Well said, Chris. 


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listed above and discard the original.-----Original Message-----
From: [email protected] [mailto:[email protected]] On
Behalf Of [email protected]
Sent: Saturday, June 13, 2009 12:08 AM
To: [email protected]
Subject: Re: [OTlist] Dental Hygienst Knows About OT...

I see the horse is not dead yet!!!!

This age old debate revolves around the top down approach and the 
bottom up approach to treatment, or the occupation as a means or an 
end.  We as OTs in physical disabilities can choose either to treat 
occupational dysfunction in two ways a) Use occupations as the 
treatment modality to combat the issue of occupational dysfunction 
either through restoration or compensation or b) Treat the underlying 
impairment.  In my opinion it simply depends on what is causing the 
occupational dysfunction.  If an occupational takes an interest in hand 
therapy and they decide to specialize in this area (PTs can do this 
too) then I would say that the occupational therapist is doing hand 
therapy.  I would not state that they are doing physical therapy 
because this is a gray area.  Perhaps a physical therapist takes an 
interest in visual perceptual training ( my PT friend did) because of 
their strong background in neurorehabilitation.  When they utilize this 
training during treatment sessions to facilitate better outcomes with 
gait and balance, would they state that they are doing occupational 
therapy? What if a PT takes a liking to driving evals and training 
(IADL),. Would they call it occupational therapy or drivers training?

What Ron is simply trying to do is change the paradigm of occupatonal 
therapy and simply rewrite the textbooks we once read in school, by 
erasing the biomechanical model.  I applaud him to a certain extent, 
but at times I an confused by his reasoning.

Hand Therapy does not necessarily mean a cone or peg pusher therapist.  
A Hand therapist does not necessarily give the pubilic a certain image 
of what OT is , but it is the misguided therapist that provides OT 
without meaning in order complete enough time to reach a certain RUG 
level or complete the "Three hour rule".  I do not think it is Ron's 
intent to upset all of the OTs who practice hand therapy, but to guide 
phys dys OTs to provide meaning during their therapy sessions in order 
to clean up the public perception of what we do.

Chris Nahrwold MS, OTR..

-----Original Message-----
From: Ron Carson <[email protected]>
To: Kristin <[email protected]>
Sent: Fri, 12 Jun 2009 10:04 pm
Subject: Re: [OTlist] Dental Hygienst Knows About OT...

Kristin, I don't really know where to start, so let me just jump in.

In  my  opinion, the BIGGEST problem facing OT is that we do not do what
we  say  we do. Comparing AOTA's rhetoric and practice patterns of adult
phys  dys  OT's  does  not  paint  a congruent picture. On paper, the OT
profession  is  all about occupation. In practice, adult phys dys is all
about UE rehab. For me, this inconsistency is killing our profession!

I'm going to disagree with some of what you've written:

 1) A broken finger may or may not cause occupational deficits. And even
 if  it does, these deficits may not require the skill of an OT.

  2) I don't care if the hygienist had a good or bad experience. I do 
care
 if the experience revolved around occupation.

 3)  Occupation  should  NOT be things talked about during rote therapy.
 Occupation should be the FOCUS and outcome of treatment.

 4) The profession needs therapists who are experts in occupation. Leave
 the UE specialization to PT.

Disclaimer:

        My  comments  are  not  directed towards YOU. They are just
        general comments about how I feel towards OT.

        Everyone  is  welcome  to  join  this conversation. Only through
        honest  and  logical  dialogue  will  we  better  understand and
        appreciate everyone's viewpoints.

Thanks,

Ron

~~~
Ron Carson MHS, OT
www.OTnow.com



----- Original Message -----
From: Kristin <[email protected]>
Sent: Thursday, June 11, 2009
To:   [email protected] <[email protected]>
Subj: [OTlist] Dental Hygienst Knows About OT...


K> I guess I dont understand why it's such a horrible thing for OT's to
K> be knowledgeable and profiecient in treating UE ailments. I agree
K> that shouldn't be the only area for the profession to focus on, but
K> having a broken finger causes dysfunctional occupational performance!
K> At least the dental hygenist had a good experience with OT as opposed
K> to the 'cone therapists'. I would be interested to hear if the
K> therapist discussed what the patient could do at home to reduce pain
K> and improve function. The things we should be talking about when
K> performing more rote therapy techniques.
K> I think the profession needs OT's who are UE specialists! We don't
K> want to loose that specialty area!

K> Kristin



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