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

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

The APTA Standards of Practice5 reiterates the primary focus of service in physical therapy. Standard IIIA emphasizes the collaboration required between physical therapists and patients/clients throughout the rehabilitation process, empowering the patients/clients as primary participants in their rehabilitation and reminding the physical therapists of their first among equals status in this partnership. Greenleaf suggested an organizational structure based upon the Roman primus inter pares, or "first among equals" model, rather than the traditional hierarchical model.14(p74) In patient care, such a model empowers any member of the patient-health care team to serve as first among equals, or leader for a given set of circumstances. The first among equals model also promotes persuasion rather than coercion because hierarchical power is not involved.21 Thus, all team members become empowered to lead legitimately, facilitating consensus.

Covey defined core values as "something at the soul of an organization [that] does not change but will enable people to live with change."21(p3) In 2002, APTA convened a consensus conference to "define and describe the concept of professionalism by explicitly articulating what the graduate of a physical therapist program ought to demonstrate with respect to professionalism."7 The conference participants identified the core values of accountability, altruism, compassion/caring, excellence, integrity, professional duty, and social responsibility; provided a definition for each; and suggested sample indicators that described physical therapists' behaviors that represented these values. Such behaviors provide external signs that symbolize the internal reality of the values foundational to professionalism.23

The APTA Core Values directly reflect characteristics associated with servant-leadership. Accountability is "active acceptance of the responsibility for the diverse roles, obligations, and actions of the physical therapist."7 McGee-Cooper described accountability as "the rudder that keeps us on course."24(pp77-78) She extended accountability to patients as well, suggesting that a shared vision, developed between the servants (therapists) and the served (patients), empowers the served to achieve their goals. In such a relationship, "because the vision was shared, because the team created and owned the plan, because the purpose and outcome were believed to be pivotal, this team chose to hold themselves and each other accountable for results."24(p84)

Altruism, "the primary regard for or devotion to the interest of patients/clients,"7 exemplifies the focus on others' needs that is the hallmark of servant-leadership and the health care professions.9(p7),25 "Compassion, the desire to identify with or sense something of another's experience, and caring, the concern and consideration for the needs and values or others"7 reflect the empathy embraced by servant-leaders.9(p12) The ethical practice embodied in integrity represents the moral code described by Covey,22(p5) inherent in individuals who practice servant-leadership.