Ethical Issues With RIPS Model

Thank you for sharing such good examples and you tackle successfully in first one (prevent misconduct on worker compensation). According to Finch, Geddes & Larin, (2005), ethical dilemmas were more often settled when there were less emotional sequel related with the issues. However, second situations of RIPS model is challenging and morally distressful. I also have face that kind of situation in which we, as physical therapists (PTs) have their limitation especially, when physician involvement. I would like to share one of my experience with you, I was seeing the 95 year old female patient who have multiple co morbidities with weakness, unsteady gait and get verbal order from physicians office for 2times week for 6 weeks, but at end of 4th week patient is declining the function and in reassessment also shown measurable test score is declining I informed to physician's office and request to extend 2 more weeks for gait training and functional transfer training (with negotiating steps) but my request is not approved. Eventually, i know that patient fell down on 7th week while entering to home. Afterword, physician write and ordered to PT Evaluation and Treat! As a result it is also pure example of moral distress.
As per APTA(2016), NY is one of 26 state which have (physical therapy) access to patients with provision, so patient can be seen without referral for 10 visit or 30 days which ever come first. Also physical therapist older than 21 year (age) required, must working as full time and minimal three year experience. As in state of Illinois, continuous education required 40 hours and 3 credit must be in area of ethical practice but I am not sure about continuous education requirements for NY state and do they have any required specific credit hours in area of ethical practice in