Bill,
You aren't ranting, you are simply stating the truth.  My situation will 
illustrate this clearly.  8 years ago, my manager  proposed a procedure to have 
PT screen OT orders to determine appropriateness.  I fought against this policy 
successfully for 5-1/2 years.  I went out on a THREE day leave with a sick 
child and came back one day to find the other OT had agreed to the policy in my 
absence.  I was absolutely stunned.  At that time, I decided that fighting the 
policy from the outside would not change anything and decided to stay to 
facilatate change from the the inside by staying.  Also, I told them that this 
was the beginning of the devaluation of OT in this organization and that we 
would eventually be eliminated.  

Now fast forward 2 years--The OT's were downsized from 2.5 FTE's to 2.0 FTE's 
for a 700 bed hospital.  PT's are addressing most orders unless they came from 
an orthopedist, neurologist, neurosurgeon or a physiatrist.  My predictions 
have come true and I feel like I'm rearranging chairs on the Titanic.  I love 
acute care and strive to perform ONLY occupation-based intervention, but, I 
fear, it is too little, too late.  The other OT's do not espouse the same 
philosophy and just have a job.  I have a profession that I love, but sadly, we 
have shot ourselves in the foot!  

Judy Hamby, MHS, OTR/L, BCPR
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