Hello Angela, As a fellow OT who is very interested in "cog rehab" for BI and CVA rehab - I find the physiatrist's comments in your citation very pathetic.
"Thomas Watanabe, MD, professor of physical medicine and rehabilitation at Drake Center University of Cincinnati says, Its hard to demonstrate cognitive progress to the insurance company. If a patient starts out in a wheelchair and then starts walking with a cane, you can measure that progress. Here are some clear examples of concrete progress for patients in "cog rehab" that I use daily in OT (from admit to d/c): Oblivious to time - now makes/follows self generated time schedule Can't count money - now able to balance checking account Can't follow 1 line written directions - now he understands a paragraph of complicated instructions to operate a machine Family dispenses medicine - now patient independently takes meds on schedule Trouble boiling water - now safely making a meal Can't find items in therapy room - walks independently to/from grocery store Can't find item on shelf - arranges items on shelves appropriately Doesn't acknowledge others in room - asks others for directions Can't remember activity 5 mins later - now able to take notes to compensate for memory deficit There are many more - none of them physical or basic ADL goals or traditional neuropsych 'cog rehab" definitions of "brain healing". Whether the progress statements above address medical problems that medical insurance wants to cover is really the question. Rob Koch --- angela jones <[EMAIL PROTECTED]> wrote: > This is in Rehab Today online magazine. Their > description of measurable > progress is what the patient uses as a device for > ambulation. I'm frustrated > that it isn't common sense to see measurable goals > through cognitive testing > and outcomes in fuctional skills. Is this in part > due to OT not providing > enough evidenced based research? Angie Jones > > January 29, 2007 > > NEWS > > Health Insurers Do Not Cover Cognitive > Rehabilitation > According to the Wall Street Journal, many brain > injury patients who > experience problems with memory, mental processing, > or behavior, do not > receive cognitive rehabilitation because their > health insurers do not cover > the treatment. > > Preliminary studies indicate the effectiveness of > cognitive rehabilitation, > but research into the treatment remains limited > because of a lack of funding > by pharmaceutical companies. > > A committee established by the National Institutes > of Health in 1998 to > evaluate cognitive rehabilitation concluded that the > evidence supports the > use of certain cognitive and behavioral > rehabilitation strategies as part > of a structured plan. In addition, an analysis of 87 > studies published in > the Archives of Physical Medicine and Rehabilitation > in 2006 found > substantial evidence to support cognitive > rehabilitation for people with > traumatic brain injury. > > However, many health insurers maintain that research > to support the > effectiveness of cognitive rehabilitation remains > insufficient. In 2002, the > BlueCross BlueShield Association Technology > Evaluation Center said, > Available data are considered insufficient to make > conclusions on whether > cognitive rehabilitation results in beneficial > health outcomes. WellPoint > covers cognitive rehabilitation for patients > involved in accidents but not > for those who experience strokes. > > Thomas Watanabe, MD, professor of physical medicine > and rehabilitation at > Drake Center University of Cincinnati says, Its > hard to demonstrate > cognitive progress to the insurance company. If a > patient starts out in a > wheelchair and then starts walking with a cane, you > can measure that > progress. > > _________________________________________________________________ > Laugh, share and connect with Windows Live Messenger > > http://clk.atdmt.com/MSN/go/msnnkwme0020000001msn/direct/01/?href=http://imagine-msn.com/messenger/launch80/default.aspx?locale=en-us&source=hmtagline > > > > -- > Options? > www.otnow.com/mailman/options/otlist_otnow.com > > Archive? > www.mail-archive.com/[email protected] > > ************************************************************************************** > Enroll in Boston University's post-professional > Master of Science for OTs Online. 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