Jimmie: ."....you poll nurses, you will generally get those that feel OT
does the upper body and those that feel OT does ADL"
I like that comment. I do see us at times 'pigeon-holing' either in just
biomechanical aspects without respecting the "occupational" needs of the
patient (sorry, "client") or just at times not even training but performing
the "true occupations" (ofcourse, you have known those AM care OTs that
nurses love, too) with utter disregard to the biomechanical or other
performance componential/ skills (motor, process, comunication/ interaction
skills), patterns, context, activity demands or client factors that are
required to do that function/ occupation in an 'appropriate' manner. In this
process, we either become a glorified nurse's aide or, a bad imitation of a
'non-function oriented' PT, may be more like a non-skilled activities person
doing one of those "sit-ercies" with colorful bands and those pink "dumb"
bells. Could this also be because we do not always ask our clients or we
(when they cannot tell us, based upon our professional 'expertise' on human
occupation/ life- stages) cannot or do not determine as what should be
"occupationally" appropriate for our client and then correctly articulate it
to the client/ family/ other health providers/ insurance companies? I know,
I am avoiding the words "asking the patients what is meaningful to them"! I
and most in medical settings agree that we need to be paternalistic at
times. An acute TBI cannot tell you what is meaningful, their family might
not really know what to expect either. They rely on the doctors, nurses and
yes, OTs, amongst others to do what is "meaningful" for the client based
upon what is biologically (age, gender, physically, mentally), culturally/
socially thus, also morally appropriate or close to the so called "normal"
as possible.
My view of OT is that while physicians/ dentists (MDs, DOs, DPMs, DDS, ND)
address the biochemical/ physiological aspects (via pharmacotherapeutics/
dietitics, etc.) and anatomical structures (via surgery, radiotherapy, etc.)
of human functioning, i.e, internal aspects of life - enabling a person to
live as a human being (as defined in all states expect I believe NJ as until
the whole-brain ceases to function); OTs addresses the external features of
human functioning, i.e., the physical/ emotional- mental/ socio-cultural/
spiritual aspects of living as an "occcupational" being. (When does one
cease to be an "occupational" being, is a good question for the
philosophers and ethicists). As no one physician can address all aspects of
life by himself/ herself, no one OT can possibly handle all aspects of human
occupation either. That is why we have formal specialists or at least ones
specially trained.
Joe
----- Original Message -----
From: "Jimmie Arceneaux" <[EMAIL PROTECTED]>
To: <[email protected]>
Sent: Monday, July 11, 2005 9:23 AM
Subject: RE: Re[2]: [OTlist] Army OT/PT Descriptions
Hello Joe,
I believe that one of the major obstacles facing OT is that quite a few OTs
are providing misleading information to referral sources, patients, other
professionals and the general public regarding exactly what they do as a
profession. If you poll nurses, you will generally get those that feel OT
does the upper body and those that feel OT does ADL. It is a direct
consequence of occupational therapists framing themselves in a context not
based in the framework of their profession. How many times have you seen
physician referrals regarding OT for upper extremity ROM? How many times
have you heard reports of lackluster interest in past OT coupled with
enthusiasm for PT with the stated reason, "I just want to walk." Could it
be that the PT goal of improving the ability to walk has a more tangible
benefit to the patient (sarcasm intended)? Don't get me wrong, I'm not
stating that there can't be a tangible beneift to OT, but patient's don't
see that benefit if the OT only marches in to do UE exercise and help them
get dressed.
Jimmie
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
Behalf Of Joe Wells
Sent: Monday, July 11, 2005 7:42 AM
To: [email protected]
Subject: Re: Re[2]: [OTlist] Army OT/PT Descriptions
Hi Ron:
OTAs can enlist in the army. Additionally, the army does train its own OTAs
as well. http://www.cs.amedd.army.mil/dms/otbranch/default.htm. They are
usually called OT specialists in the army. I agree that our product is
diverse and thus, the scope is wide. I am convinced that if we all accept
that with different settings our practice mode may differ (i.e. one aspect
of the domain may take precedence over the other, e.g. a hand clinic versus
a shelter-home versus an acute care hospital) although not deviating from
our core principles that thread us together, we will still be able to
package our product. Our profession may be fluid but we can give it the
shape of a container. Barring just a few inconsistencies, I felt the AOTA
framework is a commendable tool to introspect our own practice similarities
and differences (explain what we do internally), find that 'thread' that
binds the OT community together and then externalize it as an easily
identifiable product (1). I hope that this could be a part of the OT
curriculum as well, so that all new grads can identify with a common
practice framework versus what one school wanted to follow over the other. I
believe it is now is a part of the ACOTE standards.
Other links:
http://www.goarmy.com/amedd/army_health_care_corps.jsp- Recruiting as an OT
http://usmilitary.about.com/library/milinfo/navynec/blhm8467.htm Recruiting
as an OTA
1. AOTA (2002). Occupational therapy practice framework: Domain and
processs. American Jouranal Occupational Therapy. 56, 609-639.
Joe
----- Original Message -----
From: "Ron Carson" <[EMAIL PROTECTED]>
To: "Joe Wells" <[email protected]>
Sent: Monday, July 11, 2005 1:56 AM
Subject: Re[2]: [OTlist] Army OT/PT Descriptions
Hello Joe:
Good idea to do further investigating and great links, thanks!
The Army brochure that I used for my quoted does contain comprehensive
info about OT. Perhaps I should have included some quotes relating to
group therapy, alcohol rehab, etc.
Maybe I missed it, but I haven't read anything about the Army using
OTA's. I am interested to hear if they in fact, they do.
One of the reasons I posted my original message is because of the recent
discussions about marketing "out product". I am convinced that our
product is too diverse, inconsistent and misunderstood to market. Until,
the profession of OT's internal structure is more clearly defined, I
think that marketing is not a good use of resources.
Somehow, AOTA and practicing OT's, must develop a model of theory and
practice that is specialized, understood by both internal and external
audiences, deliverable and practiced. To date, in my opinion this has
not happened.
----- Original Message -----
From: Joe Wells <[EMAIL PROTECTED]>
Sent: Sunday, July 10, 2005
To: [email protected] <[email protected]>
Subj: [OTlist] Army OT/PT Descriptions
JW> Hi Ron:
JW> Just out of curiousity, I checked the Walter Reed Medical Center
website
JW> http://www.wramc.amedd.army.mil/departments/Ortho/PhysMed/otscope.htm.
The
JW> OT scope explained there is a little more comprehensive. I also
checked the
JW> PT scope at
JW> http://www.wramc.amedd.army.mil/departments/Ortho/PhysMed/ptscope.htm
and
JW> found the scopes to have a lot of areas overlapping. In the military,
my
JW> guess is that the model is very transdisciplinary. I believe the
student
JW> appointment is an internship (level II fieldwork) affiliation since
there
JW> are no OT academic programs in the Army, although as you mentioned,
they do
JW> have a DPT program at the US Army- Baylor University
JW> (http://www.amsc.amedd.army.mil/training.asp). The army does train
its own
JW> OTAs. More on the OT internship program
JW> http://www.amsc.amedd.army.mil/Doc/otintership.pdf. Do we have any
army OTs
JW> on the board ? It would be nice to hear about their army expeeiences.
JW> Other Army sites:
JW> http://www.wramc.amedd.army.mil/departments/Ortho/index.htm
JW> http://www.amsc.amedd.army.mil/about.asp
JW> Joe
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