Hello All, After reading many of the posts on OTs purpose and function. I noticed some things were not mentioned. One being that in most Reahb hospitals OT is slotted to provide 1.5 hours per day and for many pateints functional issues can be addressed more quickly and effieciently and then that leaves a lot of itme available that has to be filled in. For example, after a couple of OT sessions to address dressing equipment, home management, & bathing issues, etc, hip & knee patients need an OT less than they get in Rehab. I think that new students then come away with this idea of OT doing exercise because they have to fill in that time. Also don't forget insurance payors. You start documenting working on leisure skills and they begin to balk. I find that if I really focus on functional issues (and yes I do actually work on leisures skills in conjuction with my treatment for daily living skills) many times I can be out quickly, needing very few treatments or many patients don't want to worry about those issues, preferring to have family cook, etc. So I believe it is a complex problem. I work in home health and do (in home) outpatient OT services and am able to just see patients to address their needs and get out without having to make up things to work on as happens in Rehab & SNF frequently. I have done some PRN work in SNF lately and they did not like my style of treatment as many times after a certain period and goals were met I would try to decrease minutes for the week instead of doing UE exercise to fill in the time. So I do agree that the issue often is about money but it is also about OTs retaining a certain level of hours (workload) either for payments from insurance or to keep their of income at a certain level or lack of patient interest in addressing Daily Living Skills. Out of my home health caseload, I would estimate that about only 25% of my referrals have daily living needs that I can address (or clients want addressed). Frequently one to five visits may take care of any area that need to be addressed. So my caseload is composed of a few clients who I see twice weekly for 9-12 weeks and most who I see one to five visits. While PT can go in and do exercises, etc 3X weekly for 4-9 weeksfor most of their patients. OT generally doesn't need to see as many patients for that length of time. I think sometimes we think quantity more than quality. While I do see many patients who need OT not getting it, I also see patients getting OT services not needed (by that I mean they aren't addressing Daily Living Skills). That means an OTs role may be smaller in quantity compared to other disciplines (but no less important) and many OTs (or facilities) want more time. I realize I am preaching to the choir as most OTs on this lilst understand this or they wouldn't bother to be here. Just my take. Gina Tate
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