Just a quick response. First of all, thoughtful comments from everyone. What has struck me in the past 27 years of practice, however, is that there is much of a continuum in the area of recognition or non-recognition in health care. We as OTs feel misunderstood understood and under appreciated. I have spoken to classes of music therapists, who expressed their envy at the recognition that OTs get, being included whenever governments ask for input or comments on health areas. I have also spoken to massage therapists, who feel that nobody understands what they have to offer, and even worse, mistake them for workers in the infamous massage parlours.
This is not to say that we do not need to continue to work on behalf of the profession in establishing further credibility, definition, evidence based practice, and all that other good stuff. It's just the "glass is half full" version of the picture. Mary Lou Boudreau Ron Carson wrote: > Hello Ann: > > Thanks for writing back, I enjoy your posts because you really make me > think! > > Regarding evidence of OT being swallowed up, I guess I have several sources > for my statements: > > 1. My experience working in Rehab, Home Health, Private Practice and in > Education clearly demonstrates to me that by far, the majority of people > (clients, Doctors, other therapists) have little idea of what OT is or isn't > and some have little respect for our role in client care. > > 2. Several years ago, PT Practice Guidelines expanded to include themselves > as wanting to be recognized experts in community, and home reintegration and > in self-care management. These Guidelines represent an expansion of PT > philosophy at the National level and clearly represent a challenge to OT's > traditional domain of concern. > > 3. PT's are changing their State Practice Acts to incorporate the above > guidelines. The Practice Acts provide language for what PT can legally > claim to do. Whether they can actually do it better than OT doesn't matter. > Once it's in their practice act they can legally claim expertise in the > area. > > 4. The strong separation between OT professional philosophy and actual > practice. For example, I have yet to read anywhere were OT is considered to > be upper-extremity experts. However, many OT's practice and receive > referral for injuries above the waist while PT's receive referrals for below > the waist injuries. This separation of Philosophy and Practice drives a > severe wedge in our profession and makes us weak (in my opinion). > > 5. Several articles published in the last 10 years or so which suggest the > possible demise of OT unless changes are made in our practice patterns. If > you are interested, I will provide some references. In fact, I have OTD > students read some of the articles. > > 6. Numerous discussion I have heard and participated in regarding the fusion > of OT and PT into a single profession. > > 7. OT not being able to open Medicare home health case speaks volumes of our > diminishing role in that arena of care. > > 8. The migration of Mental Health OT's out of traditional Psychs settings. > This left a tremendous gap in psych services which has been filled (in many > cases) by non-skilled technicians. > > 9. Several published articles discussing the ill-fit of OT and the medical > model of care > > Finally, Ann, I don't think that OT is alone with its professional identity > battles. Even PT has ongoing debate about the nature of their professional > identity. And, I don't think all is ill with OT. Like other readers have > pointed out, their are MANY, MANY OT's who are working hard to make ends > meet and thriving in the mass market of 3rd party reimbursement. My hat > goes off to all of them! And, I certainly don't mean to slander any single > therapist. I guess, if anything that is written on this list applies to a > reader then they may want to consider what's said. If what's written > doesn't apply, then maybe readers should just take it with the grain of salt > and go on with business as usual. > > Take care and I look forward to more discussion. > > Ron > > ~~~~~~ > On Monday, April 22, 2002, [EMAIL PROTECTED] wrote: > > Dac> Ron- I think there are a fair number of OTs that feel the way that you do, > Dac> but frankly, I'm quite surprised that is your personal reason. In the past, > Dac> your posts have made it quite clear that you see the roles of OT and PT as > Dac> very different, and have stated that you feel one of the "problems" in our > Dac> profession are OTs who function more as PTs. I would think those OTs would > Dac> be the ones most threatened by a better known PT profession "stealing" away > Dac> their business. > > Dac> To which practice areas do you feel that your scenario applies? It seems to > Dac> me that this potential situation would occur primarily in the outpatient > Dac> arena, and frankly, there are many clients treated in outpatient PT programs > Dac> who are most appropriately seen by PTs. In a school setting, at least in my > Dac> experience, the OTs are as well known as the PTs, and sometimes more likely > Dac> to be called upon. In a rehab. center, every patient is exposed to the > Dac> entire interdisciplinary team, not just PT. In an acute care hospital, there > Dac> are frequently critical pathways that have referrals built in for OT for > Dac> certain diagnoses like CVA, and while the OTs often play a smaller role, it > Dac> is quite possible for proactive, effective OTs to expand their role, and the > Dac> awareness of the MDs, by offering meaningful functional suggestions for their > Dac> patients. The same goes for home care. Non traditional, non-medical model > Dac> settings are not traditionally areas that PT gets as involved in, except > Dac> maybe work hardening. I think that area is as open to OT as it is to PT, > Dac> depending on the marketing skills of the individual therapist. Again, I am > Dac> not stating that I think we are necessarily well known, or that there aren't > Dac> MDs out there who don't know what we do, but at the places I have > Dac> worked(rehab., outpatient, home care, school, preschool, long term care), the > Dac> MD is not the only referring source. The nurses, teachers, OTs, and SLPs > Dac> have all referred patients to me in these various settings. Developing a > Dac> good relationship to them and letting them see what I can do for their > Dac> patients has led to these referrals increasing. Working within the medical > Dac> model(or the educational one) rather than trying to impose a purely > Dac> occupational model on them has also helped strengthen these working > Dac> relationships, as we are all "talking the same language" > Dac> On a different note, in your reply to Irene, you state: > Dac> 1. I believe OT may be in danger of being 'swallowed up' if we don't make > Dac> some fundamental changes > Dac> 2. I love OT and hate to see it disappear > Dac> What evidence do you have that either of these things is happening, or that > Dac> PT thriving in their profession is going to result in OTs demise? > Dac> Ann > > Dac> *********ой*********** > > Dac> Unsubscribe? Send a message to [EMAIL PROTECTED] > > Dac> In the message's *body*, put the following text: unsubscribe OTlist > > Dac> ** List messages are archived at: > > Dac> http://www.mail-archive.com/otlist@otnow.com > > Dac> *********ой*********** > > *********ой*********** > > Unsubscribe? Send a message to [EMAIL PROTECTED] > > In the message's *body*, put the following text: unsubscribe OTlist > > ** List messages are archived at: > > http://www.mail-archive.com/otlist@otnow.com > > *********ой***********
begin:vcard n:Boudreau, M.Sc., O.T. Reg. (Ont);Mary Lou tel;fax:(613) 384-4851 tel;work:(613) 384-6633 x-mozilla-html:FALSE org:Adaptive Aids & Falls Prevention Project adr:;;1049 Old Colony Road;Kingston;ON;K7P 1M3; version:2.1 email;internet:[EMAIL PROTECTED] title:Program Coordinator fn:Mary Lou Boudreau, M.Sc., O.T. Reg. (Ont) end:vcard
