Hi Ron: Personally, I do not agree with RA Motion- 1, but can not completely oppose it either. I believe it is incomplete, and needs some corrections/ clarifications. I feel that OT education must include basic sciences that not only include occupational science but also the "whole body" anatomy/ physiology/ biomechanics and kinesiology versus just for the upper extremities. I thought this was already the case as in my bachelor’s curriculum (’90-’95) did include all but Occupational Science (which I was glad to have later for my OTD) until I saw the motion. I agree that "occupation" is our major domain, but I do not believe that we can truly facilitate that without knowing the basics of how our physical system works either (while working with physical disabilities). How do we use exercise as "means" to facilitate occupation without actually knowing what structures you need to work on? What desired effect is intended? How do the inappropriate use of cones/ dumbbells (that we have either witnessed, heard of, or personally are guilty of doing at times, either in the name of occupation or exercise or human performance or whatever else we personally choose to call them) reflect on our profession’s competence in physical rehab already? Please note: these very same “props”- the cones or dumbbells could very well be used appropriately in our treatments as well.
Ron, I hope by opposing this motion you do not mean that OT schools should stop teaching (or requiring as pre-requisites) basic clinical sciences such as anatomy, physiology, biomechanics/ kinesiology, pathology, etc.. The OT Practice Framework states OTs have knowledge of "body structures/ body functions". How do we intend to get this knowledge when we plan to eliminate the required foundation in basic sciences that make us ‘clinicians’? As aspired in our centennial vision, we must be science- driven. Our treatments/ purpose must be strongly founded in science for us to thrive in the future. Also, I fear that defeating the motion altogether (if it means excluding the sciences) may cause insurance companies/ states (e.g. California) to seek special certification in use of PAM, or further still to do other procedures commonly used in physical rehab (how do we do therapeutic exercises, manual therapies, orthotic management without having a knowledge of the body structures/ functions)? Please note that currently under Medicare, Medicaid and other health insurances, "Occupation" as an unique experience by the client, and as an outcome/ product of our service, is paid via CPT codes or similar procedural codes that address it either in a more direct manner, e.g., self-care management training, community reintegration program, or in a rather indirect manner as with the majority of the procedures listed under "physical medicine and rehab" codes, e.g., therapeutic exercises, therapeutic activities, any of the modality codes, etc.. We need to ensure that we have all "tools" available to us and that we are competent in the use of such tools. However, I agree that we do not need “advanced” education but appropriate “basic- level” education for competent entry-level “general” practice. Advanced education/ training such as the “CHT” are specializations. This is true for all fields- PT, MD, DO, DDS, etc. MD’s do not learn advance hand surgical techniques for general practice. We should not seek “advanced” professional expertise with entry-level education. The question then is- does our current curriculum prepare students with adequate skills to enter the field to practice in physical rehab? In my opinion, the motion should be re-written to ensure appropriate curricula is followed in schools pertaining to basic clinical sciences for competent entry-level practice in physical rehab (from the motion, it would seem that we do not have a standard for one already). Joe Wells, OTD, OTR/L -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Ron Carson Sent: Tuesday, March 18, 2008 3:28 PM To: OTlist Subject: [OTlist] More Rationale For Voting Against Motion 1 In my opinion, OT is NOT competitive in rehab. It never has been and never will be IF we try competing with PT, which is what Motion 1 is trying to do. The skills required for UE rehab are not unique to OT and in my opinion is not something that we should even strive for. In my opinion, OT's are stifling themselves by trying to be UE experts. First off, being an UE expert is 100% inconsistent with our Framework. secondly, our UNIQUE contribution to health care is OCCUPATION. Occupation is our bread and butter and has the potential to BREAK OPEN our inability to to be highly competitive in physical disabilities. The inconsistency between what OT says it does and what is actually does is killing us. Our feet are standing in quicksand and ever shifting. We do NOT have a solid base and NEVER will for as long as we are not consistent with our Framework. We should not go around training new therapists and acting like UE experts if such behavior is NOT supported by our theoretical foundations. Years ago when occupational science was formed, I saw it as a wonderful opportunity for OT to advance itself. Unfortunately, it is evident that many, many OT's are still resistant to such science. There are many sciences more important to OT than basic sciences. OT will never be respected as having advanced musculo-skeletal knowledge, that is PT; They are the musculo-skeletal experts. We are burning our bridges if we try pursuing that profession. We have an opportunity to forge a NEW road that MAKES PROFOUND DIFFERENCES in our patient's lives, and not just those patient's with UE deficits. Think about all the times you or other therapists have wasted patient's time and money by doing UE cones, pegs, balloons, etc. I am sure other professions laugh at us when they see us acting in such manner. Why do we do this? It's because we have segregated ourselves into UE "experts" and so that's all we know to do. We need to bust ourselves free from the shackles of our predecessors and advance ourselves forward towards the Centennial Vision. Continued specialization in UE rehab is not advancement, it's a hindrance to our profession and to our patients. <p.s. please disregard grammatical errors> Ron Carson MHS, OT www.otnow.com/motion1 -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.5.516 / Virus Database: 269.21.7/1329 - Release Date: 3/14/2008 12:33 PM No virus found in this outgoing message. Checked by AVG Free Edition. Version: 7.5.516 / Virus Database: 269.21.7/1329 - Release Date: 3/14/2008 12:33 PM -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
