Chris and Ron, 

I've  been  monitoring  your responses on the list here and I appreciate
the  discussion.  Chris,  your  points  on creating a culture, fostering
interdisciplinary  relationships,  and  earning  respect  with hard work
and effective  treatment are very much similar to my experience over the
years.

I agree wholeheartedly and have had many many similar experiences. I the
departments  that  I  have  worked the OT/PT/SLPs have all shared common
treatment   and  office  areas  and  we  communicate,  collaborate,  and
socialize  all the time. Like you Chris I've worked hard to earn respect
by  being (hopefully) a good example. Giving good OT where warranted and
getting  out  when  needed.  Some of the PT/OTs with less experience are
into  the  separation and treatment turf issues but they soon warm up to
the  value  of  creative  collaboration.     

If  you  look at the PPS/SNF system from a strickly business perspective
(which  I rarely do), you will see that the pt gets more opportunity for
beneficial   therapy  time  on  a  greater  variety  of skills  and  the
Department  gets  more  financial  benefit  from the involvement of more
services i.e. RUGS category $$$.

So  it's  win(PATIENT)-win(OT)-win(PT)-win(Administration) when teamwork
is   applied.   You   often   can   throw  in  a  win(Nursing)  when  we
involve-educated-collaborate with them.  I know I sound like a PollyAnna
but I know this concept to be true.    

The  problem  is  often  the  situation  when  PT  or OT continues to be
involved  when  a  pt  really  no longer progresses or benefits from the
skilled  service.  Then...out  comes the bad therapy practices we've all
complained  about on this list. As Breanne stated in her post, there are
companies  that  want  you to go "Create referrals through screening" or
"keep  the  pt  for  a  longer  length of stay". It's these bad clinical
decisions    that    create    the    treatment    that    causes   such
misperceptions/misunderstanding/disrespect   amongst   the  health  care
community.      

Last  time I looked there is a enough appropriate and meaningful work to
be  done  for  all of us to work together in the Rehab industry.  I have
had my moments of  professional doubt base on the types of patients that
end  up  in  SNF  (see earlier post) but I've seen a lot of good overall
practice come from a well run Rehab department.     

Another  point  that  often  irks  me   in  these  discussions  is  this
preoccupation  (pardon the pun) with being "unique" and "understood". To
me  being "effective" and "relevant" is more important to the healthcare
market   place.  As  Chris  alluded  to  about   community  respect  and
education ..a  profession's  impact is built one customer at a time, one
session at a time.

Thanks for reading, and posting,

Stir the pot!

Brent
     




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