Will the World Ever Become Global?

global-communityA lot of things have contributed to the ‘shrinkage’ of the world. The most immediate and obvious one would be the rise of the Internet, however there are many significant contributors: transport, communication (non-web based), media, finance and economics, politics, and religion have all, in their own way, helped the people of the world cross borders and create a sense of global awareness, even global community. Yet is the world truly going ‘global’? As an Australian now living in the United States, my experience suggests that we’ve still got a long way to go.

Case in point: health care, specifically my profession, Physical Therapy (Physiotherapy, or PT as it’s affectionately known here). I’ve been working as a PT in the US now for just over a month. Not a whole lot of time, but more than enough to assess the similarities and differences between how PT is done here, and how it’s done back in Australia. What I’ve discovered is that the practice of PT – that is, how you assess, treat, and manage the care of a patient – is EXACTLY THE SAME in the US as it is in Australia. Surprising? Shocking? Perhaps, but nevertheless, it’s true.

Of course, there are some differences in the way PT is delivered to people; for example, medical insurance is quite different here compared to Australia (truthfully, I’m still trying to get my head around how the insurance system here works, so please don’t ask me to explain what the differences are – just know there’s a big difference). However, having now met and worked with a number of PTs here in the States, I know that any patient I’ve ever seen in Australia would get exactly the same care by any US PT as they would by their Australian counterpart, and vice versa.

In fact, I can say the same thing about my New Zealand counterparts as well, having spent time observing PT practices there, and seeing some of their countrymen come to Australia to practice. I would go so far as to say that PT practice is pretty much the same the world over. Take a PT out of one country, put them in another, and the care patients receive will essentially be the same as if a local performed it.

In this respect – at least to my way of thinking of it – PT is a global health discipline. A PT trained anywhere in the world (at least, say, within the 21st Century) should be able to go anywhere else in the world, and still be able to deliver quality PT care.

All sounds good in theory, doesn’t it? When you try to put this into practice, as I have recently done, it doesn’t seem to quite work like that. Each country has its own rules, and regulations, and criteria, and restrictions, and limitations, all seemingly designed to protect those within its borders from those without. Protect from what, exactly? Well, that’s a question for your local consulates and embassies.

To be fair, there are obviously some professions for which it would be all but impossible to simply leave one country and pick up where you left off in another. Law would be a perfect example, considering that the statutes and regulations that make up a country’s laws are so unique to that country (and in many instances, unique to States or regions within that country) that you could not reasonably expect, for instance, an Australian criminal lawyer to come to the US and start practicing criminal law without demonstrating they have a sound understanding of the theory and application of local laws (and please, no ‘kangaroo court’ jokes).

While it’s reasonable to expect that if we haven’t been able to resolve issues like that in over a hundred-thousand years of human history we’re not likely to be able to anytime soon, given that technology, infrastructure, and ideas are only going to shrink the world even further, should we be moving towards a more truly global community? Should we start looking at the ‘sameness’ of our countries, and identify opportunities where the traversal of borders – both figuratively and literally – would present mutual benefits to all involved? Where recognising knowledge, experiences, skill sets, and ideas, and facilitating their transition and incorporation from one place to another, would improve the quality of our societies – of life in general – for everyone?

This is not to say that we should relinquish the things about our societies that are intrinsic, or give us our identity; it is not about trying to make everyone the same. It’s about making the borders that keep us separated a little more ‘permeable’, and understanding the advantage that gives us all.

Surely as a global community, we have more to offer each other than cat memes and video clips?

What do you think? Is the world global? Should it be? What helps/limits our abilities to become global? Please feel free to share your thoughts in the comments section below.

We’ll Be Right Back…

PM5544_with_non-PAL_signals

It has been some time since I last posted, for which I apologise, however, it may also be sometime until I post again.

Life has taken some twists and turns and currently demands more of me. Unfortunately, something has to give, and continuing to post to my regular schedule is one of those things.

I am hoping this will only be a short hiatus. To my regular readers – thank you for hanging in there with me, and waiting patiently for ‘something’. I hope you will understand, and still be here once I return.

Is it Time to Redefine ‘Community’?

Partnerships - reproduced with permission and acknowledgement of the Making Two Worlds Work Project

Partnerships – reproduced with permission and acknowledgement of the Making Two Worlds Work Project

 

The word ‘community’ means different things to different people. The basis for understanding what a community is can be dependent on a variety of different factors: personal beliefs, societal constraints, geography, and historical and contemporary contexts, just to name a few.

To many Aboriginal peoples in Australia – perhaps, to many Indigenous peoples the world over – community is usually associated with land, either the land on which someone resides, or the land from which a person has traditional (family) connection to. In some instances these will be one and the same place, however for many Aboriginal peoples – for many different reasons – the land they currently live on is not the land their ancestors were traditional owners of.

An interesting, and sometimes unfortunate, side-effect of this ‘dispersion’ of Aboriginal peoples across Australia is the way in which communities are now integrated and internally interact. Once we would have seen communities where the descendents of the traditional custodians made up the overwhelming majority, if not the full population, and no doubt there are still areas where this is the case. However today, many communities are made up of peoples from all over, and as these – maybe ‘multi-cultural’ is the correct word here? – communities mix and grow, issues relating to rights, responsibilities, and recognition are becoming more prevalent. This in turn is leading to dissonance, division, and lateral violence within these communities.

On the surface it seems it should be quite simple: the traditional custodians (or their descendents) of an area should be the ones who have the ‘authority’ within the community. After all, it is their land, and all others are effectively ‘visitors’ to that area. In reality it isn’t that clear cut. For example, some communities give peoples who have come from other areas the right to have ‘authority’ within the community, based on a respectful acknowledgement of their knowledge, experience, wisdom, and/or contribution to the community. Some members of the community embrace this, whereas others do not. Some communities become ‘factionalized': they create divisions within the community based on kinship and associations with others. Some communities remain locked in debate about who the traditional custodians of an area actually are. This is particularly contentious where it is apparent that custodianship of an area was in fact shared between a number of language-groups.

The unfortunate, and often regrettable, result of this are communities who expend their energies in in-fighting and lateral violence, whilst real issues that affect all members of the community fall by the wayside.

And all of this before we even start considering how non-Indigenous Australians could be ‘integrated’ into an Aboriginal community, as part of a reconciled, unified, Australia.

Having lived and attempted to be involved in several communities, as well as seeking out, understanding, and developing my own identity as an Aboriginal man, I’ve come to believe that the answer is anything but simple. But when I reflect on how this issue could possibly be resolved, I find myself coming back to the same concern…

What if we’re asking the wrong question?

I keep thinking about something my cousin, a Bundjalung Elder and Kurradji (traditional healer) said to me in the short time I got to spend with him before his passing.

“Everyone is Bundjalung.They just don’t know it yet.”

There is a sense of inclusiveness in Uncle’s statement that is profound, and also the suggestion that we – as a community, as a population – haven’t realised it yet.

Perhaps the answer lies not in trying to impose our view of what a ‘community’ is or should be, or who ‘owns’ it or belongs to it or has a say in it, but in redefining what ‘community’ actually means?

What if our ‘community’ became something that all of us could engage in, contribute to, and be proud of?

What would that look like?

What does ‘community’ mean to you? What would you like your ‘community’ to be? Please feel free to share your thoughts in the comments below.

Physical Therapy Credentialing – The Missing Tips!

certification-stampSo there I was: I’d made it through the grueling process of having my physical therapy qualifications credentialed, I’d successfully passed the National Physical Therapy Exam (NPTE), I’d received my State license, and I even had a job offer. I was all set to go get my visa and become a physical therapist in the United States. Little did I know the credentialing process wasn’t finished with me yet. A new nemesis emerged – the VisaScreen Certificate, and without it, I wasn’t going anywhere.

The VisaScreen Certificate is a requirement imposed by the US Department of Homeland Security (DHS) for all foreign (non-US) non-physician health care workers who wish to work in the United States. It aims to ensure that the foreign worker meets the minimum requirements for training, licensure, and English proficiency in their profession.

Wait a minute. Isn’t that exactly the same as the credentialing process? Well, yes, but then again, no.

It should be the same process, and obtaining one should automatically qualify you for the other, however in practice it doesn’t work that way. The reason for this is that many the State-based licensing authorities will accept credentialing reports from a number of credentialing organisations (for example, Wisconsin’s Department of Safety and Professional Services currently accepts credentialing reports from four approved organisations), however, DHS currently only accepts the issuance of health care worker certificates for physical therapists from two of these: the Foreign Credentialing Commission on Physical Therapy (FCCPT) and the Commission on Graduates of Foreign Nursing Schools (CGFNS).

The rationale for this is unclear, especially when you consider that all recognised credentialing authorities must be approved by the Federation of State Board of Physical Therapy (FSBPT) to use their Course Work Tool (CWT) in order to evaluate a foreign trained physical therapist’s qualifications. What’s worse is that neither of the organisations authorised to issue VisaScreen certificates will accept credentialing reports from any of the other FSBPT approved credentialing organsations*, so if you’ve already had your qualifications credentialed by someone else, you’re going to have to go through the whole process again. As I learned for myself.

Armed with this new information, I can now offer you two additional tips to those I have previously offered for the physical therapy credentialing process.

 

1. Choose one of the DHS approved organisations

Consider this an addendum to my previous tip on choosing a credentialing authority. While you still have the option of choosing from a number of credentialing services, you will save yourself a lot of time, effort, and expense if you choose one of the (currently) two organisations that can assess you for both licensure and VisaScreen Certificate purposes. Given that if you want to work in the US you must have both of these, it only makes sense to go through the process the one time (and certainly what I would do if I had my time over). At the time of writing, FCCPT offers an all inclusive package for qualification credentialing, English proficiency, and VisaScreen certification, whereas CGFNS offers these as separate services.

If you still choose to use a different credentialing authority to obtain your US State licensure, be aware that at the time of writing this, FCCPT does not offer an evaluation service solely for VisaScreen certification, meaning your only choice then become CGFNS.

2. Be aware of actual versus proposed processing times

Given that I was unaware of the need to obtain any sort of certification beyond my credentialing report, when my future employer’s attorney requested a copy of my VisaScreen certificate the need to obtain one became very urgent.

In addition to my previous advice on waiting times, this time through I discovered a new problem. The organisation I chose advised a four-to-six week processing time from the time they received all the required documents and information to process the application. They also offered an expedited service for an additional fee, which guaranteed a reduction in the processing time to five business days. It seemed perfect – I expected that by the time I got the documents to them (I knew what to send because I’d already been through it) and expedited the process I would have only suffered a delay of about three weeks. What I wasn’t told by the organisation is that upon receipt of my documents, they are scanned into their system before being forwarded on to the person responsible for reviewing them – and the receipt and scanning of the documents takes up to four weeks itself! So the real processing times were a minimum of five weeks, and anywhere up to ten, under optimal circumstances. (As it was it took me about four months to get through this process – bearing in mind it was the holiday season.)

My advice then is to check with the organisation as to what the actual processing times are, and whether there are any additional timeframes other than what they promote through their websites, before selecting one to go with. It’s unlikely you’ll be able to obtain a ‘promised’ turn around time, however it will give you a clearer indication as to how long you can realistically expect to wait. This is also another reason why selecting one organisation to process both your credentialing report and VisaScreen certificate can be beneficial.

Combine these with my other tips and with any luck you will find the credentialing process much easier than has been my experience. Good luck!

Have you been through the credentialing process? What was your experience? Please feel free to share in the comments section below.


* At the time of writing, CGFNS have stated that they will accept credentialing reports from the International Consultants of Delaware (ICD), which is a subsidiary of CGFNS.

Has Sorry Lost Its Meaning?

'Sorry'AirWriting(by-michael_davies-onFlickr)

On 26 May this year, the seventeenth National Sorry Day will be observed following the Bringing them Home report, which detailed the findings of the National inquiry into the separation of Aboriginal and Torres Strait Islander children from their families. Before that, on 13 February, it will be seven years since the then Australian Prime Minister Mr Kevin Rudd’s Apology to the Stolen Generations.

Both of these days have special significance for many Aboriginal and Torres Strait Islander peoples: both recognise impact that past events and policies have had on past, current, and future well-being of Aboriginal and Torres Strait Islander peoples, and through saying ‘sorry’, both suggest that there is a desire to make amends.

Yet as we start the new year, it would seem that very little has changed for Aboriginal and Torres Strait Islander peoples in any area – health, education, employment, or social justice, just to name a few. While it does appear, at least through social media, that there is increasing public recognition of, and support for, Aboriginal and Torres Strait Islander issues, this does not seem to be translating into changes in public policy, nor actions that will affect real change for Aboriginal and Torres Strait Islander peoples.

What then does ‘sorry’ mean? Does it mean anything anymore?

I tell my daughter (and anyone else who’ll listen) that ‘sorry’ only means something if you follow it up with appropriate action. That saying ‘sorry’, and then continuing to do the same thing that you’re supposed to be sorry for, means you’re not really sorry at all. In this instance, the only ‘sorrow’ you feel is guilt – either because you know that you should or shouldn’t be doing something, or because you’ve been caught doing it!

‘Sorry’ isn’t about guilt, neither is it about blame. While it could be said that someone saying sorry admits fault, or takes responsibility, for whatever has occurred, this does not always have to be the case. Consider the act of expressing sorrow at someone’s adversity – the loss of a loved one, a traumatic event, or something similar. We may have no part in what has caused the adversity, yet we are still sympathetic to the person who has experienced it. If we have a close association to that person, we most likely also feel that we want to do something about it. We might not be able to alter the event that has already occurred, but we can take actions that can have a direct effect on the person who has experienced them. This isn’t an act of guilt, it’s an act of kindness, consideration, and support, brought about by the desire to effect change.

If the responsibility is ours, then the desire to effect change should be more pronounced, and it would be reasonable to expect that we would then take appropriate action to either make amends, or ensure that the event did not occur again. To do this, there needs to be adequate identification of what the adverse or undesirable event was, so that how and why it occurred can be understood, and appropriate measures taken to ensure it doesn’t happen again.

This is why when my daughter (or anyone else) tells me they are ‘sorry’ for ‘something’, my usual response is, “what are you sorry for?” If you don’t know what you’re apologising for, you can’t change anything – more than that, you might be trying to apologise for something this is not the crux of the matter, or even something for which you’re not accountable. Without recognising what the apology is for, and whether this is in fact what the apology should be for, ‘sorry’ becomes meaningless – at best it is simply ‘sorry for sorry’s sake’.

This is why then Prime Minister Kevin Rudd’s apology had such a profound impact, and was accepted and appreciated by many Aboriginal and Torres Strait Islander peoples. In his speech, Mr Rudd clearly explained what he, on behalf of the Australian Government, was apologising for, and also expressed his vision of the outcomes that could be achieved following this apology.

At the time there was no question as to the sincerity of the National Apology; many perceived this to be the beginning of real change in Aboriginal and Torres Strait Islander affairs, and the start of moving towards true Reconciliation in this country. Yet with continued gaps in health, education, employment, and social justice, continued experiences of discrimination and racism, and continued denial in some sectors that the atrocities of the past, including the Stolen Generations, ever actually occurred, we must wonder whether this apology had any real meaning or value.

As we move through 2015, and these events are brought to our attention, perhaps Australia needs to ask itself: are we sorry for what has happened to Aboriginal and Torres Strait Islander peoples? And if so, what is it that we’re sorry for, and what are we going to do about it?

What does ‘sorry’ mean to you? Should Australia be sorry for its past (or present) treatment of Aboriginal and Torres Strait Islander peoples? How do we move forward from here? Please feel free to share your thoughts in the comments section below.

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