Hey Ron:
I will take a jab at it.
As you, I believe the divide now is more on a philosophical level.
1. PT is mainly focused on the physiological/ physical responses and
functioning of the body, i.e, preventing and treating physical dysfunctions.
OT's philosophical basis considers physiological/ physical aspects but as a
part of human functioning, the others involve mental/ emotional,
socio-cultural aspects as well and thus, are holistic in their approach and
scope. That is, OT's approach, thus, is to prevent and treat aspects of
human functioning that 'also' involves and doesn't just solely involve
physical aspects. Ofcourse, our roots derive this philosophical divide.
2. As pointed out by you, due to its focus, PTs were traditionally better
suited in acute care (emphasis on identifying and mitigating/ addressing
pathophysiology) versus identifying/ addressing the long-term effects of
illness/ conditions which also involve the mental/ emotional and
socio-cultural effects on living. OTs were supposed to be that link (there
are many more knots in there now). However, now PTs are equally into
longterm as OTs are in acute care.
3. Enter DRGs, PPS, third-party payors- "no duplication of goals, etc."- now
OTs and PTs each could not claim the whole body just to themselves without
duplicating goals (as everyone has to be 'functional' as well). So, one way
out- OTs you are good with fine motor (after all you basket weaved,
moccassined, coppertooled), PTs you are gross-motored afterall you lift
weights. OTs don't document LEs or mobility as PTs did the walking and thus,
will stengthen/ range them as well, PTs don't document UEs as OTs did the
combing and dressing and will address the strength/ ROM of the UEs as well.
Alright, the mouth to the gut goes to the SLP ! OTs and PTs can share the
trunk, OTs and SLPs can share the brain! I did have a speech once ask me
that as they did 'higher' functions, could OTs do basic ('lower'?) brain
functions- so that, tgey were no duplications!
4. With the same human body and finitely-infinite numbers of things that can
go wrong with the body, PTs and OTs barring their philosophical differences
and journal transcript styles, have to still evaluate, address/ treat much
the same conditions, especially with the physical dysfunctional population.
Ask a PT and he/ she will say that they too are concerned about the
somatogenic/ somatic implications to psychopathological conditions and
psychogenic/ psychological implications to somatic disorders as well. And,
every one in the health team wants the client to be 'productive' and 'live
his life to the fullest', from the activities asst. to the LSW. Hence, the
division of labor between disciplines are many a times taken by the
clinicians themselves at the facility (e.g.: wheelchair positioning is OT,
w/c mobility is PT !), based upon managerial arrangements such as, staffing-
okay, we have less PTs- OTs will do the "walk to dine" afterall, dining is
an ADL, right! Based upon who in the facility is more lazy- the PT or OT, or
merely who is more competitive and thetrue and loyal defender of their scope
of practice; sometimes based on who gets to decide this, whether the rehab
director is an OT or PT. (I was once at a seminar on documentation presented
by two PTs, I was told by these two that OTs should not work or document on
standing or mobility...this would lead to a denial, no we were not talking
duplication here. Ofcourse, we all know where the denial lies).
5. I believe that today in actual practice; PT and OT, share a similar
relationship as the MDs/ DOs, the divide being one of philosophy. Sometimes
our tools look different and sometimes not. I was reading about both our
histories as 'reconstruction aides'. Back then the difference between the
two types of reconstruction aides were based upon their uniforms. These
ancestral PTs wore short sleeves asthey worked with water and paraffin,
etc., and our professional ancestors wore full-sleeves.
6. From a scope standpoint, today PTs and OTs share similar major
specialties/ interest areas [neuro, peds, hand, industrial, wound- to a
great degree, acquatics, geriatrics, orthopedics (PT)/ physical dysfunctions
(OT)]. Notable among the differences are Low-Vision, Mental Health and
Driver Rehab for OT, and Electrophysiology/ electromyography, orthopedic
manual therapy and fast growing -primary care, in PT. Barring the differnces
in semantics, PTs are supposed to be as "functional" as OTs atleast when it
comes to physical components of ADLs and OTs use "physical" means to treat
all the time ( agreed "exercising is but primarily a physical occupation")!
7. So fight it out. Just kidding. Base the divide at the facility level or
even in independent practice, on the actual skills, interests and comfort
levels of the individual practitioners themselves. This will be in the best
interest of the patients as well.
As always, just my two cents but many sentences in.
Joe
----- Original Message -----
From: "Ron Carson" <[EMAIL PROTECTED]>
To: "Ron Carson" <[email protected]>
Sent: Friday, July 15, 2005 8:57 PM
Subject: Re: [OTlist] Tough Question
Come on, help me answer this question....
Here's what I've come up with so far:
Ron's answer> Hello Lance:
Ron's answer> Of course the most common division between OT and PT is UE
Ron's answer> and LE - but I don't buy this. Unfortunately, it is not
Ron's answer> easy to clearly say, "this" is PT and "this" is OT,
Ron's answer> there's just too much overlap between the professions.But,
Ron's answer> here's my "best guess" at a possible division.
Ron's answer> Generally, I think of PT is being better skilled to treat
Ron's answer> acute medical problems relating to musculoskeletal
Ron's answer> conditions. I tend to think of OT as better skilled to
Ron's answer> treat chronic issues relating to
Now, my above ATTEMPT is pretty lame. Obviously, I'm struggling. I've
never had to put in writing how to divide PT and OT.... HUUUMMMHHH,
maybe this is a topic for an OTnews article...
Any way, I could use some help!
Ron
----- Original Message -----
From: Ron Carson <[EMAIL PROTECTED]>
Sent: Friday, July 15, 2005
To: OTlist <[email protected]>
Subj: [OTlist] Tough Question
RC> Hello:
RC> Here's a tough question:
quote>> Ron,
quote>> what is the best way to divide the resposibilities between PT and
quote>> OT?
RC> The above question was written by a PT in private practice living
in
RC> California.
RC> Accurately and clearly delineating "our" differences is difficult.
RC> Anyone willing to offer an answer?????
RC> Ron
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