Professional Standards & Expectations in Health Professions

Dr. Meaghan MacNutt

Acknowledgment of the traditional, ancestral, and unceded territory of the Syilx Okanagan Nation.

After this class, students will be able to:

Discuss the role of regulatory colleges and professional associations for both regulated and unregulated health professions.
Demonstrate awareness of professional expectations as outlined in various health profession Codes, including the recognition of the eight principles of professional practice.
Define and recognize workplace conduct related to discrimination and harassment; distinguish between non-discriminatory practice and inclusive practice.
Discuss the value and limitations of professional Codes and the importance of professional judgment in aligning practice with professional principles and expectations.

Profession Definition: "any type of work that needs special training or a particular skill, often one that is respected because it involves a high level of education" (Cambridge Dictionary).
Health Profession: Involves the "study, diagnosis, treatment, and prevention of human illness, injury, and other physical and mental impairments; also involves health promotion aimed at improving individual and population health" (World Health Organization, 2013).
- More than 250 different kinds of health professions (Jensen 2015 Integr Med).

Regulated Health Profession: Operate under a regulatory college that is "legally responsible for ensuring that health professionals provide health services in a qualified, safe, and ethical manner" (BC Health Regulators).
They are governed under provincial law, particularly the Health Professions Act.
Registrant: Health professional registered with the regulator; they are legally required to register and pay fees to practice.
Regulatory colleges ensure:
- Qualifications: Ensuring registrants are qualified and competent.
- Defined Standards of Practice and Ethics:
- Scope of Practice: What professionals do.
- Standards of Practice: How professionals should perform their duties.
- Education Recognition: Recognizing education programs that meet standards.
- Licensing Requirements: Setting the credentials needed for practice.
- Searchable Registrant List: Maintaining a public list of registrants.
- Addressing Public Complaints: Disciplining registrants as necessary.

Purpose: To serve their members; joining is optional for health professionals (e.g., Physiotherapy Association of BC, Canadian Physiotherapy Association).
Functions:
- Advocacy: Representing the profession.
- Resource Creation/Sharing: Providing materials to support practitioners.
- Continuing Education: Offering educational opportunities for ongoing professional development.
- Networking: Creating opportunities for practitioners to connect and support each other.

Regulatory Colleges in BC:
- BC College of Nurses and Midwives
- BC College of Oral Health Professionals
- College of Pharmacists of BC
- College of Physicians and Surgeons of BC
- College of Complementary Health Professionals of BC
- College of Health and Care Professionals of BC
Unregulated Health Professions: Not all health professions are regulated.
- Example: Qualified exercise professionals (CEPs, CPTs, Kinesiologists) are not currently regulated in BC.
- Standards: Even unregulated professions may have standards, which are ethically driven rather than legally mandated.
- Professional Associations for Unregulated Professions:
- QEPs: Governed by the Canadian Society for Exercise Physiology and the American College of Sports Medicine.
- Kinesiology: Governed by the BC Association of Kinesiology.

Regulatory Colleges:
- Legally responsible for practice standards, qualification requirements, and public safety oversight.
Professional Associations:
- Provide support and advocacy for professionals; membership is elective and typically involves fees.

Professional conduct encompasses actions, behaviors, and digital communication.
- Codes of conduct indicate what is considered “professional”.
- Professionalism is frequently identified as a core value within these Codes.

Legal Framework: Under federal and provincial human rights laws, discrimination and harassment based on protected characteristics are prohibited.
- Relevant Laws:
- Canadian Human Rights Act
- BC Human Rights Code
- Discrimination: Denying treatment or unfair treatment based on protected characteristics.
- Protected Characteristics: Included but are not limited to:
- Age
- Race, ancestry, color, place of origin
- Sex, gender identity/expression
- Sexual orientation
- Marital or family status
- Mental/physical disability
- Religion
Harassment: Involves actions or words that intimidate, insult, offend, or humiliate an individual, and applies to clients, colleagues, and employees.

Example of Discrimination: An employee not promoted due to age bias, despite qualifications.
Example of Harassment: A health professional making repeated sexually explicit comments to a client despite requests to stop.
Perceived Bias: A hiring manager's considerations based on a candidate’s accent reflecting other biases.
Assignment of Tasks: Inappropriate assignment under biased assumptions about race can be judged as discrimination under the right context.
Professional Practices Concern: Repeated denial of appointments based on body odor could relate to a disability, thus involving ethical considerations of discrimination.

Discrimination: Unfair treatment based on a protected characteristic, which can be singular or a pattern of behavior.
Harassment: Unwelcome behavior that creates a hostile environment, can be a serious incident or series of minor incidents.
- Outside human rights violations, other forms of workplace harassment are illegal under employment law and can lead to disciplinary actions, including potential lawsuits.

Understanding the difference and implications of discrimination and harassment is essential, as both legal and ethical aspects impact the professional integrity and responsibilities of health professionals.