“Treat them with respect, let them learn from their peers, and give them freedom to make decisions as a team”.
Sounds like a prescription for PT’s? Actually, it is for teachers according to Dr. Andy Hargreaves and Dr. Michael Fullan authors of Professional Capital: Transforming Teaching in Every School recent recipients of the 2015 Grawemeyer awards in Education. After spending some time with this book and in conversations with Dr. Fullan, I am convinced they are onto something-as much about physical therapists as they are teachers.
While there is way more substance to their treatise, let’s examine four key commonalities with physical therapists. According to the authors:
Teachers have had an undue emphasis on accountability which has subverted the profession by pitting teachers and schools against each other and stealing the joys of teaching. PT’s have likewise had an over emphasis on process measures all in the name of accountability-PQRS, documentation guidelines, plans of care, modifiers for example which has likewise reduced the joys of evaluating and treating patients.
Teachers will automatically elevate their own competency when placed in a team environment that encourages individual contributions, group interaction, and continuous learning. Similarly, key competencies for PT’s are the tacit knowledge skills through teamwork, collaboration, and peer to peer communication, feedback, and reflection.
Teachers have been ingrained with performance based education models that reward or punish teachers-all of which have lacked signfiicant empirical support and are undergoing revisions. This blog has been unrelenting in the view of the unintended consequences and failure of pay for performance measures in healthcare and in particular PT’s (related posts on this topic HERE).
Teachers can thrive when they are treated with dignity, and given freedom to exercise professional judgment together. Same for PT’s who would greatly benefitby a more permissive practice act rather than a prescriptive list of do’s and don’ts (APTA HOD are you listening to @childsjd post and comments?)
Perhaps the consistencies between teachers and PT’s are remarkable simply because PT’s are in part teachers-however, the demands from third parties (e.g. payors, government) and other watchdog groups creating complex ways in the name of improvement are just radically misguided. Individuals migrate towards professional career paths primarily because of intrinsic motivators or desires to perform or participate in an activity for it’s own sake. The external focus of process measurements (extrinsic motivators), so called “accountability” of outcomes, and third party constraints squelch the very drivers of these noteworthy careers causing the joys or internal benefits of teaching and applying physical therapy to be zapped. Certainly, treating with respect, learning from peers, and giving freedom to make decisions would work in our profession-but then again that would be too much common sense and we live in an overly regulated world where common sense is not common practice.
Thoughts?
@physicaltherapy
