Hello David: I am not active enough at the National level to be aware of what is happening to move away from the medical model.
I think the discussion of moving from the medical model leaves many OT's confused and scared. While I strongly advocate moving from the medical model, I see this move as complementary to reimbursement. To me, moving from the medical model simply means that as a profession, we don't strive to treat medical diseases and processes. Instead, we treat the problems caused by diseases. Medicine is skilled at treating diseases (as defined by the ICD) but OT should be skilled at treating occupational dysfunction that results from the disease. This is the same argument that I've previously put fort about "Framing the Problem" (see OTnews at www.otnow.com) OT treatment from this 'new' perspective is more of an enabling approach to human peformance. Any of my former students who are still on this list will remember that I am very fond of the "enabling occupation" approach utilized by the Canadians. Moving towards this enabling model of treatment is 100% compatible with Medicare. It's what I use and it's how I bill. I see clients because they have occupational deficits, I treat them (and bill) to improve these deficits. It's that simple. About the only procedure codes that I use are 97001 (OT Eval) and 97535 (Self-care/Home Mgmt Training). There are other procedure codes that are relevant to OT but there are limitations as to how they can be used. As far as I am concerned, OT's promotion of itself is independent of the payer source. My treatment and goals are the same regardless of who is paying the bill. I must admit that finding clients to pay cash for OT is not easy. I have only had one such client! Ron ======================================================= On Friday, February 13, 2004, @ 1:38 PM, you wrote: LD> My friend, Ron....so, what is happening within your professional LD> organization via the president's call for advocating occupation and LD> moving away from the medical model? Is there a task force, a LD> conference, or any format to discuss this and make it happen? Also, it LD> is apparent the medical model, or should we say the medical model LD> business is what led to OTs constraints of what you do (PTs, too). What LD> will OT do is they move away from medical model? Will it be more of a LD> cash only clientel, as I assume insurance reimbursement may be an issue LD> if outside the medical system? And, if this is so, how will OT promote LD> and define their purpose and usefulness to the cash only client? LD> Just thinking out loud. LD> Hope all is well. LD> David A. Lehman, PhD, PT LD> Associate Professor LD> Tennessee State University LD> Department of Physical Therapy LD> 3500 John A. Merritt Blvd. LD> Nashville, TN 37209 LD> 615-963-5946 LD> [EMAIL PROTECTED] LD> -----Original Message----- LD> From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On LD> Behalf Of Ron Carson LD> Sent: Friday, February 13, 2004 11:11 AM LD> To: [EMAIL PROTECTED] LD> Subject: [OTnow] Another Client's Experience with OT :-( LD> I was at an ALF doing some screens when a woman in a wheelchair asked LD> if I LD> was a therapist. When I said yes, she told me that she was getting OT LD> and LD> PT. She went on to say that she had just got out of 100 days of rehab. LD> When I asked her about her OT treatment, she said that they weren't LD> doing LD> much. The client said the OT was having her pick up cones with her good LD> arm. LD> She said the the therapist got off on a bad start because she told LD> the LD> client that she "would bring back her arm". The client said that after LD> 100 LD> days of rehab nothing had changed! LD> Anyway, I asked the client if she was having trouble caring for LD> herself LD> because and she said that she could pull up herself from the toilet LD> using a LD> grab rail and her good arm but then she was stuck because she couldn't LD> let LD> go of the rail. She denied that the OT was working on any of LD> the LD> occupational things. LD> In my mind, I am just thinking what in the heck are these OT's doing. LD> Why LD> are they 'wasting this woman's valuable money and time by LD> working on LD> something so limited as an arm instead of focusing treatment on LD> trying to LD> restore this woman's independence and dignity through occupation LD> based LD> evaluation, treatment and outcomes. I am so disgusted with my LD> profession at LD> times because most of us don't seem to know what we are supposed to be LD> doing LD> for our clients. How did WE get so far off base from what used to be LD> good LD> quality therapy. I bet I can count on one hand how many times a client LD> has LD> said that their OT worked on occupation (or something like LD> self-care, LD> grooming, etc). It is almost always the same thing.... they worked LD> on my LD> arm!!!! LD> The most recent issue of Advance talked about needing a special LD> interest LD> section for hands and upper extremity treatment. We don't need a LD> special LD> interest section for hand therapy because apparently the majority of LD> OT's LD> are already practicing the stuff. Seems like we need a special LD> interest LD> section on occupation!!!! LD> We are such a fragmented profession it's not even funny. On one hand LD> you LD> have the AOTA president advocating for occupation and movement away from LD> the LD> medical model. Next you have clinicians practicing and wanting to LD> practice LD> like PTs and then the educational model is stuck not knowing what to LD> do. LD> What a mess!!!!!! LD> Ron LD> _______________________________________________ LD> To unsubscribe, visit: LD> http://otnow.com/mailman/listinfo/otlist_otnow.com LD> The OTnow Mail Archive: LD> www.mail-archive.com/[EMAIL PROTECTED] LD> =============================================== LD> _______________________________________________ LD> To unsubscribe, visit: LD> http://otnow.com/mailman/listinfo/otlist_otnow.com LD> The OTnow Mail Archive: LD> www.mail-archive.com/[EMAIL PROTECTED] _______________________________________________ To unsubscribe, visit: http://otnow.com/mailman/listinfo/otlist_otnow.com The OTnow Mail Archive: www.mail-archive.com/[EMAIL PROTECTED] ===============================================
