Ethical Issues in Physical Therapy

When going to a store, customer service is able to dictate anybody’s experience, which usually dictates if the consumer will plan on going back or not. This has the same concept of physical therapy. Physical therapy, such as all healthcare, has “ever-changing” rules and regulations that need to be followed. Many ethical issues are introduced in physical therapy, as well as any other profession. Avoiding regulatory fraud and abuse, practicing relevant dilemma’s and being logical with alternative payments (Medicare) are three major concepts when talking physical therapy issues.

Physical therapists treat severe pain for patients who do not know what is going on. Examination or treatment include flexion, extension, adduction, and abduction. With severe pain, the patient may claim fraudulent “abuse,” which could be a controversial lawsuit. To avoid this from happening, educating your patients thoroughly will make them feel secure in your care. Therefore, providers should talk to people like people. Seeing fewer patients allows for closer relationships with patients.

Treating patients like people and not numbers will make the patient feel at home.

Also, demonstrating leadership and excellence will minimize the number of fraudulent abuse cases. For example, if a physical therapist has a 5-star facility and tracts a continuous excellence, it would be more likely to have less amount of abuse cases. Prioritizing value and quality of physical therapy will reflect with patients, which allow leighway to educate physical therapists and PTA’s while performing. Patient orientation will make a patient feel safe and while all practice is evidence-based, not many patients may file for “abuse” when taking care of the patient.

To promote this, physical therapists need one-on-one time with the patient. Special attention is needed in order to return back to the patient’s physical abilities. Little movements such as reaching too far could impact this change.

Listening to the patient’s body is,  when examining and throughout the plan. Lastly, representing the facility with honor and purity will lead to surroundings recognizing that. Great practice and efficient evidence-based plans with education-driven faculty will prevent ethical issues. When speaking on relevant dilemma’s in physical therapy, everything ties back to therapy autonomy, or the freedom of being able to make and implement procedures based on professional judgments. Ethical issues correspond within clinical misjudgments, each health care profession encounters different ethical dilemmas and problems, which is why professionals of all professions should prioritize sound decision making.

Making the most correct and sound decision could separate average physical therapists from an excellent physical therapist. Given the ever-changing ethical dilemmas, Physical therapists Purtilo and Guccione concern that moral priorities should keep up to par with the increasing complexity and evolving professional autonomy of physical therapy, which will keep the practice relevant. For example, if you had a patient with major brain trauma, you’d ask yourself how can the patient achieve maximum rehabilitation potential, if not full rehabilitation?

To what extent should the therapist support publicly for the patient? If management provides problems for cost issues, a physical therapist may also have a dilemma between loyalty to the patient and business decisions for themselves. You’d need a correct balance of ethic and business to make the correct decision. Alternative payment could always be an option for cost issues, however, taking the initiative to rehabilitate a major brain trauma patient could be rough emotionally and physically for a patient. As a provider, taking all variables into consideration and decide if it is worth it, financially, for the business, and themselves is key.

Financial problems could, unfortunately, make a heavy impact on the professional’s choice corresponding with the patient. Changes happen almost every year with finances in physical therapy. For physical therapy and speech-language pathology combined, the therapy cap amount for 2017 is $1,980 which is up $20 from last year, with a separate $1,980 cap for occupational therapy. Caps are not the only concern when considering alternative payment options. To even qualify for Medicare benefits, it is determined by medical necessity, which means the provider must provide care that is reasonable and necessary.

The reasonable and necessary care must be chosen with the clinically based evidence, not by the clinicians choice. Now physical therapist’s have the autonomy to choose what they want to do, however, if the patient wants Medicare, you’d have to focus on the main points, rather than extra beneficiary curriculum. Medicare covers therapy while the patient is at home-bound, as well as skilled therapy services that are “necessary to maintain the patient’s current condition or prevent or slow further deterioration (WEBPT.)” Ultimately, physical therapists have many options when billing patients, it is dependent, however, with certain regulations and what they believe is absolutely necessary for a patient to rehabilitate.

Which is where ethical dilemmas come into play, considering that many therapists may stretch necessary procedures based off of their own beliefs, more than the evidence. To put into reality, going back to the 16-year-old with severe brain trauma, you would have to apply Medicare considering his financial situation. Which means therapist would have to implement a stay-at-home plan for the kid with minimal clinical appointments. While still making an ethical decision based off of his evidence from examination.

Lastly, in order to be eligible for Medicare, documentation must defend the services that are coming from the therapist’s bills. Medicare reimburses physical therapists when the documentation and claim forms accurately report the necessary services that Medicare is covering. Which includes the medical diagnosis, the prior observations, dysfunctional treatment, and plan. To be a sound decision-making physical therapist, weighing out all variables is essential. Which includes avoiding regulatory fraud and abuse, practicing relevant dilemma’s and being logical with alternative payments.

With the patient being a therapist’s first priority, they have to look at the overall situation. If finances are no problem, the therapist will be able to have efficient clinical sessions, however, unfortunate patients will also need an efficient plan to implement in the home environment. Great practice with good morality and sound decision-making will excel is physical therapy.

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