...With u Gillian! Semantics- some antics!
After all, we all want to look and feel different.....earlier you had a GP
(general practitioner) doing mostly everything including minor surgeries,
now you have a split in the GP as well- internist and family practice; and a
specialist for every function and, part of the body. So do we see a
gastro-enterologist, or a proctologist? :-)


----- Original Message -----
From: "Gillian Brotherton" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Thursday, August 07, 2003 10:07 AM
Subject: Re: [OTlist] what is OT?


> i smile to myself when i see all these words being exchanged.......my
> thoughts turn to the theorists who make a nice income out of "buzzwords"
and
> such like. My favourite is 'models of practice'. :-)
>
>
> ----Original Message Follows----
> From: "Charles Willmarth" <[EMAIL PROTECTED]>
> Reply-To: [EMAIL PROTECTED]
> To: <[EMAIL PROTECTED]>, <[EMAIL PROTECTED]>
> Subject: Re: [OTlist] what is OT?
> Date: Thu, 07 Aug 2003 10:03:38 -0400
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>
> I don't think "function" is the latest buzzword, but rather it is a term
> that is very important to payment.  For example, Chapter 2 - Coverage of
> Services of the Outpatient Physical Therapy Comprehensive Outpatient
> Rehabilitation Facility  and Community Mental Health Center Manual uses
> the term in reference to physical therapy and occupational therapy
> services.
>
> (see: http://cms.hhs.gov/manuals/09_opt/op202.asp#_1_99)
> Rev. 1/ 04-98/ page 2-57
> 253.    SPECIFIC CORF SERVICES
>
> 253.2    Physical Therapy Services.--The coverage guidelines in §271
> apply to physical therapy services provided by CORFs. Under those
> guidelines, maintenance physical therapy, i.e., repetitive services
> required to maintain a level of functioning, is not covered. However,
> the establishment of a maintenance program for a patient whose
> restoration potential has been reached is a covered service. The program
> may include examinations, evaluations of the patient's condition,
> preparation of the maintenance program, and the training of nonskilled
> individuals to carry out the program.
>
> 253.3    Occupational Therapy Services.--
>      A.    Definition.--Occupational therapy is medically prescribed
> treatment to improve or restore functions which have been impaired by
> illness or injury or, when function has been permanently lost or reduced
> by illness or injury, to improve the individual's ability to perform
> those tasks required for independent functioning. Such therapy may
> involve:
>
> The evaluation and reevaluation (as required) of a patient's level of
> function by administering diagnostic and prognostic tests;
> The selection and teaching of task-oriented therapeutic activities
> designed to restore physical function, e.g., use of woodworking
> activities on an inclined table to restore shoulder, elbow, and wrist
> range of motion lost as a result of burns;
> The planning, implementation, and supervision of individualized
> therapeutic activity programs as part of an overall active treatment
> program for a patient with a diagnosed psychiatric illness, e.g., the
> use of sewing activities which require following a pattern to reduce
> confusion and restore reality orientation in a schizophrenic patient;
> The planning and implementation of therapeutic tasks and activities to
> restore sensory- integrative function, e.g., providing motor and tactile
> activities to increase sensory input and improve response for a stroke
> patient with functional loss resulting in a distorted body image;
>
> I think that is important that when defining OT for external audiances
> that the language used should somewhat match language in payment
> systems.    The definition of OT in state practice acts should have some
> parallels to the services that will be paid for under Medicare, for
> example.   This is one reason for the redefinition of "physical
> therapy"...to align defintions (legally defined scope of practice) with
> what payers will pay for.
>
>
>  >>> [EMAIL PROTECTED] 08/07/03 08:36AM >>>
> Hello Jimmie:
>
> My  earlier  post  was  intended  to  push the boundaries. The reason
> is
> because  the  term 'function' is very vague. And what is function to
> you
> may  not  be  function  to  me.  Or  what is function to a PT may not
> be
> function. Function is the latest buzz word but in my opinion it is not
> a
> word that OT's should encompass.
>
> Ron
>
> =============================================
>
> On 8/1/2003,[EMAIL PROTECTED] wrote:
>
> JA> Ron, Some would say too much to say! I believe your assessment
> might
> JA> be  pushing  the  boundaries a bit. While the modalities employed
> by
> JA> the  PT  have  purpose  and  thereby  a function, I was referring
> to
> JA> functional  activity  as  it  relates  to the client. Function to
> me
> JA> entails  an engagement aspect as well as a goal which is
> purposeful.
> JA> TENS  does  not  require engagement of the client due to its
> passive
> JA> nature.  Isometric  exercises  while requiring the engagement of
> the
> JA> individual, have limited purpose and goal direction. I did like
> your
> JA> statement about perception as it relates to meaning and relevance.
>
> JA> Jimmie
>
> JA> -----Original        Message-----       From:       Ron
> Carson
> JA> [mailto:[EMAIL PROTECTED]  Sent:  Thursday,  July 31, 2003 7:38
> PM
> JA> To: Jimmie Arcenaux Subject: Re: [OTlist] what is OT?
>
> JA> Hello Jimmie:
>
> JA> I  tend to disagree with your statement that: "A functional
> activity
> JA> by  its  definition  has  meaning  and relevance to the
> individual's
> JA> life"  Well, maybe I don't disagree 100% with the statement but
> from
> JA> a therapeutic perspective, I will disagree. Here's an example.
>
> JA> My  wife  recently  began  seeing  PT  for  what  was  diagnosed
> as
> JA> degenerative  disk  disease.  The  PT  has  evaluated  her and
> began
> JA> treating with the following modalities: hot/cold, cervical
> traction,
> JA> TENS,  isometric  stretches and massage. All of these are
> functional
> JA> activities  in the sense that each modality has a function.
> However,
> JA> these  activities may have little meaning and relevance to my
> wife's
> JA> life.  Yes,  they  may  be improving her spinal function but are
> the
> JA> activities full of meaning and relevance. Probably not, but in
> truth
> JA> only she can answer that question.
>
> JA> And  I  think  that points to one of the biggest differences
> between
> JA> function  and  meaning.  Something's function is what you see on
> the
> JA> outside, however, something's meaning is what one experiences on
> the
> JA> inside. There is almost no way that you can look someone engaging
> in
> JA> an   activity,  regardless  of  its  function,  and  understand
> the
> JA> activities  meaning  and  relevance  to  the client. Only the
> client
> JA> experiences  the  meaning  so  only the client can fully express
> the
> JA> meaning.
>
> JA> Almost  everything  in  which  a person engages or experiences has
> a
> JA> function.  But of that in which we engage, how much has true
> meaning
> JA> and relevance?
>
> JA> I guess the debate begs the question, what is the difference
> between
> JA> function  and  occupation. For my opinion on this question , I
> point
> JA> you            to            the           following
> link:
> JA> www.otnow.com/newsletter/current_newsletter.htm
>
> JA> Thanks for the interesting debate,
>
> JA> Ron
>
> JA> P.S. My wife says that male OT's always have a lot to say!!! :-)
>
> JA> =============================================
>
> JA> On 7/30/2003,[EMAIL PROTECTED] wrote:
>
> JA>> Biraj,
>
> JA>> Are  you  implying that "activities which an individual needs to
> do
> JA>> or  is  expected to do" are not functional? I agree that
> occupation
> JA>> is  a  broader  concept, but I believe what is occupational is
> also
> JA>> functional.
> JA> Occupation
> JA>> to me is the work of living as a human being.  A functional
> activity by
> JA> its
> JA>> definition has meaning and relevance to the individual's life.
>
> JA>> Thanks  Brian  for  the  reference  to the roots of OT. I could
> not
> JA>> agree
> JA> with
> JA>> you more.
>
> JA>> Jimmie
>
> JA>> -----Original         Message-----        From:
> Incandescent
> JA>> [mailto:[EMAIL PROTECTED]  Sent: Wednesday, July 30, 2003
> 9:04
> JA>> AM To: [EMAIL PROTECTED] Subject: Re: [OTlist] what is OT?
>
> JA>> Hi Jimmie:
>
> JA>> Not  to  put  too  fine  a  point on this but my sense is that
> when
> JA>> viewed
> JA> from
> JA>> the
> JA>> perspective of activities "Occupational" is a distinct and larger
> JA> concept
> JA>> than
> JA>> "functional". The former also includes within it what is
> meaningful to
> JA> the
> JA>> individual, whereas "functional" as the word implies refers to
> those
> JA> aspects
> JA>> of
> JA>> activities which an individual needs to do or is expected to do -
> thus
> JA>> functional.
>
> JA>> What do others think?
>
> JA>> Biraj
>
> JA>> Jimmie Arcenaux wrote:
>
>  >>> I  believe also that the use of occupational or "functional" (I
> hate
>  >>> using  that  term  because  it  is  coined  well  too  often by
> OTs)
>  >>> activities  as  the  primary  treatment  modality  is  a hallmark
> of
>  >>> occupational  therapy.  It  is what the professions history is
> based
>  >>> upon. Jimmie
>
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