Re: [OTlist] what is OT?

Gillian Brotherton Thu, 14 Aug 2003 12:01:37 -0700

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 MIME-Version: 1.0 Received: from mc3-f17.law16.hotmail.com ([65.54.236.152]) by mc3-s16.law16.hotmail.com with Microsoft SMTPSVC(5.0.2195.5600); Thu, 7 Aug 2003 07:02:16 -0700 Received: from addr15.addr.com ([209.249.147.60]) by mc3-f17.law16.hotmail.com with Microsoft SMTPSVC(5.0.2195.5600); Thu, 7 Aug 2003 07:01:17 -0700 Received: from addr15.addr.com (localhost.addr.com [127.0.0.1])by addr15.addr.com (8.12.8/8.12.8/Submit) with ESMTP id h77E1Dtm048723;Thu, 7 Aug 2003 07:01:13 -0700 (PDT) Received: from localhost ([EMAIL PROTECTED])by addr15.addr.com (8.12.8/8.12.7/Submit) with SMTP id h77E1CvM048721;Thu, 7 Aug 2003 07:01:12 -0700 (PDT) Received: by addr15.addr.com (bulk_mailer v1.12); Thu, 7 Aug 2003 06:59:50 -0700 Received: from addr15.addr.com (localhost.addr.com [127.0.0.1])by addr15.addr.com (8.12.8/8.12.8/Submit) with ESMTP id h77Dxntm048315for <[EMAIL PROTECTED]>; Thu, 7 Aug 2003 06:59:49 -0700 (PDT) Received: (from [EMAIL PROTECTED])by addr15.addr.com (8.12.8/8.12.7/Submit) id h77Dxn1q048314for [EMAIL PROTECTED]; Thu, 7 Aug 2003 06:59:49 -0700 (PDT) Received: from addr-mx01.addr.com (addr-mx01.addr.com [209.249.147.145])by addr15.addr.com (8.12.8/8.12.8/Submit) with ESMTP id h77Dxltm048290;Thu, 7 Aug 2003 06:59:47 -0700 (PDT) Received: from online.aota.org (online.aota.org [65.205.48.9])by addr-mx01.addr.com (8.12.8/8.12.2) with ESMTP id h77DxkS5042753;Thu, 7 Aug 2003 06:59:46 -0700 (PDT) Received: from Groupwise-MTA by online.aota.orgwith Novell_GroupWise; Thu, 07 Aug 2003 10:04:00 -0400 X-Message-Info: oZ2qq1sZ3e7BXLfifQt4gVPLwyLnC70/QwKOnivX3fk= X-Authentication-Warning: addr15.addr.com: rdcarson owned process doing -bs X-Authentication-Warning: addr15.addr.com: rdcarson set sender to [EMAIL PROTECTED] using -f Message-Id: <[EMAIL PROTECTED]> X-Mailer: Novell GroupWise Internet Agent 6.0.4 Beta X-Spam-Checker-Version: SpamAssassin 2.50 (1.173-2003-02-20-exp) Sender: [EMAIL PROTECTED] X-Loop: [EMAIL PROTECTED] Return-Path: [EMAIL PROTECTED] X-OriginalArrivalTime: 07 Aug 2003 14:01:18.0837 (UTC) FILETIME=[5FF40250:01C35CEC]

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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Re: [OTlist] what is OT?

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