5E. Physical therapists who have knowledge that a colleague is unable to perform their professional responsibilities with rea- sonable skill and safety shall report the information to the appropriate authority. 5F. Physical therapists shall provide notice and information about alternatives for obtaining care in the event the physical thera- pist terminates the provider relationship while the patient/ client continues to need physical therapy services. Interpretation: Colleague Impairment (APTA, 2013a). The cen - tral tenet of Principles 5D and 5E is that inaction is not an op - tion for a physical therapist when faced with the circumstances described. Principle 5D states that a physical therapist shall en- courage colleagues to seek assistance or counsel. Principle 5E addresses reporting information to the appropriate authority. 5D and 5E both require a factual determination by the therapist. This may be challenging in the sense that the therapist might not know or it might be difficult to determine whether someone, in fact, has a physical, psychological, or substance-related impair- ment. In addition, it might be difficult to determine whether such impairment may be adversely affecting his or her professional re- sponsibilities. Moreover, once the therapist makes these determinations, the obligation under 5D centers not on reporting, but on encourag- ing the colleague to seek assistance. However, the obligation un- der 5E does focus on reporting. Note that 5E discusses report- ing when a colleague is unable to perform, whereas 5D discusses encouraging colleagues to seek assistance when the impairment may adversely affect his or her professional responsibilities. So 5D discusses something that may be affecting performance, whereas 5E addresses a situation in which someone is clearly unable to perform. The two situations are distinct. In addition, it is important to note that 5E does not mandate to whom the therapist should report and gives the therapist discretion to determine the appro- priate authority. Principle #6: Physical therapists shall enhance their expertise through the lifelong acquisition and refinement of knowledge, skills, abilities, and professional behaviors. ( Core value : Excellence. ) 6A. Physical therapists shall achieve and maintain professional competence. 6B. Physical therapists shall take responsibility for their profes- sional development based on critical self-assessment and reflection on changes in practice, education, health care de- livery, and technology. 6C. Physical therapists shall evaluate the strength of evidence and applicability of content presented during professional de- velopment activities before integrating the content or tech- niques into practice. 6D. Physical therapists shall cultivate practice environments that support professional development, lifelong learning, and ex- cellence. Interpretation: Clinical Competence (APTA, 2013a). 6A requires a physical therapist to maintain professional competence within one’s scope of practice throughout one’s career. Maintaining com- petence is an ongoing process of self-assessment; identification of strengths and weaknesses; acquisition of knowledge and skills based on that assessment; and reflection on and reassessment of performance, knowledge, and skills. Numerous factors—includ- ing practice setting, types of patients/clients, personal interests and the addition of new evidence to practice—will influence the depth and breadth of professional competence in a given area of practice. Interpretation: Professional Growth (APTA, 2013a). 6D elabo- rates on the physical therapist’s obligations to foster an environ- ment conducive to professional growth even when not supported by the organization. The essential idea is that it is the physical
therapist’s responsibility, whether or not the employer provides support. Principle #7: Physical therapists shall promote organizational behaviors and business practices that benefit patients/clients and society. ( Core values : Integrity, accountability. ) 7A. Physical therapists shall promote practice environments that support autonomous and accountable professional judg- ments. 7B. Physical therapists shall seek remuneration as is deserved and reasonable for physical therapist services. 7C. Physical therapists shall not accept gifts or other consider- ations that influence or give an appearance of influencing their professional judgment. 7D. Physical therapist assistants shall ensure that documentation for their interventions accurately reflects the nature and ex- tent of the services provided. 7E. Physical therapists shall be aware of charges and shall ensure that documentation and coding for physical therapy services accurately reflect the nature and extent of the services pro- vided. Interpretation: Charges and Coding (APTA, 2013a). Principle 7E provides that the physical therapist must make sure that the process of documentation and coding accurately captures the charges for services performed. Where charges cannot be deter- mined because of payment methodology, physical therapists may review the House of Delegates policy titled “Professional Fees for Physical Therapy Services.” Additional resources on documen - tation and coding include the House of Delegates policy titled “Documentation Authority for Physical Therapy Services and the Documentation and Coding and Billing” on the APTA website. Principle #8: Physical therapists shall participate in efforts to meet the health needs of people locally, nationally, or globally. ( Core value : Social responsibility. ) 8A. Physical therapists shall provide pro bono physical therapy services or support organizations that meet the health needs of people who are economically disadvantaged, uninsured, and underinsured. 8B. Physical therapists shall advocate to reduce health dispari - ties and health care inequities, improve access to health care services, and address the health, wellness, and preventive health care needs of people. 8C. Physical therapists shall be responsible stewards of health care resources and shall avoid overutilization or underutiliza- tion of physical therapy services. 8D. Physical therapists shall educate members of the public about the benefits of physical therapy and the unique role of the physical therapist. Interpretation: Pro Bono Services (APTA, 2013a). The key word in Principle 8A is or. If a physical therapist is unable to provide pro bono services, he or she can fulfill ethical obligations by sup- porting organizations that meet the health needs of people who are economically disadvantaged, uninsured, and underinsured. In addition, physical therapists may review the House of Delegates guidelines titled “Guidelines: Pro Bono Physical Therapy Servic- es.” Additional resources on pro bono physical therapy services are available on the APTA website. 8A also addresses supporting organizations to meet health needs. In terms of supporting organizations, the principle does not spec- ify the type of support required. Physical therapists may express support through volunteerism, financial contributions, advocacy, education, or simply promoting their work in conversations with colleagues.
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