Physical Therapists' Perception of Risk of Violating Laws and Rules Governing the Practice of Physical Therapy and/or Their Personal Moral and Ethical Values When Failing to Provide Treatment for an Uninsured or Underinsured Patient
Date of Award
Doctor of Education (Ed.D.)
There will be times when physical therapists will be asked to treat patients who cannot afford needed services. Under such circumstances, physical therapists are at serious risk of violating the laws and rules governing their profession and also, perhaps, at risk of violating their personal moral or ethical values if they fail to treat, or arrange alternative treatment for, these patients. The purpose of this study was to examine the relationship between two independent variables, (1) Professional role of the physical therapist (clinician, administrator, or educator), and (2) APTA membership status, and two dependent variables, (1) perceived level of risk of violating the laws and rules governing the practice of physical therapy in Ohio, if treatment is not provided to, or arranged for, the patient in a case dilemma, and (2) perceived risk of violating personal moral or ethical values in the same situation. This study utilized a questionnaire that asked respondents to rate perception of risk of violating the dependent variables in each of four defined resolutions to the dilemma of treating an uninsured or underinsured patient. These resolutions were (A) fail to provide, or arrange for, treatment, (B) refer the patient to a safety-net provider, (C) provide some, but not all, necessary treatments or, (D) make illegal adjustment(s) to billing. APTA members reported a higher perceived risk than non-APTA members of being out of compliance with the laws and rules governing physical therapy in Ohio if they resolved the dilemma by providing some forms of treatment, which were more affordable or were covered by the patient's insurance plan, not providing other services, which although needed, are un-reimbursable (Resolution C). Educators reported a higher perceived risk than administrators of violating personal moral or ethical values if they utilized this same resolution. APTA members also displayed a significantly greater perception of risk than non-APTA of violating laws and rules across all four resolutions and when comparing combined dependent variables. The results of this study indicate that there is room for growth in the perception of risk across all resolutions and among all respondents and presents challenges on three fronts: the need for expanded provision of services to uninsured and underinsured patients; the need for revision of the laws and rules governing physical therapy in Ohio; and the need to educate physical therapists in the discrepancies in the laws and rules governing the profession that are putting them at risk. The role(s) each physical therapist might play in meeting these challenges are discussed.
Carroll, Mark, "Physical Therapists' Perception of Risk of Violating Laws and Rules Governing the Practice of Physical Therapy and/or Their Personal Moral and Ethical Values When Failing to Provide Treatment for an Uninsured or Underinsured Patient" (2007). Leadership Studies Ed.D. Dissertations. 24.