Ann:
Thank you for your question. I envision the entry-level doctorate would be
beneficial for all settings. It does improve public perception and
confidence in general, no matter what setting we are in. An MD is certainly
going to feel more confident in a Psy.D. than an LISW, a PT than a CMT. A
patient usually places more confidence on a doctor than a PA/ nurse
(unless,the PA/nurse is more competent and the patient knows that). The
driving force of this confidence again is educational level and traditional
heirarchy that results from it. Also the parity in 'perceived' educational
preparation allows for more collaborative/ peer roles versus one somewhere
in the food chain, at least generally speaking so. In private practice, it
certainly is more evident than all other settings/ does give you the
leveling field as a professional with similar professions in an age where
clients are becoming more and more aware of their choices and making them
more independently versus what the "doctor ordered" (this ties in with
direct access issues). Irrespective of all these, I believe the knowledge
base has certainly grown to an extent that we need an expansion of our
programs and make it more directed toward clinical practice versus just
practicing theory. Higher degrees do not always mean higher wages. It is a
demand and supply market all along. Being a manager with a SNF chain, I saw
wages reduced by 20% when PPS hit us in 1999. And, then are we sure we
deserve what we make now with the work we do? If so, for how long? Again, I
agree that difference in degrees do not always produce better clinicians
but hopefully the education behind the degree if structured corectly will,
at least for the majority. To be more more honest, I found most with 4 to
4.5 years Bachelors' doing better than Entry level Masters'. The reason, I
feel is because their undergrad was not structured well for the basics and
the Masters was probably too, crammed. And, probably the average Bachelor's
with experience is still better than the Master's with none. (By the way, I
am also one from the old school Bachelor's).
On EBP, it seems impractical, costly and time consuming but truly it isn't.
I can do a search online (usually free) and get the "evidence or lack of it"
in maybe 15- 30 minutes/ over my lunch-break. It is pretty simple once we
are introduced to it right. Really, with the internet you can unsubscribe
all your journals or as my EBP gurus told me "just throw them away or stack
them on my table to scare people away ".
Joe
----- Original Message -----
From: <[EMAIL PROTECTED]>
To: <[email protected]>
Sent: Wednesday, July 06, 2005 8:10 PM
Subject: Re: [OTlist] Forum of Clinical Occupational Therapists-
www.f-cot.org
Joe,
I'm curious what setting(s) you envision the entry level doctorate OT to
best
fill. Many of your arguments in support of this and direct access seem to
be
directed toward a private practice setting. In medical settings,
including
acute care, rehab. hospitals and nursing homes, as well as school
settings, I
doubt you could find many or any patients who would be able to identify
for you
who in the dept. had a bachelor's vs. a masters, and in some settings, who
was a COTA and who was an OTR. I know as a former manager of an OT dept.,
the
degree that an applicant had was no guarantee of the subsequent skill
displayed
once hired - I have hired both masters prepared and bachelors prepared,
and
the degree did not determine the quality of the employee. I also had no
ability to pay a higher salary to the more advanced degrees, and in this
age of
pressure to reduce health care costs, the ability to pay more for an even
more
advanced degree is highly unlikely.
I too believe in EBP, but am not convinced that spending more time
learning
about it in college results in its regular practice or promotion in the
clinic.
An environment needs to exist that allows the resources, time and support
for research. Unfortunately, in this age of productivity standards and
diminishing resources and reimbursement, that environment is difficult to
come by.
Ann
In a message dated 7/6/2005 3:36:12 AM Eastern Standard Time,
[EMAIL PROTECTED] writes:
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.
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