Working as practice advisor, I receive questions everyday from physiotherapists. Some are fairly run of the mill and others require detailed research and careful contemplation. Recently, I received this question, related to care that was not optimal or contraindicated: “What is my responsibility in providing feedback to other physiotherapists with whom I do not have any direct contact, regarding how they have treated patients who are now under my care?”
Just pause for a moment and think about what you think the correct answer to the question is. Then, ask yourself what you have done when faced with this situation. The truth is, many of us have faced this problem and have attempted to address the issue with varying degrees of success.
It may surprise you to know that providing feedback to fellow physiotherapists isn’t just the right thing to do, it is required of you, as a registered member of a regulated profession. In fact, the very foundation of self-regulation is the expectation that the profession, in exchange for self-regulation, will “develop, implement, and enforce various rules. These rules are designed to protect the public by ensuring that services from members of the profession are provided in a competent and ethical manner.”1
The basis of self-regulation is ‘that members of a profession are in the best position to set standards and to evaluate whether they have been met.”1 In other words, you are the best one to judge if the practice of your colleagues meets the standards and expectations of the profession.
While the College of Physiotherapists of Alberta gets involved when issues are brought to our attention, “ultimately, public protection depends on the culture of self-responsibility and accountability that goes with professionalism”2 and that’s on all of us.
Wanting to provide this physiotherapist with a complete answer, I went to the Code of Ethical Conduct and the Standards of Practice looking for answers.
The Code of Ethical Conduct provides physiotherapists with guidance regarding physiotherapists’ professional responsibilities which include the need to:
- Be professionally and morally responsible for addressing incompetent, unsafe, illegal, or unethical practice of any health-care provider and legally responsible for reporting conduct that puts the client at risk to the appropriate authority/ies.
- Recognize the responsibility to share evidence-informed and clinical best practices in physiotherapy with each other and other health-care professionals.
- Contribute to the development of the profession through support of research, mentoring, and student supervision.
By upholding the responsibilities in the Code of Ethical Conduct, physiotherapists maintain and enhance the reputation of the physiotherapy profession and inspire the public’s trust and confidence.
The Standards of Practice speak directly to the importance of practicing within one’s own individual competence. They also address the importance of:
- valuing the client’s best interests,
- engaging in respectful, open and honest communications in all professional interactions, and
- sharing information regarding evidence and best practices to support improvement of client outcomes and the delivery of quality services within the health-care system at large.
The public interest is and must be the primary focus of regulatory bodies and registered physiotherapists alike. Failure to have public interest take precedence “leaves the profession open to losing its self-regulatory status and potentially being regulated directly by government.”1 Helping your colleagues to meet the expectations outlined in the Code of Ethical Conduct and Standards of Practice also helps to support ongoing self-regulation of the physiotherapy profession.
However, we all know there is a difference between knowing we need to do something and taking action.
In the course of our careers we’ve all been on the receiving end of feedback, both good and bad. Here are some tips to help when it comes to giving and receiving feedback:
For those providing feedback:
- Remember there is a difference between “what I would do” and practice that is “wrong, dangerous or contraindicated.” The former represents a difference of approach, the latter demands that you act.
- Ask permission and tell the person what you want to discuss.
- Make an appointment to have a discussion at a mutually agreeable time.
- Remember that the point is to help your colleague do a better job. The value of feedback is in the value it has to the recipient, not the giver.
- Focus on the facts and objective observations, not inferences. Be specific.
If you are on the receiving end:
- Listening to feedback can be hard. Feedback isn’t always balanced or accurate. None-the-less, listen for the grain of truth that you are being told.
When faced with practice that is unsafe or contraindicated, we have a responsibility to each other to make sure that we provide feedback and elevate the practice of physiotherapy in general. Giving, receiving and incorporating feedback is essential to quality, safe and effective physiotherapy practice.
- Randall G. Understanding professional self-regulation. Available at: http://www.oavt.org/self_regulation/docs/about_selfreg_randall.pdf Accessed February 17, 2015.
- Lahey W. Is self-regulation under threat? Canadian Nurse 2011; May. Available at: http://canadian-nurse.com/en/articles/issues/2011/may-2011/is-self-regulation-under-threat Accessed February 17, 2015.
- Physiotherapy Alberta - College + Association. Code of Ethics. Edmonton: Physiotherapy Alberta – College + Association, 2011. Available at: http://www.physiotherapyalberta.ca/physiotherapists/what_you_need_to_know_to_practice_in_alberta/code_of_ethics Accessed February 17, 2015.
- Physiotherapy Alberta - College + Association. Standards of Practice for Alberta Physiotherapists. Edmonton: Physiotherapy Alberta – College + Association, 2012. Available at: http://www.physiotherapyalberta.ca/physiotherapists/what_you_need_to_know_to_practice_in_alberta/standards_of_practice Accessed February 17, 2015.