Hello Ann: Again, thanks for taking time to write. While this dialogue has primarily been between you and I, hopefully others are taking time to read them and will 'jump in' with their observations and comments.
In rereading your comments, I stopped at #1. It occurs to me that we may have had different perceptions and experiences because of the way we define and try to practice OT. So, if you agree, maybe it will be helpful if we have have a 'discussion' about the nature of OT practice and what it is and/or isn't. Ron ~~~~~~ On Tuesday, April 23, 2002, [EMAIL PROTECTED] wrote: Dac> I have a couple of comments related to your assertions(follow each of your Dac> numbered points) Dac> In a message dated 4/23/2002 1:15:36 AM Eastern Standard Time, Dac> [EMAIL PROTECTED] writes: >> Regarding evidence of OT being swallowed up, I guess I have several sources >> for my statements: >> >> 1. My experience working in Rehab, Home Health, Private Practice and in >> Education clearly demonstrates to me that by far, the majority of people >> (clients, Doctors, other therapists) have little idea of what OT is or >> isn't >> and some have little respect for our role in client care. Dac> *I'm sorry you had such unproductive relationships in these various arenas. Dac> While I have met people of other disciplines in each of the above settings Dac> who don't have a good understanding of OT, after working with us in all of Dac> those settings, most of the ones I have dealt with have increased their Dac> understanding, and have respected our contribution. Again, I feel that the Dac> OTs who are most successful at achieving these results with other disciplines Dac> have been able to effectively mesh their occupational approach within the Dac> primary model of the setting in which they work, be it medical or Dac> educational, rather than trying to impose a different model on the rest of Dac> the team. There are some members of other disciplines who are not reachable, Dac> but in my experience they were the minority, not the majority. >> >> 2. Several years ago, PT Practice Guidelines expanded to include themselves >> as wanting to be recognized experts in community, and home reintegration >> and >> in self-care management. These Guidelines represent an expansion of PT >> philosophy at the National level and clearly represent a challenge to OT's >> traditional domain of concern. >> *While I don't discount the threat this poses, I also work with PTs on a >> daily basis, and most of them are clueless when it comes to approaching >> these areas, and don't tend to try to do stuff they don't feel comfortable >> with. We have a Community Re-entry program, and OT, PT, ST, and Rec. >> therapy all are potential disciplines to take the patients on the outings. >> PT is the least likely to participate, and the least comfortable in >> suggesting adaptive approaches to the patients while they are on the >> outings. I have known a few PTs over the years who are exceptions to this, >> but they were the minority. >> >> 3. PT's are changing their State Practice Acts to incorporate the above >> guidelines. The Practice Acts provide language for what PT can legally >> claim to do. Whether they can actually do it better than OT doesn't matter. >> Once it's in their practice act they can legally claim expertise in the >> area. Dac> *This does pose a potential threat if we as OTs don't also seek to market Dac> ourselves to the community, and work with our state associations to protect Dac> our areas of expertise. I think that working with and developing strong Dac> relationships with our referral sources will be the most effective means of Dac> counteracting this threat. >> >> 4. The strong separation between OT professional philosophy and actual >> practice. For example, I have yet to read anywhere were OT is considered to >> be upper-extremity experts. However, many OT's practice and receive >> referral for injuries above the waist while PT's receive referrals for >> below >> the waist injuries. This separation of Philosophy and Practice drives a >> severe wedge in our profession and makes us weak (in my opinion). Dac> *I have heard your feelings on this area. This area of practice is the one Dac> that I think is the most threatened by being taken away by PT, but since you Dac> feel that these OTs are not really doing OT anyway, I'm not sure why you're Dac> concerned that PT is more recognized for these types of treatments(based on Dac> your previous response to me). And again, I would go back to one of my Dac> previous posts to you, regarding the fact that different OTs treating with Dac> different approaches is just different not right/wrong, or driving a wedge. >> >> 5. Several articles published in the last 10 years or so which suggest the >> possible demise of OT unless changes are made in our practice patterns. If >> you are interested, I will provide some references. In fact, I have OTD >> students read some of the articles. Dac> *I'd be happy to see what you have, as I am always interested in hearing Dac> varying opinions. If the opinions are not backed by facts, than I tend to Dac> take them with a grain of salt. I'll be curious to see what facts these Dac> articles use to support the assertions they make. >> >> 6. Numerous discussion I have heard and participated in regarding the >> fusion >> of OT and PT into a single profession. Dac> *Discussions with whom? Have you seen any movement in this direction by the Dac> AOTA, APTA, 3rd party payor demands, etc.? I've heard nothing in regard to Dac> changes in legislation, reimbursement or educational programs related to Dac> this. >> >> 7. OT not being able to open Medicare home health case speaks volumes of >> our >> diminishing role in that arena of care. Dac> *OT had NEVER been able to open Medicare home health care cases, and if Dac> anything, are closer to achieving this goal than they ever have been, since Dac> at least legislation has been proposed in the past year to change this. Not Dac> sure why you see this as new evidence of our demise. >> >> 8. The migration of Mental Health OT's out of traditional Psychs settings. >> This left a tremendous gap in psych services which has been filled (in many >> cases) by non-skilled technicians. >> *Mental Health is not an area I have participated in since my fieldworks, >> so I don't feel qualified to judge anything going on there, but I would ask >> why OTs migrated out? >> 9. Several published articles discussing the ill-fit of OT and the medical >> model of care >> *This is something that I have perceived is consistent with your beliefs, Dac> based on multiple posts by you in the past. This is at the heart of what I Dac> find inconsistent about your concerns. You feel that true OT philosophy does Dac> not mesh well in the medical model of care, yet you express concern about Dac> potential loss of referrals from the medical community. If you don't think Dac> we mesh into that model, than why are you even seeking referrals (or mourning Dac> the potential loss of them) from MDs, 3rd party payors, or others in the Dac> medical profession? I happen to work in a medical model setting, and I daily Dac> see the valuable contribution that the OTs who work in my dept. make with Dac> their patients. The fact that someone published an article talking about how Dac> we don't fit is not at all consistent with the 20+ years I have spent working Dac> within the medical model. Dac> I think that with the shrinking reimbursement dollar, all health care Dac> professionals are feeling threatened. I frankly think PT has done a better Dac> job of reacting to this threat by actively planning to ensure their survival. Dac> This does not mean that OT cannot do the same. Their is an article in an OT Dac> Practice from last year that talked about OTs in I think KY who offered Dac> educational programs for case managers that sounded extremely effective in Dac> reaching this important referral/reimbursement source. I think doing more of Dac> this kind of thing would be a positive step that our profession could make. Dac> Ann *********��*********** Unsubscribe? Send a message to [EMAIL PROTECTED] In the message's *body*, put the following text: unsubscribe OTlist ** List messages are archived at: http://www.mail-archive.com/[email protected] *********��***********
