Working in healthcare most of us have interacted with physiotherapists and know part of their role as helping patients to take their first steps after an injury or disease. In this blog we will explore how these members of the interprofessional team with strong values and a unique professional identity are perfectly poised to help Canadians step into a new era of proactive health care.
In 2016 approximately 39% of all physiotherapists in Canada worked in the hospital system with approximately 49% of physiotherapists were employed in a community setting (CIHI, 2017).
Now imagine for a moment a health care system with an emphasis on preventative medicine where instead of taking a step in the direction of recovery, physiotherapists can help to take a step in the direction of prevention.
With the distribution of physiotherapists divided with half in in hospital and half in the community this group of health care professionals are uniquely poised to tackle a shift towards more emphasis placed on preventative medicine. Let us discover some of the values of the profession of physiotherapy and see if these health care professionals are well suited to preventative medicine.
The College of Physiotherapists of Ontario, the regulatory body for physiotherapists, has adopted a values-based code of ethics. There are four main values 1. Excellence 2. Autonomy and Well Being 3. Communication, Collaboration and Advocacy 4. Honesty and Integrity (COPO, 2013).
Let us reflect on the value of advocacy through my own personal experiences. Every day in practice I am advocating for patients to receive the best care from requesting additional services to helping patients and their families understand the health care system and how better to navigate it. With the acute care system bursting at the seams there is a constant pressure to clear beds as soon as possible. Daily I must advocate for patients not to be discharged before they are safe to do so. What about physiotherapists advocating for the need to change the health care system into more of a proactive rather that reactive system. For that we need to explore a little more about how physiotherapy services fit into the Canadian health care system.
In hospital physiotherapy services are covered in Ontario by the Ministry of Health and Long Term Care. Government funded physiotherapy services are also available provided certain conditions are met to some outpatient clinics, long term care facilities, and in home physiotherapy services (Ontario, 2017). Approximately 53% of physiotherapists work in private practice (CIHI, 2017) where patients must pay out of pocket for services which they may or may not have reimbursed through extended health insurance coverage.
Physiotherapists must advocate for a better health care system. The Institute for Healthcare Improvement has created a framework for optimizing health care systems by simultaneous accomplishing three critical objectives: 1. Improving the patient experience of care 2. Improving the health of populations 3. Reducing the per capita cost of health care; called the triple aim (Berwick, Nolan, & Whittington, 2008). I believe by re-distributing funding to preventative health programs we can impact all three objectives and thus optimize our health care system.
We know that physiotherapists practice advocacy and are poised in an almost equal split among those in the hospital and in the private sectors. Lastly, we need to explore how these professionals identify themselves in both at work and in their community.
Firstly, I would say that the profession of physiotherapy tends to attract active individuals, given the make-up of my university class and my physiotherapy colleagues for the last eight years. Secondly, people know me as a “physio” and therefore will connect my personal identity with my professional identity. I believe all health care providers have a higher standard to set and therefore must be mindful of how they portray themselves in person and what they post on social medial. Human nature will connect personal comments to the values and identity of the profession and certain opinions or behaviours that are incongruent with the practice of that health professional group will cause public distrust and possible serious consequences with their professional body. I feel a strong need to practice what I preach which dictates both my personal and professional identity.
Hopefully we have learned more about how these physiotherapists, with their unique split in the health care system, their values, and how their professional and personal identity tends to overlap strongly are well suited to help Canadian take a step towards preventative health care.
References
Berwick, D. M., Nolan, T. W., & Whittington, J. (2008). The triple aim: Care, health, and cost. Health Affairs, 27(3), 759–769. https://doi.org/10.1377/hlthaff.27.3.759
Canadian Institute of Health Research (2017). Physiotherapists in Canada. Retrieved https://secure.cihi.ca/estore/productSeries.htm?pc=PCC439
College of Physiotherapists of Ontario (2013). Code of Ethics. Retrieved https://www.collegept.org/rules-and-resources/ethics
Government of Ontario (2017). Get Physiotherapy. Retrieved https://www.ontario.ca/page/get-physiotherapy?_ga=2.233950235.486181278.1517335939-1648455931.1516126707
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