THE IMPORTANCE OF PHYSIOTHERAPY AUTONOMY
Ask anyone who is working as a qualified physiotherapist within the healthcare industry and majority would agree that professional autonomy brings about job satisfaction, motivation and improved self-confidence within their workplace practice. Professional autonomy is directly associated with the therapist’s increase in task responsibilities and an improvement in patient-centered care within their healthcare organization. It is an act of professional control and influence over their day-to-day decision making skills as a physiotherapist with regards to the context of patient-therapist trust, resulting in better treatment outcome without the need to be dominated by other healthcare and/or medical profession.
Professional autonomy allows physiotherapist to execute treatment that best meets their patient’s needs, which indirectly promotes self-confidence and the desire to improve. As a physiotherapist by profession, I have been working in the private healthcare industry for the past 8 years. I have been blessed to be able to adopt and practice professional autonomy within my organization with the help and support of our consultants and the hospital’s management. My team and I are allowed the freedom to access and to plan rehabilitation treatments for our patients, whilst reporting and updating our consultants in regards to our patient’s rehabilitation progress.
However, I have always wondered if my fellow physiotherapists from other private healthcare organizations and rehabilitation centers are practicing and adopting this similar concept.
There has been endless articles and publications with regards to professional autonomy amongst physiotherapy in America & European countries with most articles concluding on positive outcomes of practicing professional autonomy. The board of directors of the American Physical Therapy Association (APTA) has defined autonomy physiotherapy practice as, I quote “independent, self-determined professional judgment and action”, whereby physiotherapist have the ability, capability and competency to practice professional judgement within their field of work. Researchers Johnson and Abrams also stated that “physiotherapy are ready to emerge from the multidisciplinary, interdependent healthcare modal and grow into a more autonomous profession”.
Although I am confident that Malaysian allied health practitioners can achieve professional autonomy in the near future, I could not help but wonder, if professional autonomy in physiotherapy is widely adopted, practiced and more importantly, accepted by the current healthcare community and medical professionals in Malaysia. Furthermore, my thoughts lay on the challenges that lies ahead on the confidence & competency of the physiotherapist themselves in adopting the professional autonomy modal to their current practice.
As I was pondering on this matter, I took to research articles on the co-relations between allied health autonomy and the influence it brings within the multidisciplinary healthcare modal. As expected, I stumbled upon a few factor that I thought might be the impeding factor of physiotherapy autonomy in Malaysia. Medical dominance within the healthcare system has been traditionally the principle of healthcare delivery. Medical power translates as the professional autonomy of consultants and on how their role is a pivoting point through dominance over patient referrals and allied health professionals.
A research study done within the Australian healthcare workforce has identified numerous abuse of professional autonomy. Amongst those factors identified are:
• Medical professional exercising autonomy on its own field, without subjugation of evaluation from other healthcare professionals.
• Medical professional exercising autonomy by directing and limiting procedures of other allied health professionals.
• Medical professional wielding administrative power and control over patient referrals.
That being said, there are also other few key concerns to bear in mind on the limitations of Physiotherapy Autonomy implementation as such:
• The number of qualified professional physiotherapist within the country.
• Quality of Physiotherapy Education.
• The limitation of autonomy experienced by Malaysian physiotherapists due to dominance of medical rehabilitation disciplines.
Malaysia has produced some of the best physiotherapists and allied health professionals throughout the years. With the support of the Malaysian Physiotherapy Association (MPA), I believe that our Malaysian physiotherapists is ready to take the step forward in adopting this healthcare modal. Hence, I hereby urge our future generation of Malaysian physiotherapists to embrace this healthcare modal as a new frontier for physiotherapy and continue to address and advocate Healthcare Autonomy in future studies.
Head of Physiotherapy
KPJ Sentosa KL Specialist Hospital