Title: RE: Re[2]: Dichotomy of teaching OT

Ron,

Just remember that facilities are in business to make money. Don't be picky. PT is not picky. If it comes down to budget cuts and the value of rehab services, because you turn down requests for service, OT will be the first to go. Then, PT will the only rehab profession at this facility doing their work and OT also. Yes, the referral might have been for UE tightnes, which effects occupation. Accepting this referral would have been a perfect opportunity to demonstrate the value of OT and the use of occupation in physical rehab.

Irene

-----Original Message-----
From: Ron Carson [mailto:[EMAIL PROTECTED]]
Sent: Wednesday, October 02, 2002 10:15 AM
To: Dana Levinson
Subject: Re[2]: Dichotomy of teaching OT


Hello Dana:

I  don't  necessarily disagree with all you say but I do NOT think that as a
professional  organization,  we market ourselves as being UE experts. AOTA's
web site, state practice acts, etc talk about meaningful activity, function,
ADL's,   etc,   they  don't  talk  about  neurological  and  musculoskeletal
impairments  as  the primary focus of our concern. And yet, on the practice
front, we practice as if we are UE experts in physical medicine.

I  am not a social occupational therapist, I am an occupational therapist. I
try  to  do  what  it  is  the professional organization says we do. I don't
exclude  biophysical  from  my practice area, but it's not the reason for my
treatment. I think we can spend many e-mail discussing what it is we do, but
let  me  ask you a question; "When you receive a client referral, how do you
know if that client is appropriate for OT treatment?"

With  regard  to  focusing on both ends of the continuum, I don't think
that's  a  viable  option.  I  believe  that  as  a profession, we must
identify which end from which we want to operate. As far as I can tell,
we  will  NEVER  be  seen  as orthopedic experts because that market is
already  full.  However, the market for expertise in occupation is wide
open and all we need do is step through the door.

Yesterday,  I  received  a  hospice referral for a woman with bilateral
upper  extremity  tightness.  The  therapy  director  told  me that she
thought  of  me  first but that either an OT or PT could go. I told the
director  that  if  the  primary complaint is upper extremity tightness
then  she should send a PT. Now, some OT's think I'm crazy, but I think
it's  the right choice. I don't want to receive referrals because of UE
problems, I want referrals because of occupational problems.

Ron

============================================

On 10/1/2002, [EMAIL PROTECTED] said:


DL> Ron,

DL>  You're what I call a "Social Occupational Therapist," the OT version of
DL> a   Social   Psychologist.   The  other  type  of  psychologist  is  the
DL> BioPsychologist.  In  my  opinion,  there  is  a tremendous lack of "Bio
DL> Occupational  Therapists."  In  essense,  the difference is studying the
DL> field  at  a  Macro  vs. Micro Level. This has been a deep debate in the
DL> Philosophy  of  Science. Which is better? Which is necessary? The answer
DL> is both.

DL>  Imagine what psychology would be if purists took over. The entire field
DL> would be doing psychoanalysis. What made Psychology such a booming field
DL> is that they expanded their scope of research and practice... So much so
DL> that  there is an entire medical specialty (Psychiatry, obviously) based
DL> on Biopsychology.

DL>  Here's  what  it  comes  down  to...  You  want  to focus on Occupation
DL> (Macrolevel)...  But  occupation  is  accomplished  through  micro-level
DL> processes  (e.g.,  UE strength). IMHO, if OT wants to grow, it will need
DL> to be thoroughly knowledgeable at both micro and macro levels. What will
DL> distinguish  us  from  PT  is that we can (and will hopefully) focus our
DL> efforts at both levels while PT focuses on only the micro level.

DL> Just my opinion.

DL> Dana



DL> On Tue, 1 Oct 2002 11:03:52 -0400, Ron Carson wrote:
>>Today, �in �my �human occupation class, I spent a solid hour
>>discussing
>>occupational �performance as it relates to role competence. The
>>theory,
>>as � written � in �Christiansen �and �Baum's, �"Enabling �Function
>>and
>>Well-being", �is �that �humans �engage �in �occupation �in �order to
>>be
>>competent �at �their �roles. �And that role competence is a
>>fundamental
>>drive �of �healthy humans. The point of the lecture is to help
>>students
>>begin �to �gather �some �understanding of the necessity, complexity
>>and
>>depth of enabling occupation in their future clients.
>>
>>At �the �completion �of �class, �a �student �held �up a poster that
>>was
>>requesting �volunteers �or �announcing a presentation or something.
>>The
>>research and poster were about UE Muscle Strength. I asked the
>>students
>>if �they �were �confused by this dichotomy that we had just had a
>>class
>>about �human �occupation �and �why �OT �should �not �be �practiced
>>like
>>upper-extremity PT and then to be doing research on UE function.
>>
>>One �student �responded �that �it �was �confusing and the other
>>student
>>seemed �confused. �And �frankly, I'm confused!! It seems like some
>>OT's
>>see �UE function as our trademark practice pattern while other OT's
>>see
>>occupation �as �our �trademark. �I �am �confused by this situation,
>>can
>>anyone help??????
>>
>>Thanks,
>>
>>Ron
>>
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DL> Dana Levinson
DL> Rehab Science, Inc.
DL> http://www.rehabscience.com/
DL> [EMAIL PROTECTED]

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