their time and energies to this challenging initiative; a first step inclearly articulating for the physical therapist what are the core values that define professionalism and how that concept would translate intoprofessional education.

3USING THE SELF-ASSESSMENTThe Self-Assessment that follows is intended for the user to develop an awareness about the core values and to self-assess the frequency withwhich he or she demonstrates the seven core values based on sample indicators (behaviors not intended to be an exhaustive list) that describewhat the practitioner would be doing in daily practice. These seven core values were identified during the consensus-based conference thatfurther defined the critical elements that comprise professionalism. Core values are listed in alphabetical order with no preference or rankinggiven to these values. During the conference many important values were identified as part of professionalism in physical therapy, howevernot all were determined to be core (at the very essence; essential) of professionalism and unique to physical therapy. The seven valuesidentified were of sufficient breadth and depth to incorporate the many values and attributes that are part of professionalism.For each identified core value, (ie, accountability, altruism, compassion/caring, excellence, integrity, professional duty, andsocial responsibility) a definition and sample indicators (not intended to be exhaustive) are provided that describe what the physical therapistwould be doing in practice, education, and/or research if these core values were present.Complete the Self-AssessmentReview each core value indicator and check the frequency with which you display that sample indicator in your daily practice based on therating scale provided (1-5). It is not expected that one will rate himself or herself as 5 (always) or 1 (never) on every item. Be candid in yourresponse as this is a self-assessment process with an opportunity for personal learning and insight, identification of areas of strength andgrowth, and assessment of your development in the professionalism maturation process.Analyze the Completed Self-AssessmentOnce you have completed the Self-Assessment, you may want to reflect as an individual or group on the following questions: On what sample indicators did you or the group consistently score yourself/themselves on the scale at the 4 or 5 levels? Why did you or the group rate yourself/themselves higher in frequency for demonstrating these sample behaviors? On what sample indicators did you or the group score yourself/themselves on the scale at level 3 or below? Why did you or the group rate yourself/themselves lower in frequency for demonstrating these sample

The Code of Ethics for the Physical Therapist and the Standards of Ethical Conduct for the Physical Therapist Assistant are reprinted with permission of the American Physical Therapy Association. This material is copyrighted, an