Funny you mention UE splinting. I received a request from a HH agency for a hand surgery patient, needing OT. I am NOT an UE expert and consider my ortho hand skills to be minimal, at best. I had to tell the HH agency that I couldn't treat the patient. Now, I wonder why they would associate a hand patient with OT???
----- Original Message ----- From: Neal Luther <[email protected]> Sent: Friday, April 10, 2009 To: [email protected] <[email protected]> Subj: [OTlist] We Better Wake Up... NL> Hey Ron, NL> I've been taking a temporary break from responding but I could not agree NL> with you more. NL> It's what Deborah Aminni (sp?) (and I'm sure others) who writes a column NL> for OT Advance calls a reductionist mentality. I think she's right. NL> If, for example, we become the "go to" discipline for ue splinting this NL> has the appearance of being a good thing simply from a "keeping the NL> caseload full" perspective. In the end, however, we are reduced to NL> becoming a vendor for all things regarding splinting. NL> Case in point is a referral I received the other day who was clearly NL> documented as having no further skilled OT need by the OT a couple of NL> months ago. She did have some swallowing issues the SLP has been NL> addressing. Here comes the kicker...the pt. Kept complaining to the NL> staff and SLP about wanting another splint for her LUE. The CVA was NL> some twenty years ago. The splint however, was deemed appropriate on NL> the last referral. This time when I arrived and began my interview with NL> the pt. All she wanted was the cover to be taken off and washed. The NL> ALF facility claims they had no idea it came off. In the end I did not NL> make any further recommendations. I did review appropriate care of NL> splint with all parties. To me this was a complete waste of time. It NL> kept me busy. But what a waste of time and resources. NL> Neal C. Luther,OTR/L NL> Advanced Home Care, Burlington Office NL> 1-336-538-1194, xt 6672 NL> [email protected] NL> Home Care is our Business...Caring is our Specialty NL> P Please consider the environment before printing this e-mail NL> The information contained in this electronic document from Advanced NL> Home Care is privileged and confidential information intended for NL> the sole use of [email protected]. If the reader of this NL> communication is not the intended recipient, or the employee or NL> agent responsible for delivering it to the intended recipient, you NL> are hereby notified that any dissemination, distribution or copying NL> of this communication is strictly prohibited. If you have received NL> this communication in error, please immediately notify the person NL> listed above and discard the original.-----Original Message----- NL> From: [email protected] [mailto:[email protected]] On NL> Behalf Of Ron Carson NL> Sent: Thursday, April 09, 2009 9:17 AM NL> To: Mary Alice Cafiero NL> Subject: Re: [OTlist] We Better Wake Up... NL> Hey Mary Alice, thanks for posting. NL> I tend to be guilty of talking out of both sides of my mouth but I'm OK NL> with that. Normally, being "double minded" is a bad thing, but in this NL> case, I think it's OK. Like it or not, health care is a business and OT NL> is part of this business model. And like most businesses, it's a "dog NL> eat dog" world. As a business, OT must work VERY hard to expand its NL> presence while at the same time, restricting the efforts of others who NL> are doing the same. And while many OT's see this as a "bad" thing, it's NL> what other professions do and it's what OT MUST also do. EVERY NL> profession is literally in a war to protect itself from absorption. NL> As it stands now, OT is a very small "player" in the health care world. NL> We are not well known, even by professions who should know us. In my NL> opinion, we are not well respected, even by profession who know what we NL> do. And we do not do a good job of practicing what we preach. NL> Lastly, OT has always had a large cadre of cheerleaders within the NL> profession. In fact, it seems to me that in general OT does not do a NL> good job of receiving self-critical analysis. As a profession, it seems NL> that what we want is the sweet without the bitter. We want the cream NL> without the fat. And while that may make us feel good, it really is a NL> "head in the cloud" approach to the harsh realities of the highly NL> competitive American healthcare model. I think many OT's are happy just NL> sitting on their duff's taking whatever hand outs come their way. This NL> "welfare" model may allow us to survive, but it will NOT allow us to NL> thrive. As a play against our new brand, our profession is NOT living NL> its life to the fullest. NL> Thanks for the dialogue, I hope others join in.... NL> Ron NL> ~~~ NL> Ron Carson MHS, OT NL> www.OTnow.com NL> ----- Original Message ----- NL> From: Mary Alice Cafiero <[email protected]> NL> Sent: Wednesday, April 08, 2009 NL> To: [email protected] <[email protected]> NL> Subj: [OTlist] We Better Wake Up... MAC>> Susanne, MAC>> I have to agree with you. I don't think OTs have a lock on the NL> market MAC>> of making an activity functional. Certainly I find plenty of OTs NL> that MAC>> are threatened by PTs use of functional activity and functional NL> goals. MAC>> Interestingly, the first time I heard that PT was trying to take NL> over MAC>> OT because they dared to say they were doing functional tasks was MAC>> about 15 years ago. So far, it seems that there is plenty of room NL> for MAC>> all of us to help our patients in a variety of ways with varying MAC>> approaches/frames of reference. MAC>> It is hard to avoid feeling that many OTs who are upset by this are MAC>> "talking out of both sides of their mouth". How can we be upset NL> that MAC>> PT is frustrated when we address gait, balance, functional NL> mobility, MAC>> transfers, and even progression to different assistive devices for MAC>> ambulation when, at the same time, we are frustrated that they are MAC>> using functional language? Personally, I feel that it is splitting MAC>> hairs. MAC>> If we focus instead on helping clinicians (PT and OT) be creative NL> with MAC>> treatment approaches and individual specific goals within the MAC>> allowances of the health care system, we will be busy for years. MAC>> Instead of just sitting around moaning and groaning that there is MAC>> another therapist out there doing upper body bike exercises or pegs NL> in MAC>> putty, start where you are with education on ways to change it up a MAC>> bit. Trust me, I was in a skilled nursing rehab unit today, and saw MAC>> the usual line-up of suspects doing their upper extremity exercise MAC>> time.... was very frustrating to observe. I talked with the therapy MAC>> director and set up an inservice with the staff to talk about how NL> to MAC>> come up with treatment ideas and individual goals in their practice MAC>> setting. We shall see how it goes. MAC>> Always interested to hear everyone's opinions. Thanks for sharing! MAC>> Mary Alice MAC>> Mary Alice Cafiero, MSOT/L, ATP MAC>> [email protected] MAC>> 972-757-3733 MAC>> Fax 888-708-8683 MAC>> This message, including any attachments, may include confidential, MAC>> privileged and/or inside information. Any distribution or use of NL> this MAC>> communication by anyone other than the intended recipient(s) is MAC>> strictly prohibited and may be unlawful. If you are not the NL> recipient MAC>> of this message, please notify the sender and permanently delete NL> the MAC>> message from your system. MAC>> 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, NL> 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 NL> 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 >>> >>> >>> >>> -- >>> Options? >>> www.otnow.com/mailman/options/otlist_otnow.com >>> >>> Archive? >>> www.mail-archive.com/[email protected] MAC>> -- MAC>> Options? MAC>> www.otnow.com/mailman/options/otlist_otnow.com MAC>> Archive? MAC>> www.mail-archive.com/[email protected] NL> -- NL> Options? NL> www.otnow.com/mailman/options/otlist_otnow.com NL> Archive? NL> www.mail-archive.com/[email protected] -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
