Hey Mary Alice, thanks for posting.

I  tend to be guilty of talking out of both sides of my mouth but I'm OK
with  that.  Normally, being "double minded" is a bad thing, but in this
case,  I think it's OK. Like it or not, health care is a business and OT
is  part  of  this business model. And like most businesses, it's a "dog
eat  dog"  world.  As  a  business, OT must work VERY hard to expand its
presence  while  at the same time, restricting the efforts of others who
are  doing the same. And while many OT's see this as a "bad" thing, it's
what  other  professions  do  and  it's  what  OT  MUST  also  do. EVERY
profession is literally in a war to protect itself from absorption.

As  it stands now, OT is a very small "player" in the health care world.
We  are  not  well  known, even by professions who should know us. In my
opinion,  we are not well respected, even by profession who know what we
do. And we do not do a good job of practicing what we preach.

Lastly,  OT  has  always  had  a  large cadre of cheerleaders within the
profession.  In  fact,  it  seems to me that in general OT does not do a
good  job of receiving self-critical analysis. As a profession, it seems
that  what  we  want  is the sweet without the bitter. We want the cream
without  the  fat.  And while that may make us feel good, it really is a
"head  in  the  cloud"  approach  to  the  harsh realities of the highly
competitive  American healthcare model. I think many OT's are happy just
sitting  on  their duff's taking whatever hand outs come their way. This
"welfare"  model  may  allow  us to survive, but it will NOT allow us to
thrive.  As  a  play against our new brand, our profession is NOT living
its life to the fullest.

Thanks for the dialogue, I hope others join in....

Ron

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

----- Original Message -----
From: Mary Alice Cafiero <m...@mac.com>
Sent: Wednesday, April 08, 2009
To:   OTlist@OTnow.com <OTlist@OTnow.com>
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 market  
MAC> of making an activity functional. Certainly I find plenty of OTs that  
MAC> are threatened by PTs use of functional activity and functional goals.  
MAC> Interestingly, the first time I heard that PT was trying to take 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 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 that  
MAC> PT is frustrated when we address gait, balance, functional 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 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 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 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> m...@mac.com
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 this  
MAC> communication by anyone other than the intended recipient(s) is  
MAC> strictly prohibited and may be unlawful. If you are not the recipient  
MAC> of this message, please notify the sender and permanently delete 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, 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" <rdcar...@otnow.com>
>> (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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>>
>> Archive?
>> www.mail-archive.com/otlist@otnow.com

MAC> --
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