Case Study: “Best Deal”

Focus: purchasing equipment for a client

An occupational therapist works in two different settings: an acute care orthopedic unit and a community-based private clinic. A client from the unit has tried different dressing aids and finds that a few really help increase his independence and comfort. The client would like to purchase these for use at home but has a limited income. The private clinic where the occupational therapist works orders these dressing aids in bulk so can offer competitive pricing.

How should the occupational therapist proceed? (Select 1)

  1. Arrange for the client to buy the dressing aids from the clinic at their regular price.
  2. Arrange for the client to buy the dressing aids from the clinic at a discounted price.
  3. Provide the client with a list of various retailers who sell the dressing aids.
  4. Give the client dressing aids from the clinic with the recommendation to follow up there.

College Preferred Answer

3 is correct

A conflict of interest occurs when the occupational therapist’s interests interfere with the client’s best interests or the occupational therapist’s own responsibilities. Practice Standard #2: Preventing Conflict of Interest states that occupational therapists must “provide clients with alternative options for receiving occupational therapy services in circumstances where a perceived or actual conflict of interest exists or a potential conflict of interest may arise” (p. 17). In this case, if the list includes the private clinic where the occupational therapist works, it will be important that she manage the conflict of interest in accordance with Practice Standard #3: Managing Conflict of Interest. This involves disclosing the conflict, providing information about options, informing the client of his right to decline the service, and documenting any steps taken.

1 and 2 are incorrect

Practice Standard #1: Recognizing Conflict of Interest indicates that occupational therapists must “recognize if a situation involves any direct or indirect benefit (i.e., personal, professional, political, academic, financial, or material) to the occupational therapist that could affect his or her professional judgement” (p. 13). If the occupational therapist specifically arranges for the client to buy the dressing aids from the private clinic, the occupational therapist may directly or indirectly benefit, creating a conflict of interest.

4 is incorrect

The occupational therapist stands to gain by soliciting the client to contract her privately as a way of obtaining the dressing aids for free. Additionally, it is unclear from the information provided in the scenario that the client actually requires follow up.

Additional Questions for Reflection

Additional questions for reflection, on your own or with others…

  • What would you do in a similar situation?
  • What other factors might have made it easier or more difficult for the occupational therapist to maintain professional boundaries?
  • What organizational policies are in place – or could be – to help prevent conflicts of interest in your practice?

References

College of Occupational Therapists of British Columbia. (2016). Conflict of interest practice standards.