Everyday Ethics: Productivity and Ethical Practice

Everyday Ethics (2)

This is Part II of a two-part mini series on ethics in OT practice. This post discusses productivity requirements and how they impact practice for OTs and other rehabilitation professionals both in and out of the workplace. Click here to read Part I, about my experiences with ethics as a FWII student.


In my current vocational rehabilitation (VR) fieldwork setting, the VR counselors and others have productivity standards measured by how many cases they successfully close, which is typically defined as clients becoming employed. Although right now I am working in a non-traditional setting, there is a much larger discussion taking place about ethics as they relate to productivity standards in the rehabilitation and skilled nursing facility (SNF) settings where a large percentage of OT/As work. The argument being made by professionals in several different fields, including PT, OT, and SLP, is that the extremely high productivity standards to which they are being held takes an extremely negative toll on the quality of care they are able to provide, as well as placing them in ethically compromising situations.

The ongoing issue of productivity as it relates to ethics sheds some light on a grim reality of occupational therapy practice that students, new grads, and others may not be aware of as they enter the profession and begin practicing. After my initial FWI experiences in a large teaching hospital and outpatient pediatric clinic last fall, I became very aware of the pressure put on therapists to see 8-10 patients – and complete documentation, attend meetings, and coordinate case services – during the workday in order to meet unrealistic standards of 75-90% productivity.

It was a sad reality check, seeing the “dark side” of the fun sessions and client interactions I observed that initially drew me to OT. However, now that I have been in OT school for over a year and seen all sides of the therapy process, I’m coming to realize that it’s not all sunshine and successful sessions.

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