Ron....I admire your facilitation and management of this discussion listserve. Your discussion threads are thought provoking and enlightening. Keep up the good work.
So, who will be there first? I suggest it will be the profession that has the money and power as well as the one who establishes themselves with sound theory and research that supports our theory. Maybe this is even more a reason to get an OT degree, then I will be there for whichever dog wins:). > David A. Lehman, Ph.D., P.T. > Assistant Professor > University of St. Augustine > 1 University Blvd. > St. Augustine, FL 32086-5783 > (904) 826-0084 ext. 227 > [EMAIL PROTECTED] > > -----Original Message----- From: Ron Carson [mailto:[EMAIL PROTECTED]] Sent: Tuesday, July 16, 2002 11:22 AM To: [EMAIL PROTECTED] Subject: FIM - OT/ PT and who gets there first Hello: In the article "Adjustments to Managed Health Care: Ushing Against IT, Going With It and Making The Best of It, (AJOT, 55(2) p. 132) a therapist states the following about the Functional Independence Measure (FIM): "There are about 12 or 15 sections that are scored ..., probably about 10 of them are OT areas. Again, they [the payer] are telling you one message, how OT is so important to the function of the patient when they go home (by FIM scores), but OT's aren't allowed so see the patients as much. It's very frustrating. Or, you come in after PT, like you are second." I had these exact feelings when I worked in rehab. We used the FIM as our outcome measure. The FIM was essential to our companies (HealthSouth's) perceptions of outcomes success, so much so that we routinely had in-services on how hospitals compared with regards to FIM outcomes. But, like the above writer states, I almost NEVER felt that OT was given the clout and authority with regard to patient care even though the majority of what we were responsible for treating was the majority of FIM. I never heard our physician or case manager say, this client can't dress themselves without assistance so let's keep working. Without exception, the single biggest predicator of progress and discharge was clients ability to walk. In fact, our physiatrist held a weekly gait clinic to watch clients walk and to provide treatment suggestions to the PT's. Some times the physiatrist would actually laugh a clients struggling to dress themselves. On time I actually talked with the doctor about my concerns. She assured me that she valued OT's contribution but I never saw any evidence that this was true. Of course, physiatiry is a combination of physician and physical therapist so it's little wonder that physical medicine and physical therapy were her primary concerns. Now, with PT's expanding scope of practice including training in community reintegration and home management skills and them having first-line access to Medicare home health clients, what the heck is OT going to do? If PT can "do it all" and they are there first, when and why will they refer to OT. And, let's not forget the dog-eat-dog aspect of this situation. *********��*********** 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] *********��*********** *********��*********** 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] *********��***********
