Just got back from a marketing call with an in-patient rehab facility. I
am seeing one of their patients for the second time so this is a great
time to call on them.
I met w/ the admissions/discharge planner and explained myself, OT and
my company. I explained that in rehab OT is typically used for above the
waist and PT is below the waist but doing this was just a matter of
convenience.
Everything is going good, right. So, I ask her about patients being
discharged with OT. Her reply?.... Very few of our patients are
discharged with OT!
As many times as I've marketed, I should be prepared for this, but I
still shake my head in bewilderment at the state of our profession. But
you know what, give the type of OT that this person received, it's no
wonder the facility doesn't order OT.
My patient, a personal friend, said that the OT did nothing but arm
exercises, both standing and sitting. The patient's diagnosis? Right hip
fracture, s/p ORIF. Her arm strength prior to accident 5/5. Was her arm
strength so greatly diminished by her 1 week hospital stay that she
needed two WEEKS of UE strengthening? NO! I told the patient to d/c the
OT but she didn't see any harm in it. Now isn't that a sad statement! I
know some of you probably think I embellish or make up these scenarios,
but I don't!!
Now, compare the above example of an OT's in-patient rehab for a hip
fracture (which by my observation is pretty common) to what Fred Somers'
says in part about our profession.
"... as a profession that offers unique services that are
ideally suited to meet the health, participation, and quality of
life needs of people of all ages, occupational therapy is
well-positioned to succeed and flourish in the 21st century."
[Fred Somers, AJOT, April, 2005, p. 127]
I'm not picking on Fred but come on. Why are our leaders saying we are
well-positioned to flourish? Why does our Framework say one thing and
many of us do something totally contrary? How does this make ANY sense
to anyone? And you know what's REALLY sad, we CAN do the above but we
have a LOT of work to do! We have so many barriers, both external and
internal, that need to come down. We MUST figure out what we are doing
and then do it!! We MUST figure out how to establish our services in a
manner that both fits and is understandable to doctors, insurance
companies and referral sources. I think PEDS and HANDS have already
wedged themselves into the market, but those of us working in general
adult rehab are getting hung out to dry!
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