Ron,
  You hit the nail on the head.  that is exactly why OT is essentially the 
bottom of the totem pole in the rehab community.  Its hard to sell occupation 
in a world where focus is essentially on somatics.  It is far easier to sell OT 
services to corporate structures which rely on outcome data to show how 
effective they are (i.e. Inpatient Rehab relies heavilly on OT as it changes 
key indicators on the FIM and home helath agencies depend on OT to decrease 
overutilization.)
   
  In regards to your question about ways to rejuvinate your business:  Have you 
tried contracting with home health agencies to provide OT services for them?  
Key points to discuss witth them:  Have a thorough knowledge of the payment 
structure of home care.  Let them know how aware you are of the benefits a home 
health agency receives from competent OT care.  Specifically address how OT 
services can help them to meet the obligations of M0825.  This is the OASIS 
question that asks if a patient will meet a high therapy utilization or not.  
It is a major add on to the home care agencies bottom line if therapy is 
indicated at a high utilization rate.  Let them know how you can help to reduce 
costs i.e. decreasing home care aide visits by making patients more independent 
or by reducing twice a day nursing visits for a diabetic that can't self 
medicate.
   
  Another idea might be to provide services to nursing homes that are having 
difficulty with behavioral management issues on their dementia units.  That is 
an avenue that I am exploring right now.  It seems that most OTs working in 
nursing homes are not strong at providing interventions for dementia patients.  
Nursing homes, even ones contracted with contracted therapy agencies, in my 
area are requesting training and services to assist them in handling behavioral 
management issues.
   
  Jimmie


  Jimmie earlier posted a question from the website:

http://welcome.to/occupationaltherapy.com


Here's another interesting question and partial answer from the site:

========================================

question> When a patient is recovering from an injury, what does he
question> want to do?

answer>> He wants to go back to doing the activities and occupations
answer>> that made his life enjoyable.

========================================

Is this true? Not in my experience! What I've found is that when a
person is is actively recovering from their injury, that's IS what
they want to do. They want to recover! In other words, the person
wants their pain to decrease, or their body to work better -- that's
what they want to get better.

In my opinion, a person with an injury is primarily focusing on just
that, the injury (or illness). Not that people don't think about
getting back to their "activities and occupations", but in my
experience most people see lost "activities and occupations" as a
by-product of their injury or illness, not as the problem(s) to be
addressed.

I know that as a profession, we want to believe that people recovering
from injury want to get back to doing their "activities and
occupations" but I just don't think that is the way in which our
patients generally think. At least not in my experience. If it was the
way people think, our profession would be flourishing, both internally
and externally.

Ron


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