Hi Jimmie:
I do strongly believe that OT should go entry level doctorate and be
directly accessible. My justifications are-
In favor of doctorate-
1. Advances in Occupational Science and healthcare in general necessitates
it
2. New graduates are required to be more independent and with more
"supervisory" skills
3. The OT masters program already has more credit hours than most regular MS
programs. It takes 5-6 years to become a DC or Pharm.D., 5-7 to become a DPT
or Au.D, and 5-6 years to be a MOT.
4. Though arguable, educational preparation (usually evidenced by formal
degrees) plays an important part in public perception and confidence. When
you need counselling, you usually choose a Psy.D. over a LSW and when your
back really hurts, you go to the DC (or, better still the Orthopod) versus
the massage therapist, mostly without knowledge of the individual provider's
skills.
5. Clinical doctorate will generate clinicians with better EBP skills, a
must for collaborative health care decision making today more than ever. OTs
must embrace the evidence based practice movement, otherwise we will soon be
recognized as practicing vodoo or placebo therapy.
For direct access
1. I believe this will empower clients to choose OT versus having a
gatekeeper ( most often one who does not fully understand the scope of OT or
else an understanding that PT can do it all)
2. I believe a professional is one that can make 'independent' decisions
and is accountable for his/ her actions. If ours is an "autonomous"
profession, why is our start and stop button in others' hands?
3. If we are the expert in identifying and addressing functional/
occupational dysfunctions, deprivations or maladaptations, should n't we be
able to do so independently? Don't we all do it anyway except for the
certification/ co-signature needs primarily for the payor source?
4. OTs already 'diagnose' the condition they are treating. The diagnosis for
pathology is not usually within the scope of OT ( and neither are we
treating the pathology directly) and when required must be referred to a
physician for the same. In fact,the OT diagnosis process and terminology
complement the WHO's ICF, mode for diagnosing clients based upon body
functions (physiological), body structures (anatomical), activity and
participation.(WHO, 2002).
" Occupational therapists and occupational therapy assistants have knowledge
of these body functions and understand broadly the interaction that occurs
between these structures and engagement in occupation to support
participation. Some therapists may specialize in evaluating and intervening
with a specific structure........" (American Occupational Therapy
Association (2002). Occupational therapy practice framework. Domain and
process. American Journal of Occupational Therapy, 56, p.626)
5. There are very few side-effects/ contra-indications for OT that would
concern direct access.
6. Most countries already have direct access for OT. Aren't we in the land
where OT was founded, slightly behind the curve?
Dr. Breines, Charles and others:
I do agree that unless insurance companies pay for our services, direct
access holds no meaning. Kinesiotherapy and Massage therapy has direct
access nationwide but certainly it hold no meaning. That is the reason why
although we have direct access in 35+ states, we do not have true access in
terms of patients, as insurance agencies do not recognize this status.
Currently, I practice in Ohio and my practice averages around 5 referrals a
month under direct access (Ohio Rehab Services Commission and private
payors).
P.S.: Please note that, I do not believe that we should go for the
doctoral or direct access just due to competition issues. I do feel that we
should have taken this step irrespective of what PT is doing because this I
believe is a societal demand. I believe our approach should not be of "if
PT gets this then we should, too" but rather because we deserve it.
Sorry for the long mail. Just feel there is so much to say on this topic.
Joe
----- Original Message -----
From: "Jimmie Arceneaux" <[EMAIL PROTECTED]>
To: <[email protected]>
Sent: Tuesday, July 05, 2005 9:13 AM
Subject: RE: [OTlist] Forum of Clinical Occupational Therapists-
www.f-cot.org
Thank you for the link Joe. I checked it out and it seems from my read that
you are clearly pro movement toward both entry level doctorate and direct
access. Do you think that direct access will fly with OTs current status as
a consumer product? What can change that?
Jimmie
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
Behalf Of Joe Wells
Sent: Saturday, July 02, 2005 8:40 PM
To: [email protected]
Subject: [OTlist] Forum of Clinical Occupational Therapists-
www.f-cot.org
Ron et al:
No I wasn't retired from the list completely. Just as most of us, was in my
corner with my own frustrations. I guess forums like this and one that I
just co-founded with a few others,most of whom are in private practice still
serve the purpose to allow a place to exchange ideas or simply vent at
times. I am hoping that OTs will participate more in discussing what there
future seems like now and what it could be. While we all may not agree,
however, it would still be representative of the perspectives out there.
I am sure, we are all following the trends relating to medicare direct
access and move to endorse doctoral entry by the American Physical Therapy
Association. This move has created quite an uproar and confusion in the OT
community. Ofcourse, the way I see it, it will effect us. The current status
is-
1. Status-quo on what actually should be the right entry for OTs (while more
than 50% of PT schools are already giving-out entry-level doctorates and by
2013, 85% are estimated to move to a doctoral entry). According to a couple
of attendees at this year's AOTA national conference, schools that already
offer entry level OT doctorates were even hinted at possible forced revertal
to MOT. In my opinion, this is certainly a step backwards and the 5 schools
with entry-level OTDs were obviously not happy.
2. AOTA and APTA do not seem to agree over direct access and doctoral-entry
issues. AOTA does not support APTA's views.
Keeping this in view, the Forum for Clinical Occupational Therapists (F-COT)
was formed. As in the name, this forum hopes to serve the interests of the
OTs in medical settings. This forum seeks to-
1. Facilitate discussion amongst therapists at all levels, especially at the
grass-root,on vital issues facing the profession.
2.Be able to represent the true views of the "field" therapists to bodies
such as AOTA and WFOT.
3. Be what the "members" want it to be!
Please visit the site www.f-cot.org and REGISTER YOURSELF AS A MEMBER TODAY.
Membership is free. Pass it on to any OTs/ OTAs that you know. PLEASE GET
INVOLVED!
The website again is www.f-cot.org
Joe Wells
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