Ethics in the Workplace

Knowing and using proper ethical practice is vital for newcomers to the O&P field and established practitioners alike. Not only does it enable providers to deliver the best patient care possible, it also acts as a preventative for fines and lawsuits. A code of ethics is essential for understanding ethical precepts, but even that cannot cover every moral situation a person might come across. Sometimes it is difficult to determine appropriate ethical behavior. In my recent course work, I was required to interview an O&P professional about business and personal ethics. I took the assignment a step further and sent a questionnaire to the OANDP-L listserve. These are some of the subjects the questionnaire addressed: What does it means to be a professional in the O&P field? Does a code of ethics help individuals in their performance? Did your education help prepare you to deal with ethical dilemmas? Compare your personal ethics to your professional ethics? What ethical dilemmas have you encountered in the workplace? I received responses from both males and females from all over North America, with experience in the O&P field ranging from four to more than 40 years. Professionalism When asked what it means to be a professional in the O&P field, responses varied, but they all carried a similar general theme. "[To be a professional] means to behave in a prescribed fashion. You accurately describe the services...on invoices, and you provide what doctors ask for.... You don't sell [patients or clients] things they don't need, and you don't touch them in an inappropriate way...." "From patients to case managers, doctors, and even other practitioners...they all demand different professional respect.... [G]iving each the highest respect and performing each task above and beyond the call of duty is professional." "[To be a professional is to] provide quality orthotic/prosthetic care, [and to] treat the whole patient." I think the general description of "professional" was best summed up in one respondent's answer: "Educated, experienced, and ethical." Ethical Standards The American Board for Certification in Orthotics and Prosthetics (ABC) Canons of Ethical Conduct defines the rules of appropriate behavior in the field; however, when asked if a code of ethics helps an individual in his or her performance at work, the answers were surprisingly negative. One respondent, who has been in the O&P field for 24 years, answered, [A code of ethics helps], but only so far as that person is ethical to begin with. Enforcement is weak due to the inability to provide concrete evidence of a violation, the public's lack of knowledge on how to report violations, and the reluctance of fellow practitioners to report violations." Another participant responded, "No.... There is limited ability to censure those who have not followed the Canons." Education and Ethics Education plays a large role in orthotic and prosthetic training, but when asked how they felt their education had prepared them to deal with ethical dilemmas, the majority of respondents expressed that formalized ethical training is largely absent. "My upbringing, not my education, prepared me." "[The ethical training came] more so [from] my character; the education prepared me to provide quality care." "Education provided the blueprint for ethical dilemmas, but...I have come to realize that there is no substitute for experience and maturity." Ethical Dilemmas While each of the respondents had experienced at least one ethical dilemma during his or her employment, no one reported situations having to do with harassment, abuse, or a physical issue involving a patient. The most commonly reported ethical issue was the intentional incorrect billing for services. Respondents reacted in much the same way to such dilemmas: "[I] told the patient that I would write down what was actually sold and not what they wanted me to write." "[I] reported violations to company owner [and] Medicare." Others stated problems including patients wanting services provided at little or no cost and uninsured patients with poor credit requiring services. As a newcomer to the O&P profession, I know that I will be faced with ethical predicaments; however, I feel better prepared to handle or even avoid future dilemmas knowing that my personal ethics already are established by my own upbringing and that I have excellent counsel to look back on. One of the best pieces of advice I received was from prosthetist Robert Chung, CP, who said, "When you are faced with an ethical dilemma, ask for the advice of trusted staff around you, but realize that it is ultimately your decision, and the repercussion for a wrong move will come back on you, not them." Julie Whittinghill is a recent graduate of OSU-Okmulgee's O&P Assistant program. The complete American Board for Certification in Orthotics and Prosthetics (ABC) Canons of Ethical Conduct as established by the ABC's Committee on Professional Discipline can be accessed at www.abcop.org/Assets/PDF/CanonsOfEthics.pdf

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