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INTRODUCTION

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Physical therapists shall promote organizational behaviors and business practices that benefit patients/clients and society.

Principle 7, APTA Code of Ethics

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CASE 10.1 Moving into Management

Sara responded to an advertisement placed by Northeastern Health Care for the position of chief physical therapist at a local hospital. She had decided to make the change from practicing physical therapist to supervising therapist because she hoped to improve outcomes in health-care delivery. Northeastern offered only a slightly higher salary than she had received as a practitioner, and the hours were going to be longer. Nevertheless, she saw the new job as a genuine opportunity.

At first, the job of supervising eight therapists and eight aides was overwhelming. In the first month, she called a department meeting and asked the therapists and staff what they would like to see improved. To her surprise, their only concerns were to reduce the patient load and to increase the flexibility of work hours. She had fully expected to hear complaints about overdelegation of patient care to aides, lack of continuing education leaves, and the absence of certified specialists on staff. After the meeting, she set up an appointment with her boss, John, director of the rehabilitation division. She expressed to John her surprise that the staff did not appear to be worried about the quality of care the patients were receiving or the absence of a dynamic professional exchange of ideas and expertise. She wondered about the feasibility of her plan to require weekly case conferences at which therapists could present difficult cases for input from other therapists. In fact, she was beginning to wonder whether any of her ideas for professional development would work.

John told her the hospital was happy with the way things were now. The department was producing a good profit, the employees performed their jobs, and few patients complained. He said anything she could do to increase productivity and profit would be welcomed, but any efforts that might detract from the current level of productivity would need to meet with his approval before they could be introduced to the staff. Sara began to realize that she was essentially being asked to function as an efficient manager, whereas she had changed jobs hoping to expand into more of a leadership role in the health-care environment.

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LEADERSHIP IN PROMOTING AN ETHICAL CLIMATE

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Throughout their careers, physical therapists must work collegially with supervisors, managers, coworkers, and support staff. In doing so, therapists need to understand ethical issues from the point of view of people in positions of authority because therapists often oversee the activities of a variety of support personnel, thereby functioning as supervisors in the delivery of care, and many therapists move into supervisory and management positions at some point during their careers. As stated in “Guidelines: Physical Therapy Claims Review” (G08-03-03-07), effective practice includes the ability to “interact and practice in collaboration with a ...

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