Terianne, Thanks for articulating this frustration for me (us). The details of the market are different here in Canada, of course, but the end result is sometimes the same. Joan
-----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Terrianne Jones Sent: Sunday, March 11, 2007 7:58 PM To: [email protected] Subject: Re: [OTlist] on the "uselessness of OT " and other things "My other curiosity is why, if people are having such negative OT experiences in rehab, they bother to come for more OT once discharged?" Jeanne, you pose an interesting question, and one that is pretty easily answered. For the population covered by Medicare A , which is the main payer for physical rehabilitation for the largest portion of the population receiving OT services, it is ignorance plain and simple. Most of these clients have no idea what the MD's order; many a time I go to do a home care OT eval and my clients will balk that they didn't know the doctor ordered home care let alone OT. So in a sense they are somehat a captive audience. And since under the part A benefit they cannot be balanced billed, the see no direct out of pocket cost associated with OT. So, although they may hate or love their OT, until our clients have more connection to the investment versus outcome assoicated with OT, we will continue to offer in some circumstances a mediocre product with not much accountability, because the market will bear it. I am surprised quiet frankly that Medicare hasn't demanded more from the profession. When I teach OT students, my mantra is always "would YOU pay out of pocket for your service? Would others see the value in what you are doing with their loved one? Would there be enough face validity to your interventions that you could feel good about what you are doing and what you charge for the skilled service? " If you can't answer yes to these questions, then in all likelihood you are not offering a skilled intervention and will burn out in this field" After 15 years in this profession, I have really come to the conclusion that many OT's in adult and geriatric rehab are not that invested in truly operating as professionals. They want the paycheck and some sort of prestige, but they don't hold up their end of the equation by continuing their educations, using the best evidence and offering their clients a truly unique and skilled service. And they can get away with it because the patients/clients don't know any better and don't have to yet. If there were even a $5co -pay under part A for every therapy visit/session, this situation would change in a heartbeat, because the clients would demand better from us, and we would have to deliver to remain viable as a profession. The real question is: do we continue to "feast" on a sinking ship or do we abandon sloppy practice and hold ourselves accountable before we are forced to do so? In my mind that is what makes a real professional. Terrianne JM <[EMAIL PROTECTED]> wrote: < they were supposed to do, they would make a big difference in patient's lives".>> I would also be interested in knowing what the sister believes O T's are supposed to be doing.... a lot of people don't even know what OT is. My other curiosity is why, if people are having such negative OT experiences in rehab, they bother to come for more OT once discharged? I would be very uncomfortable working in a SNF where I was not allowed to address mobility in regards to ADLs....I have been fortunate to never have been pigeon-holed in that manner. Currently in my inpatient acute setting, I am constantly working on educating other staff that I am not a "PT" because I happen to get people out of bed-----Unfortunetly, I follow several OT's that never got people out of bed--fairly useless in my opinion On another topic, I am arranging activities at my facility for OT month--I had to cringe when the COTA was wanting to bring the cones and the arc to the demonstration table as OT modalities. I don't use these things as a general rule except with very low level neuro for tracking/color recognition and some basic grasp etc. I gently declined in favor of providing information on how not to pack a backpack and fall prevention in the community.....Just having items on a table doesn't show purpose even when there is one... anyway, always intersting to open my OTLIST digests :> Jeanne Marie -- 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 **************************************************************************** ********** --------------------------------- Be a PS3 game guru. Get your game face on with the latest PS3 news and previews at Yahoo! Games. -- 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 **************************************************************************************
