Hey folks, I agree with Joe, in that OT's need to start practicng by incorporating all of the aspects of our practice, ie, physical, cognitive, psychosocial, habits/routines, communication, etc....What I see many OT's doing is focusing mainly on the physical aspects of life involvement/engagement. I understand that we have been forced into that role somewhat by the rules and regulations governing payment, but by the same token, I have seen rules change when we stand up for our practice and educate others on the many components that may interfere with client function. (I have fought various denials in the LTC arena and won) I almost hate to say this, but what is unique about OT is the fact that we (dare I say it) are "Generalists" to some extent. That means we address not just one component of function but the various components....or at least that is what I thought we were taught to do. My opinion is that one day the medical comminity will wake up and see that all they need are OT's! Ok, maybe I overstepped a bit, but really, that is what is unique about us, is that we are not "over-specialized". It's what we love about OT, but also what drives us crazy when we try to explain what we do. Just a few thoughts, Terrie ----- Original Message ----- From: <[EMAIL PROTECTED]> To: <[email protected]> Sent: Tuesday, March 06, 2007 6:36 AM Subject: OTlist Digest, Vol 26, Issue 6
> Send OTlist mailing list submissions to > [email protected] > > To subscribe or unsubscribe via the World Wide Web, visit > http://otnow.com/mailman/listinfo/otlist_otnow.com > or, via email, send a message with subject or body 'help' to > [EMAIL PROTECTED] > > You can reach the person managing the list at > [EMAIL PROTECTED] > > When replying, please edit your Subject line so it is more specific > than "Re: Contents of OTlist digest..." > > > Today's Topics: > > 1. Re: PT's and Functional Trainig (Ron Carson) > 2. Re: MOTOM (Ron Carson) > 3. Re: PT's and Functional Trainig (Chuck Willmarth) > 4. Re: PT's and Functional Trainig (Ron Carson) > 5. Re: PT's and Functional Trainig (Chuck Willmarth) > 6. Re: PT's and Functional Trainig (Joe Wells) > 7. Re: PT's and Functional Trainig (Joe Wells) > 8. Re: MOTOM (Lucy Simpson) > 9. Re: PT's and Functional Trainig (Ron Carson) > > > ---------------------------------------------------------------------- > > Message: 1 > Date: Mon, 5 Mar 2007 16:27:07 -0500 > From: Ron Carson <[EMAIL PROTECTED]> > Subject: Re: [OTlist] PT's and Functional Trainig > To: Chuck Willmarth <[email protected]> > Message-ID: <[EMAIL PROTECTED]> > Content-Type: text/plain; charset=us-ascii > > Hello Chuck: > > The whole concept of "functional training" is very etheral. I see the > word function in everything from orthopedic surgeons all the way to > recreational therapists. > > What I'm trying to say is that limiting physical therapist to > functional training as it relates to movement and mobility is really > no limit at all. With a few notable exceptions, all function involves > movement and most involves mobility. > > While applauding AOTA's efforts, I just don't see how the modified > language is going to prevent encroachment. I think the key word for > limiting PT's practice is in "function" as it relates to self-care, > mobility, etc. > > Ron > > ----- Original Message ----- > From: Chuck Willmarth <[EMAIL PROTECTED]> > Sent: Monday, March 05, 2007 > To: [email protected] <[email protected]> > Subj: [OTlist] PT's and Functional Trainig > > CW> Ron, > > CW> Are you suggesting that physical therapists do not (or should not) > CW> provide functional training? > > > > CW> Chuck > > CW> -----Original Message----- > CW> From: [EMAIL PROTECTED] > CW> [mailto:[EMAIL PROTECTED] On > CW> Behalf Of Ron Carson > CW> Sent: Friday, March 02, 2007 11:20 PM > CW> To: [email protected] > CW> Subject: [OTlist] PT's and Functional Trainig > > CW> Hello All: > > CW> Recently, I receive something from AOTA talking about PT's and > CW> self-care training. In part, the message states: > > CW> "AOTA and state OT associations have lobbied state legislatures to > CW> ensure that state PT licensure laws reflect this context by including > CW> language that states that functional training is related to 'movement > CW> and mobility.'" > > CW> I know that States where PT's have tried to expand their scope of > CW> practice to include ADL's, OT's have rallied to have the above > CW> language INCLUDED. > > CW> But, I don't really understand how limiting PT's to 'movement and > CW> mobility' really limits their practice, or significantly separates > CW> them from OT. I understand that the OT role includes cognition, but > CW> many, many patient's don't have cognitive factors limiting their daily > CW> living. > > CW> Am I missing something here?? > > CW> Ron > > > CW> -- > CW> Options? > CW> www.otnow.com/mailman/options/otlist_otnow.com > > CW> Archive? > CW> www.mail-archive.com/[email protected] > > CW> > ************************************************************************ > CW> ************** > CW> Enroll in Boston University's post-professional Master of Science for > CW> OTs Online. Gain the skills and credentials to propel your career. > CW> www.otdegree.com/otn > CW> > ************************************************************************ > CW> ************** > > > > > > > > ------------------------------ > > Message: 2 > Date: Mon, 5 Mar 2007 16:29:29 -0500 > From: Ron Carson <[EMAIL PROTECTED]> > Subject: Re: [OTlist] MOTOM > To: "Jessica R. Gross" <[email protected]> > Message-ID: <[EMAIL PROTECTED]> > Content-Type: text/plain; charset=ISO-8859-15 > > Don't you know anything? > > A MOTOM is the southern way of spellin' and pronouncin' "modem" !!! > > Seriously, I have no earthly idea!! <grin> > > Ron <from the South> > > ----- Original Message ----- > From: Jessica R. Gross <[EMAIL PROTECTED]> > Sent: Monday, March 05, 2007 > To: [email protected] <[email protected]> > Subj: [OTlist] MOTOM > > JRG> What is MOTOM? > > JRG> -----Original Message----- > JRG> From: [EMAIL PROTECTED] > JRG> [mailto:[EMAIL PROTECTED] On > JRG> Behalf Of Lucy Simpson > JRG> Sent: Sunday, March 04, 2007 12:51 PM > JRG> To: [email protected] > JRG> Subject: [OTlist] MOTOM > > JRG> Is anyone using MOTOM as an outcome measure. I am working in the > JRG> community (physical adult). We are currently trying to decide which > JRG> outcome measure to use, I think Motom would be good but cannot find > much > JRG> information on it. If anyone is using it please let me know how you > are > JRG> getting on with it, and how you came to choose MOTOM over any other > JRG> outcome measure. > > JRG> Thanks > JRG> Lucy > > > JRG> --------------------------------- > JRG> The all-new Yahoo! Mail goes wherever you go - free your email > address > JRG> from your Internet provider. > JRG> -- > JRG> Options? > JRG> www.otnow.com/mailman/options/otlist_otnow.com > > JRG> Archive? > JRG> www.mail-archive.com/[email protected] > > JRG> > ************************************************************************ > JRG> ************** > JRG> Enroll in Boston University's post-professional Master of Science for > JRG> OTs Online. Gain the skills and credentials to propel your career. > JRG> www.otdegree.com/otn > JRG> > ************************************************************************ > JRG> ************** > > > > > > ------------------------------ > > Message: 3 > Date: Mon, 5 Mar 2007 17:17:46 -0500 > From: "Chuck Willmarth" <[EMAIL PROTECTED]> > Subject: Re: [OTlist] PT's and Functional Trainig > To: <[email protected]> > Message-ID: <[EMAIL PROTECTED]> > Content-Type: text/plain; charset="US-ASCII" > > Ron, > > I'm not sure what you mean by "I think the key word for limiting PT's > practice is in 'function' as it relates to self-care, mobility, etc." > > The model PT practice act includes the phrase "functional training in > self care and in home, community or work reintegration." AOTA and state > OT associations have pursued amendment language that states "functional > training related to physical movement and mobility in self-care and in > home, community or work integration or reintegration." The purpose of > the amendment language is clarify the context of interventions by > physical therapists. > > Re: "All function involves movement and most involves mobility." > > OK, but performing ADLs is not just about the ability to move body > parts. OT interventions are complex and consider many factors. From > AOTA's Scope of Practice document: > > "Evaluation of factors affecting activities of daily living (ADL), > instrumental activities of daily living (IADL), education, work, play, > leisure, and social participation, including > 1. Client factors, including body functions (e.g., neuromuscular, > sensory, visual, perceptual, cognitive) and body structures (e.g., > cardiovascular, digestive, integumentary, genitourinary systems). > 2. Habits, routines, roles, and behavior patterns. > 3. Cultural, physical, environmental, social, and spiritual contexts and > activity demands that affect performance. > 4. Performance skills, including motor, process, and > communication/interaction skills." > > Chuck > > > > -----Original Message----- > From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On > Behalf Of Ron Carson > Sent: Monday, March 05, 2007 4:27 PM > To: Chuck Willmarth > Subject: Re: [OTlist] PT's and Functional Trainig > > Hello Chuck: > > The whole concept of "functional training" is very etheral. I see the > word function in everything from orthopedic surgeons all the way to > recreational therapists. > > What I'm trying to say is that limiting physical therapist to > functional training as it relates to movement and mobility is really > no limit at all. With a few notable exceptions, all function involves > movement and most involves mobility. > > While applauding AOTA's efforts, I just don't see how the modified > language is going to prevent encroachment. I think the key word for > limiting PT's practice is in "function" as it relates to self-care, > mobility, etc. > > Ron > > > > ------------------------------ > > Message: 4 > Date: Mon, 5 Mar 2007 19:30:20 -0500 > From: Ron Carson <[EMAIL PROTECTED]> > Subject: Re: [OTlist] PT's and Functional Trainig > To: Chuck Willmarth <[email protected]> > Message-ID: <[EMAIL PROTECTED]> > Content-Type: text/plain; charset=us-ascii > > Hello Chuck: > > You said: > > CW> AOTA and state OT associations have pursued amendment language > CW> that states > > CW> "functional training related to physical movement and mobility in > CW> self-care and in home, community or work integration or > CW> reintegration." > > When I look at the above, I feel that the words "functional training > related to physical movement and mobility" are NOT threats to our > domain. However, I think that "Self-care and in home, community or > work integration" are. > > It seems to me that a better way to limit PT's scope is to leave off > the self care and integration components. > > It also occurs to me that the vast majority of adult patients are > referred to therapy for movement and mobility related issues. In fact, > the majority (maybe all) of my patients are seen exactly for these > reasons. And while daily living skills certainly involve much more > than just physical movement, in adults it is often the loss of > physical movement (i.e. spinal cord injury, CVA, fracture, > arthoplasty, weakness, ALS, Parkinson's, Alzheimer's, etc) that lead > people to therapy. > > And according to AOTA's proposed PT scope of practice language, as far > as payers, doctors and patient's are concerned, PT can equally treat > as well as OT. > > Ron > > P.S. As always, thanks for the dialogue! > > > ----- Original Message ----- > From: Chuck Willmarth <[EMAIL PROTECTED]> > Sent: Monday, March 05, 2007 > To: [email protected] <[email protected]> > Subj: [OTlist] PT's and Functional Trainig > > CW> Ron, > > CW> I'm not sure what you mean by "I think the key word for limiting PT's > CW> practice is in 'function' as it relates to self-care, mobility, etc." > > CW> The model PT practice act includes the phrase "functional training in > CW> self care and in home, community or work reintegration." AOTA and > state > CW> OT associations have pursued amendment language that states > "functional > CW> training related to physical movement and mobility in self-care and in > CW> home, community or work integration or reintegration." The purpose > of > CW> the amendment language is clarify the context of interventions by > CW> physical therapists. > > CW> Re: "All function involves movement and most involves mobility." > > CW> OK, but performing ADLs is not just about the ability to move body > CW> parts. OT interventions are complex and consider many factors. From > CW> AOTA's Scope of Practice document: > > CW> "Evaluation of factors affecting activities of daily living (ADL), > CW> instrumental activities of daily living (IADL), education, work, play, > CW> leisure, and social participation, including > CW> 1. Client factors, including body functions (e.g., neuromuscular, > CW> sensory, visual, perceptual, cognitive) and body structures (e.g., > CW> cardiovascular, digestive, integumentary, genitourinary systems). > CW> 2. Habits, routines, roles, and behavior patterns. > CW> 3. Cultural, physical, environmental, social, and spiritual contexts > and > CW> activity demands that affect performance. > CW> 4. Performance skills, including motor, process, and > CW> communication/interaction skills." > > CW> Chuck > > > > CW> -----Original Message----- > CW> From: [EMAIL PROTECTED] > CW> [mailto:[EMAIL PROTECTED] On > CW> Behalf Of Ron Carson > CW> Sent: Monday, March 05, 2007 4:27 PM > CW> To: Chuck Willmarth > CW> Subject: Re: [OTlist] PT's and Functional Trainig > > CW> Hello Chuck: > > CW> The whole concept of "functional training" is very etheral. I see the > CW> word function in everything from orthopedic surgeons all the way to > CW> recreational therapists. > > CW> What I'm trying to say is that limiting physical therapist to > CW> functional training as it relates to movement and mobility is really > CW> no limit at all. With a few notable exceptions, all function involves > CW> movement and most involves mobility. > > CW> While applauding AOTA's efforts, I just don't see how the modified > CW> language is going to prevent encroachment. I think the key word for > CW> limiting PT's practice is in "function" as it relates to self-care, > CW> mobility, etc. > > CW> Ron > > > > > > ------------------------------ > > Message: 5 > Date: Mon, 5 Mar 2007 21:19:43 -0500 > From: "Chuck Willmarth" <[EMAIL PROTECTED]> > Subject: Re: [OTlist] PT's and Functional Trainig > To: <[email protected]> > Message-ID: <[EMAIL PROTECTED]> > Content-Type: text/plain; charset="iso-8859-1" > > Ron, > > The purpose of the phrase "functional training related to physical > movement and mobility" > is to clarify the context in which physical therapists provide "self-care > and in home, community or > work integration." > > I think it would be difficult to argue to state legislators that the whole > phrase should come out given language in PT accreditation standards. > The language has been there for ten years now. > > We reviewed PT literature and textbooks to see how they talk about > ADLs/functional training; the focus is on movement and mobility. > > "And according to AOTA's proposed PT scope of practice language, as far as > payers, doctors and patient's are concerned, PT can equally treat > as well as OT." > > I disagree with your conclusion. I don't see anything in the language > that talks about payment for services or that PT can "equally treat as > well as OT." As you know, OT and PT are separate benefits under Medicare > and other payment systems. OTs can't provide PT and PTs can't provide > OT; OT and PT are not interchangable. As far as payers, patients and > doctors are concerned, my view is that we need to do more to educate them > about the unique benefits of occupational therapy. > > Chuck > > > ------------------------------ > > Message: 6 > Date: Mon, 5 Mar 2007 23:38:56 -0500 > From: "Joe Wells" <[EMAIL PROTECTED]> > Subject: Re: [OTlist] PT's and Functional Trainig > To: <[email protected]> > Message-ID: <[EMAIL PROTECTED]> > Content-Type: text/plain; charset="windows-1250" > > > In my opinion, there is nothing that can be done to stop PT or any other > discipline from addressing "function", "ADL", or for that matter anything > that we do as long as they do not call it "occupational therapy", and do > not > call themselves "OT" or "OTA". I do not believe that legally we have > exclusive rights to any modality/ intervention methods. > > Specifically, the PT Guide to Practice, and as rightly indicated by this > thread- PTs are allowed to address ADL, even if it were in the context to > "physical movement" and "mobility". Like Ron, I am not convinced either > that > really puts a stop to an enlightened PT from addressing ADL in any > traditional way the OTs do (i.e., if there is actually one). We can deduce > that to just about anything, even addressing cognition in order to elicit > a > purposeful physical function/ movement that will aid in the ADL. After > all, > to function (other than at the cellular/ tissue level), almost always, > would > require a movement of some sort (this includes environmental controls via > eye movements as well). I guess the exceptions would be mental functioning > without outward bodily movements, e.g. mental calculations, relaxing > listening to music (without even tapping your feet ;-), meditation phases, > etc. > > However, I strongly advocate that we should try and claim/ protect our > domain as much as we can and limit the language in others', if we can. > This > just reinforces our scope/ "perceived" expertise or else aspects of it > will > be gradually lost (remember dysphagia). We need to practice all aspects as > allowed by our scope addressing and applying interventions for physical, > mental, socio-cultural functioning. While we can not really stop others > from > practicing what we do, we must ensure the right to at least practice what > we > are supposed to. > > > > Joe K. Wells, OTD, OTR/L > > > -- > Internal Virus Database is out-of-date. > Checked by AVG Free Edition. > Version: 7.5.446 / Virus Database: 268.18.4/702 - Release Date: 2/25/2007 > 3:16 PM > > > > > > ------------------------------ > > Message: 7 > Date: Mon, 5 Mar 2007 23:53:23 -0500 > From: "Joe Wells" <[EMAIL PROTECTED]> > Subject: Re: [OTlist] PT's and Functional Trainig > To: <[email protected]> > Message-ID: <[EMAIL PROTECTED]> > Content-Type: text/plain; charset="windows-1250" > > > A few excerpts from > http://www.apta.org/AM/Template.cfm?Template=/CM/HTMLDisplay.cfm&ContentID=3 > 7752 . > > "....Physical therapists diagnose and treat individuals who have medical > problems or other health-related conditions that limit their abilities to > move and perform functional activities in their daily lives. A person > coming > to a physical therapist will receive a complete musculoskeletal > examination > and an individualized treatment program to reduce pain and improve > function." > > The article goes on to say- > > "....Physical therapists (PTs) are health care professionals who diagnose > and treat individuals of all ages, from newborns to the elderly, who have > medical problems or other health-related conditions that limit their > abilities to move and perform functional activities in their daily lives. > PTs examine each individual and develop a plan of care using treatment > techniques to promote the ability to move, reduce pain, restore function, > and prevent disability." > > > > Joe Wells, OTD, OTR/L > > -- > Internal Virus Database is out-of-date. > Checked by AVG Free Edition. > Version: 7.5.446 / Virus Database: 268.18.4/702 - Release Date: 2/25/2007 > 3:16 PM > > > > > > ------------------------------ > > Message: 8 > Date: Tue, 6 Mar 2007 10:49:50 +0000 (GMT) > From: Lucy Simpson <[EMAIL PROTECTED]> > Subject: Re: [OTlist] MOTOM > To: [email protected] > Message-ID: <[EMAIL PROTECTED]> > Content-Type: text/plain; charset=iso-8859-1 > > It is the 'Morriston Occupational Therapy Outcome Measure' an outcome > measure developed in Morriston hospital (Wales). It is a client centred > measure, you determine the areas to measure through your goal setting > rather than using a pre determined list such as the Bartel. > > Lucy > > "Jessica R. Gross" <[EMAIL PROTECTED]> wrote: > What is MOTOM? > > -----Original Message----- > From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On > Behalf Of Lucy Simpson > Sent: Sunday, March 04, 2007 12:51 PM > To: [email protected] > Subject: [OTlist] MOTOM > > Is anyone using MOTOM as an outcome measure. I am working in the > community (physical adult). We are currently trying to decide which > outcome measure to use, I think Motom would be good but cannot find much > information on it. If anyone is using it please let me know how you are > getting on with it, and how you came to choose MOTOM over any other > outcome measure. > > Thanks > Lucy > > > --------------------------------- > The all-new Yahoo! Mail goes wherever you go - free your email address > from your Internet provider. > -- > 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. Gain the skills and credentials to propel your career. > www.otdegree.com/otn > ************************************************************************ > ************** > > -- > 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. Gain the skills and credentials to propel your career. > www.otdegree.com/otn > ************************************************************************************** > > > > --------------------------------- > All New Yahoo! Mail ? Tired of unwanted email come-ons? Let our SpamGuard > protect you. > > ------------------------------ > > Message: 9 > Date: Tue, 6 Mar 2007 06:37:04 -0500 > From: Ron Carson <[EMAIL PROTECTED]> > Subject: Re: [OTlist] PT's and Functional Trainig > To: Chuck Willmarth <[email protected]> > Message-ID: <[EMAIL PROTECTED]> > Content-Type: text/plain; charset=us-ascii > > Hello Chuck: > > I'm not doing a good job of making my point. > > I don't think the phrase: "functional training related to physical > movement and mobility" should be removed. In fact, this is the phrase > that should stay. It's the "self-care, in home and community > reintegration" phrase that should be removed. > > In my opinion, PT has always addressed function. It's what function > they are now wanting to address that's the concern. > > Ron > > ----- Original Message ----- > From: Chuck Willmarth <[EMAIL PROTECTED]> > Sent: Monday, March 05, 2007 > To: [email protected] <[email protected]> > Subj: [OTlist] PT's and Functional Trainig > > CW> Ron, > > CW> The purpose of the phrase "functional training related to > CW> physical movement and mobility" > CW> is to clarify the context in which physical therapists > CW> provide "self-care and in home, community or > CW> work integration." > > CW> I think it would be difficult to argue to state legislators > CW> that the whole phrase should come out given language in PT > CW> accreditation standards. > CW> The language has been there for ten years now. > > CW> We reviewed PT literature and textbooks to see how they talk > CW> about ADLs/functional training; the focus is on movement and > CW> mobility. > > CW> "And according to AOTA's proposed PT scope of practice > CW> language, as far as payers, doctors and patient's are concerned, > CW> PT can equally treat > CW> as well as OT." > > CW> I disagree with your conclusion. I don't see anything in > CW> the language that talks about payment for services or that PT can > CW> "equally treat as well as OT." As you know, OT and PT are > CW> separate benefits under Medicare and other payment systems. OTs > CW> can't provide PT and PTs can't provide OT; OT and PT are not > CW> interchangable. As far as payers, patients and doctors are > CW> concerned, my view is that we need to do more to educate them > CW> about the unique benefits of occupational therapy. > > CW> Chuck > > > > > > ------------------------------ > > -- > Unsubscribe? > [EMAIL PROTECTED] > > Change options? > www.otnow.com/mailman/options/otlist_otnow.com > > Archive? > www.mail-archive.com/[email protected] > > Help? > [EMAIL PROTECTED] > > > > End of OTlist Digest, Vol 26, Issue 6 > ************************************* > -- 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. Gain the skills and credentials to propel your career. www.otdegree.com/otn **************************************************************************************
