Servant-Leadership: A Philosophical Foundation for Professionalism in Physical Therapy

Journal of Physical Therapy Education, Fall 2006 by Gersh, Meryl Roth

Background and Purpose. The recent professional evolution of physical therapy highlights an awesome responsibility to offer optimal service with the highest commitment to ethical practice and leadership. An overarching focus of the physical therapy profession during the past 5 years has been the definition, development, enrichment, and inculcation of professionalism among physical therapists and physical therapist students. Central to the development of professionalism is leadership that instructs, empowers, and nurtures; in a word, serves. The tenets of servant-leadership, first described by Robert Greenleaf in 1970, offer a unifying matrix for the enhancement of professionalism in physical therapy. This paper describes the foundational elements of servant-leadership and identifies the principles of servant-leadership that the core documents that guide the profession of physical therapy embody.

Position and Rationale. The ideals affirmed by servant-leadership form a philosophical foundation for professionalism in physical therapy. Servant-leadership is based upon the elements of trust, caring, empathy, and focus on others. Effective leadership is measured by whether "those served grow as persons, when they, while being served, become healthier, wiser, freer, more autonomous, more likely themselves to become servants."9(p7)

Discussion and Conclusion. The core documents that guide physical therapy, including the APTA Code of Ethics,4 APTA Standards of Practice,5 APTA Guide for Professional Conduct,6 and APTA Professionalism in Physical Therapy: Core Values7 delineate principles and behaviors consistent with the tenets of servant-leadership. Servant-leadership, which focuses on the primacy of others' needs, the partnership between the servant-leader and the served, and the growth and empowerment of those served in the process of such leadership, provides a powerful philosophical foundation for professionalism in physical therapy.

Key Words: Physical therapy, Professionalism, Servant-leadership, Ethics, Core values.

INTRODUCTION

An overarching focus of the physical therapy profession during the past 5 years has been the definition, development, enrichment, and inculcation of professionalism among physical therapists and physical therapist students. As early as 1955, the Dictionary of Occupational Titles, cited by Plack and Wong,' defined physical therapists as professionals. Characteristics of professionals include "rigorous training that culminates in mastery of a clear and distinct body of knowledge, expertise within and contribution to that body of knowledge, and adherence to a specific code of ethics that governs autonomous professional behavior."1(p48) Implicit in this definition are the obligations of essential service to the public, social and political activism, and advocacy.

During the past 50 years, the physical therapy profession has evolved from an allied health profession in which physical therapists cared for patients/clients under the direct prescription from a physician, to a doctoring profession in which professionals deliver physical therapy services without requiring a physician's referral or prescription. The public now has direct access to physical therapy services in 38 states. Physical therapists serve as an entry point into the health care system. During the last session of the United States Congress, bills to approve direct access to physical therapy services for Medicare beneficiaries instigated heated debate. This professional evolution provides both enhanced practice opportunities and, more important, an awesome responsibility to offer optimal service with the highest commitment to ethical practice and leadership. Physical therapists now must lead by example, collaborate with other leaders to enhance health care delivery, advocate for patients, empower patients to self-advocacy, and, above all, model the ideals associated with professionalism and ethical leadership and practice. As professional education programs for physical therapists transition to the clinical doctoral degree (DPT), the challenge to prepare physical therapist students for the moral, ethical, professional, and clinical challenges that they will confront is incumbent upon physical therapist educators and academic administrators. Ultimately, in conferring the title of Doctor on our graduates, the profession holds the stewardship of the public's trust.

Recent development of official documents to guide the professional evolution of physical therapy in the 21st century highlights the focal point that professionalism plays. In 2000, the American Physical Therapy Association (APTA) adopted the Vision Statement for Physical Therapy 2020(2) that clarified the scope and breadth of physical therapist practice, the foundation of doctoral-level preparation, a commitment to integrity, life-long learning, accessible health care for all people, and evidence-based practice. In his 2003 presidential address, then-APTA President Ben Massey Jr, PT, MA3 revealed that the APTA Board of Directors had unanimously identified professionalism as the key to achieving Vision 2020.