My take on the comments about defining OT and getting the word out to the clinical world of OT is that there seems to be some ignorance on what OT is, by OTs, PTs, helath professionals, and perhapd greedy health care companies who need to define PT/OT so they can make more money through billing). Second, it seems OTs in the clinic are not up to speed on what is (or should be) taught in the academic world and therefore are resistant to change the way they practice. Maybe also, the PTs/OTs in the clinic are not given the time nor perhaps do they have the will of effort to read the literature and change the way they practice.
Does this make sense, Ron. We are dealing with the same issues in PT. One more comment about what Jimmie said about function. PTs should be using a model of disablement to define their treatment goals and efforts. We are to address impairments that lead to functional decline which therefore lead to disability. So, to say PTs are experts of function is NOT correct as our efforts should be on addressing impairments (i.e. strength, RO, balance, etc) which will in turn improve functions such as bed mobility, transfers, gait, etc... Of course we work on function but PTs that do not identify impairments and just have the patients perform the function (i.e. walk the patient down the hall), then they are perhaps working at the wrong level and succumbing to working with compensation, not improving the quality of the function. -----Original Message----- From: [EMAIL PROTECTED] on behalf of Ron Carson Sent: Tue 3/8/2005 10:16 AM To: Lehman, David Subject: Re: [OTlist] Long Rant about OT Well David, your response is NOT going to fly!!! What are you talking about!!!! Ron ===============<Original Message>=============== On 3/8/2005, Lehman, David <[EMAIL PROTECTED]> said: LD> Hello my friendly OTs. Did you think I could sit through this long LD> ranting session and be quiet? :) LD> I actually interpret this whole discussion as being a problem with two LD> things: LD> 1. Ignorance LD> 2. A disconnect between the academic world and the clinical world LD> PT has the same problem! 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 Jimmie Arceneaux LD> Sent: Tuesday, March 08, 2005 8:05 AM LD> To: [email protected] LD> Subject: RE: [OTlist] Long Rant about OT LD> Hey Ron, LD> An equally long and possibly offensive rant: LD> I hate the term function! What exactly does that denote? You see a LD> multitude of people now harping on such terms as "functional LD> ambulation", "functional memory", functional mobility". functional range LD> of motion, etc. It is silly. If there is such a thing as functional LD> ambulation, would someone care to take a stab at defining non-functional LD> ambulation? LD> I would not say that PTs are better trained at function because I don't LD> believe anyone can define function in a way that it would make any LD> sense. It is impossible to be an expert in something that doesn't truly LD> exist. I would also disagree that PTs are trained in more "body areas" LD> than OTs. The multitude of PTs I se practicing (Don't get me wrong. LD> I'm not putting down PTs. There are many PTs out there that I respect LD> and feel do a fine job) perform the same tired exercises with each LD> patient then walk with them. I must add that I see a lot of OTs doing LD> similar "shake and bake" treatments. In terms of modalities, there are LD> many PTs that are performing treatments in a way that does not reflect LD> the proper usage of the modality. LD> I will agree that PT does hold all the cards in the rehab community. LD> They are what people immediately think of when one mentions LD> rehabilitation services. Is that reflective of their marketing strategy LD> or is it due, at least in our part, to lingering confusion over the term LD> occupation. The way OTs define occupation and the way the community at LD> large (including physicians, nurses, the average Joe on the street) LD> defines the same term are two completely different things. In fact when LD> the Medicare outpatient OT regulations were first written, they just LD> copied the PT regulations and added OT. LD> It doesn't help that there are frequently OTs practicing in the field LD> that encourage the "myths" (i.e. OTs do the UEs, OTs deal with fine LD> motor, OT is about function) of OT. If you are a nurse working in a LD> hospital SNF, and your experience with OT on a daily basis is that the LD> OT shows up to do UE exercises and helps you get the patients dressed LD> and bathed every morning, what do you think that persons impression of LD> what OT does will be. LD> It will be most difficult to put a public spin on OT that will produce a LD> definition that will be so digestible to lend itself to no further LD> confusion. I would assume that we will continue to need to explain who LD> we are and what we do, however I believe that it would be a really good LD> thing if we could first get a true consensus from OTs who we are and LD> what we do. It does only limited good to develop a practice framework LD> if the common practicing OT continues to practice in a way that lends LD> itself to the above mentioned myths. LD> Jimmie LD> -----Original Message----- LD> From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] LD> Behalf Of Ron Carson LD> Sent: Monday, March 07, 2005 10:20 PM LD> To: [email protected] LD> Subject: [OTlist] Long Rant about OT LD> ---------------------------------------------------------------------- LD> What follow is a copy of my response to a message that was posted on LD> an AOTA listserve about a marketing company claiming that PT's are LD> experts in human function. LD> ---------------------------------------------------------------------- LD> WARNING! LONG RANT WITH LOTS OF PERSONAL OPINION FOLLOWS - PROCEED WITH LD> CAUTION.... LD> In my opinion, PT's are much more expert at human function (what ever LD> that means) than OT's ever will be. Generally, PT's are better trained LD> in human function than OT's because PT's receive training in more LD> modalities and body areas than the vast majority of OTs. Some will say LD> that PT's aren't trained in phsych-soc, but from my teaching LD> experience LD> that is no longer true! I think it's time for OT to realize our place LD> compared to PT! LD> PT' have clout, they have recognition and most importantly, they have LD> ACCESS!!!! They have clout because they have tons of research supporting LD> what they do! They have recognition because they have a bunch of PT's LD> running around tooting their horns! They have access to home health LD> (often times when OT doesn't), they have access to CORF's (where OT is LD> NOT a required therapy) and I believe that they will soon have direct LD> access to Medicare patients! In the field of medicine/rehab, PT's rule LD> the roost! LD> How did it get this way? What were AOTA, State organizations and LD> individual practitioners doing during this past 100 years to let this LD> happen? I don't know! LD> Does it need to be this way? Nope! LD> What can we do? I say that we focus on our expertise! What is that, you LD> say? Our expertise is occupation! If you don't believe me, look at what LD> AOTA say's in the new Framework! quote>> Occupational therapists' and occupational therapy assistants' quote>> expertise lies in their knowledge of occupation and how engaging quote>> in occupations can be used to affect human performance and the quote>> effects of disease and disability. LD> But, almost no where else in the world, does anyone recognize the term LD> occupation as it relates to the significance of doing daily LD> human LD> activity. We are experts in something that on the surface, doesn't seem LD> to mean a whole lot to a whole lot of people. So, what do we do! LD> I often feel that OT is stuck between a rock and hard place.... in my LD> mind there is NO perfect solution. However, it does seem that right now, LD> the OT profession is spinning lots of mud and getting nowhere fast! LD> I am staunch believer in OT, but I am also a realist! I have a company LD> called HOPE Therapy. HOPE = Health, Occupational Performance and LD> Empowerment. I have the words "OT" and an OT logo emblazoned on my shirt LD> sleeve and on my chest. Everyday, I go to see clients, I face the same LD> battle. "So you're a PT". I use the COPM as frequently as I can; I talk LD> about occupation and I try to practice occupation. I don't have LD> equipment, I don't use cones, putty, thera-band, etc. But everyday, it's LD> the same battle - trying to practice occupation in a non-occupational LD> world! I just doesn't seem to fit!!! At least it doesn't seem to fit in LD> the medical, third-party payment system! LD> Well, this is the end to a long rant from the middle of nowhere! LD> Ron C. LD> ===============<Original Message>=============== LD> On 3/7/2005, admin-sis Listmanager LD> <[EMAIL PROTECTED]> said: asL>> "[PT's] know they are the experts in human function". LD> -- LD> Unsubscribe? LD> [EMAIL PROTECTED] LD> Change options? 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