For a couple of years now, I have been reminded of a conversation I had on Facebook regarding a certain well-known therapy technique. During the course of this conversation, several private practice SLPs (and a couple school-based SLPs) stated they (and I’m paraphrasing) didn’t care if a product was evidence based because …
parents were specifically requesting them. In fact, they were specifically stating they were requiring all of their employees be trained in these techniques and wouldn’t hire them if they weren’t trained. They believed, strongly, that if a parent requested a specific therapy technique, such as PROMPT, then they needed to offer it to the parent regardless of the evidence behind it or they parents would go elsewhere and the private practioner would lose money…or in the case of the schools, the parents would litigate.
Today, as I was preparing to submit proposals to ASHA17, I came across this gem in our new 2016 Code of Ethics:
“Rules of Ethics III
B: Individuals shall avoid engaging in conflicts of interest whereby personal, financial, or other considerations have the potential to influence or compromise professional judgment and objectivity”
So…where does this put those practioners?
Is it a conflict of interest when a clinician knowing the product/technique/method is NOT evidence-based agrees to serve a client using that method because the parent’s request it? Does it make a difference if the reason they’re doing it is because they know the parents will go elsewhere and get their wants met and so the SLP would lose money?
Is it morally and/or ethically acceptable to accept a client/FMSO request for a treatment strategy that you know (or suspect) is NOT EBP so that you don’t lose the client and therefore don’t lose the money?
Is it morally and/or ethically acceptable for a school/institution to accept a parent’s request for a specific program/treatment methodology without the EBP to back it up simply to avoid the potential lawsuit?
Or, conversely, does the “it most likely won’t hurt anything – and may possibly help” thought offset the non-EBP for pay conflict?
I’m not sure what the answer is, but I’d love to hear your comments. Please, drop me a line here and let me know your thoughts. I’m hoping to share some of them with my student clinicians.
Until then…Adventure on!