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เพื่อประหยัดเวลาเขียน ขอแบ่งปันคำตอบการบ้านข้อแรกของวิชา Business and Marketing (PT 655) กับพี่ๆน้องๆค่ะ
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What would be your “Hierarchy of challenges related to the business of physical therapy?
List 5 in decreasing level of challenge with a one paragraph descriptor of each challenge
Answer
As I am a Lecturer as well as a physical therapist in Bangkok, Thailand, my view of challenges of the business of physical therapy might be different than others in class. Since we have different health care system and environment. I would like to share my perspective about the challenges related to the business of physical therapy as follows:
1. The work market.
Physical therapy work market in Thailand has changed dramatically in the last decade. The former main workplace, hospitals both government and private, are not the major place new PT aiming to anymore. The reasons are from many aspects. The saturation and limitation of the job positions in the hospital has been known. Plus, young generation of PT wants to own private practice. However, running a PT clinic is not an easy business since the patients would have to pay from their pocket. PT who operates a clinic then has to face the challenge both in professional practice (the good treatment results) and business. And they need a lot of knowledge and skills other than just the treatments.
2. The different scheme of referral in Thai Health system.
By law, physical therapist in Thailand has direct access; patients can come to visit PT by themselves. Then PT has to perform evaluation and decide about “treat or refer”. However, in the hospital especially the government hospital, the system of patient coming to get physical therapy treatments are complicated. There are many types of medical doctors who can send patients to PT for consultation. However, some hospital has the system of rehabilitation department which requiring patients to see the physical medicine and rehabilitation doctors before seeing PT. Even worse, some places with such doctors would provide the treatment prescription and monitor if PT would follow the order or not. This challenge PTs who are in this kind of hospital which they have to find ways to give the best treatment without confrontation situation.
3. Use of evidence based practice in PT clinics
The treatments provided by physical therapy in Thailand are various depending on experiences and preferences of PT. The concept of using treatments which have appropriate evidences is not widely adopted enough in Thailand. This would be a threat of profession in public and slow down the professional development.
4. The expense of PT treatment especially in cases of long term care
Without certain discharge plan and regulation of payment for physical therapy treatment, the cost of PT treatments is running high. This is apparent in case of long term care such as stroke or spinal cord injury or even in cases of geriatric patients who have health problems from degenerative changes. PT needs to show the effectiveness and plan of care in the major conditions so public would know and accept the treatments, also the financial management plan could be set appropriately.
5. The adjustment of physical therapy school and education
Since the health environment and system are evolved quickly, the education institutes who offer PT program would have to adjust to these changes in many aspects. The examples of issues needed to be adjusted are the curriculum and content to build PT response to aging society, new methods of payments, entrepreneurship, and others.
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