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INTRODUCTION

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Physical therapists shall discourage misconduct by health care professionals and report illegal or unethical acts to the relevant authority, when appropriate.

Principle 4C, APTA Code of Ethics

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CASE 9.1 Misassigning an Aide

Margaret has been a physical therapist since 1982 and has been in private practice for 12 years. Her practice has flourished, and she currently employs two physical therapists, two aides, and a receptionist. One of her aides, Dwayne, has been with her since she opened the practice. He enrolled in a doctor of physical therapy program 2 years ago and has worked part-time while in school. The practice functions on a “family” model, and so far no one who has joined the practice has left. The business aspects of the practice have become very time-consuming, and Margaret would much rather treat patients. She decides to ask a friend, Mark, who is also a physical therapist, if he would like to become a partner in her practice. He immediately says yes.

The transition goes well, and Mark is amazed at how efficient Margaret is in patient care. In turn, he picks up his productivity partly by using Daphne, the other aide, to help him prepare for and clean up after patients. Margaret calls in one Wednesday to tell the receptionist that she has a plumbing emergency at home and will not be in the clinic until noon at the earliest. The receptionist tries to reach all the morning patients, but she cannot reach two returning patients and one new patient scheduled for an evaluation. Because all the therapists are booked, Margaret tells the receptionist to ask Dwayne to take over for her. Around 11 a.m., Mark sees Dwayne talking with a new patient in the treatment area. At lunch he asks Dwayne what was going on, and Dwayne explains that Margaret asked him to evaluate the new patient, which he did.

Mark becomes agitated and tells Dwayne that all of them could get in big trouble if it were discovered that an aide was evaluating and treating patients. Dwayne explains that will not happen because Margaret recopies his notes in the chart and then signs them; they have done it many times before. Mark tells him that he will be fired if it ever happens again. He then tells the receptionist to let Margaret know that he wants to see her as soon as she gets in. Shortly after 2 p.m. Margaret arrives and asks Mark what is on his mind. He explains what happened, and Margaret acknowledges that in pressing circumstances she has used Dwayne to help her. She states that Dwayne has worked for her 10 years, is excellent, and now he has most of his basic training behind him. Mark tells her that is irrelevant and that she cannot use an aide to treat and evaluate. She agrees not to let it happen again.

Four months later, Mark takes time off to go to ...

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