Greg....your reply is well constructed and worthy of response. I feel you
(and Mr. Carson) have clearly helped me to better understand this issue. I
respect the way you showed that we can use anecdotal "evidence" to argue any
point of view and we need to be careful in how we come to judgment based on
such "evidence". How much I try to enlighten the students to this fact, and
yet, I was guilty of committing the crime. Does "do what I say, not what I
do" apply here:)
Your explanation about health professions merging in certain areas but, not
meaning we can therefore perform all the duties of another profession
similar to PT or OT, is well taken.
It does make me think about the PTs in the military that are the initial
health professional seen by clients and they have privileges to administer
medical procedures that are usually done by the nurse or doctor (i.e.
injections). I believe the direct access issue is leading some PTs to
believe we can save $$ if the PT is allowed to do more with the initial
intake of a patient. Scary?
As far as your direct questions, you stated:
By the way, my questions are not rhetorical. They are meant to challenge
your reasoning and I do expect answers out 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.
I feel you strategically used your questions to challenge my reasoning and
to prove your points. I would like to know if you will give me credit for
being decent enough to be in this discussion and not feel I did not have
the "common decency" to answer your questions last time.
Now, I must reply. Your points are well taken! I am not so sure anymore
that I can meet the challenge as you have helped me to see that perhaps my
reasoning is flawed.
I believe I have a better understanding of our professional relationship. I
guess I feel limited in the scope of my profession as I would like to be
able ("qualified") to address the issues of emotions, environment,
cognition, and mentation, in addition to the physical. I felt I could do
this as a PT. I now see that there is a place for us all. As I stated
before, maybe I need to get an OT degree:)
I believe that just because there is a physical impairment does not mean it
is necessary for it to be addressed as it relates to a person's occupational
satisfaction. In neuro, I see the issue of constraint induced movement
therapy (CIMT) as an example. If a person can dress themselves, drive to
work, and perform efficiently, then why put them through hours and hours of
CIMT to improve a little hand motion?
I think I will now refer to OT in many cases where perhaps I would not have
done so before. Perhaps the place to start in the rehab phase is for
patients to be referred to OT first, where the important occupational
factors can be identified. The OT can then refer back to the PT,
psychologist, etc.. for therapy on the impairments to help achieve the
overall occupational goals! Seems there is still a need for educating the
health care professionals of what their roles are and what the roles of the
other professionals are!
I thank you for your insight and hope that I can further the cause to better
delineate what our professions are and the importance of PT and OT in the
health care environment.
sincerely,
David Lehman, PhD, PT
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