Saturday, June 8, 2013

Professional Issues Class Post 5: Ethics

The assignment:  What do you think contributes to ethical lapses in the profession and how can they be prevented?  Have you seen anything in your externships that could lead to ethical lapses?  One component of the Code of Ethics is that you have to report it if you think there is a violation.  Not to do so, is in itself, a violation.

A lot of people like to distinguish between what is Ethical versus what is Legal.  I think the conventional wisdom is that "legal" is the bare minimum and as humans with functioning frontal lobes, we tend to do the right thing for higher reasons...or rather just because something is legal, doesn't mean it's ethical.  In other words,  the principal of "ethics" is what separates us from the lower life forms who just do the right thing to avoid negative consequences.

However, some folks can use the Ethical versus Legal debate to justify doing something technically illegal, but for the "greater good".   They may use it to justify the idea that while laws are great for the most part, sometimes you may have to bend the law a little in order to do the right thing.   Sort of a modern day Robin Hood.

I feel there could be a risk of ethical lapses in my future profession when it comes to insurance and billing.   Rules, regulations, Medicaid/Medicare changes, therapy caps, pre-existing conditions, benefit limits, copays, deductibles, paperwork and more paperwork.   SLPs (and other "helping professionals") get into this business because they care about people.   We want to help.   We forge relationships with our clients and their families.   It gets hard when you just want to help a child, but are up against regulations that state you can't, because a client has run out of visits, or that their speech therapy isn't "life sustaining" or that the copay has gone up and the parents just cant afford treatment anymore.    It would be tempting to fudge a little paperwork, trump up a goal or two or some other "little white lie" that would not really hurt anyone, other than a faceless insurance company or government entity. 

I imagine this kind of thing comes up more in a private clinic setting, where the clinician is directly involved with billing.  However, even in a school setting, I can see how one might be tempted to embellish an assessment score to make sure a child qualified.  Maybe  you think a child may benefit from your services but the numerical data is not falling within the required range in order for you to qualify them.   

While I haven't had the opportunity to experience any situation like this, I am not going to fool myself into thinking I wont be faced with such dilemmas at some point.  I hope that I can keep the profession as a whole in mind, and continue to uphold the standards we are asked to represent as SLPs.   One embellished test score or trumped up goal may not seem like much, but is it worth it to taint the whole industry?  Will we really be able to continue helping the thousands of children we currently help if we give the impression that we have to lie to make a difference? 

Turning away that one client may break my heart into a million pieces.   But what can I do? I can compile a list of resources of where they can get help.   I can point those families towards Babies Cant Wait, or FOCUS or Parent to Parent of GA.    I can continue to advocate through ASHA or GSHA for insurance and Medicare billing policies that allow us to help those we want to help.  

But definitely not this:

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