Bill,  I  am  still digesting your message, but I want to make a quick
comment.

Earlier,  someone  asked  how  OT became cornered into UE treatment. I
don't  KNOW  the  answer but now I'm wondering if productivity demands
aren't part of the reason.

Any opinions out there?

Ron

----- Original Message -----
From: Bill Maloney <[EMAIL PROTECTED]>
Sent: Saturday, October 18, 2008
To:   [email protected] <[email protected]>
Subj: [OTlist] OTlist Digest, Vol 43, Issue 17

BM> OK, time for me to chime in.  Been reading long enough, and felt the need to
BM> offer some thoughts, hopefully insightful and helpful but more than anything
BM> else just an "amen", to this thread.

BM> The productivity "problem" isn't unique to HH, or any other profit-driven
BM> setting.  And, let's not kid ourselves here people....we hear all the fancy
BM> mission statements and "recruiter speak" from any/all organizations; and,
BM> while they sound good, at the end of the day the ONLY mission that matters
BM> is PROFIT.  Like it or not, agree or not, that is the FACT.  It's no wonder
BM> that those clinicians (of whichever discipline) who support that mission are
BM> the stars.  So, there obviously is no solution to this situation.

BM> I've been fortunate enough over the years to dodge disciplinary action due
BM> to low productivity (which is almost a forgone conclusion if you focus on
BM> quality of care, or if the employer has low OT census).  And, for what it's
BM> worth Ron, my current HH employers productivity standard for OT is 32
BM> points/week (OT initial evaluation counts as 1.5 points and subsequent
BM> visits are weighted as 1).  I have, for the past year and a half of
BM> employment, consistently run around 20 to 25 points.  Of course, many of my
BM> PT colleagues run higher than that for the same reason you mentioned, they
BM> do 10 to 15 minute visits (yes, this is verified and factual).  I have
BM> personally witnessed nurses do 5-minute visits.  BUT, I literally cannot
BM> tell you how many patients say, unsolicited, to me things like, "I get so
BM> much more out of your visits than that other guy/gal."  Duh!  Of course they
BM> do!!!  I am actually taking the time to listen, intervene, teach, treat,
BM> care...provide a valuable and obviously relevant (to them) service.  This
BM> gets back to my employers, via various avenues, and I guess the positive PR
BM> in some ways outweighs the productivity deficit.  I can relate to what you
BM> said, Ron, when you leave a patients home sweating and exhausted from your
BM> beautiful efforts, and the only feedback you get from the boss is that your
BM> productivity is low.  All the while, the clinicians who exceed the quota,
BM> yet SUCK clinically and ethically, get the praise!  It's honestly so
BM> disgusting at times, I wonder why I/we bother.  But then I remember that
BM> little man/woman who looks me right in the eye and tells me, in their own
BM> words how much they appreciate what I do.  That may not immediately impact
BM> others' knowledge of "what OT is" but I truly believe it's a start.  I know
BM> that doesn't "solve" our plight, but isn't that why we do what we do
BM> anyway?  At some point, I/we have to believe that we'll impact a difference
BM> in this grass-roots way.

BM> There is a new OT publication beginning circulation, "Today in OT" (GHG
BM> Gannett Healthcare Group, a subsidiary of Gannett Company, Inc. [USA Today])
BM> which ended up in  my mailbox this week.  I also get "Advance for
BM> Occupational Therapy Practitioners" but not sure how these find me since I
BM> am not a current member of AOTA, or the Texas OT Assn. (a story for another
BM> time I suppose).  I am not a literature snob, but know that these are not
BM> the benchmark references for evidence-based practice.  But some of the
BM> articles are interesting, informative and thought-provoking nonetheless.
BM> Interestingly enough, one article in particular in "Today in OT" entitled
BM> "Improving Your Ability to Think Critically" was written by an RN who was
BM> highlighting OTs in particular for this being a leader in this skill.  Also,
BM> the cover article was entitled, "By Leaps and Bounds - OT gains momentum as
BM> one of the best professions."   I have to believe that at some point OT will
BM> evolve into what we all want and so richly have earned through our daily,
BM> grass-roots struggles.

BM> While I acknowledge my posting has not solved or resolved anything, I hope
BM> that I have placed at least a small amount of "hoorah" in your day.  Hang in
BM> there.  By the read of these postings, our profession is in good hands.  I
BM> believe there are enough of us out here who practice sound, evidence-based
BM> and relevant Occupational Therapy to advance our profession.  I enjoy
BM> reading these posts, so keep 'em coming.

BM> Bill Maloney, OTR
BM> Dallas, Texas





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