Ethical and Legal violations in Physical Therapy - Reporting barriers in Physical Therapy practice in Pakistan

Abstract

Background: There is insufficient literature regarding legal and ethical violations in clinical workplace training in Pakistan. Objective: To determine the legal and ethical violations in clinical workplace training among physical therapy students in Pakistan. Methodology: The study was a descriptive cross-sectional study with a duration of six months after approval of the synopsis from July to December 2022.  The study was conducted at Lahore College of Physical Therapy, Lahore Medical and Dental College. The sample was calculated from 191 students from all the public and private institutions of  Pakistan. The sample technique was non-probability, convenience sampling, using WHO software. Both male and female students of 22-26 years, from the 4^th and 5^th professional year, enrolled in the annual system of examination, and doctor of physical therapy students enrolled in all UHS-recognized public and private physical therapy institutes of Pakistan were included. Students who have already graduated, been detained, or failed were excluded. The data was collected via a pre-validated structured questionnaire. The data was collected in the form of questionnaires printed and distributed among students of institutions within the vicinity of Lahore. Analysis included bar charts for the pictorial representation of age, gender, professional year, and the institution of participants. It included a frequency table for the pictorial representation of the tool used for the study. Informed consent was obtained from all the participants before the study. Confidentiality of the data was ensured, and no harm to the respect of the patients was caused by the researcher. Results: Among all of the legal violations, 85.9% of participants had no idea about the reimbursable codes. Almost 55.5% of the participants responded by witnessing documentation of a billing code for which they spent an insufficient amount of time. About 54.5% of the participants responded that they witnessed a patient being billed for a treatment session that never took place. Conclusion: This concludes that physical therapy students frequently encountered critical bioethical issues during their clinical placements, which raised significant concerns about professional practice and patient rights. One of the most commonly reported issues was the failure to discharge patients at the appropriate time.