Professional
Practice
Delivered by
Dr Abdul Haseeb Bhutta (PT)
DPT, M.Phil (SMMPT), PGD
(E&TM)
PHD
The Physical Therapist as
Professional
• As much as we would like to think so, Physical
therapy not yet completely recognized as a
profession.
“ Catherine
Worthingham”
• Before deciding a definition of Physical therapy,
Physical therapist must decide whether they
really want to be professional or just make
believe they are by paying lip service to
professionalism.
“Mary E Kolb”
Definitions- Profession &
Professional
• Profession:
• Latin precursor—profiteor—means “To profess a belief”
• A profession is an occupation that is viewed by the
society as a profession on the basis of its
characteristics ,developents,or power.
• Professionalism:
• Professionalism is the internalized conceptualization of
expected professional
obligations,attributes,interactions,attitudes,values,and
role behaviours in relation to individual patients and
clients and society as a whole .
Cont…
• Individual Professionalism:
• Internalized beliefs of an individual as a member
of profession regarding professional
obligations,attributes,interactions,attitudes,valu
es,and role behaviours .it is also called as
“Professional Role Concept”
Sociological Perspective about
Profession:
• Sociological literature about profession takes three
approaches.
• 1-Structural Approach.
• 2-Processual Approach.
• 3- Power approach.
• 1-Structural Approach.
• Focus on the static characteristics that an occupation
must possess to be considered a profession.
• Four elements– theoretical knowledge, some degree of
professional autonomy,ethics,accontability to society.
Cont..
2-Processual Approach.
• Focus 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.
3- Power approach.
• Believe that a profession’s ability to obtain the
political and social power to define its work is its most
important characteristics.
Characteristics of a Profession cited in
Literature:
1-Knowledge:
• Broad, generealized,theoratical,systemic knowledge.
• Unique body of knowledge.
• “Formal Knowledge” knowledge that is embedded and
applied in and through the professional.
02-Autonomy in professional decisions:
• Autonomy from client.
• Autonomy from organizations or external parties.
• Autonomy in selecting colleagues.
Cont…
03-Authority:
• Based on internal knowledge.
• Granted by society.
• Demonstrated by power and status in society.
• Demonstrated by monetary and symbolic awards.
04-Education:
• Extensive
• Skillled,technical,esoteric
• High standards for admissions.
Cont..
05-Responsibility,Accountability,&
Ethics:
• Service Orientation.
• Accountability and responsibility to society.
• Formal code of ethics that members enforce.
• Self control of behaviour that internalize
professional ethic.
• Belief in self regulations.
• Community interest more important that self
interest.
• Trustworthiness.
Cont…
06-Nature of work & Decision:
• Important or essential to clients.
• Complex.
• Not routine.
• Not programmed.
07-Role and Identity:
• Internally based and sense of calling.
• Formed and driven by the professional group.
• Extending beyond the specific work situation.
Pavallko’s occupation to Profession
continuum.
Dimensions Occupation Profession
Theory ,intellectual Absent Present
technique
Relevance to social Not relevant Relevant
values
Training period A-Short A-Long
B-Non specialized B-Specialized
C-involves things C-involves symbols
D-subculture unimportant D-subculture
important
Motivation Self interest service
Commitment Short term Long term
Sense of community Low High
Code of ethics undeveloped Highly developed
Autonomy Absent Present
Qualities of professions
• AUTONOMY,
• SELF-REGULATION OF ETHICAL
STANDARDS,
• AND ACCOUNTABILITY
Autonomy
• As the previous section suggests,
autonomy in making professional
judgments is a
• “litmus test” for professions. Autonomy
can be defined as the “extent to which [a
profession] or an individual feels freedom
and independence in his/her role.”
Privileges of Autonomous Practice in 2020
• Each of these elements includes two overarching concepts:
recognition of and respect for physical therapists as the
practitioners of choice, and recognition of and respect for the
education, experience, and expertise of physical therapists in
their professional scope of practice.
1. Direct and unrestricted access : The
physical therapist has the professional capability and ability
to provide to all individuals the physical therapy services
they choose without legal, regulatory, or payer restrictions.
• 2. Professional ability to refer to other
health care providers: The physical therapist
has the professional capability and ability to refer to others in
the health care system for identified or possible medical
needs beyond the scope of physical therapist practice.
3. Professional ability to refer to
other professionals: The physical therapist
has the professional capability and ability to refer to
other professionals for identified patient/client needs
beyond the score of physical therapist practice.
4. Professional ability to refer for
diagnostic tests: The physical therapist has
the professional capability and ability to refer for
diagnostic tests that would clarify the patient/client
situation and enhance the provision of physical
therapy services.
• In Rothstein’s opinion, “interdependence is not a sign
of weakness.
• “Autonomy” conveys arrogance.
Self-Regulation of Ethical Standards
• A second important characteristic of professionals is
ethical conduct and self regulation. This includes the
possession of a code of ethics and mechanisms that
ensure members abide by the code’s principles. The
American Physiotherapy Association, the forerunner of
the APTA, adopted its first code of ethics in 1935.31
The first code identified four major ethics violations:
• Four major ethics violations:
• Making a diagnosis
• Offering a Prognosis
• Advertising for patients
• Criticizing the doctor or other co-workers
• The obligation to enforce a code of ethics is
also called self-regulation/…..
Accountability of professionals
The third important attribute of professionals is responsibility
and accountability
• Taken together, these terms mean that professionals have
obligations and must "account” to the public for the
discharge of these duties.
Emanuel and Emanuel define accountability as “the process by
which a party justifies its actions and policies”
Justifies action and policies
• three separate models of accountability:
• Professional
• Political
• Economic
• Patient , association , investors , courts , Govt etc
• Physical therapy & concept of
professionalism
• DPT
• Expectations
• Individual professional
