Ron,
Not sure where the disagreement is found "Chris, so of what you say is
correct, but much isn't"
So it is ok to step out of your traditional role as an OT to complete
lymphedma treatment, but it is not ok to step out of the traditional
role as an OT to complete UE orthopedic treatment? Seems to me you are
on both sides of the fence, but for some reason you cannot stand UE
impairment based treatment.
Chris
-----Original Message-----
From: Ron Carson <rdcar...@otnow.com>
To: cmnahrw...@aol.com <OTlist@OTnow.com>
Sent: Sat, Jun 13, 2009 3:07 pm
Subject: Re: [OTlist] Dental Hygienst Knows About OT...
Hello All:
Chris, so of what you say is correct, but much isn't.
I am 100% for treating physical disabilities as they impair occupation.
However, my experience is that MOST (almost 100% is my guess) ONLY TREAT
the UE as it relates to occupation. That to me is WRONG for patients and
wrong for our profession.
I agree that "true" hand therapy is a gray area and as you mention, can
be done by OT or PT. In these cases I prefer to think the person is
doing hand therapy, not OT or PT. At some point, any professional can
move so far away from their practice paradigm that they are no longer
practicing their profession. This is almost never a clear cut line.
However, hand therapy is not a real concern for me. What does bother me
is that most OT's who I know that work in adult phys dys practice like
hand therapists, but without the advanced skills. In my experience, OT
is known as UE hand therapy. Almost EVERY experience that people relate
to me about OT is hand/UE related. I almost NEVER hear about an OT
giving people back their lives, or restoring occupation, etc.
In my opinion, despite a significant change in AOTA's literature, almost
nothing has changed in adult phys dys practice. Today, OT use the word
occupation, but that's about it. They don't really practice occupation
based therapy because if they did, most of them would not be focused on
the UE.
In my home health company, I refuse to treat UE injury UNLESS the
patient is FOCUSED ON IMPROVING OCCUPATION. Initially this caused a
significant rift for my employer but they have accepted it and worked
around it by referring such patients to other OT's. But, this does not
mean I don't treat PEOPLE with UE injury. In fact, I just d/c'd such a
person.
It is my SINCERE (and I mean SINCERE) desire to see the profession of OT
embrace occupation. I will continue beating this "horse" until I give up
or die. And I mean that with all my heart.
----- Original Message -----
From: cmnahrw...@aol.com <cmnahrw...@aol.com>
Sent: Saturday, June 13, 2009
To: OTlist@OTnow.com <OTlist@OTnow.com>
Subj: [OTlist] Dental Hygienst Knows About OT...
cac> I see the horse is not dead yet!!!!
cac> This age old debate revolves around the top down approach and the
cac> bottom up approach to treatment, or the occupation as a means or
an
cac> end. We as OTs in physical disabilities can choose either to
treat
cac> occupational dysfunction in two ways a) Use occupations as the
cac> treatment modality to combat the issue of occupational dysfunction
cac> either through restoration or compensation or b) Treat the
underlying
cac> impairment. In my opinion it simply depends on what is causing
the
cac> occupational dysfunction. If an occupational takes an interest in
hand
cac> therapy and they decide to specialize in this area (PTs can do
this
cac> too) then I would say that the occupational therapist is doing
hand
cac> therapy. I would not state that they are doing physical therapy
cac> because this is a gray area. Perhaps a physical therapist takes
an
cac> interest in visual perceptual training ( my PT friend did) because
of
cac> their strong background in neurorehabilitation. When they utilize
this
cac> training during treatment sessions to facilitate better outcomes
with
cac> gait and balance, would they state that they are doing
occupational
cac> therapy? What if a PT takes a liking to driving evals and training
cac> (IADL),. Would they call it occupational therapy or drivers
training?
cac> What Ron is simply trying to do is change the paradigm of
occupatonal
cac> therapy and simply rewrite the textbooks we once read in school,
by
cac> erasing the biomechanical model. I applaud him to a certain
extent,
cac> but at times I an confused by his reasoning.
cac> Hand Therapy does not necessarily mean a cone or peg pusher
therapist.
cac> A Hand therapist does not necessarily give the pubilic a certain
image
cac> of what OT is , but it is the misguided therapist that provides OT
cac> without meaning in order complete enough time to reach a certain
RUG
cac> level or complete the "Three hour rule". I do not think it is
Ron's
cac> intent to upset all of the OTs who practice hand therapy, but to
guide
cac> phys dys OTs to provide meaning during their therapy sessions in
order
cac> to clean up the public perception of what we do.
cac> Chris Nahrwold MS, OTR..
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