An out patient physical therapy clinic
Discuss your responses to the following case scenarios. Make sure to cite the appropriate Ethical considerations you utilized using the APTA Code of Ethics for Physical Therapists.
An out patient physical therapy clinic provides several jobs for many people in a small town where employment has been difficult to find. The company has stayed in the town even though it could grow much faster and find more competitively waged workers elsewhere. The physical therapists and staff have become loyal to the company due to the jobs and the citizens are happy to not travel hours to receive much needed care. Over the years, the company has developed a reputation in the town for taking care of its employees and being a responsible corporate citizen. You become a physical therapist in the said business and noticed that the company advertises that their therapists are doctors of physical therapy and are specialists. You noticed that only half of the PTs have their doctorate and only half have the specialties. You ask the PT Director and she replies "We have consistently provided care at the doctoral and specialist levels. Many of our older PT's have 20 years or more of experience and know more than the doctoral graduates. Besides, all our clients report high satisfaction with care, and if we were not here, there would be no local services". Describe what you would do in this situation.
The gentleman you are treating is the father of the CEO of your skilled nursing facility. He wishes to be seen a certain time and wants to utilize the NuStep machine between the hours of 3:30pm-4:30pm. Your colleagues have told you that this is the busiest time for the equipment and that the device could be utilized by at least three patients during that same time frame. You talk to your patient and he says he is only available during those hours and that he is only comfortable using that machine. Your director says it will be a few more years before a similar machine can be purchased and your colleagues want you to share the machine with them. What would you do in this situation?
You are a credentialed clinical instructor working with a physical therapy student in a multitherapy (OT's, PT's, SLP's) hospital rehabilitation facility. You are confident with your student Malcolm and he is doing great for his final week of a 10 week rotation. State guidelines require you to be 100% percent present when it comes to supervision of the student. You and your student have three more hours left in the day and 6 patients coming in during the busiest day of the week. You receive a phone call that there is a family emergency and that you need to leave the facility. How will you tackle the rest of the clinical day?
Case 1: Ethical Dilemma in a Small Town Clinic
Ethical Considerations:
- Beneficence: Promoting the well-being of patients.
- Veracity: Truthfulness and honesty.
- Integrity: Adhering to professional standards.
Analysis: The clinic's advertising practices raise ethical concerns regarding veracity and integrity. While the clinic has provided valuable services to the community, misrepresenting the qualifications of therapists is unethical. The director's argument focuses on patient satisfaction without addressing the ethical implications of false advertising.
Actions:
- Internal Communication: I would initiate a private conversation with the PT director to express concerns about the advertising practices. I would emphasize the importance of accurate representation and the potential legal and ethical consequences of misleading patients.
- Documentation: Document the conversation and any subsequent discussions related to this issue.
- Professional Development: Encourage the clinic to invest in continuing education and opportunities for therapists to obtain advanced degrees and certifications.
- Seek Guidance: If the issue is not resolved internally, consider consulting with the state physical therapy board or seeking guidance from the APTA.
Case 2: Conflict of Interest and Resource Allocation
Ethical Considerations:
- Beneficence: Promoting the well-being of patients.
- Justice: Fair and equitable treatment of patients.
- Nonmaleficence: Avoiding harm to patients.
Analysis: The situation presents a conflict between the patient's preferences and the needs of other patients. While it is important to accommodate patient preferences, it is also essential to ensure equitable access to resources.
Actions:
- Open Communication: Discuss the patient's preferences and the equipment availability with the patient and the CEO.
- Explore Alternatives: Offer alternative treatment options or exercise regimens that can be performed at different times.
- Implement Scheduling Strategies: Explore scheduling options to accommodate the patient's preferences while minimizing disruptions to other patients.
- Educate the Patient: Explain the importance of equipment sharing and the impact on other patients.
- Involve the Director: If the situation cannot be resolved, involve the director to mediate the conflict and develop a fair solution.
Case 3: Student Supervision and Emergency
Ethical Considerations:
- Beneficence: Promoting the well-being of patients.
- Nonmaleficence: Avoiding harm to patients.
- Accountability: Taking responsibility for patient care.
Analysis: The sudden departure of the clinical instructor creates a challenging situation for the student and the patients. Ensuring patient safety while maintaining the student's learning experience is crucial.
Actions:
- Prioritize Patient Care: Assess the patients' needs and prioritize care based on urgency.
- Communicate with Colleagues: Inform other therapists about the situation and request assistance if needed.
- Provide Clear Instructions: Give the student clear and concise instructions for each patient, emphasizing patient safety and communication.
- Monitor Progress: Maintain regular communication with the student to assess their ability to handle the workload and provide support as needed.
- Document the Situation: Document the emergency, the actions taken, and the student's performance.
By following these steps, the clinical instructor can mitigate the impact of the emergency while ensuring the safety and well-being of patients and the student.