professionalism. Definition, introduction

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1. The Physical Therapist as Professional By Dr . Yasira Faisal 1

2. WHEN YOU SAY PROFESSIONALISM WHAT CAME FIRST IN YOUR MIND ? 2

3. The Physical Therapist as Professional As much as we would like to think so, physical therapy is not yet completely recognized as a profession. (Catherine Worthingham ) 3

4. Before deciding on a definition of [physical therapy], physical therapists must decide whether they really want to be professional or just make believe they are, by paying lip service to professionalism. (Mary E. Kolb) 4

5. The Physical Therapist as Professional We adhere to a code of ethics. We have defined our scope of practice. We have developed a unique body of knowledge. We are documenting the effectiveness of our outcomes. And we take responsibility for the well-being of patients and clients. If follow above True autonomy is the destination. (Ben Massey) 5

6. Definition A profession is an occupation that is viewed by society as a profession on the basis of its characteristics, development, or power. 6

7. Professionalism is the internalized conceptualization of expected professional obligations, attributes, interactions, attitudes, values, and role behaviors in relation to individual patients and clients and society as a whole. 7

8. Professionalism may be collective (practiced by the profession as a whole) or individual. 8

9. Profession in Sociological Perspective According to Ritzer , sociological literature describes three approaches to understand profession: Structural Approach Processual (or process) Approach Power Approach 9

10. Structural Approach The structural approach focuses on the static characteristics that an occupation must possess to be considered a profession. 10

11. Processual Approach The Process Approach focuses on either the stages and developmental periods that an occupation must pass through or activities that its members must perform to achieve recognition as a profession. A utonomy is the defining attribute of professions ( Moore and Pavalko ) 11

12. Power Approach The Power Approach believe that a profession’s ability to obtain the political and social power to define its work is its most important characteristic. 12

13. Negative aspects of power: setting up economic monopolies using political power for self interest accusing on professional autonomy and self-governance without consideration of the public welfare 13

14. Characteristics of Professions 14

15. Knowledge Broad, theoretical, generalized, systematic knowledge Unique body of knowledge “Formal” knowledge that is “embodied and applied in and through the professional ” 15

16. Autonomy in professional decisions Autonomy from client Autonomy from organizations or external parties Autonomy in selecting colleagues 16

17. Authority Based on internal knowledge Granted by society Demonstrated by power and status in society Demonstrated by monetary and symbolic awards 17

18. Education Extensive Skilled, technical High standards for admission 18

19. Responsibility, Accountability, and Ethics Service orientation Accountability and responsibility to society Formal code of ethics that members enforce Self-control of behavior through internalized professional ethic Belief in self-regulation Community interest more important than self-interest Fiduciary(ethical) relationship and trustworthiness central 19

20. Nature of work and decisions Important or essential to clients Complex Not routine Not programmed 20

21. Pavalko’s Continuum 9/24/2025 21 [email protected]

22. AUTONOMY, SELF-REGULATION OF ETHICAL STANDARDS, AND ACCOUNTABILITY Whether a profession is defined by its characteristics, stages of evolution, or power, the following qualities of professions have historically been held in high regard: Autonomy Ethical standards Accountability 22

23. Autonomy Autonomy is “litmus test” for professions E xtent of freedom and independence in the role F reedom from clients and the organization that employs the professional Occupations whose members have had high autonomy in decision making and high degrees of control over their work have been considered true professions. Occupations whose members enjoyed less autonomy in decision making and less control over their work were relegated to being semiprofessions , paraprofessions , or nonprofessions . 23

24. Autonomy (cont..) Whether PTs have enough autonomy in their work to be considered professionals?? For much of physical therapy’s history, PTs have worked under the supervision of or through referral from physicians. “Physical therapists will be practitioners of choice in clients’ health networks and will hold all privileges of autonomous practice.” (APTA VISION 2020 ) PT education, direct access, referral, role of health care system 24

25. Self-Regulation of Ethical Standards The possession of a code of ethics and mechanisms that ensure members abide by the code’s principles. APTA adopted its first code of ethics in 1935. A code of ethics is meaningless unless its members live by its ideals and enforce its provisions. The obligation to enforce a code of ethics is also called self-regulation and is frequently framed in terms of an implied social contract. 25

26. Self-Regulation of Ethical Standards Professionals have a great deal of autonomy and freedom that enables them to serve the interests of their clients. In return for this freedom, society expects responsible behavior and action in the public interest. For example, society expects professionals to take action against incompetent colleagues and provide pro bono care for those who cannot afford professional services. Unfortunately, many professionals fail to live up to the high standards espoused by professional codes of ethics, and few professions have been successful in policing their own ranks for ethical breaches. 26

27. Accountability of Professionals Professionals have obligations and must “account” to the public for the discharge of these duties. Emanuel define accountability as “the process by which a party justifies its actions and policies” Three separate models of accountability: Professional Political Economic 27

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29. Ozar’s Models of Professionalism as Applied to Physical Therapy Ozar developed three different models of professionalism for medicine and dentistry Commercial Guild Interactive These models of professionalism are also applicable to the work of the PT. 29

30. Commercial Model Professionalism is a commercial interchange in which physical therapy is a product or commodity and the therapist must compete with the patient and other professionals to sell services and maximize profit. Any duties of the therapist toward the patient are based on contractual agreements. In this model, professional associations exist to promote common business interests. 30

31. Guild Model T he profession is the transmitter of expertise, competence, and moral standards. The PT functions in a paternalistic (authoritative) role , providing services to a patient who is the uninformed, passive recipient of professional expertise. 31

32. Interactive Model This model avoids the negative aspects of both the commercial and guild models, with therapists and patients interacting as moral equals in a relationship in which each person has a different function. Because the community has given professional status, the PT is obligated to care for the patient in need. The context for professional activity is construed as one of interaction between the PT and the community. 32

33. PHYSICAL THERAPY AND CONCEPTS OF PROFESSIONALISM Since its early years physical therapy’s efforts to professionalize have concentrated on gaining increased autonomy building a case for its expertise through improving education and scholarship gaining public recognition enhancing political power through lobbying efforts the appropriate degree to offer 33

34. PHYSICAL THERAPY AND CONCEPTS OF PROFESSIONALISM(cont..) The rationale for awarding the DPT is based on at least four factors, among others: The desired level of practice required considerable breadth and depth in educational preparation S ocietal expectations that the fully autonomous healthcare practitioner The realization of the profession’s goals in the coming decades, including direct access, “physician status” for reimbursement purposes, and clinical competence consistent with the preferred outcomes of evidence-based practice Many existing professional (entry-level) MPT programs already meet the requirements for the clinical doctorate 34

35. PHYSICAL THERAPY AND CONCEPTS OF PROFESSIONALISM (cont..) T he DPT degree links various aspects of professionalization: autonomy, attainment of adequate power, and status. The perception is that the DPT will enhance professionalization, enabling physical therapy to enjoy the professional status and power of other professions. 35

36. PHYSICAL THERAPY AND CONCEPTS OF PROFESSIONALISM (cont..) P hysical therapy is taking its last steps toward professionalization!! Society and individual patients continue to have high expectations for professionals!! Dimensions of professionalism (authority, autonomy, responsibility, expert judgment, accountability, and ethical ideal). Oath and PTs: Writing an individual or a collective oath can be a vehicle for reflection on a personal model of individual professionalism. 36

37. 37 THANKS