Blog 15: Entrepreneurship

The item that impacted me most from the entrepreneurship discussion in class was having time for your family.  That is something that I value greatly.  One of the sites presented to us in class said that entrepreneurs have more time for themselves and for their families; in my experience I don't think this is true.  All of the entrepreneurs I have worked with appear to be so consumed in their work that they don't have much free time to be with their families.  They may be able to make their own schedules and make time for certain family events, but aside from that they work the longest hours out of any employee and often bring their work home with them.  Typically entrepreneurs do things that they love, but that lifestyle seems more stressful to me; it would be nearly impossible to escape work.  I know this from first hand experience too.  My mom is a small business owner, and my family hardly takes vacations because of it; but when we have she is often to worried about her business to be able to really relax on vacation.  


My career goals are to be a physical therapist, and at least for my first 10 years I know that I don't want to have my own clinic.  My passion is helping people and working with the human body.  So, I'm not saying that I want to be a business person, I just want to do what I love.  I want to help people move and teach them how to maintain their physical health.  I don't want to deal with hiring, firing, bills, insurance companies and other managerial duties.  I hope to find a job that would be flexible with my children's schedules so that I don't miss out on their events.


I think I fall in a different category from the classic "business person" or "entrepreneur"; I do want to be innovative in my treatments, so in that sense I will be a type of an entrepreneur.  There are new modalities, techniques, and areas of expertise being developed constantly in physical therapy; I aspire to be on the cutting edge of that technology.  I just don't want the responsibilities of running a clinic, I would rather focus all of my attention on the patients.  

Blog 14: Lean Process

To implement a lean process in my work space, I decided to focus on motion.  By decreasing the motions necessary to function in my work space, I can save time and work more efficiently.  To do this, I put the most commonly used objects:  pen, pencil, lap top and charger, and biology book in close reach.  The lap top charger is run underneath the desk to reduce clutter.  Other items that are used less frequently:  highlighter, post-it notes, calculator and physics books, are stored near by in drawers.  And items that are only used occasionally, like my accounting book, and printer are stored in a closet.
By having the items that I use most frequently easily accessible I can spend less time moving around and searching for them.  This will allow me to focus on my work more, which in turn will lead to a more productive study session.

Blog 13: Criteria for Evaluation

Quality: Evaluate group members by ranking in numerical order; do not include yourself in this evaluation.

1.      Participation:

a.       researching topics

b.      adding to the conversation

c.       asking questions

d.      attendance in group meeting and class

2.      contributions

a.       quality effort

3.      Tasks accomplished

a.       follow the timeline established by the group

4.      professionalism

5.      communication 

Blog 12: 5S

For my 5S project, I organized a messy work area.  While doing so I assessed the 8S's discussed in class.  The first S is for Sorting:  I disposed of unneeded papers and materials, and stored tools that weren't frequently used to reduce clutter.
The second S stands for Straightening:  To exercise straightening, I grouped together writing utensils by type, and found a home for all of the materials that are used on a regular basis.  This will make materials easily accessible when needed.
For the third S, Sweeping:  I dusted, and vacuumed the work area.  I placed a garbage can under the desk to make cleaning easier and I put an air freshener in the room to provide a fresh aroma.
The next S is for  Standardizing.  This S will be practiced in daily and weekly cleaning routines.  When things are reorganized, they will go back in their places so that they can be easily found.
To go along with standardizing, the next S, Sustaining the discipline, allows for change where it is fit.  Over time, the materials used at this work place may vary, therefore it's important to periodically reassess the needs of the work place.
Safety is the next S that is sometimes included in the 5S process. For this work space, I stored sharp objects out of immediate reach, so that they are not accidentally grabbed.  I also made sure that proper power strips were used so that circuits were not blown.
For Security, I made sure that window fixtures had proper locks and that the server being used was password protected.
The final S, Satisfaction, can be assessed after the re-organized work space is used.  The worker can make suggestions and describe features that they would change.  The work space can then be re-adjusted to accommodate for the the workers needs and preferences.

Before

After

Blog 11: Quality Management

Identify and describe a quality management process that is utilized in your field of interest. Typically this process is in response or guided by a professional organization in that field. Identify that organization.


In the Physical Therapy profession, PTs utilize surveys to measure and evaluate patients' progress throughout therapy.  One company that has a series of surveys for PTs to use is Focus On Therapeutic Outcomes, Inc.  (FOTO).  On their website, they describe how their system works:  "Patients complete our survey on their first visit, or at intake. Surveys are tailored to the specific care type, body part or impairment requiring treatment. The survey is retaken one or more times during the patient's course of treatment, and again at discharge. The outcome is the difference between the FS Score at intake and the FS Score at discharge."
This ensures quality in care by proving that a patient is improving or has improved upon discharge from therapy.  FOTO is recognized by other organizations as being a legitimate and accurate measure of quality.  This system of managing quality is approved by the Physician Quality Reporting Initiative.  The information gathered from these surveys can also be directly delivered to the Centers for Medicare and Medicaid Services.  


Sources:


http://www.fotoinc.com/assets/pdf/UnderstandingNeuro.pdf

Blog 9: Project Plan

Curing COPD


Issue:  The two main diseases categorized as chronic obstructive pulmonary diseases are asthma and emphysema.  Currently there is no cure for COPD, the only options to control the disease are a variety of drugs and therapy, and surgery in some severe cases.  However, drugs and therapy don't provide lasting relief and they can't undue damage caused by emphysema.  


Action Plan:  
1)  research COPD:  causes, current treatments, hypothesized cures
2)  meet with a physician to discuss possible cures
3)  formulate a cure or treatment or device
4)  investigate costs, longevity of cure, and sustainability of cure

Blog 10: Specific Ethical Question

I am a pre-physical therapy student, at my internship this past summer I was introduced to a new physical therapy modality:  trigger point dry needling.  According to Kinetachore, this treatment technique "uses small filament needles to release tight muscles with the goal of permanently reducing pain and dysfunction."  The pain that this treatment is attempting to cure is pain caused by a trigger point: an irritated contraction knot found in tight bands of muscles. The needles used for dry needling are solid, and they do not cut the skin or muscle; they function by deactivating and desensitizing myofascial pain.  At first this seems like a good approach to overcome pain caused by trigger points.  However, after collaborating with other physical therapists, I found that physical therapists are not in agreement on the technique.  

One physical therapist that I recently shadowed is against trigger point dry needling because in his experience injections are more effective and provide long-lasting relief faster.

According to Progressive Physical Therapy, after a dry needling session, you will likely be sore for about 2 days, and a day or 2 of relief will follow.  A patient will likely need multiple dry needling sessions to obtain permanent relief.  This does not seem like a good approach to treat a trigger point, as a patient I would want lasting relief as soon as possible.  

The Department of Physical Medicine & Rehabilitation at the University of California Irvine did a study to compare the outcomes of patients treated with trigger point dry needling as opposed to patients treated with injections that contained 0.5% lidocaine. After receiving treatment, 100% of the patients who were dry needled experienced soreness different from their previous trigger point pain, while only 42% of patients who received lidocaine injections experienced soreness.   The author states that, "Patients treated with dry needling had postinjection soreness of significantly greater intensity and longer duration than those treated with lidocaine injection."  Through this study, it is apparent that lidocaine injections are a better option in treating trigger points than dry needling.  The two main reasons are that patients don't become as sore and that relief lasts longer.  

After observing how effective lidocaine injections can be, I began to wonder why a physical therapist would use dry needling as a technique.  The only reason I can conclude is that physical therapists aren't licensed to administer injections; they are only allowed to perform dry needling.  I don't think it's ethical for a physical therapist to perform a certain treatment if there is a better treatment option available; even if they have to give up patients.  In health care, it's all about the patients; a physical therapist should recognize which patients would better benefit from lidocaine injections and refer them to a doctor who will give the patient the injections.  Patients with trigger point pain should receive injections as a faster and more pleasant treatment. 

Sources

1)  Hong, CZ. "Lidocaine Injection versus Dry Needling to Myofascial Trigger Point. The Importance of the Local Twitch Response." Pubmed.gov. Department of Physical Medicine & Rehabilitation, University of California Irvine, Orange. Web. 24 Oct. 2011. <http://www.ncbi.nlm.nih.gov/pubmed/8043247>.

2)  "TDN Overview." Intramuscular Manual Therapy, Aka Trigger Point Dry Needling, Training Physical Therapists. Web. 24 Oct. 2011. <http://www.kinetacore.com/physical-therapy/TDN-Overview/page34.html>.

3)   "Trigger Point Dry Needling." Progressive Physical Therapy. 1 May 2011. Web. 24 Oct. 2011. <http://pptaccess.dot3tech.net/?p=35>.

Blog 8: Ethical Question

I am somewhat torn on this issue, some people may think that Wild tickets are a bribe.  However if the physician attends the game with the pharmaceutical rep, it could be chance for the physician and pharmaceutical rep to discuss new drugs.  This would be a time for the physician to learn about new drugs.  Pharmaceutical reps provide info to physicians about developing drugs.  Therefore this is a two way street:  Pharmaceutical reps are trying to make sales, and physicians are trying to learn - both parties could potentially benefit from attending the game together. 

Blog 7: General Ethics

The code of ethics for physical therapists in the United States; defined by the American Physical Therapy Association.

This Code of Ethics is built upon the five roles of the physical therapist (management of patients/clients, consultation, education, research,

and administration), the core values of the profession, and the multiple realms of ethical action (individual, organizational, and societal).

Physical therapist practice is guided by a set of seven core values: accountability, altruism, compassion/caring, excellence, integrity, professional duty, and social responsibility. Throughout the document the primary core values that support specific principles are indicated in

parentheses. Unless a specific role is indicated in the principle, the duties and obligations being delineated pertain to the five roles of the

physical therapist. Fundamental to the Code of Ethics is the special obligation of physical therapists to empower, educate, and enable those

with impairments, activity limitations, participation restrictions, and disabilities to facilitate greater independence, health, wellness, and

enhanced quality of life.

Principles

Principle #1: Physical therapists shall respect the

inherent dignity and rights of all individuals.

(Core Values: Compassion, Integrity)

1A. Physical therapists shall act in a respectful manner toward

each person regardless of age, gender, race, nationality, religion, ethnicity, social or economic status, sexual orientation,

health condition, or disability.

1B. Physical therapists shall recognize their personal biases and

shall not discriminate against others in physical therapist practice, consultation, education, research, and administration.

Principle #2: Physical therapists shall be trustworthy

and compassionate in addressing the rights and

needs of patients/clients.

(Core Values: Altruism, Compassion, Professional

Duty)

2A. Physical therapists shall adhere to the core values of the profession and shall act in the best interests of patients/clients

over the interests of the physical therapist.

2B. Physical therapists shall provide physical therapy services

with compassionate and caring behaviors that incorporate

the individual and cultural differences of patients/clients.

2C. Physical therapists shall provide the information necessary

to allow patients or their surrogates to make informed decisions about physical therapy care or participation in clinical

research.

2D. Physical therapists shall collaborate with patients/clients to

empower them in decisions about their health care.

2E. Physical therapists shall protect confidential patient/

client information and may disclose confidential information to appropriate authorities only when allowed or as

required by law.

Principle #3: Physical therapists shall be accountable

for making sound professional judgments.

(Core Values: Excellence, Integrity)

3A. Physical therapists shall demonstrate independent and objective professional judgment in the patient’s/client’s best interest

in all practice settings.

3B. Physical therapists shall demonstrate professional judgment

informed by professional standards, evidence (including

current literature and established best practice), practitioner

experience, and patient/client values.

3C. Physical therapists shall make judgments within their scope

of practice and level of expertise and shall communicate with,

collaborate with, or refer to peers or other health care professionals when necessary.

3D. Physical therapists shall not engage in conflicts of interest that

interfere with professional judgment.

3E. Physical therapists shall provide appropriate direction of and

communication with physical therapist assistants and support

personnel. Principle #4: Physical therapists shall demonstrate

integrity in their relationships with patients/clients,

families, colleagues, students, research participants, other health care providers, employers,

payers, and the public.

(Core Value: Integrity)

4A. Physical therapists shall provide truthful, accurate, and relevant information and shall not make misleading representations.

4B. Physical therapists shall not exploit persons over whom

they have supervisory, evaluative or other authority (eg,

patients/clients, students, supervisees, research participants,

or employees).

4C. Physical therapists shall discourage misconduct by health

care professionals and report illegal or unethical acts to the

relevant authority, when appropriate.

4D. Physical therapists shall report suspected cases of abuse

involving children or vulnerable adults to the appropriate

authority, subject to law.

4E. Physical therapists shall not engage in any sexual relationship with any of their patients/clients, supervisees, or

students.

4F. Physical therapists shall not harass anyone verbally, physically, emotionally, or sexually.

Principle #5: Physical therapists shall fulfill their

legal and professional obligations.

(Core Values: Professional Duty, Accountability)

5A. Physical therapists shall comply with applicable local, state,

and federal laws and regulations.

5B. Physical therapists shall have primary responsibility for

supervision of physical therapist assistants and support

personnel.

5C. Physical therapists involved in research shall abide by

accepted standards governing protection of research

participants.

5D. Physical therapists shall encourage colleagues with physical,

psychological, or substance-related impairments that may

adversely impact their professional responsibilities to seek

assistance or counsel.

5E. Physical therapists who have knowledge that a colleague is

unable to perform their professional responsibilities with

reasonable skill and safety shall report this information to

the appropriate authority.

5F. Physical therapists shall provide notice and information

about alternatives for obtaining care in the event the physical therapist terminates the provider relationship while the

patient/client continues to need physical therapy services.

Principle #6: Physical therapists shall enhance their

expertise through the lifelong acquisition and

refinement of knowledge, skills, abilities, and

professional behaviors.

(Core Value: Excellence)

6A. Physical therapists shall achieve and maintain professional

competence.

6B. Physical therapists shall take responsibility for their professional development based on critical self-assessment and

reflection on changes in physical therapist practice, education, health care delivery, and technology.

6C. Physical therapists shall evaluate the strength of evidence

and applicability of content presented during professional

development activities before integrating the content or

techniques into practice.

6D. Physical therapists shall cultivate practice environments

that support professional development, lifelong learning,

and excellence.

Principle #7: Physical therapists shall promote

organizational behaviors and business practices

that benefit patients/clients and society.

(Core Values: Integrity, Accountability)

7A. Physical therapists shall promote practice environments

that support autonomous and accountable professional

judgments.

7B. Physical therapists shall seek remuneration as is deserved

and reasonable for physical therapist services.

7C. Physical therapists shall not accept gifts or other considerations that influence or give an appearance of influencing

their professional judgment.

7D. Physical therapists shall fully disclose any financial interest

they have in products or services that they recommend to

patients/clients.

7E. Physical therapists shall be aware of charges and shall ensure

that documentation and coding for physical therapy services accurately reflect the nature and extent of the services

provided.

7F. Physical therapists shall refrain from employment arrangements, or other arrangements, that prevent physical therapists from fulfilling professional obligations to patients/

clients.

Principle #8: Physical therapists shall participate in

efforts to meet the health needs of people locally,

nationally, or globally.

(Core Value: Social Responsibility)

8A. Physical therapists shall provide pro bono physical therapy

services or support organizations that meet the health

needs of people who are economically disadvantaged, uninsured, and underinsured.

8B. Physical therapists shall advocate to reduce health disparities and health care inequities, improve access to health care

services, and address the health, wellness, and preventive

health care needs of people.

8C. Physical therapists shall be responsible stewards of health

care resources and shall avoid overutilization or underutilization of physical therapy services.

8D. Physical therapists shall educate members of the public

about the benefits of physical therapy and the unique role

of the physical therapist.

The Indian Physical Therapists’ Association states that it has an ethical committee who has a code of ethics, but their code of ethics cannot be found on their website.  http://www.indiapt.org/index.html

China is part of the World Confederation for Physical Therapy and therefore practices this code of ethics (found at http://www.wcpt.org/):

The World Confederation for Physical Therapy (WCPT) expects its member organisations to:

·         have a code of ethics or code of conduct

·         publish, promote and circulate their code of ethics or code of conduct for the benefit of their members, the general public, employers, governments and government agencies

·         have procedures for monitoring the practice of their members, disciplinary procedures and sanctions for members whose practice falls outside their code of ethics or code of conduct

WCPT offers advice and support to its member organisations wishing to develop codes of ethics or conduct.

The following statements expand on WCPT’s ethical principles.[1] They are intended to help member organisations and individuals interpret WCPT's ethical principles, with a particular view to supporting those physical therapy organisations wishing to develop codes of ethics that are consistent with WCPT's own ethical principles.

Ethical principle 1

Physical therapists respect the rights and dignity of all individuals.

Everyone who seeks the services of a physical therapist has the right to service regardless of age, gender, race, nationality, religion, ethnic origin, creed, colour, sexual orientation, disability, health status or politics.

Physical therapists should assure that patients/clients have the right to:

·         the highest quality physical therapy services

·         information about the physical therapy services

·         make an informed consent

·         confidentiality

·         have access to their physical therapy data

·         health education and health promotion services

·         choose who should be informed on his/her behalf

Ethical principle 2

Physical therapists comply with the laws and regulations governing the practice of physical therapy in the country in which they practise.

Physical therapists will have a full understanding of the laws and regulations governing the practice of physical therapy. They have the right to refuse to treat or otherwise intervene when, in their opinion, the service is not in the best interests of the patient/client.

Physical therapists have the right to advocate for patient/client access to physical therapist services when, in their opinion, there is restricted access to those who have the capacity to benefit.

Ethical principle 3

Physical therapists accept responsibility for the exercise of sound judgement.

Physical therapists are professionally independent and autonomous practitioners. They make independent judgements in the provision of services for which they have knowledge and skills.

With each patient/client, physical therapists undertake appropriate examination/assessment to allow the development of a diagnosis. In light of the diagnosis and other relevant information about the patient/client and their goals, physical therapists determine the prognosis/plan of care and implement the interventions/treatment. When the goals have been achieved or further benefits can no longer be obtained, the physical therapist shall inform and discharge the patient/client. When the diagnosis is not clear or the required intervention/treatment is not within the realm of physical therapist practice, the physical therapist shall inform the patient/client and facilitate a referral to other professionals.

Physical therapists shall not delegate to another health professional or support worker any activity that requires the unique skill, knowledge and judgement of the physical therapist.

If the patient/client has been referred to the physical therapist by a medical practitioner and the treatment programme prescribed is not appropriate in the judgement of the physical therapist, then the physical therapist should consult with the referring medical practitioner.

Physical therapists have the right to expect co-operation from their colleagues.

Ethical principle 4

Physical therapists provide honest, competent and accountable professional services.

Physical therapists shall:

·         ensure that their behaviour and conduct is professional at all times

·         deliver timely, patient/client-specific physical therapy intervention/treatment in line with the individual’s goals

·         ensure that patients/clients understand the nature of the service being provided, especially the anticipated costs (both time and financial)

·         undertake a continuous, planned, personal development programme designed to maintain and enhance professional knowledge and skills

·         maintain appropriate patient/client records to allow effective evaluation of the patient’s/client's care and evaluation of the physical therapist's practice

·         not disclose any information about a patient/client to a third party without the patient’s/client's permission or prior knowledge, unless such disclosure is required by law

·         participate in peer review and other forms of practice evaluation, the results of which shall not be disclosed to another party without the permission of the physical therapist

·         maintain data to facilitate service performance measurement and make that data available to other agents as required by mutual agreement

·         not allow their services to be misused

The ethical principles governing the practice of physical therapy shall take precedence over any business or employment practice. Where such conflict arises, the physical therapist shall make all efforts to rectify the matter, seeking the assistance of the national physical therapy association if required.

Ethical principle 5

Physical therapists are committed to providing quality services.

Physical therapists shall:

·         be aware of the currently accepted standards of practice and undertake activities which measure their conformity

·         participate in continuing professional development to enhance their basic knowledge and to provide new knowledge

·         support research that contributes to improved patient/client interventions and service delivery

·         keep up to date with the best evidence available and implement it in their practice

·         support quality education in academic and clinical settings

Physical therapists engaged in research shall ensure that they:

·         abide by all current rules and policies applying to the conduct of research on human subjects

·         have obtained subjects’ consent

·         protect subjects’ confidentiality

·         protect subjects’ safety and well-being

·         do not engage in fraud or plagiarism

·         fully disclose any research support and appropriately acknowledge any assistance

·         report any breaches of the rules to appropriate authorities

·         freely share the results of their research, especially in journals and conference presentations

Physical therapists in the role of employer shall:

·         ensure all employees are properly and duly qualified, ensuring compliance with statutory requirements

·         apply current management principles and practices to the conduct of the service, with particular attention to appropriate standards of personnel management

·         ensure policies and procedures are properly developed, implemented and monitored

·         ensure that clinical practice is appropriately evaluated and audited

·         provide adequate opportunities for staff education and personal development based on effective performance appraisal

Ethical principle 6

Physical therapists are entitled to a just and fair level of remuneration for their services.

Physical therapists shall:

·         ensure that their fee schedules are based on prevailing market conditions

·         ensure that fees charged offer value for money

·         ensure as much as possible that reimbursement from third-party funders are reflective of and consistent with good practice (third-party funders should not seek to exert control in any way that restricts the scope of practice of physical therapists or inhibits their right to fair remuneration)

·         ensure that influence is not used for personal gain

·         ensure that sound business principles are applied when dealing with suppliers, manufacturers and other agents

Ethical principle 7

Physical therapists provide accurate information to patients/clients, other agencies and the community about physical therapy and about the services physical therapists provide.

Physical therapists:

·         shall participate in public education programmes, providing information about the profession

·         shall inform the public and referring professionals truthfully about the nature of their service so that individuals are more able to make a decision about the use of the service

·         may advertise their services

·         shall not use false, fraudulent, misleading, deceptive, unfair or sensational statements or claims

·         shall claim only those titles which correctly describe their professional status

Ethical principle 8

Physical therapists contribute to the planning and development of services that address the health needs of the community.

Physical therapists have a duty and obligation to participate in planning services designed to provide optimum community health.

Physical therapists are obliged to work toward achieving justice in the provision of health services for all people.

In Thailand, The Physical Therapy Association of Thailand provides Regulations of the Association that are to be followed (http://www.thaipt.org/th/index.php/about-pt/2009-06-07-11-44-28.html): 

1. Name of Association "Physical Therapy Association of Thailand," the word "S.k.t." known in English as The Physical Therapy Association of Thailand is an acronym that PTAT.

2. The mark of a canopy over top of rice. The snakes have thousands of wood bracing.Edge on the show today. The text below is in English as "Physical Therapy Association of Thailand," and the abbreviation "S.k.t." text in English as The Physical Therapy Association of Thailand that the PTAT abbreviation as shown below. 

3. The place is located at the offices of the Association. Lottery Building, 4th Floor, Siriraj Hospital. Bangkok Noi district, Bangkok 10700.

4. Objective 
    4.1. The center of the members to exchange ideas. As well as knowledge about the art and science, physical therapy, both in theory and practice 
    4.2. The physical therapy center for the dissemination of knowledge on the prevention of disease. As well as causing potential for the rehabilitation of patients. 
    4.3. To honor and security of physical therapy profession. Quality control and standards of the profession. The standard of education, physical therapy 
    4.4. Working together to maintain. And promotion of professional ethics as the public's trust. Prevent and solve problems. This is an obstacle to the advancement of the profession. Protect the legitimate interests of the profession. To promote unity. And mutual assistance among the same profession. 
    4.5. The central coordination. Physical, technical and academic knowledge in other fields. As well as cooperation with other organizations. Both domestically and internationally. 
    4.6. A non-political association.

5. Sort of.
   . 5.1   members.    and. Individuals who received a Bachelor of Science. (Physical Therapy). 
   5.2.   Member extraordinary     is. 
            5.2.1. Honorary members are individuals who have been invited to be members of the Association. The Committee agreed that the person was made ​​of. The benefits to the association or an individual qualified in Physical Education. 
            5.2.2 Associate members are people who are in the field of physical therapy for more than 3 years, or who receive a certificate, diploma. Or graduation from a foreign country. That person is an ordinary member status after receiving approval from the Board of Directors with a 2 in 3 of the members present. 
            5.2.3 Members include students, junior physiotherapists, which turns an ordinary member status on by default. after graduation. 
            5.2.4 Members include individuals who are interested in academic and physical therapy without the need to apply for membership of the Association.

6. Is.
    . 6.1  members.
            6.1.1. Any person who wishes to become a member of the Association. Make your request in writing to the Secretary in accordance with the application of association 
            6.1.2. The Secretary-General announced candidate for the office of the Association not less than 15 days after the Board of Directors to consider subscribing.The annual fee as prescribed. 
    . 6.2 members associate   members and junior members. I do the same. But there must be a member of. 
have paid the annual fee as prescribed.  

7. the objection is.
    7.1. Person wishing to object to the application without the members of the applicant by the Secretary-General announced that the written objection filed with the Secretary-General. At least no more than 15 days from the date of notification to the Secretary-General will present the Executive Committee for further consideration. 
    7.2. The resolution of the Board of Directors is unanimous. In order to get the objected to a member or not. If you have received the affirmative votes of not less than 2 in 3 of the Executive Board at the meeting.

8. The rights of its members.
    8.1. Members.
            8.1.1. Vote and present their views at the meeting. 
            8.1.2. A director in a position to enact the regulations that has been selected. 
    8.2. Member extraordinary
            8.2.1. Attend the meeting and discuss the proposed ideas. But without any voting rights. 
            8.2.2 The directors in office at par in the Articles of Association. 
    8.3. Members are entitled to benefit from everything the association held for members. The conditions and regulations of the association 
    8.4. when members have any comments whatsoever about the affairs of the Association. Make the notification to the Secretary to the Board of Directors.

9. The duty of members.
    9.1. Must respect and abide by the rules and regulations of the association 
    9.2. The association must pay the fee every year. In the case of an annual 
    9.3. Must follow the etiquette and ethics for the profession. 
    9.4. Support for the association. In order to achieve the objectives of the association 
    9.5. The move addresses. Change name or extension shall be notified in writing. To solve the Registrar within 60 days from the date of change 
    9.6. Attended the annual

10. The lack of membership
    was 10.1. 
    10.2 resign by notifying the Secretary in writing and pay the debt owed ​​to the Association. 
    10.3. Board approve the termination of membership with the sound of not less than 2 in 3 of the members present. When it appears that 
            10.3.1. Drug addicts to blame. 
            10.3.2. As leprosy, tuberculosis and other diseases, alcoholism, or objectionable. 
            10.3.3 insane or deranged mind imperfect 
            10.3.4. The final verdict is bankrupt 
            10.3.5. Sentenced to imprisonment without the penalty of imprisonment or a heavier sentence. However, unless the offense is a misdemeanor. Or guilty of the acts of negligence. 
            10.3.6. Is a character in a way that will bring discredit to the profession. 
            10.3.7. Unpaid fee within 90 days without reason.

11. Finance and Services Association.
    11.1. proceeds Association with income. As follows.
            11.1.1. Association membership fee. 
            11.1.2. Bank Honorary Member. Donation to the association or the public. 
            11.1.3. Payment shall be presented as a debate over fair or other 
            11.1.4. The proceeds from the activities of professional physical therapy 
            11.1.5. Interest on deposits. 
            11.1.6. Money or any other property acquired by the law. 
    11.2. Evidence finance
            11.2.1. All receipts must be issued a receipt as evidence. All receipts must be signed by the treasurer of the association across the face of the bill during Coeฉik.Therefore be considered as a valid receipt. 
            11.2.2. Payment of the association, whether in any event would require the signature of the payee and bill of lading. Treasurer and approve 
            11.2.3. Treasurer shall prepare accounts for the association as evidence. And the need to preserve evidence before it. 
            11.2.4. The preparation of accounts. The Executive Committee shall lay down rules otherwise. It shall be prepared in accordance with general accounting principles.
            11.2.5. At the end of month. Treasurer, cash advances, the statement of receipts - expenses. And balance monthly to the Board of Directors of the Board of Directors by rotation. In this regard, the Commission may request documents from the treasurer's check book. For its consideration. When considered appropriate, the record is any evidence 
            11.2.6. Making statements such advances. To be appropriate. The Prime Minister may order otherwise modified by the Treasurer of the proposal within the prescribed period of a few months later. 
            11.2.7. The Treasurer presented the balance sheet accounts receivable - the year of the Association. The auditors of the Association for review before presentation to the meeting and appointed the new executive committee at the end of the term of the original series. 
            11.2.8. Payer money, the Association will be responsible for paying the money.If payment is not valid or misuse of the Association. If the order has been approved by the Board of Directors. The Executive Committee shall be responsible jointly with But excluding any director who does not agree with the payment of money or who did not attend the meeting.

12. The appointment of auditors.
    12.1. Appointment of Members to the meeting. This is not the association or a third party auditor. 
    12.2. If the general meeting appoint an auditor from office for any reason. Before the audit is completed. The Commission has the authority to any person. Non-members association, the auditor instead of 
    12.3. The auditor shall audit the accounts and financial documents of the association and the authority for the directors and officers of the association.

13. Board of Directors of association
 boards of directors comprised of not less than 10 and not more than 20 people at the election of a meeting of members to hold membership, or for not less than one year and shall be in a position to time. 2 years (since May - the month of April of next year). 
    13.1.  President of the Association.
            13.1.1. Leadership in the management of the Association.  
            13.1.2. Presided over the meeting. 
            13.1.3. As representatives of the Association in dealing with institutions. 
            13.1.4. The Association has the power to order payment of the amount specified. If more than this must be approved by the Executive Committee. 
    13.2. Vice President of Administration.
            13.2.1. Acting President when the President is not present. 
            13.2.2. General liaison with the Board or committee appointed by the Executive Committee. The administration of the affairs of the association 
    13.3. Vice President for Academic Affairs.
            13.3.1. Acting President or Vice President of Administration was not present. 
            13.3.2. Meeting the academic and technical, as appropriate. 
            13.3.3. The academic advisor of the association 
    13.4. Secretary.
            13.4.1. Operation and administration of the association. 
            13.4.2. And regulations of the association 
            meetings and 13.4.3 of the agenda. Records and reports. 
            13.4.4. Reports and activities of the Association's annual meeting. 
            13.4.5. Receiving the comments of members of the association 
    13.5. treasurer
            13.5.1. Responsible for the association. 
            13.5.2. Financial accounting and general accounting. 
            13.5.3. Not exceed a specified amount of cash. The majority of deposits with banks in order to find interest. "Physical Therapy Association of Thailand". 
    13.6. release.
            13.6.1. Responsible for the dissemination activities of the association, the media and the public. 
            13.6.2. Dissemination activities. Physical Activity and industry association members. Strengthen public understanding. 
    13.7. hostess
            13.7.1. Coordination between the association and the students. Physical therapy students. 
            13.7.2. Association representing participants in the activities of students.Physical therapy students. 
            13.7.3. And invite and welcome those who attend or visit the association. 
            13.7.4. Assistance in organizing all kinds of social association 
    13.8. the registrar.
            13.8.1. Member to the Association. 
            13.8.2. A registration profile and related statistics. 
    13.9. editor
            13.9.1. Preparation of an academic journal of the Association. 
            13.9.2 Preparation of the journal, documents or other publications for distribution. 
            13.10. Other directors. 
            13.10.1. Perform the assigned task. 
            13.10.2 meeting.

14. The election of directors.
    14.1. to recruit.
            14.1.1. 45 days before election day shall apply to ordinary members. In order to be a director. 
            14.1.2. When compiling the list of candidates in various positions, then the Secretary shall notify the member's name or a notice of the meeting. 
    14.2. the voting and vote counting.
            14.2.1. The meeting elected or appointed by the president to be elected from ordinary members. At the meeting on that day by holding a 2-tone basis. 
            14.2.2. M be the number of members present at the meeting on that day shall not be less than 1 in 2 in the number of ordinary members of the association. If it does not limit it to a new meeting within 45 days of the meeting was to hold a general membership meeting at which a quorum. In the event that a member can not attend the meeting. Entitled to appoint another member in writing to the meeting and vote on behalf of the members have chosen. 
            14.2.3. In cases where more than one candidate in any location that has the highest score is deemed to have been elected. 
            14.2.4. If there is only one candidate in any position and get a 2 to 1 vote at the meeting of members shall be deemed to be in that position without the void. Must be new elections. 
            14.2.5. How to vote. May be made ​​by means of a confidential or disclose 
notes. If you do not comply with Article 14.2.1 - 14.2.5 the meeting to determine how the other is on.

. 15 meeting
    15.1. of the meeting.
            15.1.1. The annual general meeting. 
            15.1.1.1. Once per two years. Which must be held before the end of the term of the original series. 
            15.1.1.2. Members of the Association must have attended at least 1 in 2 of the ordinary members of the association at that time. Is considered a quorum. 
            15.1.2. A special general meeting. 
            15.1.2.1. Council meeting when needed. 
            15.1.2.2. When a member of at least 10 people sign up to the Board of Directors meeting. 
            15.1.3. The Board of Directors by rotation. The committee will have at least 2 months at a time. 
    15.2. the meeting.
            15.2.1. Prior to the meeting. Must notify members in writing at least 10 days in advance with the agenda 
            15.2.2. The meeting provided a majority basis. If the votes are equal, the chairman of the umpire 
            15.2.3. When the President is absent from the meeting. The Vice President acts as President, instead of 
            15.2.4. The President and Vice President of the Executive Committee chose not to make themselves up as president 
            15.2.5. The Committee considered a 2-volume basis.

16. The term of office of the Executive Committee.
    16.1. the end of the work
    16.2. resign. Approval at the discretion of the Board of Directors.
    16.3. The board of directors resigned.
    16.4. lack of membership. In either case the clause. 10.
    16.5. the general meeting vote of no confidence.
    16.6. The Executive Committee has resolved more than 2 in 3 out of position. In the following cases.
            16.6.1. In the management of erectile dysfunction. 
            16.6.2. Dereliction of duty and cause serious damage. 
            16.6.3. Not cooperating in the administration of the association 
    16.7. When a member who vacates office.
            16.7.1. The Registrar shall supply a name from the register of Directors of the Association. 
            16.7.2. The Secretary General shall notify the Board of Directors shall determine. , And proclaim the name of the association is less than 15 days. 
            16.7.3 The Board of Directors selected the old ones. Which will remain in office only for the remaining period of the old ones.

17. Changes to the regulations of the association. May be made ​​by
    17.1. The Executive Committee of the Association not less than 1 in 2 proposed change 
    17.2. Signed as a member of not less than 10 people submitted to the meeting. Or the Board of Directors. 
    17.3. Chairman presented for approval at the annual general meeting. 
    17.4. The President will propose to the meeting. The Secretary-General announced that it will change at the Association for a period of not less than 15 days, or by other means to promote it.

18. The host association
         of the Executive Committee may invite persons who have agreed to become patron of the association.

Saudi Arabia and Israel are also a part of the World Confederation for Physical Therapy and therefore have the same guidelines for ethics as China.