In my opinion, of ALL the things that OT should NOT do, going to
entry-level doctorate is it! We are so far behind the power curve in
having an established presence that is unified, authentic and accurate
that the vast amounts of money needed to develop and implement mandatory
doctoral degrees will only set us back further.
However, looking at the number of required credit hours for various
professions is a bit sobering.
I also disagree that OT or PT should be granted Medicare direct access.
My opinion, is that a patient needs a gate-keeper that manages their
care, and that should be the MD. Granted, most MD's don't do a great job
of managing care but effort should be made to change the existing flaws
rather than adding another layer of providers. Having Medicare direct
access will substantially help PT's business but it wont' do much, if
anything for OT. Of course, if PT gets it, we better hope that OT get's
it as well!
Ron
----- Original Message -----
From: Joe Wells <[EMAIL PROTECTED]>
Sent: Wednesday, July 06, 2005
To: [email protected] <[email protected]>
Subj: [OTlist] Forum of Clinical Occupational Therapists- www.f-cot.org
JW> Hi Jimmie:
JW> I do strongly believe that OT should go entry level doctorate and be
JW> directly accessible. My justifications are-
JW> In favor of doctorate-
JW> 1. Advances in Occupational Science and healthcare in general
necessitates
JW> it
JW> 2. New graduates are required to be more independent and with more
JW> "supervisory" skills
JW> 3. The OT masters program already has more credit hours than most
regular MS
JW> programs. It takes 5-6 years to become a DC or Pharm.D., 5-7 to become
a DPT
JW> or Au.D, and 5-6 years to be a MOT.
JW> 4. Though arguable, educational preparation (usually evidenced by
formal
JW> degrees) plays an important part in public perception and confidence.
When
JW> you need counselling, you usually choose a Psy.D. over a LSW and when
your
JW> back really hurts, you go to the DC (or, better still the Orthopod)
versus
JW> the massage therapist, mostly without knowledge of the individual
provider's
JW> skills.
JW> 5. Clinical doctorate will generate clinicians with better EBP skills,
a
JW> must for collaborative health care decision making today more than
ever. OTs
JW> must embrace the evidence based practice movement, otherwise we will
soon be
JW> recognized as practicing vodoo or placebo therapy.
JW> For direct access
JW> 1. I believe this will empower clients to choose OT versus having a
JW> gatekeeper ( most often one who does not fully understand the scope of
OT or
JW> else an understanding that PT can do it all)
JW> 2. I believe a professional is one that can make 'independent'
decisions
JW> and is accountable for his/ her actions. If ours is an "autonomous"
JW> profession, why is our start and stop button in others' hands?
JW> 3. If we are the expert in identifying and addressing functional/
JW> occupational dysfunctions, deprivations or maladaptations, should n't
we be
JW> able to do so independently? Don't we all do it anyway except for the
JW> certification/ co-signature needs primarily for the payor source?
JW> 4. OTs already 'diagnose' the condition they are treating. The
diagnosis for
JW> pathology is not usually within the scope of OT ( and neither are we
JW> treating the pathology directly) and when required must be referred to
a
JW> physician for the same. In fact,the OT diagnosis process and
terminology
JW> complement the WHO's ICF, mode for diagnosing clients based upon body
JW> functions (physiological), body structures (anatomical), activity and
JW> participation.(WHO, 2002).
JW> " Occupational therapists and occupational therapy assistants have
knowledge
JW> of these body functions and understand broadly the interaction that
occurs
JW> between these structures and engagement in occupation to support
JW> participation. Some therapists may specialize in evaluating and
intervening
JW> with a specific structure........" (American Occupational Therapy
JW> Association (2002). Occupational therapy practice framework. Domain
and
JW> process. American Journal of Occupational Therapy, 56, p.626)
JW> 5. There are very few side-effects/ contra-indications for OT that
would
JW> concern direct access.
JW> 6. Most countries already have direct access for OT. Aren't we in the
land
JW> where OT was founded, slightly behind the curve?
JW> Dr. Breines, Charles and others:
JW> I do agree that unless insurance companies pay for our services,
direct
JW> access holds no meaning. Kinesiotherapy and Massage therapy has direct
JW> access nationwide but certainly it hold no meaning. That is the reason
why
JW> although we have direct access in 35+ states, we do not have true
access in
JW> terms of patients, as insurance agencies do not recognize this status.
JW> Currently, I practice in Ohio and my practice averages around 5
referrals a
JW> month under direct access (Ohio Rehab Services Commission and private
JW> payors).
JW> P.S.: Please note that, I do not believe that we should go for the
JW> doctoral or direct access just due to competition issues. I do feel
that we
JW> should have taken this step irrespective of what PT is doing because
this I
JW> believe is a societal demand. I believe our approach should not be of
"if
JW> PT gets this then we should, too" but rather because we deserve it.
JW> Sorry for the long mail. Just feel there is so much to say on this
topic.
JW> Joe
JW> ----- Original Message -----
JW> From: "Jimmie Arceneaux" <[EMAIL PROTECTED]>
JW> To: <[email protected]>
JW> Sent: Tuesday, July 05, 2005 9:13 AM
JW> Subject: RE: [OTlist] Forum of Clinical Occupational Therapists-
JW> www.f-cot.org
JW> Thank you for the link Joe. I checked it out and it seems from my
read that
JW> you are clearly pro movement toward both entry level doctorate and
direct
JW> access. Do you think that direct access will fly with OTs current
status as
JW> a consumer product? What can change that?
JW> Jimmie
JW> -----Original Message-----
JW> From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
JW> Behalf Of Joe Wells
JW> Sent: Saturday, July 02, 2005 8:40 PM
JW> To: [email protected]
JW> Subject: [OTlist] Forum of Clinical Occupational Therapists-
JW> www.f-cot.org
JW> Ron et al:
JW> No I wasn't retired from the list completely. Just as most of us, was
in my
JW> corner with my own frustrations. I guess forums like this and one that
I
JW> just co-founded with a few others,most of whom are in private practice
still
JW> serve the purpose to allow a place to exchange ideas or simply vent at
JW> times. I am hoping that OTs will participate more in discussing what
there
JW> future seems like now and what it could be. While we all may not
agree,
JW> however, it would still be representative of the perspectives out
there.
JW> I am sure, we are all following the trends relating to medicare direct
JW> access and move to endorse doctoral entry by the American Physical
Therapy
JW> Association. This move has created quite an uproar and confusion in
the OT
JW> community. Ofcourse, the way I see it, it will effect us. The current
status
JW> is-
JW> 1. Status-quo on what actually should be the right entry for OTs
(while more
JW> than 50% of PT schools are already giving-out entry-level doctorates
and by
JW> 2013, 85% are estimated to move to a doctoral entry). According to a
couple
JW> of attendees at this year's AOTA national conference, schools that
already
JW> offer entry level OT doctorates were even hinted at possible forced
revertal
JW> to MOT. In my opinion, this is certainly a step backwards and the 5
schools
JW> with entry-level OTDs were obviously not happy.
JW> 2. AOTA and APTA do not seem to agree over direct access and
doctoral-entry
JW> issues. AOTA does not support APTA's views.
JW> Keeping this in view, the Forum for Clinical Occupational Therapists
(F-COT)
JW> was formed. As in the name, this forum hopes to serve the interests of
the
JW> OTs in medical settings. This forum seeks to-
JW> 1. Facilitate discussion amongst therapists at all levels, especially
at the
JW> grass-root,on vital issues facing the profession.
JW> 2.Be able to represent the true views of the "field" therapists to
bodies
JW> such as AOTA and WFOT.
JW> 3. Be what the "members" want it to be!
JW> Please visit the site www.f-cot.org and REGISTER YOURSELF AS A MEMBER
TODAY.
JW> Membership is free. Pass it on to any OTs/ OTAs that you know. PLEASE
GET
JW> INVOLVED!
JW> The website again is www.f-cot.org
JW> Joe Wells
JW> --
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