To All the Great OTs Out There:
   
  I am an OT located in Massachusetts that owns a company providing medical and 
durable medical equipment.  I have partnernships with various companies in 
various settings, including skilled nursing facilities, homecare, out-patient 
clinics and staffing companies.  We provide DME through Medicare and 
"out-of-pocket."  We provide your typical DME like wheelchairs, walkers and tub 
benches, but also provide wheelchair cushions, overlay mattresses, UE/LE 
orthotics and diabetic shoes.  This way we are  a one-stop medical equipment 
provider.
   
  I have recently started a divsion of my company where therapist can provide 
this DME and medical equipment as independent contractors.  I started this 
company in 2002 becuase I knew I could provide better education/consulting on 
products and at lesser than suggested retail price.  What better marketing 
approach, a better customer service at a lesser price.
   
  As a independent contractor, you would provide the equipment while receiving 
a comission.  The commission is 25% of the subtotal/reimbursable amount. You 
set your own hours and markets you would like to target.  I have some therapist 
that do this as their full-time job and some as a per-diem job.
   
  With that piece of general information, I am looking for feedback.  I am 
looking for positives, negatives and any other thoughts.
  I am also looking for any therapists that might interested in learning about 
becoming a independent contractor or how Home Medical Consulting can better 
serve your organization or clients.
   
  Once again, thank you for taking your time.  I look forward to hearing from 
you and HAPPY OT MONTH!!!!
   
  Sincerely,
   
  Gregory Stelmach, OTR/L
  Home Medical Consulting
  53 Columbus Ave. Suite 402
  North Providence, RI 02911
  (508)801-9776
  www.homemedicalconsulting.com 

Carmen Aguirre <[EMAIL PROTECTED]> wrote:
  I STRONGLY believe in the power of Occupational therapy. 

I See the need and the results for enhanced self performance in just about 
every referral even if it is for 1-2 visits. I know and see the factual 
difference with other allied health and have no "sleep-depriving" fears about 
"others' taking over. 
Our profession has a lot to offer to clients and our knowledge in the 5 domains 
is the perfect tool to get started and facilitate restoration, compensation 
and/or adaptations.
As we humans evolve, so our interactions with the environment and our 
occupational landscape . I see us OT's, right there evolving along...

Good day everyone,
Carmen
----- Original Message ----- 
From: michael butterfield 
To: [email protected] 
Sent: Wednesday, April 26, 2006 8:06 PM
Subject: Re: [OTlist] Occupation


Great posts Carmen and Ron,
I also have been wondering for a while when an occupation based approach is 
needed. Is it only needed when an exercise/medical model approach cant "cure 
the impairments ?" (ex: complete spinal cord injury or head inury with chronic 
memory loss..) Is an occupation based approach needed when a patient is not 
interested in exercise/medical model approach? (very rare in my practice!)?
Part of my job is covering the swing unit in a critical care hospital and I get 
a lot of hip fx's, TKR, genral deconditioning...in most cases once the 
impairments/compenents are improved pt's are quite happey with thier level of 
independence. When given the choice of brushing thier teeth standing at the 
sink perfoming resistive standing exercises in paraleel bares in most cases pt 
choose the exercises. If i had a dollar for every time a patient gave me a goal 
of "walking by my self" I could pay of my car loan! Again in my experience at 
the orthopedic/geriatric popualtion pt's want thier treatment at the impariment 
compenent level.
On the flip side another part of my job that I have somewhat success with 
Occupation based approach is with my pediatric/school based kids. for ex: third 
grader with high level CP. failed at home/school learing how to tie shoe laces 
he was . I helped him spray paint a pair of payless sneakers bright gold, one 
lace got applied glitter glue and worked on reverse chaining with "magic 
shoes"..you peds OT know the rest of the story after 3 weeks he was successful.
To make a long rant short, about 75 percent of my job I am not using an 
occupation based approach but my patients still percieve success and 
indepedence in their routine. Am I practicing like a AOTA OT...No...does this 
bother me...sometimes..am I worried about the my future in OT sometimes.
Mike Butterfield


Ron Carson > wrote:
Yes, we see a dentist because of the toothache, not so we can eat corn
on the cob! We call the electrician because we have an electrical short,
not so we can watch TV. We take our care to a mechanic because it's
broken, not so we can drive to a movie.

We call an OT because because we can't wash our feet....

Now, who thinks of OT like that?? NO ONE, well almost no one!

About the only time that I hear mention of OT (keep in mind that I work
in an outpatient private practice setting) is for fine motor, UE, and
cognition. Once, I had a referral from a chiropractor to do a home
safety assessment for his Dad, also a chiropractor. But by far, OT is
normally referred to for anything OTHER than occupation. And that's a
problem!

In my opinion, we MUST:

1. Change our message

2. Change our delivery

3. Or a combination of the two

----- Original Message -----
From: Carmen Aguirre 
Sent: Wednesday, April 26, 2006
To: [email protected] 
Subj: [OTlist] Occupation

CA> Ron...
CA> When we get sick, have a tooth ache, bleeding, etc we seek a
CA> doctor to stop/cure/remediate the cause in order to restore "normal"
CA> life (occupation). Why would it be different for patients who need
CA> our services...I truly don't see the dis-articulation. Help?
CA> Carmen
CA> ----- Original Message ----- 
CA> From: Ron Carson 
CA> To: [EMAIL PROTECTED] 
CA> Sent: Wednesday, April 26, 2006 11:17 AM
CA> Subject: Re: [OTlist] Occupation


CA> Yes, I agree 100% with your statement. BUT most patients that I see are
CA> not at the point of compensation. And besides, I don't think that
CA> compensation is really a big part of medicine. I just can't see me going
CA> to a doctor and saying;

CA> " If you have any patients who can't use their arms, hands, legs,
CA> etc. then send them to me so I can teach them how to compensate"

CA> Maybe this SHOULD be the role of OT but it is one role that in my
CA> opinion is not highly promoted, practiced or warranted for many of our
CA> patients.

CA> Ron

CA> ----- Original Message -----
CA> From: [EMAIL PROTECTED]
CA> >
CA> Sent: Wednesday, April 26, 2006
CA> To: [email protected]
CA> >
CA> Subj: [OTlist] Occupation

CA> Enrc> Ok - I understand what you're saying, but let's just say that it was
CA> Enrc> not possible that this person receive a lens replacement and 
everything
CA> Enrc> did not get better and the problem could not be fixed. In this case,
CA> Enrc> occupation and compensation WOULD come to the forefront, no?

CA> Enrc> ----- Original Message -----
CA> Enrc> From: Ron Carson
CA> >
CA> Enrc> Date: Wednesday, April 26, 2006 7:34 am
CA> Enrc> Subject: [OTlist] Occupation
CA> Enrc> To: [email protected]

CA> >> Hello All:
CA> >> 
CA> >> Recently Biraj pointed out that I:
CA> >> 
CA> >> > always championed and advocated, very strongly I might
CA> >> add,> occupation-based practice but now it seems [I am]
CA> >> extremely> disappointed of anything the term has to do with in the
CA> >> OT profession.
CA> >> 
CA> >> Biraj is correct about my past vocalizations but today I don't 
CA> >> feel that
CA> >> I am disappointed about occupation. I still feel the same
CA> >> aboutoccupation but I think that I am becoming a bit jaded
CA> >> at trying to
CA> >> integrate occupation into my private practice. You see, 
CA> >> occupation is
CA> >> important, it's important to ALL of us, but what I am 
CA> >> discovering is
CA> >> that treating occupational deficits does not fit well with my
CA> >> clientsbecause clients don't consider occupational deficits to be
CA> >> the problem.
CA> >> Here's a non-OT story to make my point.
CA> >> 
CA> >> Recently, someone I know was diagnosed with cataracts. The 
CA> >> cataractsaffected his vision to the point that modifications were
CA> >> needed to read,
CA> >> work and play. Now, what do you think this person saw as the
CA> >> problem;cataracts or occupations. Obviously, the impact on his
CA> >> occupation is
CA> >> what brought the cataracts to the forefront and motivated him to
CA> >> seek a
CA> >> lens replacement, but cataracts are the problem, not the
CA> >> loss of
CA> >> occupation. So, the person received a lens replacement and 
CA> >> everything is
CA> >> getting better. Well, how does this 'story' apply to OT.
CA> >> 
CA> >> Simple, our clients are seeking answers to problems. They want
CA> >> theseproblems fixed. But the problems are not occupation, the
CA> >> problems are
CA> >> things like weakness, loss of balance, developmental delay, 
CA> >> depression,etc. Clients see these 'components' as the problem and
CA> >> this is what they
CA> >> expect their therapist to address. This is the way the entire
CA> >> world of
CA> >> medicine works and for OT to be any different just doesn't work.
CA> >> 
CA> >> What I think needs to be done is for our patients to recognize
CA> >> loss of
CA> >> occupation as the primary problem. Then, they recognize the need
CA> >> for an
CA> >> occupational therapist. And as far as I can tell, the ONLY way 
CA> >> that this
CA> >> is going to happen on a large scale is for AOTA to put 
CA> >> together a
CA> >> NATIONAL ad campaign directed at educating people about 
CA> >> occupation and
CA> >> thus occupational therapy.
CA> >> 
CA> >> Finally, there are settings were occupation is the concern but 
CA> >> about the
CA> >> only one that I know of is long-term mental health. And 
CA> >> given that
CA> >> therapeutic occupation is rooted in mental health, this makes
CA> >> perfectsense. But for the majority of OT's working in the US,
CA> >> I think that
CA> >> trying to integrate occupation as our main form and outcome is
CA> >> a lost
CA> >> battle, unless patients are EDUCATED, INTEGRATE and 
CA> >> EXPERIENCEoccupation-based therapy.
CA> >> 
CA> >> Ron
CA> >> 
CA> >> 
CA> >> 
CA> >> 
CA> >> -- 
CA> >> Unsubscribe?
CA> >> 
CA> [EMAIL PROTECTED]
CA> >> 
CA> >> Change options?
CA> >> 
CA> www.otnow.com/mailman/options/otlist_otnow.com
CA> >> 
CA> >> Archive?
CA> >> 
CA> www.mail-archive.com/[email protected]
CA> >> 
CA> >> Help?
CA> >> [EMAIL PROTECTED]
CA> >> 



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