Mr. Lehman, I have responded within the text of your reply for clarity. ----- Original Message ----- From: "David Lehman" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Monday, July 22, 2002 9:00 AM Subject: RE: FIM - OT/ PT and who gets there first
> Dr. Breines, > > You replied: > > "However, please do not conclude that you are fully apprised of what OTs > know and believe" > > Thank you for joining the discussion. I guess the reason I mentioned a > merging of the PT/OT profession, was because I do think beyond the physical > impairment. I thought I had a good idea of how OTs think, and thought maybe > more PTs did also....I do see your point. I would expect PTs to think beyond impairment, as each profession blurs into the others in some areas, however that in it itself does not logically lead to a complete merger. OT and PT have blurred areas of practice with Nursing, but that does not mean that OTs and PTs should merge with Nursing. It is not that we are not intelligent enough to learn how to start an IV (as one example of a Nursing skill), but it does not fit closely with our areas of practice, philosophy or role as has been determined through systemic efficiency as established over time. I have worked in teams that cooperate well together and have mutual respect. In that sort of context, I see various professions roles blurring at the margins and open, constructive team communication: SWs commenting on things that would apply to the OT or PT goals, Nursing stating observations and suggesting an area to look at. I frequently refer to/advocate for PT, SW or other professions as they are necessary. I have worked in situations with PTs and other professionals who have taken on the negative competition and disrespect and I have been more reluctant to refer to such a service seeing that they have a poor concept of their strengths and may not be capable of providing appropriate service. > What is amazing to me, is I am not so sure OTs know what they think. I have > been working in an acute care/SNU lately, and I ask the OTs and COTAs about > this issue. They seem to be lost when I bring up the idea of the > occupational model, and what is interesting, they are a part of this UE/LE > territory issue. My impression was they thought occupation went only to the > basic ADL level of toileting and personal hygiene....I never saw any > reference to occupational goals that went beyond the getting ready for the > day issues. Since you are using anecdotes as your argument, would you like me to share my experience of opportunistic PTs who felt they could prescribe wheelchairs who relied on vendor assessment and recommendations and simply rubber stamped the vendor recommendations? Or the PT who recommneded a repositioning sling that was inappropriate which led to the sling not being used and subsequent workplace incidents filed by the caregivers related to repositioning? What about the head of a PT department who assessed a persons wrist extension as a 3/5 when I had seen this person before and after and the person had a 0/5 wrist flexion with no change in condition between visits? How about the PT who wanted me to provide putty for finger grip/flexion exercises to someone who had a radial nerve palsy with 0/5 finger extension? There are other examples, if you want to talk about anecdotes. There are individual differences in practice. When you referred to the "occupational model", which one are you referring to? GK's MOHO, the COPM or some other? When the OTs and COTAs "seem to be lost" when you were testing them, were they aware you were testing them? > Another responder to this discussion said the academic world should stay out > of this discussion, because they felt the UE/LE issue was created in > academics and perhaps that we perpetuate this problem. Perhaps you are > right....but, what academic institution started this and how did it take > off? I agree with you in a sense, for I know many OT students are educated > in UE and LE techniques such as PNF, etc...but, they are not required but to > demonstrate UE techniques for practical exams. The reason? Because there > is not enough time for there are other important areas for the student to > learn such as cognitive, psychosocial areas.... "...many OT students..." and "...not required to demonstrate..." again appears anecdotal. When skills were taught in our OT program, we were required to demonstrate them as well as on clinical placements. I don't question that different OT programs have different strengths and weaknesses, but that also applies to PT programs. If PTs are going to continue to shift their focus to providing Occupational Therapy, then will the healthcare system have to turn more and more to Chiropractors for Physical Therapy? By the way, my questions are not rhetorical. They are meant to challenge your reasoning and I do expect answers aout of common decency and for the integrity of this discussion. I have repeated questions I asked you that you left unanswered so you have the opportunity to tackle them head-on. Sincerely, Greg McNeely, OT > Good day. > > 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] Here are the questions I asked of you in previous posts that you have not responded to: 1) When PTs try to act like OTs, who is doing what PTs are specially trained for? (previously stated as, but also you did not respond to: If PTs are doing what OTs are more skilled at, then who is doing what PTs are skilled at? ) Similarly, you have not yet answered these direct questions: 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? 2) So you tell me, have PTs lost the sense of importance and value of their work? 3) 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"? New: In an 8 hour day, what aspect of Physical Therapy is being left out to provide Occupational Therapy by PTs? Finally, I repeat the following to emphasize that my point is not to engage in useless battle, but to continue to work to improve healthcare through challenging our professions to provide the best care from our unique philosophical perspectives, knowledge, skills, training and practice: "I am a strong advocate for Physical Therapy. I am a strong advocate for Occupational Therapy. " "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." *********��*********** 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] *********��***********
