Hello Terrianne:
THANK YOU VERY MUCH for your thought-provoking words. You have given
us (the list) much food for thought.
With your permission, I wish to let my psychosocial OT class read your
message.
Thanks,
Ron
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
On 9/10/2001, [EMAIL PROTECTED] <[EMAIL PROTECTED]> wrote:
tse> Ok, I am going to take a stab here at what is a very complex issue...I myself
tse> have pondered this very question and have come up with the following conclusion.
tse> One: the roots of this profession, as far as treatment venues are concerned,
tse> are with the Army. As with anything closely associated with the government
tse> (until very recent history that is), there becomes a sort of complacency about
tse> having to explain the rationale for why something is or why it even exists.
tse> Two: Building upon fact one above, for many years the VA and government run
tse> psychiatric facilities were the largest employers of OT's. Same analysis.
tse> Three: Enter Medicare and mandated coverage for services. OT is a covered
tse> service; no questions asked. Hence there is no need to explain or even
tse> differentiate ourselves from PT. OTgets reimbursed because it is on the list
tse> of covered services.
tse> Four: Now the mandated service is extended to the public schools. Same
tse> scenario as above.
tse> Five: enter managed care. and its infiltrating influence to the government
tse> programs, culminating in health care with the Balance Budget act of 1997.
tse> Suddenly everything is being scrutinzed as never before.
tse> Througout the history of this profession, we have privately (in our own little
tse> professional body) expressed our exasperation at the lack of understanding of OT
tse> to the public and to our colleagues in other professions. I am sure there have
tse> been many efforts by individual practitioners or even by subgroups within OT to
tse> promote the profession. But the bottom line is this: we have never been
tse> collectively challenged to justify our existance until very recently. And the
tse> result is a profession that has gotten lazy.....again, I know that there are and
tse> have been dedicated OT's doing research, fighting to make a name for OT etc.,
tse> and thank God for them! And our founders, what a vison they had of what OT
tse> could be! But something has gone wrong in this profession since about the 60's
tse> on...Until 3 years ago, if you asked your average OT on the street how critical
tse> it is to make OT known, I don't think you would have gotten the same response
tse> you would get today.
tse> Before I rile too many more people up, let me add this: I remember in 1992, as
tse> a FW student, asking my supervisiors why something was "OT" or why it
tse> wasn't....I was at a VA and a community hospital psychiatric unit in a major
tse> metropolitan area known for cranking out OT's. I remember vividly the day
tse> that my Supervisior at the psych hospital said: "Just do a good job and make
tse> sure the clients like OT...don't worry so much about what OT is or isn't...we
tse> are a covered service and they wouldn't know what to do with the patients all
tse> day without us". I remember even as a very green young therapist how taken
tse> aback I was by her response. I was depressed to realize that even she didn't
tse> care to know if what we were doing made any difference.
tse> Fast forward one year, 1993 to my job as a staff therapist at a large regional
tse> medical center. Here I am, new graduate, looking up to senior therapists as
tse> mentors. Out of a group of 25 OT's, there were 2 that were members of AOTA or
tse> the state association. Two. If the hospital didn't pay for it, then they
tse> didn't do it. This was a group of well compensated (the height of the add on
tse> bonus era I might add) group of people who had no excuse not to support the
tse> profession. I remember them saying "AOTA doesn't do anything for me".
tse> Continuing ed was seen as a way for the hospital to pay for a trip somewhere and
tse> a few days away for the clinic. I again remember the department director saying
tse> "they love OT at this hospital.. we and PT are the bread and butter around
tse> here. We make money for the hospital".
tse> As time progressed and I became more experienced, I wanted to engage in research
tse> in the clinic. I was shot down. "we don't need to do that" I was told again
tse> and again.
tse> Then the reimbursement started tightening up thanks to manged care and suddenly
tse> the pressure was on. Now the excuse to not engage in research was that
tse> productivity would be an issue. And then turf wars really heated up....I could
tse> go on and on.
tse> Let me conclude with this: If you are reading this diatribe you are not likely
tse> part of the problem...you ARE a dedicated OT, trying to prove our worth and
tse> asking the tough questions. It is our colleagues who were signed on for the
tse> good times only (read: many of the graduates from the mid eighties until
tse> 1996...) that were lured into the profession by lucrative salaries, etc., who
tse> are hindering NOT HELPING our cause. And they are leaving the profession in
tse> droves, and I for one am glad. Let a new crop of dedicated students who will be
tse> prepared to engage in research and ask the tough questions come into the
tse> profession knowing full well the challenges ahead.
tse> I am now in an academic setting where I feel like I can do my part to encourage
tse> students to support the profession and articulate what OT is and what it isn't.
tse> One area of research I hope to engage in is to study the impact on a profession
tse> when sign on bonuses and inflated salaries are major enticements to enter a
tse> profession. The literature from the business sector indicates that ultimately
tse> the practice backfires and committment to an organization (or in our case , a
tse> profession) are even lower than before all the incentives were added on.
tse> Well, let me have it! Prove me wrong every one out there! I want to hear it
tse> loud and clear. Thanks, Terrianne
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