The Identification of Ethical Issues in Physical Therapy Practice

Triezenberg, Herman L

doi:10.1093/ptj/76.10.1097

Cited by 54 publications

(33 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Through their scope-of-practice guidelines, many states have granted therapists autonomy of practice or role release to evaluate patients and/or initiate and provide therapy services without physician authorization. [55][56][57][58][59][60][61][62][63][64][65][66][67][68] However, it should be noted that state and federal regulations and third-party payers frequently mandate a physician's signature on prescriptions and treatment plans. If physicians sign off on prescriptions or plans without proper review or supervision, then they should be aware that they could be held legally responsible if adverse events, such as injuries, occur or if fraudulent practices, such as delivery of unauthorized or improper services, take place.…”

Section: Physician's Role In School-based Teamsmentioning

confidence: 99%

“…In the educational setting, therapists may be considered "service providers," a category that may include a number of NPHCPs. Articles on interdisciplinary teams produced by therapists [45][46][47][48][49][50][51][55][56][57][58][59][60][63][64][65][66][67][91][92][93][94][95][96] seem to recognize physicians as team members less frequently than those produced by physicians. 1,2, It has been suggested that physicians who assert their role in therapy and e620…”

Section: Physician's Role In Team Participationmentioning

confidence: 99%

See 1 more Smart Citation

Policy Versus Practice: Comparison of Prescribing Therapy and Durable Medical Equipment in Medical and Educational Settings

Sneed

May

Stencel³

2004

Pediatrics

View full text Add to dashboard Cite

ABSTRACT. Objective. The American Academy of Pediatrics (AAP) has promoted pediatrician involvement in the care of children with special health care needs (CSHCN), including the prescription and/or supervision of therapies and durable medical equipment (DME) for children in both medical and educational settings, such as schools and early intervention programs. Through this survey, we attempted to quantify objectively how pediatricians direct and coordinate therapy and DME for CSHCN and how these efforts correlate with AAP recommendations.Methods. A survey was mailed to a random sample of 500 physicians listed in the AAP directory, resulting in a final sample of 217 responding physicians who indicated that they provide services to CSHCN. Results of the survey were reported as proportions, means with standard deviations, or medians with interquartile range. Comparisons of proportions among certain subgroups of interest were made using Fisher exact tests.Results. The most recent AAP policy revision addressing the role of physicians in prescribing therapy services for children with motor disabilities appeared in Pediatrics 1996. It listed 6 key items that should be part of a therapy prescription: diagnosis, precautions, type, frequency, anticipated goals (educators may prefer the term "objectives"), and duration. The policy addressed and emphasized the need for what may be additional objectives, namely regular communication between all parties involved, ongoing supervision and reevaluation of the program and problem, and awareness of other community resources for possible referrals. Except for providing a diagnosis, the majority of surveyed pediatricians do not regularly comply with AAP policy recommendations on prescribing therapies and DME in medical and educational settings. Physicians who were trained before 1980 tend to follow AAP recommendations more closely than later graduates. Decreasing involvement of private outpatient pediatricians in coordinating and supervising CSHCNs care was noted. Furthermore, the majority is willing to defer decisions about treatment and goals to nonphysician health care providers (NPHCPs) and, in some cases, even equipment vendors. More than two thirds of the respondents indicated that they would sign a prescription for therapy without their previous initiation if it had been initiated by a therapist. Likewise, most respondents said that they would sign a wheelchair prescription sent to them by a therapist. Few expressed confidence in determining the appropriateness of leg brace (orthosis) prescriptions and arm/hand brace prescriptions. The majority of survey participants said that they give open-ended length of time (no limits under 1 year) on prescriptions for therapy services as part of school-based programs. However, patients' conditions and their therapeutic or equipment needs may change during the school year. Because open-ended prescriptions do not require periodic renewal, they do not provide opportunities for periodic feedback that helps to ensure that the pediatrician is...

show abstract

Section: Physician's Role In School-based Teamsmentioning

confidence: 99%

Section: Physician's Role In Team Participationmentioning

confidence: 99%

Policy Versus Practice: Comparison of Prescribing Therapy and Durable Medical Equipment in Medical and Educational Settings

Sneed

May

Stencel³

2004

Pediatrics

View full text Add to dashboard Cite

show abstract

“…[1][2][3] Physiotherapists are routinely involved in making ethically significant decisions, including those relating to service access and usage that emerge from stretched financial and human resources, heightened demand, and increased public expectations. [4][5][6][7] As the Canadian population ages, and life expectancy and the prevalence of chronic diseases increase, the need for physiotherapy will also grow. Faced with limited human and financial resources, publicly funded physiotherapy outpatient departments in Canada are required to prioritize patients for care.…”

mentioning

confidence: 99%

Patient Prioritization Preferences among Physiotherapy Entry-Level Students: The Importance of Chronic Pain

Laliberté

Feldman

2013

Physiotherapy Canada

View full text Add to dashboard Cite

Purpose: To investigate physiotherapy entry-level students' preferences in prioritizing patients, specifically, patients with chronic pain. Methods: After a group discussion, 249 Canadian entry-level physiotherapy students completed a questionnaire that used five distinct scenarios (fictitious patient cases). Respondents were asked to prioritize the patients (P1 ¼ highest priority, P5 ¼ lowest priority). Results: Physiotherapy students accorded the highest priority to the patient with chronic pain and the post-surgical patients; the elderly patient and the patient with cognitive impairment were given low priority. Conclusions: A diagnosis of chronic pain is given the highest level of priority by physiotherapy students. The literature shows, however, that chronic pain is given the lowest priority in physiotherapy department triage tools. There may be a shift in preferences with respect to patients with chronic pain between the pre-licensure (student) phase and the post-licensure (clinician) phase.Key Words: resource allocation; health priorities; health resources; triage; outpatients; chronic pain. RÉ SUMÉObjectif : É tudier les pré fé rences des é tudiants en physiothé rapie au niveau dé butant sur le plan de l'attribution d'une priorité aux patients, en particulier aux patients vivant avec une douleur chronique. Mé thode : Aprè s une discussion en groupe, 249 é tudiants canadiens en physiothé rapie au niveau dé butant ont rempli un questionnaire basé sur cinq scé narios distincts (cas de patients fictifs). On a demandé aux ré pondants d'attribuer une priorité aux patients (P1 ¼ priorité la plus é levé e, P5 ¼ priorité la plus basse). Ré sultats : Les é tudiants en physiothé rapie ont accordé la priorité la plus é levé e aux patients vivant avec de la douleur chronique et aux patients qui venaient de subir une intervention chirurgicale. Le patient â gé et le patient qui avait un dé ficit cognitif ont reç u une priorité plus basse. Conclusions : Les é tudiants en physiothé rapie accordent la plus grande priorité à un diagnostic de douleur chronique. Les publications montrent toutefois que la douleur chronique constitue la priorité la plus basse dans les outils de triage des dé partements de physiothé rapie. Il pourrait y avoir un virage au niveau des pré fé rences entre la pé riode qui pré cè de la pratique (é tudiants) et celle qui la suit (clinicien) en ce qui a trait aux patients vivant avec une douleur chronique.Questions related to resource allocation are important in the Canadian health care system, including in rehabilitation departments. These questions raise issues of fairness and are a source of ethical dilemmas for clinicians and stakeholders.

show abstract

“…KEY WORDS: Bioethics; Ethics, professional; Physical therapy/education INTRODUÇÃO O desenvolvimento da Fisioterapia está associado à evolução de procedimentos e métodos de ensino-aprendizagem de conteúdos curriculares e aos avanços clínico-científicos da saú-de. Em decorrência dessa evolução, aumentou a expectativa por resultados positivos pós-tratamento e, também, a responsabilidade no ato de cuidar do paciente [1][2][3][4] . Exige-se do profissional, assim, uma formação generalista, humanista, crítica, reflexiva, autônoma, responsável e balizada em princípios éticos 5 .…”

unclassified

“…E à transformação do ato de cuidar, que atualmente enfatiza o vín-culo terapeuta-paciente 2,3,7 , mas carece de desenvoltura ética e moral 6,7 .…”

unclassified

O preparo bioético na graduação de Fisioterapia

et al. 2008

View full text Add to dashboard Cite

RESUMO: O desenvolvimento da Fisioterapia, aliado às mudanças na educação e na saúde, faz com que a autonomia e os dilemas éticos do fisioterapeuta sejam maiores a cada dia, expandindo seu papel no cuidado do paciente. Para além do Código de Ética, as noções de Bioética são centrais no preparo de graduandos para os desafios profissionais. Este estudo verificou a capacidade de tomar decisões éticas de alunos no último ano de Fisioterapia de duas universidades na cidade de São Paulo, das quais uma oferece no currículo a disciplina Bioética e a outra não. Cinqüenta alunos de cada universidade responderam a um questionário sobre dilemas éticos correspondentes a artigos do Código de Ética; cada questão oferecia três alternativas de resposta: uma bioética, outra referente ao Código e uma não-ética. As respostas foram analisadas estatisticamente. Os resultados mostraram um bom preparo ético em pouco mais de metade dos alunos das duas universidades, sugerindo que ambas oferecem preparo ético similar aos graduandos, independente da diferença curricular. No entanto, os alunos da universidade que oferece Bioética tiveram resultados significantemente melhores nos quesitos referentes à relação com outros profissionais da saúde, sugerindo que essa disciplina oferece melhores condições para o relacionamento interprofissional, fator importante tanto na prática clínica quanto para elevar o status da Fisioterapia. DESCRITORES: Bioética; Ética profissional; Fisioterapia/educação ABSTRACT: Physical therapy recent expansion, along with changes in education and health, enhance physical therapists' role in patient care, while increasing both their autonomy and the ethical challenges they face in daily clinic. In addition to knowledge of the professional ethical code, notions of Bioethics are thought to be central to students training. This study analysed the ability to make ethical decisions among 100 physical therapy undergraduate students at two universities in São Paulo, of which only one offers the discipline Bioethics. Fifty students of each university answered a questionnaire of dilemmas related to items of the Physical Therapy Code of Ethics; for each question there was a choice between three answers, bioethical, in accordance with the ethical code, or non-ethical. Answers were statistically analysed. About half the students of both universities seemed to be satisfactorily prepared to act ethically, thus suggesting that both offer similar ethical training, regardless of curricula differences. However, students from the university that offers Bioethics had significantly better results in questions concerning the relationship with other health providers, thereby suggesting that this discipline may provide better student training for inter-professional relationship, which is important both to clinical practice and to raise physical therapy status.

show abstract

The Identification of Ethical Issues in Physical Therapy Practice

Cited by 54 publications

References 7 publications

Policy Versus Practice: Comparison of Prescribing Therapy and Durable Medical Equipment in Medical and Educational Settings

Policy Versus Practice: Comparison of Prescribing Therapy and Durable Medical Equipment in Medical and Educational Settings

Patient Prioritization Preferences among Physiotherapy Entry-Level Students: The Importance of Chronic Pain

O preparo bioético na graduação de Fisioterapia

Contact Info

Product

Resources

About