No definition – but three conditions to be met
While the term “professional autonomy” is frequently used in the discourse of actors in the health and social services system (these include unions, employers, and the MSSS), it has not been provided with a definition in any of the laws or collective agreements covering our members’ work.
Professional autonomy is mentioned in some codes of ethics (such as the one for psychologists), but it is never clearly defined. Lacking a definition, we can usually say that an employee has professional autonomy when three conditions are met:
- They themselves can define their activities and missions.
- They have discretionary power over the way their work is carried out on a daily basis.
- On the basis of their judgement, they can deviate as they see fit from work as prescribed.
Why professional autonomy is important in health and social services
In the health and social services system, professional autonomy means the capacity of employees to make independent decisions based on their expertise and clinical judgement. This includes choosing methods and approaches that are adapted to service users’ needs, in compliance with prescribed professional standards.
Professional autonomy enables employees to make their own choices, which gives them satisfaction and is a way of recognizing their value. But it also has another very important consequence. It has a decisive impact on the quality of care, because it means that care can be adapted to the specific needs of each service user.
Even when an employee has no direct contact with service users, professional autonomy ensures that services are carried out in optimal conditions, with reduced risk of error. It also favours innovative approaches because it allows employees to improve practices on the basis of their clinical judgement.
When workload is a threat to autonomy
A workload that is too heavy reduces the time that an employee can devote to each service user and their ability to use their clinical judgement in a deeper and more personalized way. The stress and exhaustion associated with a heavy workload may also affect the quality of decisions and increase the risk of error.
One final note: autonomy is generally defined at the individual level, but an effective autonomous practice often implies that the person can take time to invest in their community of practice by exchanging with colleagues. This becomes difficult when a person’s workload is too heavy.
Studies have shown clear links between low autonomy at work and a number of health problems, especially when the psychological demands associated with a job are intense. For that reason, it’s important to have healthy management practices that support professional autonomy. You should be concerned if this is not the case.
Professional autonomy is essential to guarantee quality care and employee satisfaction in health and social services – and a reasonable workload is essential to make sure employees can fully exercise this autonomy.
Professional autonomy is your right. If you think it’s being compromised, talk to your local union team to find out what you can do about it.