Sorry, not sorry.

Physiotherapy, profession or corruption? Agency, power and control.

Power and control. Who is the one who holds power? Who possesses the ability to pass on power and take it back? Is it really the one who has power through profession, or the one who has power because of their mind and spirit?

My ethical dilemma started in my first year. Unfortunately for me in terms of education, I have been surrounded by unpassionate, poor leading people, in positions they take for granted. If there is something that truly strays me away from class it is someone who demands my time and money but is not passionate, nor effective and good at educating others. This is a waste of my time. I too can read.

Through the years many of my educators (not all of them) have been in a position to force the student to remain in class, and make empty threats if they do not pitch. But if the student is bored, disappointed and truly doesn’t learn in the class, an example is made of them, as becoming a failure. The study by (Yunusa, Osman, & Ishak, 2011) found that efficient teacher-student relationships contribute to students’ increased level of motivation to learn and the enhancement of students’ academic achievement. The impact that someone in a position of power has over of a certain aspect of ones learning is great on many levels, and the motivation is influenced by the attitude and emotion that is associated with that lecturer/educator.

At the end of the day, no person should put the responsibility of their learning and growth or lack thereof on another. That is where you will truly lose your power, but surely if we are paying for a service, should we not receive it in full?

Student physiotherapist – Physiotherapist – Lecturer

In my third year of study, I had the opportunity of meeting the laziest, most demotivated and unpassionate physiotherapist. This physio had no qualms for displaying this to patients, fellow staff members as well as the student physiotherapists who practice there. There is no one example that I can bring forward to sufficiently give the reader perspective on the unethical, disrespectful behaviour they have and the poor representation they hold for the physiotherapy profession.

Let us name them unprofessionalism*, yes.

Unprofessionalism.

Each day they showed me something different.

Situation 01:

“If I don’t get to see a patient and they die by the next day, it was their time to go, hahaha”, “I only book 5 patients a day because I don’t like to be busy throughout the day”

Unprofessionalism introduced me to the staff members, very friendly and involved in their work. One day, two medical doctors came up to me and asked if I was a student physio working there, so I acknowledged this, and the amount of absolute relief and joy that they had was not normal. They were genuinely happy to be able to refer patients who essentially needed treatment for physiotherapy.

The way that I handled this: In my opinion, unprofessionalism disregarded the patient’s dignity and right to access of health care services. Many patients would end up waiting on an outpatient list for 3 to 4 months before receiving treatment, because unprofessionalism did not want to see that many patients, it was almost as though unprofessionalism was forced into this job. I specifically use the word job because they were just doing it for the money. How I ended up handling this situation whilst avoiding conflict, I would take the clinicians patients as my own and rather have unprofessionalism be at ease with having a relaxed day. I was able to see all the patients, and sometimes went overtime.

Situation 02:

A patient refused treatment and unprofessionalism insisted that they wanted to show the student physiotherapist this specific treatment, but the patient refused again. Unprofessionalism replied by saying that if the patient wanted to die, then that is what will happen, the patient could rot in the bed, and unprofessionalism then discharged the patient from physiotherapy.

The way that I handled this: In this case, I would make trips to see the patients progress, I would encourage them to do what they needed to do, and would make pamphlets for them so that could understand their condition and how to manage it as well as educated the patient on their rights as a patient. It felt so wrong, because my superior forbade me from seeing the patient because she was seen as a “yellow flag”, I trusted my gut and reasoned the unprofessional behaviour and decision making the clinician made.

Situation 03:

During one day, I asked unprofessionalism if they would continue with practising because obviously, in my mind they are poor representation for my own passion. Unprofessionalism stated that they are just maintaining the job and then will go into lecturing then they could be that, “cool” and “chilled” lecturer.

My heart could not help but feel absolute sadness for the students who would be in the same position as myself, that same revolving door. I couldn’t help but feel helpless for a generation of physiotherapists still to come. Because here, once again, do we find ourselves in the position where those in power have the capability and resources to make impact and influence in a profession with such substance.

Right to Human Dignity, Section 10 and Life, Section 11: This speaks of how each person has the right to have their dignity respected and protected. Right of access to Health Care Services, Section 27 (1a) of the Constitution of the Republic of South Africa, 1996. Physiotherapy services, in and outpatient play a huge role especially when the community all depend on government services. These are prominent human rights according the Constitution, which is the supreme law of the country.

Ethics, professionalism, work, patient, people. People are the ones whom are affected and who affect, so why not work on yourself, a person?

I have heard many students’ complaints and have taken part in some of these criticisms of superiors whom take the opportunity to break down students in public, to try make us feel like nothing and to disregard any sort of suggestion we bring forward. We will constantly go through a revolving door of behaviour, a pattern that continues to write our future if we are influenced by this. This profession, physiotherapy, should be one we are proud of, one we believe in, not because of the money we can make out of it as a business or financial security but for the way that we as physical therapists are able to add to another’s life.

Despite how unprofessionalism’s behaviour could have strayed me, and created a sense of hunger for money in physiotherapy, everything but that happened. Each day I would walk into work regardless of their attitude towards my passion, I would show respect and greet my clinician. I would not allow unprofessionalism’s reality to suppress mine, I was a professional respecting their rights in that situation.

In every scenario we may find ourselves in, people are constantly going through emotions and circumstances, but do you fall or do you stand on your values and foundation? These times in your life mould how you treat others, because of how you treat yourself and what you deserve. I specifically chose this clinicians behaviour, because the one party is considered a ‘professional’ by entitlement versus the other a student not yet ready to be a professional.

So I ask once again, where does professionalism begin, and how does a single professional look? I understand that we need a baseline, a standard to set in order to control behaviour but we also need to realise that it much deeper than that, because it is our lives being controlled so why not challenge the reasons for this standard. In this you are able to understand the deeper meaning for your views and for the reasoning on the views we vow to. If in the eyes of the court, ignorance is not valid, how do you reason your resolve for an ethical dilemma if your values and principles are not in line with those of your profession and the ethical code of conduct you so rightfully signed up for?

It is unfortunate that some people in a superior position have let down the youth and community because of poor leadership and unprofessionalism in dealing with dilemmas. However when we are faced with these dilemmas now or one day in the future, will we handle it the same or will we be different? Important aspects to meeting a resolve are: the way we handle the dilemma at the given time; the manner in which we approach others after the conflict; the way we manage or deal with a situation like that afterwards, these are key elements towards growth post dilemma.

Despite the many negatives I faced with my clinicians behaviour and conduct, I acknowledged them as a human being, I respected the position they were in regardless of the manner they carried it forward and I learned immensely from the lessons unprofessionalism could not care less about.

References

Amon, J., Baral, S., Beyrer, C., & Kass, N. (2012). Human Rights Research and Ethics Review: Protecting Individuals or Protecting the State? PLOS Medicine , 9(10), 1001325. Retrieved from https://doi.org/10.1371/journal.pmed.1001325

Bandura, A. (2006). Toward a Psychology of Human Agency. Perspectives on Psychological Science , 1(2), 164–180.

Currie, I., & De Waal, J. (2016). The Bill of Rights Handbook. Cape Town: JUTA Law.

Global Corruption Report. (2006). Transparency International. London: Pluto Press.

Health Professions Amendment Act: No. 29 of 2007. (2008). Government Gazette, 511(30674).

Hoffmann, W., & Nortjé, N. (2015). Ethical misconduct by registered physiotherapists in South Africa (2007–2013): A mixed methods approach. South African Journal of Physiotherapy, 71(1), 1-7.

JUTA’S Statutes. (2012). The Constitution of the Republic of South Africa Handbook . Cape Town: JUTA Law .

Kusurkar, R. A., Ten Cate, T. J., Vos, C. M., & Westers, P. (2013). How motivation affects academic performance: a structural equation modelling analysis. Advances in Health Sciiences Education, 18, 57–69.

Metz, T. (2011). Ubuntu as a moral theory and Human Rights in South Africa. AFRICAN HUMAN RIGHTS LAW JOURNAL, 532-559.

Mphale, L., & Mhlauli, M. (2014). An Investigation on Students Academic Performance for Junior Secondary Schools in Botswana. EUROPEAN JOURNAL OF EDUCATIONAL RESEARCH, 3(3), 111-127.

Rispel, L., de Jager, P., & Fonn, S. (2016). Exploring corruption in the South African health sector. Health Policy and Planning, 31(2), 239-249.

Robinson, V., Lloyd, C., & Rowe, K. (2008). The Impact of Leadership on Student Outcomes: An Analysis of the Differential Effects of Leadership Types. Educational Administration Quarterly, 44(5), 635-674.

Yunusa, M., Osman, W., & Ishak, N. (2011). Teacher-student relationship factor affecting motivation and academic achievement in ESL classroom. Procedia Social and Behavioral Sciences, 15, 2637–2641.

Introducing me: Genevieve Gani

Professionalism or social conformity?

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