David,
Just need to say...I'm talking about pulling together the different groups in OT, not 
combining PT and OT. I think OT is very different from PT! We need each other to work 
together and respect each other's area of expertise. I have no problem referring to PT 
when I know that that is what is going to help my client get the mobility they need to 
perform their occupations
Mary-Ellen

        -----Original Message----- 
        From: Lehman, David [mailto:[EMAIL PROTECTED] 
        Sent: Thu 11/20/2003 3:12 PM 
        To: [EMAIL PROTECTED] 
        Cc: 
        Subject: RE: [OTnow] RE: [OTlist] 2 OT's with different approaches
        
        

        AMEN!
        I have just sent out a list serve request to the aptaeducation list serve to 
see what PT educators are thinking.  I think our students here will be better OTs//PTs 
because of your response and those of others.  I want say it, but, combining our 
professions....I have heard that before...and many take offense, huh?
        
        David A. Lehman, PhD, PT
        Associate Professor
        Tennessee State University
        Department of Physical Therapy
        3500 John A. Merritt Blvd.
        Nashville, TN 37209
        615-963-5946
        [EMAIL PROTECTED]
        
        
        
        
        -----Original Message-----
        From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
        Sent: Thursday, November 20, 2003 1:38 PM
        To: [EMAIL PROTECTED]
        Subject: [OTnow] RE: [OTlist] 2 OT's with different approaches
        
        
        David,
        
        I speak from the perspective of long term care with the elderly where I've 
mostly practiced. I volunteered in a nursing home when I was in my teens- a while ago! 
I worked in PT and eventually found OT more holistic and interesting. At that time OT 
ran recreation too. Activities were seen as therapeutic or diversional. After high 
school I ended up first as a recreation director. When I was able I went to school for 
my associates in OT. When I did my fieldwork at a nursing home (late 70's) OT and Rec 
had split, but OT was still very craft based. What I did notice though was that the 
poulation had changed - more impaired, physically and cognitively - and they didn't 
seem to be getting a lot of OT. By the time I went back for my bachelors OT was 
getting Medicare B reimbursement. We were seeing more people for shorter periods of 
time. With OBRA we began seeing residents in the NH for things like restraint 
reduction, adaptive seating, feeding and swallowing issues, pressure sores etc. And I 
saw more residents who were very impaired. We used occupation in what ever way we 
could, but there were pressures for productivity. I know that affected what we did. We 
always kept the perspective of occupation in our goals though, for instance, if we did 
adaptive seating it was for more that just getting someones head up off their chest; 
it was so they could attend to their environment. We were lucky in that we had a well 
stocked clinic, but we were in-house therapists and over the years had built up the 
department. Friends of mine who worked for agencies often went into situations where 
they had very little to work with, but were pretty creative. There was very little 
support for the concept of occupation though. Sometimes it seemed to me that all that 
anybody from OT was to do ADLS and/or solve a problem with someone that no one else 
could figure out what to do with. Often too, they were not the ones to decide who 
would get OT...that was decided by nursing or the rehab dir., often a PT. I think 
reimbursement issues, for-profit organization priorities and productivity issues have 
had a profound change on not only our profession, but on health care. Look at how 
little time a doc spends with patients!
        
        Another thing....we have done little to educate people about the whole 
elephant when all they have seen is a tail or an ear (You know the blind men and 
elephant story, right?) This is interesting....my university, Sacred Heart U. runs a 
Health and Wellness Center in partnership with an inner city parish in Bridgeport CT. 
We have a grant for OT, PT, and Nursing to screen seniors to increase access to health 
care. I made up a list of about 1 1/2 pages of questions I wanted to use in my 
interviews. When the nurse read it she said "Oh, this is more than OT." I told her no, 
this was OT. I was looking at more than ADLS. I had questions to screen for that, but 
also for cognitive issues, depression, environmental problems, support systems...in 
short anything that was interfering with occupation now or that I could see could pose 
a problem in the future. We're about the most holistic profession I know!
        
        I don't know what the answer to the present muddle we find ourselves in is, 
but I know we all need to pull together and be one profession, not segmented into 
educators, pracs and researchers if we are going to be around in the future...and we 
need to get to the 3/4? of the OT's who are not AOTA members and let them know they 
are needed so we can have the clout we need to effect change. (AOTA needs to poll them 
and find out why they left or never joined, and what would bring them in - a whole 
'nother subject!!)
        
        Anyway...this is more than I've written to a list serve in a month-of-Sundays 
and I need to go back to working!! Bye for now.
        
        Mary-Ellen
        
        -----Original Message-----
        From: Lehman, David [mailto:[EMAIL PROTECTED]
        Sent: Thu 11/20/2003 1:24 PM
        To: [EMAIL PROTECTED]
        Cc:
        Subject: RE: [OTlist] 2 OT's with different approaches
        
        
        
                May-Ellen...please share with me your understanding of the historical 
and external factors to the defining of an OT in clinical settings.
                Thanks.
               
                David A. Lehman, PhD, PT
                Associate Professor
                Tennessee State University
                Department of Physical Therapy
                3500 John A. Merritt Blvd.
                Nashville, TN 37209
                615-963-5946
                [EMAIL PROTECTED]
               
               
               
               
                -----Original Message-----
                From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
                Sent: Thursday, November 20, 2003 12:11 PM
                To: [EMAIL PROTECTED]
                Subject: RE: [OTlist] 2 OT's with different approaches
               
               
                Yes, that was really good to hear. I think practioners can feel a 
little beat up when they keep hearing about what they are not doing. There are a lot 
of historical and external to the profession factors that have shaped current practice 
and maybe if we all are on the same team we can effect change.
                Mary-Ellen
               
                        -----Original Message-----
                        From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
                        Sent: Wed 11/19/2003 4:38 PM
                        To: [EMAIL PROTECTED]
                        Cc:
                        Subject: Re: [OTlist] 2 OT's with different approaches
                      
                      
               
                        The good news is that there is interest in this issue.  I was 
told that at
                        the recent Program Directors's meeting last week that there is 
an interest in
                        merging the efforts, practice, ideas etc of Researchers, 
Academics and
                        Pracitioners.  The meeting including a discussion of ideas how 
to do this.
                        Wendy
                      
                        In a message dated 11/19/2003 3:26:11 PM Eastern Standard Time,
                        [EMAIL PROTECTED] writes:
                      
                        > Ron,
                        >
                        > I just wanted to say that I also see the 2 different
                        > approaches in practice. Maybe it could help if the OT
                        > educators do inservices for clinical OT's on the
                        > importance of using occupation as a framework of
                        > practice. For those who have been away from university
                        > environments, I find it is very hard to grasp/apply
                        > the  occupational framework and using the old, already
                        > ingrained medical model approaches seems easier.
                        >
                        > Naz
                        > 3 yr post graduaction
                        >
                      
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