Advocacy for Quality Practice Settings
Being a physiotherapist brings with it the respect and trust of the public. Physiotherapists have a duty to honor this trust by contributing to the public debate on service quality and availability, and promoting the goals of the profession in a manner that meets the needs of the patients.Physiotherapists do this by working with administrators, owners and payers to identify opportunities for improving the quality of care.
Most private practices and health organizations follow a principle of cost effectiveness when setting policy. By definition, this means the organization aims to provide the highest quality of care at the lowest price. Problems can arise when policies are introduced that may compromise quality in the name of cutting costs.
Physiotherapists have an obligation to honour and respect the policies and philosophy of the work setting but can find themselves in situations of ethical distress where they encounter isolated or repeated situations where the policy compromises quality care. At times policy and decision-makers are not aware of the problem or the full implications of the problem.
Ideally everyone who is affected by a policy should have some say in its development and/or assessment. Your involvement in development and review is the only way you can assure you will not be caught in a situation where you or your patients are compromised. You may do this personally or have someone representing you. For example in a hospital you may have a professional practice leader who brings forward the position of the physiotherapists. Ask yourself if you are clear that your representative fully appreciates your position and is bringing it forward.
In order to contribute to promoting a quality workplace, consider the following strategies:
- Continually strive to identify policies or procedures that may compromise the quality of practice.
- Make those in authority aware of your concerns and be open to working together for change. For example, know the processes in an organization. Know the name of the committee for a given policy process and who is sitting on the committee. Find out how you can provide input.
- Know the name and position of the person who is representing your interests and those of your patients. Meet with this person to discuss any pertinent issues.
- Find out how you can be nominated or appointed to a policy-making committee. For example consider representing your profession at the College of Physiotherapists of Ontario, the Ontario Physiotherapy Association, the Canadian Physiotherapy Association or volunteer to sit on a committee at the setting where you work.
- Advocate for change even if you are not asked to do so. For example, if your employer is not a health-care professional s/he may not understand the standards of practice for physiotherapists or how quality could be compromised by some policies. Remember your responsibility to your patients and work with your employer to improve practice.
- Determine the professional values and standards of a work setting before accepting employment. In rare circumstances you will encounter a setting where it is impossible to offer ethical, quality care because of the policies and practices of the setting. It is better to have identified these issues before accepting employment and either negotiate appropriate changes or decline the position.
