5 ROLES OF A PHYSICAL THERAPIST

PATIENT/CLIENT MANAGER
CONSULTANT
CRITICAL INQUIRER
EDUCATOR
ADMINISTRATOR
 PHYSICAL THERAPIST AS A PATIENT / CLIENT MANAGER

Patient/ Client model

Examination
Evaluation
Diagnosis
Prognosis
POC
Outcomes
Supervision
Discharge /Discontinuance
Referral Relationships
PHYSICAL THERAPIST AS A CONSULTANT

Service-based Consultation
Needs Based Consultation
Relationship Based
Trust Based
 PHYSICAL THERAPIST AS A CONSULTANT

Patient/ Client Consultant

Examination Data Collection

Evaluation Identify problems
Diagnosis
Prognosis Setting Goals
Intervention Action-
Outcome Evaluation of Process
 PHYSICAL THERAPIST AND RESEARCH

•1) Evidence Based Therapy

•2) Exploiting the Vulnerable
•3) Recent concerns
•4) Respect for Autonomy
•5) Authorship
PHYSICAL THERAPIST AND RESEARCH
Evidence Based Medicine
Diagnosis and Screening
Prognosis
Therapy (intervention)
Harm
Sackett, Straus, Richardson, Rosenberg, Haynes
PHYSICAL THERAPIST AS A CRITICAL INQUIRER

Ethical Issues Related

APTA CODE of Ethics
Guide to Professional Conduct
Core values
State Practice Act
Organizational and State laws
related to human subjects
 PHYSICAL THERAPIST AS A CRITICAL INQUIRER
Specifically –
1- Protection of Human Subjects
1-nature, duration, and purpose of the experiment
2-method and means by which it is to be conducted
3-all inconveniences and hazards reasonably to be expected
4-the effects upon his health

2- Protection of identity
3- Subject Consent
• 1-The degree of risk to be taken should never exceed that determined by the humanitarian importance
 
• 2- Proper preparations should be made and adequate facilities provided to protect the experimental
subject against even remote possibilities of injury, disability, or death. 
• 3- The experiment should be conducted only by scientifically qualified persons.
• 4- The human subject should be at liberty to bring the experiment to an end. 
• 5- During the course of the experiment, the scientist in charge must be prepared to terminate the
experiment at any stage, if he has probable cause to believe, in the exercise of the good faith, superior
skill and careful judgement required of him, that a continuation of the experiment is likely to result in
injury, disability, or death to the experimental subject.

Nuremberg code 1947

PHYSICAL THERAPIST AS A CRITICAL INQUIRER

Principle of Respect
individuals should be treated as autonomous agents
that persons with diminished autonomy are entitled to
protection.
Principle of Beneficence
(1) do not harm
(2)maximize possible benefits and minimize possible
harms.

Belmont report 1979

 PHYSICAL THERAPIST AS A CRITICAL INQUIRER

IRB
Subjects Vs. Patients
Responsibilities of Clinical Researchers
PHYSICAL THERAPIST AS AN ADMINISTRATOR
Managerial Positions:

Patient / Client Manager

Oversees Billing
Directs Support Personnel
Schedules Caseloads
Collects Data, Documents Care
PHYSICAL THERAPIST AS AN ADMINISTRATOR
Managerial Positions:

First Line Manager:

Mid Level Manager:
CEO:
Ethical and Legal Considerations in Organizations and Administration

• Systemic Conflicts within Managed Care

• Physician referral
• Equipment and supplies
• Gifts
• Sexual Harassment
• Drug Abuse by Professionals
• Fraud
• Family violence
• Reporting abuse
– Elder
– Child
• Promoting an Ethical Climate
• Decision Making and Clinical Models
• Personal Duties
• Workers Safety
• Patient Safety
• Microallocation- Balancing patient Needs
• Macroallocation- Balancing Public Needs
• Rawls Theory of Economic Justice
• Pro Bono Services
 PHYSICAL THERAPIST AS AN
ADMINISTRATOR- Ethical
Considerations
Organizational Ethics
Conflicts of interest
 PHYSICAL THERAPIST AS AN EDUCATOR

Patient care
Patients
Family members
Care givers
Other Health Care Providers
PHYSICAL THERAPIST AS AN EDUCATOR
Beyond Patient Care
Presentations/ posters
Continuing education
Academic Teaching
Teaching
Scholarship
Service
Clinical Instructors
PHYSICAL THERAPIST AS AN EDUCATOR

Ethics
Code of Ethics
Guide for Professional Conduct
Continuing competence
Academic Integrity
Students and Teacher
PHYSICAL THERAPIST AS AN EDUCATOR

Ethics
Code of Ethics
Guide for Professional Conduct
Continuing competence
Academic Integrity
Students and Teacher