05- PT as a consultant.pptx

describe the role of PT as a consultant

1. The Physical Therapist As Consultant SYED ZAIN UL ABIDIN DPT, MSPT IPM&R(KMU)

2. Learning Purposes The purposes of this chapter are T o provide a clear picture of consultation in physical therapy, I dentify opportunities for physical therapy consultation Qualities of consultants.

3. “Consultation is the rendering of professional or expert opinion or advice by a physical therapist. The consulting physical therapist applies highly specialized knowledge and skills to identify problems, recommend solutions, or produce a specified outcome or product in a given amount of time on behalf of a patient/client.” – The Interactive Guide to Physical Therapist Practice with Catalog of Tests and Measures (2002)

4. PHYSICAL THERAPY CONSULTATION Consultation is the practice of providing advice for a fee. This is a two-way interaction, a process in which a person or an organization seeks help, which the consultant provides. The ultimate outcome of the process is a change in the way the person functions or an organization operates. The person or organization seeking help is the client, who may also be known as the customer, patient, or advisee. Regardless of the label applied to the interaction (advising, coaching, counseling, consulting), this helping process is a key function of all professionals, including physical therapists.

5. The patient/client management role of the PT is a form of consultation, because patient care is a process of giving and receiving help. By developing and implementing plans of care, PTs learn how to establish helping relationships with patients and ways to offer advice.

6. POWER OF THE ADVICE The power of the advice given depends on two factors: how much the consultant helps clients use their own knowledge, experience, and expertise to arrive at a decision or solve a problem how much the client participates in the proposed course of action In some consultation arrangements, the consultant provides an expert opinion that the client is expected to follow; in others the consultant draws upon the client’s knowledge and expertise to help make the decision.

7. PTs make every effort to move away from the paternalistic model of “doing for the patient”; instead, they try to use the active participation model, involving patients in decisions about their rehabilitation .

8. Fuller suggested framework that consultants could use to clarify their responsibilities. This model identifies types of consultation in terms of client demands for the following continuum of services: ● Specialized services ● Administrative skills ● Problem solving ● Investigative studies. ● Assessments. ● Advice TYPES OF CONSULTATION

9. Client Needs Met by Physical Therapy Consultants Physical therapy consultants are hired to meet a range of client needs. McGonagle and Vella and Cohen have identified broad categories of client needs that can be applied to physical therapy consultation. The following are the Consultant’s Roles in the mentioned circumstances

10. Inadequate human resources Make up for a shortage of a particular expertise among existing personnel. Serve as an alternative when hiring restrictions are in place Help to manage a sudden increase in expectations or demand Provide services when time limits prevent existing personnel from completing the work at hand Work on a new project that does not warrant the hiring of full-time personnel

11. Objective point of view Provide guidance or insight on a particular patient or management problem Present new ideas for revitalizing the practice Devise fresh approaches for overcoming barriers to successful treatment outcomes

12. Periods of change Serve as a catalyst to help generate change in a health care organization Lend credibility to a change already determined to be necessary Provide seminars for or coaching of personnel to provide information and new skills to improve clinical practice Provide rapid access to latest technology and its application Serve as an independent mediator to resolve differences when two health care organizations merge( e.g RMI NWGH)

13. Business management Improve referrals to the physical therapy service Research sources of capital funding to initiate a physical therapy practice Improve an organization’s efficiency and scope of practice Ensure compliance with regulatory and accreditation demands or third-party payer rules for reimbursement Help with a complete turnaround in a practice resulting from a change in mission or organizational structure so that the practice remains competitive as health care changes occur

14. Consulting requires skills beyond the consultant’s ability to convey expert knowledge and advice. For example, a number of skills are needed for the practical business aspects of consulting. A major component of a consultant’s success is the ability to use entrepreneurial and business skills to build up and sustain a client list.

15. This quick self-test can help PTs determine where their interests might lie in physical therapy consulting

16. BUILDING A CONSULTING BUSINESS Consultants must be prepared to pay themselves and have money left for developing and managing the business Consulting Fees Although the value of the consultation ultimately is determined by the client, fees are determined by many factors. On the client’s side, these factors include the type of business or industry, its size and location, the demand for consultants by such businesses, and the client’s history of consultant use. On the consultant’s side, factors include the individual’s level of expertise, degree of experience, and professional standing. This supply-and-demand situation creates a wide price range for consultation.

17. Many organizations and government agencies insist on a fixed price for projects, which often is determined through a request for proposal (RFP) process. The organization announces an RFP with a particular goal or product in mind. Several consultants submit proposals, including a fixed bid, and the organization selects the best proposal for the best price.

18. The Consulting Process Parallels can be drawn between the patient/client management process in physical therapy and the true consulting process as described by Lippitt and Lippitt Like PTs, consultants identify problems, consider alternatives, select and implement the best solution, and evaluate the solution’s effectiveness.

19. Comparison of patient/client management and consulting processes Lippitt G, Lippitt R.

20. A strong consulting proposal hinges on a thorough knowledge of the client and the client’s needs. The proposal should include the following sections, which are based on an outline by Hoyt: 1. Purpose of the proposal [or an objective]: A brief statement, couched in general terms, of what the client wants. 2. Solution or action steps: Presented perhaps as a bulleted list or a table, this section specifies the sequential actions to be taken, including dates for submission of periodic progress reports. The steps may include information and data gathering, design, content to be included, materials needed, and the implementation strategy. CONSULTANT PROPOSAL

21. 3. Anticipated benefits: The improvements the client can expect as a result of the consultation. 4. Evaluation: A plan for measuring the effectiveness of the consultation.

22. The Skills of a Good Consultant Consultation demands skills beyond good advice, technical capabilities, and entrepreneurial talent. The ability to get along well with others, The ability to diagnose problems and find solutions The ability to communicate The ability to work under pressure Some personal qualities and attitudes are also critical. Consultants must be adventuresome, willing to accept risk, and determined to find answers to problems Even when all the appropriate skills are in place, the key to success as a consultant is the ability to build a trusting relationship with the client.

23. Trust in the Consultant/Client Relationship Consultants must be able to give their clients objective, independent advice that is unaffected by the client’s own biases , fears , and blind spots . However, consultants must also be alert to their own biases, fears, and self-interests and take steps to guard against them. Clients often have mixed feelings about consultants that affect the consultant client interaction.

24. A consultant who puts the client’s interests first and is sensitive and careful in interactions with the client and others affected greatly improve the chances of success. Trust is earned through direct experience in a highly personal, emotional, and dynamic two-way relationship that involves risk on both sides

25. ETHICAL AND LEGAL ISSUES IN CONSULTATION The consultant role of the PT raises a number of legal and ethical issues, many of them related to the type and setting of the consultation Legal Status of Employment: Consultants act with a system rather than as an integral part of it. However, the substance of the relationship, rather than the label it is given, determines the consultant’s legal employment status.

26. Contract Law Because the legal definition of consulting is unclear, a consulting agreement or contract must clearly delineate the factors that establish, maintain, and terminate the consultant-client relationship.

27. COMPONENTS OF A CONSULTING AGREEMENT The nature and scope of the services to be performed A statement specifying the consultant’s employment status and ownership of any final work product The details of payment of compensation and costs The duration of the agreement In what ways, when, and by whom the agreement can be terminated In what ways the work to be performed can be changed and by whom

28. Special requirements (covenants) to protect the client, such as the handling of confidential information The manner in which any disputes will be handled The remedies available (and to whom) for default or failure to perform, as well as remedies that are not available The manner in which formal notice is to be given, and how changes in the scope of the assignment are to be recorded

29. Lippitt and Lippitt have devised a code of ethics for consultants based on 11 principles : Responsibility Competence Moral and legal standards Avoidance of misrepresentation Confidentiality Client welfare Announcement of services Intraprofessional and interprofessional relations Remuneration Responsibility toward client organization Promotional activities Codes of Ethics for Consultants

30. APTA Code of Ethics and Guide for Professional Conduct The ethical principles cited by Lippitt and Lippitt are similar to the expectations of PTs stated in the APTA’s Code of Ethics. In general, if PT consultants can transfer the ethical standards they are expected to uphold in patient/client management to their consultant/client relationships, they can be relatively confident they are on the right ethical track. The “rules” are the same.

31. “A physical therapist shall seek consultation whenever the welfare of the patient will be safeguarded or advanced by consulting those who have special skills, knowledge, and experience” (GPC 11.1). Clients of PT consultants should expect the consultant to be trustworthy, to maintain confidentiality, and to “make professional judgments that are in the patient’s/client’s best interests” (GPC 4.1A).

32. Thank You