Hey Ron, I've been taking a temporary break from responding but I could not agree with you more. It's what Deborah Aminni (sp?) (and I'm sure others) who writes a column for OT Advance calls a reductionist mentality. I think she's right. If, for example, we become the "go to" discipline for ue splinting this has the appearance of being a good thing simply from a "keeping the caseload full" perspective. In the end, however, we are reduced to becoming a vendor for all things regarding splinting. Case in point is a referral I received the other day who was clearly documented as having no further skilled OT need by the OT a couple of months ago. She did have some swallowing issues the SLP has been addressing. Here comes the kicker...the pt. Kept complaining to the staff and SLP about wanting another splint for her LUE. The CVA was some twenty years ago. The splint however, was deemed appropriate on the last referral. This time when I arrived and began my interview with the pt. All she wanted was the cover to be taken off and washed. The ALF facility claims they had no idea it came off. In the end I did not make any further recommendations. I did review appropriate care of splint with all parties. To me this was a complete waste of time. It kept me busy. But what a waste of time and resources.
Neal C. Luther,OTR/L Advanced Home Care, Burlington Office 1-336-538-1194, xt 6672 neal.lut...@advhomecare.org Home Care is our Business...Caring is our Specialty P Please consider the environment before printing this e-mail The information contained in this electronic document from Advanced Home Care is privileged and confidential information intended for the sole use of otl...@otnow.com. If the reader of this communication is not the intended recipient, or the employee or agent responsible for delivering it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please immediately notify the person listed above and discard the original.-----Original Message----- From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com] On Behalf Of Ron Carson Sent: Thursday, April 09, 2009 9:17 AM To: Mary Alice Cafiero Subject: Re: [OTlist] We Better Wake Up... 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 >> >> >> >> -- >> Options? >> www.otnow.com/mailman/options/otlist_otnow.com >> >> Archive? >> www.mail-archive.com/otlist@otnow.com MAC> -- MAC> Options? MAC> www.otnow.com/mailman/options/otlist_otnow.com MAC> Archive? MAC> www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
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