Joe, that book changed my practice.

The book was part of the human occupation course that I developed and
taught at the U. of St. Augustine.  It was a required text for students!

I just recently put my Enabling Occupation PowerPoint class presentation
up on the Internet at:

www.otnow.com/resources   <Password required>

The presentation is just a primer to the book but maybe it will promote
more OT's to buy the text.

Ron

----- Original Message -----
From: Joe Wells <[EMAIL PROTECTED]>
Sent: Wednesday, March 19, 2008
To:   [email protected] <[email protected]>
Subj: [OTlist] Vote NO on Motion 1

JW> Hi Ron, Terrianne and others:

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

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

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

JW> Joe






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

JW> Hello Joe and Others:

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

JW> My primary contentions with Motion 1 are:

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

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

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

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

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

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

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

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

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

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

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

JW>         "Enabling Occupation: An Occupational Therapy Perspective"

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



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

JW>> Hi Ron:

JW>> Personally, I do not agree with RA Motion- 1, but can not completely
JW> oppose
JW>> it either. I believe it is incomplete, and needs some corrections/
JW>> clarifications. I feel that OT education must include basic sciences
JW> 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
JW> 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
JW> works
JW>> either (while working with physical disabilities). How do we use
JW> exercise as
JW>> "means" to facilitate occupation without actually knowing what
JW> 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,
JW> 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
JW> 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
JW> 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
JW> should
JW>> stop teaching (or requiring as pre-requisites) basic clinical sciences
JW> such
JW>> as anatomy, physiology, biomechanics/ kinesiology, pathology, etc.. The
JW> 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
JW> 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
JW> in
JW>> the future. Also, I fear that defeating the motion altogether (if it
JW> means
JW>> excluding the sciences) may cause insurance companies/ states (e.g.
JW>> California) to seek special certification in use of PAM, or further
JW> still to
JW>> do other procedures commonly used in physical rehab (how do we do
JW>> therapeutic exercises, manual therapies, orthotic management without
JW> having
JW>> a knowledge of the body structures/ functions)? Please note that
JW> 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
JW> service,
JW>> is paid via CPT codes or similar procedural codes that address it either
JW> 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
JW> majority
JW>> of the procedures listed under "physical medicine and rehab" codes,
JW> e.g.,
JW>> therapeutic exercises, therapeutic activities, any of the modality
JW> codes,
JW>> etc.. We need to ensure that we have all "tools" available to us and
JW> that we
JW>> are competent in the use of such tools. 

JW>> However, I agree that we do not need “advanced” education but
JW> appropriate
JW>> “basic- level” education for competent entry-level “general” practice.
JW>> Advanced education/ training such as the “CHT” are specializations. This
JW> is
JW>> true for all fields- PT, MD, DO, DDS, etc. MD’s do not learn advance
JW> 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
JW> 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
JW> for
JW>> competent entry-level practice in physical rehab (from the motion, it
JW> would
JW>> seem that we do not have a standard for one already). 


JW>> Joe Wells, OTD, OTR/L







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