One week on from the submission date for Professional Practice blog post 1, and 3/6 of the class have made a post on the topic. While this first post is not exactly required as such, considering the industry's scope of practice is important because it is so strongly tied to all aspects of the assessment for this course, and can be used as an element of the final assessment. I would strongly advise anyone who has not already made a post to at least consider the questions posed.
Thanks to those who did take the time to consider the questions and post their thoughts. I'd like to respond to a couple of ideas that have been explored by some of the class.
Si & Vic put forwards the thought that defining a scope of practice at this stage may unncecessarily limit the expanding profession. Their argument is that because SoP is based partially on education, and because the level of education is expanding, the industry's SoP is likely to expand. An interesting idea. I guess we need to consider what the reasonable boundaries of this expansion are likely to be. To think about this, it's good to keep in mind that our Scope of practice is defined partially by what we are able to do, but also by what other practitioners are able to do.
Think about the multi-disciplinary context of New Zealand. We have largely defined ourselves as soft-tissue therapists who engage in some assessment and some limited exercise prescription. This is more expanded than the scope of MTs in some other countries, however it seems that our SoP is largely comfortable for the other health professions. Would this be true if we expanded our assessment processes and exercise prescription skill-base? We would then be encroaching onto the turf of physiotherapists. What about expanding our skill-base in the area of joint-mobilisation? How would chiropracters, osteopaths and manipulative physios feel about this? I am not trying to say that moving into these areas is out of the question, but rather to point out that there are political boundaries which are currently in place. The massage therapy profession has little political power relative to the other players. It may be more appropriate to deepen our scope of practice rather than expand it's boundaries. I don't have a strong opinion either way, and the direction we go is something that will emerge over time.
Perhaps in my elluminate presentation on this topic I pressed the point a little too strongly that a SoP under the HPCA would define the actions that we were able to practice. While this is true, I believe that this is something that would be able to be negotiated over time. I think there is a 4 yearly review process, so defining the SoP now might not be so limiting as I implied.
Something else that I feel I need to clarify is the difference between an industry scope of practice and an individual's scope of practice. Industry scopes are negotiated and agreed. MNZ's current SoP is an example here. This is based on current expectations of levels of education & skill. An individual's SoP will develop based on their education, training & experience. The expectation is that once an individual is registered within a SoP that they will conform to the limitations of this industry-set SoP.
Deb pointed out that there are some real gaps in the current SoP around continuing education, cultural and ethical competence, as well as requirements of medical terminology. While some of these practices are implied within the processes of MNZ membership (e.g. you need to provide evidence of a certain level of professional development each year), and the Code of Ethics is referenced by the Scope of practice, it is more usual for these things to be defined within a Scope of Practice document. Consideration of the principles of the Treaty are one place where MNZ and the massage industry are lagging far behind the established ethical expectations of healthcare providers. I see these things as a sign of our industry's relative immaturity.
Great points guys. It's good to recognise that there are no right answers here. What's important is that you have considered the material and the questions posed.