Focus: offering choices
An occupational therapist (OT) works in a BC health authority residential setting. He has recently completed a seating assessment and the findings indicate that a resident requires a customized tilt-in-space wheelchair and specialty cushion. The residential setting is in an urban area where there are several local medical equipment vendors that sell these types of seating systems.
The OT is relatively new to this practice area and has limited experience working with wheelchair vendors. Recently he had an excellent experience working with one particular vendor representative and would prefer to work with representative again. The process was smooth and efficient for the OT, the vendor was knowledgeable, and the client was very satisfied. How should the occupational therapist proceed? (Select 2)
- Ask for consent to work with this preferred vendor because it is in the resident’s best interest to use a knowledgeable vendor who provides good service.
- Provide the resident with the alternatives available in the area and then encourage the resident to choose a vendor representative.
- Seek out organization policies and procedures related to working with medical equipment vendors and/or fair business practices.
- Encourage the resident to choose the vendor after outlining the alternatives and describing previous professional experiences.
- Provide the resident with information regarding vendors recommended by colleagues with more experience in the area.
College Preferred Answer
2 and 3 are correct
Conflict of Interest Practice Standard #2: Preventing Conflict of Interest states that occupational therapists “avoid preferential or discriminatory treatment towards particular … organizations” and will “apply any conflict of interest-related policies and procedures of the occupational therapist’s employer or organization” (pp. 16-17). While the occupational therapist may have had a positive experience with one particular vendor, it remains the occupational therapist’s responsibility to provide the client with information about the range of alternatives available, so that the client themselves can make an informed choice.
For example, this may include, but is not limited to, the occupational therapist objectively presenting information regarding differences in vendor costs and types of equipment sold, as well as customer service considerations such as return policies, warranties, availability of trials, and timeliness of equipment repairs and servicing. The occupational therapist must be careful not to inadvertently influence a decision when communicating information about vendors. What’s easiest for the occupational therapist is not necessarily in the client’s best interests.
Checking with your organization’s purchasing or procurement department will help prevent unnecessary violations of policies. If not available, consider developing policies and procedures to ensure you are consistent and fair when dealing with suppliers.
1 is incorrect
This approach does not give the client an opportunity to understand the alternatives available and personally make an informed choice among them.
4 is incorrect
While the occupational therapist has provided the client with an understanding of the alternatives available, by ‘encouraging’ the client to choose the occupational therapist’s preferred vendor, the occupational therapist is introducing his own bias and influencing the informed consent process.
5 is incorrect
While talking with colleagues is one approach the occupational therapist may use to develop his professional knowledge about various vendors, as with previous answers, limiting the alternatives presented impacts the client’s ability to make an informed choice among the options and introduces bias.
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 explain the conflict of interest?
- What organizational policies are in place – or could be – to help prevent conflicts of interest in your practice?
College of Occupational Therapists of British Columbia. (2016). Conflict of interest practice standard #2: Preventing Conflict of Interest, pp. 16-17.