My experience with PT in school is quite different than what I have seen in practice. We were very close to our PT classmates of the same graduating year at Queen's University in Kingston. I have seen in other areas however that there is some animosity between the professions. In Ohio, there were PTs who would take on the wheelchair assessments and the lift training, but trying to learn it on the job. They leaned on the knowledge and direction of the vendors which invariably led to second rate service.
I think PTs make great PTs and I enthusiastically refer people to them for PT service. I think however that PTs make mediocre to poor OTs and those that try to expand their scope of practice into areas that have traditionally been done well by OT and fit better with the OT philosophy and skills do us all a disservice. They give compromised service to those who require it and they neglect the areas that they have been trained well for. This "expansion of scope" is often a symptom of pressure from funding sources. I see it with a number of professions. If a profession can pass themself off as a cure all, or one-stop shopping, then they think they are preserving their job. A more mature, realistic and helpful approach would be to defend your area of expertise against cuts, instead of retreating from your legitimate area of practice to try to undercut someone else. If PTs are doing what OTs are more skilled at, then who is doing what PTs are skilled at? I have seen in practice that it seems that the PTs who do this are in effect ashamed of their own skills so try to move into other areas. I believe the solution to better over-all healthcare is for each of us to be respectful of the other professions, not undervalue their service and try to work together. The healthcare team of Nurse, PT, Dr., OT, SW, SLP, and others provide unique and necessary service and we must be respectful of each other. Sometimes, that means firmly correcting those who unscrupulously and opportunistically undermine other professions. A PT professor who responded to this e-mail said soemthing about the profession that can support itself with research will prevail. The strongest compliment that can be given is imitation, so when PTs neglect their areas of practice to act like OTs, we should be proud that they value our contribution so much, even if they don't have the sense to see that reality. ----- Original Message ----- From: "Ron Carson" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Tuesday, July 16, 2002 11:21 AM 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] *********��***********
