Writing is one of my coping strategies. One year ago, I got fed-up-to-here with pain-filled stories of suffering and injustice among my colleagues, so I responded by drafting a list of “Basic Rights for Healthcare Professionals.” Then I proceeded to record a pretty awful video of myself talking about them. I brought the video back out today as a kind of private anniversary moment, and it was painful to watch.
I was in my backyard and my neighbor was using a deafening chainsaw, but I was too stubborn to just hang it up for the day. I had to laugh at myself and was glad that not too many people had viewed it.
Despite its technically flawed delivery, I remain passionate about the Bill of Rights idea, and I still want your feedback. This time I’ll just let you read it and skip the video with the chainsaw soundtrack.
Basic Rights of OT Practitioners (a work in progress)
All certified/licensed occupational therapy practitioners deserve to be treated with respect and to practice with the autonomy conferred by our accrediting agencies and licensing boards. They have the right and responsibility to routinely and consistently:
1) Follow the standards of practice and codes of ethics of our profession.
2) Follow state and federal laws, such as those that mandate reporting suspected abuse and neglect of vulnerable clients, including fraudulent practices or documentation of services.
3) Work in conditions that routinely support basic physiological needs (i.e. flexible time to eat and use the restroom).
4) Be paid for their professional services, including documentation, evaluation interpretation and reporting, communicating with team members on behalf of the clients, and treatment planning.
5) Make clinical decisions in the service of their clients based on their professional expertise and reasoning, and to have the final say on what is and is not within their scope and domain of practice in any setting.
If we all worked under this bill of rights, we would be in full accord with the AOTA Code of Ethics. We would function as the licensed professionals that we are and suffer professional burnout less often.
Here’s how I envision these basic rights playing out in real life:
You, the OT, would make the clinical decisions about whether and when OT services are needed, how to evaluate, what the outcome goals will be and what interventions to employ. You could step up or decrease services as clinically indicated. You would not be pressured to push therapy on people who are too frail to benefit, nor on those who choose to refuse treatment.
When pressured to provide services that are clinically unwarranted, you would say, “My license and professional association prevent me from doing that. Alternative options could include…”
If business administrators pressured you to charge or document inappropriately, you would refuse and say, “I’m sure you don’t realize it, but doing that could get us all into legal trouble.” You would consistently seek help for clients whose safety was in doubt.
You would do your work at a functional pace, taking breaks to care for personal needs and to communicate with teammates.
You would have dedicated time to document, interpret evaluations, set goals, plan sessions and focus your attention on each client during their session. You would connect with your clients and they would feel cared for.
Your evaluations would fit each client’s situation and would yield rich and meaningful information toward developing individualized, occupationally relevant intervention.
Your clients would actively engage in their OT sessions, know that they were listened to and meet outcome goals that were clearly life-enhancing. They would be fulfilled and excited about your work together. Your colleagues would see value in what you bring to the team, as well.
You would experience your daily work as satisfying and meaningful, and your energy and enthusiasm would be strong. You would feel proud of your accomplishments.
So, what’s your reaction to this Bill of Rights? Did I leave something out? Is it shooting too high? Too low? Where would you like to see it go?
And if you’d like a good laugh and to hear the chainsaw, you can still check out my video.