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Why Practitioners Should Take An Ethics Course

Why Practitioners Should Take An Ethics Course

Faculty member, and Sr. TA, Mora Pluchino, PT, DPT, PRPC is a graduate of Stockton University with a BS in Biology (2007) and a Doctorate of Physical Therapy (2009). Mora authored and instructs Ethical Concerns for Pelvic Health Professionals and  Ethical Considerations from a Legal Lens.

  • "I want to start my own practice but I'm not sure if I need to hire a lawyer to help!"
  • "I have a problematic patient that I want to discontinue seeing, but don't want to be guilty of abandonment of care."
  • "I am so confused by the types of clinical insurance that I am required to have!"
  • "I want to hire an employee and include a non-compete clause in their employment contract!"
  • "I want to start my own cash-based practice and need help with this process!"
  • "I plan to market my practice for THIS population, is it legal to exclude THAT group of people?" 

With the end of 2022 approaching, now is the perfect time to take a pelvic health-focused ethics class. For many states, licensed professionals have to fulfill an ethics continuing education requirement, including physical therapists, occupational therapists, mental health, and many other healthcare providers. 

I started writing this series a year ago. I struggled to find a class to meet my biannual ethics requirement for New Jersey that was related to my practice in pelvic health. I soon realized that as a pelvic health provider and educator, the most popular questions that come up for practitioners, secondary only to specific treatment interventions, are ethical in nature. 

  • "Is ________ ok?" 
  • "What happens if ________ happens?"
  • "Can a patient sue me for ______?"
  • "How do I do ________ legally?"

Providers want to know that they are providing services that are legal and ethical. Even if you have never considered yourself as being overly concerned with the topic of ethics, you have probably had these thoughts. That was certainly the case for me! The further I fell down the rabbit hole of ethics, the more I realized it affects our day-to-day clinical life minute by minute. Ethics is the study of right versus wrong and how we make those personal qualifying decisions. So this covers everything from cleaning procedures, scheduling, patient care, and more!

Practitioners want to know that they will not be open to any legal action for the care and services provided. This usually requires more awareness and knowledge than just purchasing an annual liability insurance policy. Each provider and clinical environment has their own ethos, policies, and procedures, but there are also larger existing rules and laws to help guide providers to provide the best possible care.

In Ethical Concerns for the Pelvic Health Professional, we discuss the basics of doing no harm to our patients, obtaining informed consent, and decision-making based on different ethical models. The goal here is to send you to work immediately following this class feeling more confident in ethical labeling and decision-making. This class is a more global and essential look at the concept of ethics as applied to pelvic health. 

The sole purpose of Ethical Considerations from a Legal Lens is to explore the ethical challenges pelvic health practitioners may experience from a health law perspective. This course is for any pelvic health professional looking to build skills for ethical evaluation, problem-solving, and derivation of solutions with a specific focus on legalities and related concepts.

This series of ethics-related classes is meant to build your clinical character and problem-solving abilities in what feels like "sticky" situations and help to guide you to clinical and business decisions that make you feel comfortable at the end of a work day. 

To sweeten up this class series, each offering has an expert join the discussion on certain topics and case studies, to offer additional perspectives and points of view to the discussion. 

I am looking forward to having an open discussion about the ethical and legal considerations for our profession at the next offered class on December 10th, 2022!


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Ethical Considerations from a Legal Lens

Course Dates:
December 10, 2022
June 3, 2023
November 12, 2023

Price: $175
Experience Level: Beginner
Contact Hours: 6

Description: This one-day remote course covers ethical considerations from a legal lens for professionals working in the area of Pelvic Health. In general, Health Care Professionals have many day-to-day ethical considerations to “do no harm.” This includes basic decisions for billingpatient caresafety, and compliance. Pelvic Rehabilitation comes with additional layers of vulnerability and ethical challenges, and the legalities of pelvic health can add further complications for patient care, business, and clinical practice decisions.

The purpose of this class is to explore the ethical challenges Pelvic Health Practitioners may experience from a health law perspective. This course is for any Pelvic Health Professional looking to build skills for ethical evaluation, problem-solving, and derivation of solutions with a specific focus on the legalities and related concepts. Prior to the live aspect of this course, participants will be asked to review the ethical framework and definitions via pre-recorded lecture and take Core Values Self Assessment. Live instruction will review applicable health laws and legal terms that converge with the pelvic health world. This will be followed by case study discussion in small groups, followed by a large group discussion with input from the instructor and a legal expert/ educator. The remainder of this course is meant to be a guided discussion through the legal and ethical struggles of the pelvic health practitioner.


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Ethical Concerns for Pelvic Health Professionals - Remote Course

Course Dates:
January 29, 2023
September 16,2023

Price: $175
Experience Level: Beginner
Contact Hours: 6

Description:  This course is for any Pelvic Health Professional looking to build skills for ethical evaluation, problem-solving, and derivation of solutions, and explores the ethical challenges practitioners may experience including consent, managing trauma and abuse, and preventing misconduct. Prior to the live aspect of this course, participants will be asked to review the ethical framework and definitions via pre-recorded lecture and take Core Values Self Assessment. Live instruction will review the ways in which patients and practitioners can be vulnerable in the pelvic health treatment setting and how to address this. This will be followed by case study discussion in small groups, followed by large group discussion with input from the instructor and an ethics expert/ educator. The remainder of this course is meant to be a guided discussion through the ethical struggles of the pelvic health practitioner 

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What Are Your Core Values in Pelvic Health

What Are Your Core Values in Pelvic Health

Ethics

Mora Pluchino, PT, DPT, PRPC sat down this week with Holly Tanner in an interview to discuss her new courses, Ethical Concerns for Pelvic Health Professionals and Ethical Considerations from a Legal Lens. She is a pelvic therapist who works in an outpatient clinic, has her own side company (Practically Perfect PT), has written 2 books available on Amazon, and is a senior TA and faculty member with Herman & Wallace. Mora joins the Herman & Wallace faculty with her new course series in ethics: Ethical Concerns for Pelvic Health Professionals and Ethical Considerations from a Legal Lens

What are your core values as a pelvic health practitioner? Depending on your practitioner license these may include (1):

  • Accountability - Active acceptance of the responsibility for the diverse roles, obligations, and actions of the physical therapist and physical therapist assistant including self‐regulation and other behaviors that positively influence patient and client outcomes, the profession, and the health needs of society.
  • Altruism - The primary regard for or devotion to the interest of patients and clients, thus assuming the responsibility of placing the needs of patients and clients ahead of the physical therapist’s or physical therapist assistant’s self‐interest.
  • Collaboration - Working together with patients and clients, families, communities, and professionals in health and other fields to achieve shared goals. Collaboration within the physical therapist‐physical therapist assistant team is working together, within each partner’s respective role, to achieve optimal physical therapist services and outcomes for patients and clients.
  • Compassion and Caring - Compassion is the desire to identify with or sense something of another’s experience; a precursor of caring. Caring is the concern, empathy, and consideration for the needs and values of others.
  • Duty - The commitment to meeting one’s obligations to provide effective physical therapy services to patients and clients, to serve the profession, and to positively influence the health of society.
  • Excellence - The provision of physical therapist services occurs when the physical therapist and physical therapist assistant consistently use current knowledge and skills while understanding personal limits, integrating the patient or client's perspective, embracing advancement, and challenging mediocrity.
  • Integrity - Steadfast adherence to high ethical principles or standards, being truthful, ensuring fairness, following through on commitments, and verbalizing to others the rationale for actions.
  • Social Responsibility - The promotion of mutual trust between the profession and the larger public that necessitates responding to societal needs for health and wellness.
 

Annual CEU requirements for license renewals don’t just look at hands-on skills. Many states also require a number of ethics credits including California, Georgia, Illinois, New Jersey, and Utah (2).  In her interview, Mora Pluchino explains that one day she and her colleague were at lunch talking about course options for their ethics CEU requirement. They had taken the same course over and over at Stockton University and wanted to do something different this time. This led to Mora reaching out to Herman & Wallace and Holly Tanner who helped her start writing the course. Mora’s new courses focus on this ethics requirement, provide 6 contact hours, and registration is $175.00 for each: 

What should you expect from an ethics course? Mora breaks down the Ethical Concerns for Pelvic Health Professionals course and shares that there is about an hour of pre-course video lectures to watch, then the live course involves “a little bit of lecture in relation to pelvic health and ethics, and then there will be some case studies and group work. After this, an ethical expert will come in and do live question/answers with us.”

These courses are to really make practitioners comfortable with these ethical and moral issues. Mora explains, “I really want practitioners who take this course to understand and know where to find information about those issues that come up with their boss, their organization, their patients, or themselves. A lot of times, ethical situations just make us just know instinctively that something doesn’t feel right.” Holly follows up with “Sometimes these situations can make us feel embarrassed, and maybe we contributed or didn’t contribute in the right way to a scenario. We don’t always bring them up to other people out of this embarrassment, or we just don’t know which pathway to take.”

A lot of common questions have an ethical component such as “How do I bill for this,” “How do I tell my boss I can’t do this,” or even “Can I reuse a biofeedback sensor?” Mora shares, “Sometimes, as a practitioner you can feel pressured to do (or not do) something, and you don’t know how to say no. With these courses, you will be able to give clear reasons such as it’s in my guidelines, in my practice act, and core values as being a PT or OT.” She further expands on this, “We have all of these people working for us in the APTA and AOTA that are creating all of these ethical guidelines and all of this information to give us the support.”

The ethics topics are broken down into two courses, with the first course Ethical Concerns for Pelvic Health Professionals focused specifically on people who treat pelvises scheduled for June 18, 2022. The second course, Ethical Considerations from a Legal Lens, is scheduled for December 10, 2022, and deals with the legalities and rights of health care providers. Some questions that are touched on during lectures include abandonment of care and discrimination.  Mora also shares that a lot of the ethics courses she has taken are “from the perspective of therapists that are abusing their patients, but when you work in pelvic health world you realize it can go the other way too, or it can be a back and forth kind of thing.”

To learn more, and fulfill that ethics CEU requirement, join H&W and Mora Pluchino this summer in Ethical Concerns for Pelvic Health Professionals on June 18th or this winter in Ethical Considerations from a Legal Lens scheduled for December 10th.


Resources:

  1. APTA. Core Values for the Physical Therapist and Physical Therapist. HOD P06‐19‐48‐55. 9/20/2019. https://www.apta.org/siteassets/pdfs/policies/core-values-endorsement.pdf. Accessed 5/30/2022.
  2. Fraticelli, T. PT Progress. Physical Therapy Continuing Education: PT CEU Requirements by State. October 8, 2018. https://www.ptprogress.com/physical-therapy-continuing-education-requirements-by-state/. Accessed 5/30/2022.

Additional Resources:

• Core Values of Your Profession:
• The Core Values Self Assessment.
o This measure was created for Physical Therapists/ Physical Therapy Assistants but it has value for all health care professionals. If you are another type of health care professional, please just imagine the questions apply to your profession. https://www.apta.org/your-practice/ethics-and-professionalism/professionalism-in-physical-therapy-core-values-self-assessment
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Ethical Concerns for Pelvic Health Professionals

Mora

H&W is proud to be able to present a new remote course on ethics from new faculty member, and Sr. TA, Mora Pluchino, PT, DPT, PRPC. Mora is a graduate of Stockton University with a BS in Biology (2007) and Doctorate of Physical Therapy (2009). She has been working at Bacharach Institute for Rehabilitation ever since graduation and has experience in a variety of areas and settings, working with children and adults, including orthopedics, bracing, neuromuscular issues, vestibular issues, and robotics training.

Mora began treating Pelvic Health patients in 2016 and has experience treating women, men, and children with a variety of Pelvic Health dysfunction. In 2020, she opened her own "after hours" virtual practice called Practically Perfect Physical Therapy Consulting to help meet the needs of more clients and has been a guest lecturer for Rutgers University Blackwood Campus and Stockton University for their Pediatric and Pelvic Floor modules and has been a TA with Herman & Wallace since 2020 with over 150 hours of lab instruction experience. Mora authored and instructs Ethical Concerns for Pelvic Health Professionals. 

 ● Your employer expects you to be responsible for supervising and billing for three orthopedic clients while you are in a private treatment area with a pelvic health patient. They say that you’re fine because the aide will be assisting the patients with their program.

 ● You are a new graduate, and your employer sends you to Pelvic Floor Level 1 and expects you to start up a Pelvic Health Program at the facility. Your first scheduled patient is a diagnosis you didn’t learn about and don’t feel comfortable treating, but your student loan payments have started, and you need this job.

 ● The word has gotten out and referrals are flowing into your clinic after hearing what a life-changing service your Pelvic Health program provides. You have a 6 month long waiting list and your front desk person asks you how to organize the list. Options include prioritizing based on the severity of issues, first come/ first serve, based on past history with the facility, etc.

Put yourself in these situations and reflect. How would you feel? What would you do? All of the situations above have a common theme. They present Ethical Concerns for Pelvic Health Professionals. Ethical situations are very common in day-to-day practice for any health care professional. Treating in the pelvic region can add additional complications due to the level of intimacy and vulnerability in this care.

Ethics by definition is “the division of philosophy concerned with how a person should behave in a matter that is considered morally correct or good” that gives us standards, virtues, and rules (Boone, 2017). The professional code of ethics for each professional category and is grounded in virtue ethics. Virtue ethics includes four main concepts including balance of harms and benefits, doing no harm, justice, and autonomy (Kirsch, 2005)

Whether a practitioner is a physical therapist/ physical therapist assistant, occupational therapist, psychologist, social worker, nurse, doctor, or physician’s assistant, their governing professional organization will have a code of ethics and conduct to help guide these practitioners in good decision making. There are many ethical decision-making models to help guide an individual through the process of identifying, defining, examining, and then problem solving any ethical occurrence.

The RIPS Model, originally presented by Arlanian, Swisher & Davis in 2005, presents an ethical framework to help guide practitioners through the steps needed to address ethical concerns. The world of ethical decision-making is typically one of many options, typically being more “gray area” than simply “black” and “white.” Ethical Concerns for Pelvic Health Professionals is designed to help make these decisions easier to define, examine, discuss, and address so we can have these tough conversations!

Ethical Concerns for Pelvic Health Professionals is a one-day remote course that covers ethical considerations for professionals working in the area of Pelvic Health. In general, Health Care Professionals have many day-to-day ethical considerations to “do no harm.” This includes basic decisions for billing, patient care, safety, and compliance. The purpose of this class is to explore the ethical challenges Pelvic Health practitioners may experience including consent, managing trauma and abuse, and preventing misconduct. To learn more join us in Ethical Concerns for Pelvic Health Professionals on June 18, 2022!


Research:

Boone, B. (2017). Ethics 101: From altruism and utilitarianism to bioethics and political ethics, an exploration of the concepts of right and wrong. Adams Media.

Kirsch, N. (2005). Ethics in Physical Therapy: A Case-Based Approach. McGraw Hill Publications. American Physical Therapy Association.

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