Susanne,
I have to agree with you. I don't think OTs have a lock on the market
of making an activity functional. Certainly I find plenty of OTs that
are threatened by PTs use of functional activity and functional goals.
Interestingly, the first time I heard that PT was trying to take over
OT because they dared to say they were doing functional tasks was
about 15 years ago. So far, it seems that there is plenty of room for
all of us to help our patients in a variety of ways with varying
approaches/frames of reference.
It is hard to avoid feeling that many OTs who are upset by this are
"talking out of both sides of their mouth". How can we be upset that
PT is frustrated when we address gait, balance, functional mobility,
transfers, and even progression to different assistive devices for
ambulation when, at the same time, we are frustrated that they are
using functional language? Personally, I feel that it is splitting
hairs.
If we focus instead on helping clinicians (PT and OT) be creative with
treatment approaches and individual specific goals within the
allowances of the health care system, we will be busy for years.
Instead of just sitting around moaning and groaning that there is
another therapist out there doing upper body bike exercises or pegs in
putty, start where you are with education on ways to change it up a
bit. Trust me, I was in a skilled nursing rehab unit today, and saw
the usual line-up of suspects doing their upper extremity exercise
time.... was very frustrating to observe. I talked with the therapy
director and set up an inservice with the staff to talk about how to
come up with treatment ideas and individual goals in their practice
setting. We shall see how it goes.
Always interested to hear everyone's opinions. Thanks for sharing!
Mary Alice
Mary Alice Cafiero, MSOT/L, ATP
[email protected]
972-757-3733
Fax 888-708-8683
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On Apr 8, 2009, at 6:05 AM, susanne wrote:
Hi Ron!
Me, I'm usually happy when a PT is also observant of occupational
stuff - IMO makes their treatment more meaningful for the patient, and
helps the cooperation when both PT and OT services are
involved/available. But from there, and to advertising their services
as such - that's a stretch, I agree!
A recent example of the dangers of PT not being observant of
occupational stuff:
New PT has first treatment with a patient (quadriplegic) seen by other
PTs for years, mostly for PROM. She asks the patient about previous
treatment and preferences, but seems very much wanting to change it
regarding the paralyzed hands, which she also wants to do PROM to -
finding them much "curly" - she even starts stretching one hand while
he's looking away. At that point I could not hold myself back
anymore:-) - and explained to her how the curliness of the hands was
what made it possible for him to hold and use things like eating
utensils, cups, typing sticks, and that the hands even had been taped
in rehab to get just the right curl/tightness.
Or, maybe it's just an example that if you have a hammer, everything
looks like a nail - anyway, we all ended up agreeing that she'd stick
to treating LE:-)
Warmly
susanne, denmark
---- Original Message ----
From: "Ron Carson" <[email protected]>
(snip)
............Shouldn't PT's scope of practice be limited to
remediation
of physical dysfunction and OT's scope of practice be
limited to occupational dysfunction? Doesn't this make sense and
sound right? It does to me!
Thanks,
Ron
~~~
Ron Carson MHS, OT
www.OTnow.com
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