I am not sure who Mary McNeely is, but I will reply to your post.
I don't question your uncertainty, so I will answer your questions within
your text for clarity.
----- Original Message -----
From: "David Lehman" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Wednesday, July 17, 2002 10:08 AM
Subject: RE: FIM - OT/ PT and who gets there first
> Mary McNeely stated in her last post:...
...snip...
> I am not fully sure what you are saying, so could you please clarify so I
> may respond appropriately. Are you saying that PTs would be neglecting
> "their" profession if they give credence to the OT profession by following
> the occupational model?
PTs do give credence to the occupational model by following the occupational
model well developed by the profession of Occupational Therapy.
I am not saying PTs "would be" neglecting "their" profession. I am saying
that they are and do neglect "their" profession when they try to be
Occupational Therapists. I would add that I think PTs are better suited to
act like OTs than Nurses, Social Workers or unskilled workers, however, PTs
fall far short of delivering Occupational Therapy (or "follow the
occupational model" if that terminology makes you feel more comfortable) as
well as actual Occupational Therapists.
Knowing that payors will only pay for so much therapy, when PTs don't defend
their areas of expertise while trying to market themselves as a
jack-of-all-trades or one-stop-shopping they do their clients and over-all
healthcare a disservice. Payors are often fooled into this view and are
driven by saving money rather than preserving quality of care. When PTs,
for the sake of preserving PT jobs, nod and smile to payors who pressure for
cutting service they contribute to the problem of declining healthcare.
When PTs try to act like OTs who is doing what PTs are specially trained
for?
>And, are you saying that this "imitation" is more
> powerful than valid research on our profession's effectiveness?
>
> I am not sure how you are tying in the two concepts of research and
> imitation.
When PTs adopt OT research ("the occupational model" ) and try to practice
as OTs, while leaving behind their own specialized skills and training, they
appear to choose imitation of OTs over their own profession's research. So
you tell me, have PTs lost the sense of importasnce and value of their work?
I certainly haven't.
And let me emphasize and remind you of my previous post in which I spoke of
my great respect for the skills of PTs. Don't ignore my sincere words of
support in favour of a battle. A team of OTs, PTs and other health
professionals work well from their unique knowledge base, training and
skills. But when any of the professions turn to cheap opportunism or
aggressive self promotion they damage healthcare with regressive
competition.
> > 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]
In days gone by in some Canadian programs, professionals were trained as P
and O Ts (POTs). The combination was found to be too broad and was rejected
for streamed training as OTs or PTs.
The fundamental problem is that there are obvious limits to resources
including time and money. In a four year program of PT what is being left
out to teach the "occupational model"? When PTs are taking on OT work in
the community, who is providing the PT service? If PTs are going to take on
OT work, then will we have Kinesiologists or Chiropractors perform the
physical therapy that Physical Therapists are not doing?
I am a strong advocate for Physical Therapy. I am a strong advocate for
Occupational Therapy. I don't believe in territorialism. If there is
someone better suited to do the job then they should do it. I have seen PTs
assume they can do what OTs do and fail at it. They not only compromise
their reputation as clinicians, but also the quality of healthcare of their
clients and the over-all health system.
I hope that clarifies things.
Greg McNeely
>
>
> -----Original Message-----
> From: McNeely [mailto:[EMAIL PROTECTED]]
> Sent: Tuesday, July 16, 2002 10:09 PM
> To: [EMAIL PROTECTED]
> Subject: Re: FIM - OT/ PT and who gets there first
>
>
> 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]
>
> *********��***********
>
> *********��***********
>
> 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]
*********��***********
