Hi Ron, Terrianne and others:

Thank you for clarifying that you are in favor to retain the basic sciences
and do advocate more of it.

I agree that if the Motion is written the way it is, we will be limiting
ourselves to just UE rehab when our practice acts and OT Practice Framework
allows for a broad, all encompassing practice. For entry-level, I do believe
that OTs should have a broad knowledge of the whole body and not just UEs,
and then move on to specialization if they wish to. 

Ron, thank you for recommending the book. I read it a few years ago. I think
this should be a part of our curriculum.  I love the book.

Joe






-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf
Of Ron Carson
Sent: Wednesday, March 19, 2008 6:23 AM
To: Joe Wells
Subject: [OTlist] Vote NO on Motion 1

Hello Joe and Others:

Terrianne is right. I am not asserting that basic sciences have no place
in our education. In fact, I am 100% confident that we need MORE basic
science, but not focused on the UE (Upper Extremity).

My primary contentions with Motion 1 are:

1) It is authored by 3 CHT's. (Certified Hand Therapist)

        a. I am not against CHT, but I do not think they should
        represent general entry-level education.

        b. They are specialized in the UE so don't represent LE anatomy.
        Which is where I think OT's need much more training!

2) The language of Motion 1 indicates that increased sciences are needed
for UE Rehab

        a. Obviously, I do not believe that UE rehab should be the
        primary role of general physical disability rehab

3) The Motion asserts that OT will "retain and strengthen our presence
in these practice areas by providing science-driven OT services."

        a. This is no doubt true. But I do NOT believe that OT will ever
        successfully compete with PT by focusing our treatment on the
        UE. (And yes, PT services is one of our competitors)

The bottom line is that I am 100% opposed to the profession of OT
becoming further identified as upper extremity experts. All of us
working in phsy-dys know that this is the way that most of us practice
anyway. In fact, it is already the way many, many OT programs train
their students. It is the way I was trained in and it is the way the
University I taught at trained students.

This Motion moves OT away from occupation (which categorically includes
UE and LE) towards UE rehab (which categorically denies the LE).

I also want to clarify that occupation-focused treatment may include UE
rehab, but UE rehab does not include occupation.

As a reference to my treatment philosophy, I HIGHLY recommend the
following book:

        "Enabling Occupation: An Occupational Therapy Perspective"

Thanks,
        
Ron Carson MHS, OT
www.otnow.com/motion1



----- Original Message -----
From: Joe Wells <[EMAIL PROTECTED]>
Sent: Tuesday, March 18, 2008
To:   [email protected] <[email protected]>
Subj: [OTlist] More Thoughts on Motion-1

JW> Hi Ron:

JW> Personally, I do not agree with RA Motion- 1, but can not completely
oppose
JW> it either. I believe it is incomplete, and needs some corrections/
JW> clarifications. I feel that OT education must include basic sciences
that
JW> not only include occupational science but also the "whole body" anatomy/
JW> physiology/ biomechanics and kinesiology versus just for the upper
JW> extremities. I thought this was already the case as in my bachelor’s
JW> curriculum (’90-’95) did include all but Occupational Science (which I
was
JW> glad to have later for my OTD) until I saw the motion. I agree that
JW> "occupation" is our major domain, but I do not believe that we can truly
JW> facilitate that without knowing the basics of how our physical system
works
JW> either (while working with physical disabilities). How do we use
exercise as
JW> "means" to facilitate occupation without actually knowing what
structures
JW> you need to work on? What desired effect is intended? How do the
JW> inappropriate use of cones/ dumbbells (that we have either witnessed,
heard
JW> of, or personally are guilty of doing at times, either in the name of
JW> occupation or exercise or human performance or whatever else we
personally
JW> choose to call them) reflect on our profession’s competence in physical
JW> rehab already? Please note: these very same “props”- the cones or
dumbbells
JW> could very well be used appropriately in our treatments as well. 

JW> Ron, I hope by opposing this motion you do not mean that OT schools
should
JW> stop teaching (or requiring as pre-requisites) basic clinical sciences
such
JW> as anatomy, physiology, biomechanics/ kinesiology, pathology, etc.. The
OT
JW> Practice Framework states OTs have knowledge of "body structures/ body
JW> functions". How do we intend to get this knowledge when we plan to
eliminate
JW> the required foundation in basic sciences that make us ‘clinicians’? As
JW> aspired in our centennial vision, we must be science- driven. Our
JW> treatments/ purpose must be strongly founded in science for us to thrive
in
JW> the future. Also, I fear that defeating the motion altogether (if it
means
JW> excluding the sciences) may cause insurance companies/ states (e.g.
JW> California) to seek special certification in use of PAM, or further
still to
JW> do other procedures commonly used in physical rehab (how do we do
JW> therapeutic exercises, manual therapies, orthotic management without
having
JW> a knowledge of the body structures/ functions)? Please note that
currently
JW> under Medicare, Medicaid and other health insurances, "Occupation" as an
JW> unique experience by the client, and as an outcome/ product of our
service,
JW> is paid via CPT codes or similar procedural codes that address it either
in
JW> a more direct manner, e.g., self-care management training, community
JW> reintegration program, or in a rather indirect manner as with the
majority
JW> of the procedures listed under "physical medicine and rehab" codes,
e.g.,
JW> therapeutic exercises, therapeutic activities, any of the modality
codes,
JW> etc.. We need to ensure that we have all "tools" available to us and
that we
JW> are competent in the use of such tools. 

JW> However, I agree that we do not need “advanced” education but
appropriate
JW> “basic- level” education for competent entry-level “general” practice.
JW> Advanced education/ training such as the “CHT” are specializations. This
is
JW> true for all fields- PT, MD, DO, DDS, etc. MD’s do not learn advance
hand
JW> surgical techniques for general practice. We should not seek “advanced”
JW> professional expertise with entry-level education. The question then is-
JW> does our current curriculum prepare students with adequate skills to
enter
JW> the field to practice in physical rehab?

JW> In my opinion, the motion should be re-written to ensure appropriate
JW> curricula is followed in schools pertaining to basic clinical sciences
for
JW> competent entry-level practice in physical rehab (from the motion, it
would
JW> seem that we do not have a standard for one already). 


JW> Joe Wells, OTD, OTR/L







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