Wow,
Terrianne you realy gave it the once-over. I agree with you that we are a profession
which was saturated by an undesirable group due to expanding slaries and demand.
Thank you for your insight and opinion.
Jimmie Arceneaux
On Mon, 10 September 2001, [EMAIL PROTECTED] wrote:
>
>
>
> Ok, I am going to take a stab here at what is a very complex issue...I myself
> have pondered this very question and have come up with the following conclusion.
>
> One: the roots of this profession, as far as treatment venues are concerned,
> are with the Army. As with anything closely associated with the government
> (until very recent history that is), there becomes a sort of complacency about
> having to explain the rationale for why something is or why it even exists.
>
> Two: Building upon fact one above, for many years the VA and government run
> psychiatric facilities were the largest employers of OT's. Same analysis.
>
> Three: Enter Medicare and mandated coverage for services. OT is a covered
> service; no questions asked. Hence there is no need to explain or even
> differentiate ourselves from PT. OTgets reimbursed because it is on the list
> of covered services.
>
> Four: Now the mandated service is extended to the public schools. Same
> scenario as above.
>
> Five: enter managed care. and its infiltrating influence to the government
> programs, culminating in health care with the Balance Budget act of 1997.
> Suddenly everything is being scrutinzed as never before.
>
>
> Througout the history of this profession, we have privately (in our own little
> professional body) expressed our exasperation at the lack of understanding of OT
> to the public and to our colleagues in other professions. I am sure there have
> been many efforts by individual practitioners or even by subgroups within OT to
> promote the profession. But the bottom line is this: we have never been
> collectively challenged to justify our existance until very recently. And the
> result is a profession that has gotten lazy.....again, I know that there are and
> have been dedicated OT's doing research, fighting to make a name for OT etc.,
> and thank God for them! And our founders, what a vison they had of what OT
> could be! But something has gone wrong in this profession since about the 60's
> on...Until 3 years ago, if you asked your average OT on the street how critical
> it is to make OT known, I don't think you would have gotten the same response
> you would get today.
>
> Before I rile too many more people up, let me add this: I remember in 1992, as
> a FW student, asking my supervisiors why something was "OT" or why it
> wasn't....I was at a VA and a community hospital psychiatric unit in a major
> metropolitan area known for cranking out OT's. I remember vividly the day
> that my Supervisior at the psych hospital said: "Just do a good job and make
> sure the clients like OT...don't worry so much about what OT is or isn't...we
> are a covered service and they wouldn't know what to do with the patients all
> day without us". I remember even as a very green young therapist how taken
> aback I was by her response. I was depressed to realize that even she didn't
> care to know if what we were doing made any difference.
>
> Fast forward one year, 1993 to my job as a staff therapist at a large regional
> medical center. Here I am, new graduate, looking up to senior therapists as
> mentors. Out of a group of 25 OT's, there were 2 that were members of AOTA or
> the state association. Two. If the hospital didn't pay for it, then they
> didn't do it. This was a group of well compensated (the height of the add on
> bonus era I might add) group of people who had no excuse not to support the
> profession. I remember them saying "AOTA doesn't do anything for me".
> Continuing ed was seen as a way for the hospital to pay for a trip somewhere and
> a few days away for the clinic. I again remember the department director saying
> "they love OT at this hospital.. we and PT are the bread and butter around
> here. We make money for the hospital".
>
> As time progressed and I became more experienced, I wanted to engage in research
> in the clinic. I was shot down. "we don't need to do that" I was told again
> and again.
>
> Then the reimbursement started tightening up thanks to manged care and suddenly
> the pressure was on. Now the excuse to not engage in research was that
> productivity would be an issue. And then turf wars really heated up....I could
> go on and on.
>
>
> Let me conclude with this: If you are reading this diatribe you are not likely
> part of the problem...you ARE a dedicated OT, trying to prove our worth and
> asking the tough questions. It is our colleagues who were signed on for the
> good times only (read: many of the graduates from the mid eighties until
> 1996...) that were lured into the profession by lucrative salaries, etc., who
> are hindering NOT HELPING our cause. And they are leaving the profession in
> droves, and I for one am glad. Let a new crop of dedicated students who will be
> prepared to engage in research and ask the tough questions come into the
> profession knowing full well the challenges ahead.
>
> I am now in an academic setting where I feel like I can do my part to encourage
> students to support the profession and articulate what OT is and what it isn't.
> One area of research I hope to engage in is to study the impact on a profession
> when sign on bonuses and inflated salaries are major enticements to enter a
> profession. The literature from the business sector indicates that ultimately
> the practice backfires and committment to an organization (or in our case , a
> profession) are even lower than before all the incentives were added on.
>
> Well, let me have it! Prove me wrong every one out there! I want to hear it
> loud and clear. Thanks, Terrianne
>
>
>
>
>
>
>
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