Re: [OTlist] Over Utilization of PT in Home Health
In Colombia,S.A our profession is called ErgoTherapia Carmen From: susa...@rehabmail.com To: OTlist@OTnow.com Date: Sat, 11 Jul 2009 02:18:43 +0200 Subject: Re: [OTlist] Over Utilization of PT in Home Health I wrote a little while ago: ..My Dutch, German and Swedish colleagues are each called arbeitsterapeut (spelling differs a bit) - meaning something like work-therapist... Sorry, not correct, will try again: Sweden: Arbetsterapeut Germany: Ergotherapeut Holland: Ergotherapeut Norway: Ergoterapeut France: Ergotherapeute You can look up more from the wfot page. Warmly susanne -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com _ Windows Live™ Hotmail®: Search, add, and share the web’s latest sports videos. Check it out. http://www.windowslive.com/Online/Hotmail/Campaign/QuickAdd?ocid=TXT_TAGLM_WL_QA_HM_sports_videos_072009cat=sports -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Over Utilization of PT in Home Health
Yes, PT's skill set is much superior to OT's in the domain and manner in which they are applied. While on one hand, OT is often seen as UE experts, I am constantly amazed at the number of OT's who ask how to treat a rotator cuff injury (not that I know how). And beyond the actual skill set, PT has earned, developed and marketed itself as EXPERTS in physical function. Also, there is general consistency from one phy-dys PT to another phy-dys PT. And, not only is what they similar, it's what doctors expect and it's what patients expect. Basically, PT provides well know solutions to perceived problems. They are like car mechanics. When the car breaks and you can't fix it yourself, you take it to a mechanic, right. Same thing with the human body; you take it to a PT. Now, it's not PT's NAME that has brought them recognition and fame. It the entire package of being a profession that they have successfully grown over the years. There name helps, but it's only a small part of why others see them superior to OT. Now, I personally don't think PT is superior to OT. I think we each have our domains. However, when an OT operates outside the domain of occupation, then I generally think they are less effective than PT. The same is true for PT. When they start operating in the domain of occupation, they are generally less effective than PT. Ron - Original Message - From: Ed Kaine aloft@gmail.com Sent: Friday, July 10, 2009 To: OTlist@otnow.com OTlist@otnow.com Subj: [OTlist] Over Utilization of PT in Home Health EK If not in a name... then what? Is PTs service and skill set that EK much superior to OTs that it warrants about a 3 to 5 fold bias from EK OT to PT in nearly every setting? Your facility is probably fairly EK average in the 3 to 15 ratio... and that is home care. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Over Utilization of PT in Home Health
Ed Are you in Canada? I'm interested in where you got the Canadian stats. In this rural home care area the ratio is 3 to 1 in favour of OCCUPATIONAL THERAPY if we have a PT at all. The situation is reversed in acute care. I think this is as it should be. I also have a theory on why PT is better known. We more often deal with people who have multifactorial presentations and/or are marginalised for some reason - old, poor, disabled, mentally ill, who are not as able to problem solve through their own rehab as the active demographic in their productive years. Most people have had some contact with a PT either themselves or through others they know and most of these people do not need occupational therapy to continue or resume their usual everyday lives. Ron's stories of the clients who have been exposed to OTs 'going mindlessly through the motions' so some employer can collect payment in wasted health care dollars make my heart sick. Blessings, Joan -Original Message- From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com] On Behalf Of Ed Kaine Sent: July 10, 2009 3:01 PM To: OTlist@otnow.com Subject: Re: [OTlist] Over Utilization of PT in Home Health Hi All; If not in a name... then what? Is PTs service and skill set that much superior to OTs that it warrants about a 3 to 5 fold bias from OT to PT in nearly every setting? Your facility is probably fairly average in the 3 to 15 ratio... and that is home care. In the USA OTs are most plentiful treating pediatric populations... in Canada there is not this strong support for OT. In most settings there there are at least twice as many PTs as OTs. I'm not trying to be rhetorical here... I'm serious... I can't understand it if it's not due to our incomprehensible name. I think PT's title is just so obvious in what they can offer and why go to an OT if you're retired? I got this one again today. Administration puts their money where they expect volume and return on investment. In my opinion OT is more efficient at getting functional outcomes... but we are not known. Occupation means what it means... not what we say it means (unless it did, then it would). I think the concept is useful and we should try to get the word known, the definition expanded, but my Blog challenge cannot get it to happen, not within a year or even several. I'd really like your thoughts on the why PT is so successful and we are so not. Yours, Ed -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com Checked by AVG - www.avg.com Version: 8.5.375 / Virus Database: 270.13.9/2229 - Release Date: 07/10/09 07:05:00 Checked by AVG - www.avg.com Version: 8.5.375 / Virus Database: 270.13.9/2229 - Release Date: 07/11/09 05:57:00 -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Over Utilization of PT in Home Health
...home care area the ratio is 3 to 1 in favour of OCCUPATIONAL THERAPY if we have a PT at all. The situation is reversed in acute care. I think this is as it should be. I agree with Joan. I also think that it should be 1:1 in acute rehab hospitals. Patients get three hours of therapy per day and it is usually divded into half OT and half PT, unless ST is involved. Because of the specific guidlines set by CMS, there are very few single leg hip and knee replacements anymore, but there should only be complex orthopedic cases with significant medical issues. As a result there are many issues that OTs can address with each patient. The government is also frowning upon group therapy in which the patients' do not have a reasonable reason to be in it (staffing issues does not count). Along with that, doubling patients is beginning to be frowned upon. There really is no a excuse anymore why OTs are only completing UE strength training as the only modality in therapy. In my opinion this pattern begins as a student, in the level II Fieldwork. I have had many students over the years, and they are amazed at what I do with patients compared to their other experiences. Chris -Original Message- From: Joan Riches jric...@telusplanet.net To: OTlist@OTnow.com Sent: Sat, Jul 11, 2009 1:20 pm Subject: Re: [OTlist] Over Utilization of PT in Home Health Ed Are you in Canada? I'm interested in where you got the Canadian stats. In this rural home care area the ratio is 3 to 1 in favour of OCCUPATIONAL THERAPY if we have a PT at all. The situation is reversed in acute care. I think this is as it should be. I also have a theory on why PT is better known. We more often deal with people who have multifactorial presentations and/or are marginalised for some reason - old, poor, disabled, mentally ill, who are not as able to problem solve through their own rehab as the active demographic in their productive years. Most people have had some contact with a PT either themselves or through others they know and most of these people do not need occupational therapy to continue or resume their usual everyday lives. Ron's stories of the clients who have been exposed to OTs 'going mindlessly through the motions' so some employer can collect payment in wasted health care dollars make my heart sick. Blessings, Joan -Original Message- From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com] On Behalf Of Ed Kaine Sent: July 10, 2009 3:01 PM To: OTlist@otnow.com Subject: Re: [OTlist] Over Utilization of PT in Home Health Hi All; If not in a name... then what? Is PTs service and skill set that much superior to OTs that it warrants about a 3 to 5 fold bias from OT to PT in nearly every setting? Your facility is probably fairly average in the 3 to 15 ratio... and that is home care. In the USA OTs are most plentiful treating pediatric populations... in Canada there is not this strong support for OT. In most settings there there are at least twice as many PTs as OTs. I'm not trying to be rhetorical here... I'm serious... I can't understand it if it's not due to our incomprehensible name. I think PT's title is just so obvious in what they can offer and why go to an OT if you're retired? I got this one again today. Administration puts their money where they expect volume and return on investment. In my opinion OT is more efficient at getting functional outcomes... but we are not known. Occupation means what it means... not what we say it means (unless it did, then it would). I think the concept is useful and we should try to get the word known, the definition expanded, but my Blog challenge cannot get it to happen, not within a year or even several. I'd really like your thoughts on the why PT is so successful and we are so not. Yours, Ed -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com Checked by AVG - www.avg.com Version: 8.5.375 / Virus Database: 270.13.9/2229 - Release Date: 07/10/09 07:05:00 Checked by AVG - www.avg.com Version: 8.5.375 / Virus Database: 270.13.9/2229 - Release Date: 07/11/09 05:57:00 -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Over Utilization of PT in Home Health
Practised for a couple of years in Canada. Our Neuro program was ~1/2 PTs size, there were 2 to 3 times as many PTs in Peds, about equal in workers compensation rehab. I have no experience in HHC. Not really statistics but my experience. I started in Acute and the ratio was 7 PTs to 1 OT. I know of many places here and there that have minimal to no OTs. These were pretty effective programs despite the difference in staffing. I just think things go better with OT. Ed -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Over Utilization of PT in Home Health
US Bureau of Labor statistics 2006: PTs 172,948 PTAs 60,296 PT aides 46,242 =279486 OTs 98,858 OTAs 24,981 OT Aides 8,235 =132074 So OT has about 47% of PT, or twice as many PTs as OTs were employed in the US in 2006. The statistics are part of the story... but with OTs dominant in US pediatrics due to laws related to school services many of the other services are getting by with less. Ed -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Over Utilization of PT in Home Health
Hi All; If not in a name... then what? Is PTs service and skill set that much superior to OTs that it warrants about a 3 to 5 fold bias from OT to PT in nearly every setting? Your facility is probably fairly average in the 3 to 15 ratio... and that is home care. In the USA OTs are most plentiful treating pediatric populations... in Canada there is not this strong support for OT. In most settings there there are at least twice as many PTs as OTs. I'm not trying to be rhetorical here... I'm serious... I can't understand it if it's not due to our incomprehensible name. I think PT's title is just so obvious in what they can offer and why go to an OT if you're retired? I got this one again today. Administration puts their money where they expect volume and return on investment. In my opinion OT is more efficient at getting functional outcomes... but we are not known. Occupation means what it means... not what we say it means (unless it did, then it would). I think the concept is useful and we should try to get the word known, the definition expanded, but my Blog challenge cannot get it to happen, not within a year or even several. I'd really like your thoughts on the why PT is so successful and we are so not. Yours, Ed -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Over Utilization of PT in Home Health
Hi Ed'n all:-) I'd like to try and give an outlandish perspective on the name issue: I am from Denmark, and here we don't even have the word occupation - which seems quite a loss ie when translating the Cannadian model etc - we still talk about activities, and then has to expand: nescessary, meaningful etc activities. My title is ergoterapeut. (same ergo as in ergonomics). My Dutch, German and Swedish colleagues are each called arbeitsterapeut (spelling differs a bit) - meaning something like work-therapist... Not sure what it looks like around the world, but sure solely discussing the word occupational woun't get us all on the same page...? Then fast forward to the word function - this easily translates into Danish, I think it has a latin root, which sure helps! But even on this list I've seen it used so broadly, that it seems to loose meaning. One day we are talking about the function of walking - the function of breathing - even the function of a certain muscle. The next day we note that someone is not adressing certain things in a functional way. Seems to me we are back to the basic word work again: It functions~= it works..? But on what level? Does your elbow muscle contraction work to the level of creating heat, pain and spasticity; to the level of banging your own nose; or does it assist you in drinking your coffee? So for now, I'm at a loss for how we would better name ourselves, without ever having to elaborate - but I sure am open to suggestions! Has the PT's then had it easier - sure physical therapist is such a precise name, or? (BTW in Danish it's fysioterapeut - we like to take the latin approach:) IMO it's incredibly broad - if I didn't know better, I'd easily think my MD was a physical therapist - I sure never saw him address mental, emotional or spiritual parts of healing. But maybe if I look at it like we go about occupation - that the physical is both the road and the destination? Fine, then my chiropractor must be a PT? Yeah, I know - more questions than answers - I just am wondering:-) Warmly Susanne, Denmark Original Message From: Ed Kaine aloft@gmail.com To: OTlist@otnow.com Sent: Friday, July 10, 2009 11:01 PM Subject: Re: [OTlist] Over Utilization of PT in Home Health Hi All; If not in a name... then what? Is PTs service and skill set that much superior to OTs that it warrants about a 3 to 5 fold bias from OT to PT in nearly every setting? Your facility is probably fairly average in the 3 to 15 ratio... and that is home care. In the USA OTs are most plentiful treating pediatric populations... in Canada there is not this strong support for OT. In most settings there there are at least twice as many PTs as OTs. I'm not trying to be rhetorical here... I'm serious... I can't understand it if it's not due to our incomprehensible name. I think PT's title is just so obvious in what they can offer and why go to an OT if you're retired? I got this one again today. Administration puts their money where they expect volume and return on investment. In my opinion OT is more efficient at getting functional outcomes... but we are not known. Occupation means what it means... not what we say it means (unless it did, then it would). I think the concept is useful and we should try to get the word known, the definition expanded, but my Blog challenge cannot get it to happen, not within a year or even several. I'd really like your thoughts on the why PT is so successful and we are so not. Yours, Ed -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Over Utilization of PT in Home Health
I wrote a little while ago: ..My Dutch, German and Swedish colleagues are each called arbeitsterapeut (spelling differs a bit) - meaning something like work-therapist... Sorry, not correct, will try again: Sweden: Arbetsterapeut Germany: Ergotherapeut Holland: Ergotherapeut Norway: Ergoterapeut France: Ergotherapeute You can look up more from the wfot page. Warmly susanne -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Over Utilization of PT in Home Health
Hi Ron; I think the better question is Does anyone think OT is under utilized in most health care settings? I think there would be so much that PT could learn from OT about functioning in a home environment. There are probably many PTs who do a great job in the field. As you may imagine... I think they have their very understandable name going for them. Recently I made the argument that it is OT who should be consulted in the case of a fall at home. Why not PT? Was it not the functional environment that they fell in? Ot was likely due to something they were doing (like getting into the tub) rather than any type of gait abnormality. This falls more into the problem solving mindset of an OT. Most of the mobility issues we come across in a hospital are :Functional Mobility issues rather than significant need for gait training. Though I have a few more consults coming in for OT now I have the problem of very minimal staffing that will lead to a difficulty in meeting the demand. I have the problem of staffing OTs because administration does not understand what we can do. Yours in Occupational Therapy and Functional Therapy, Ed Kaine, OTR, RFT President of the League of Functional Therapists On Thu, Jul 9, 2009 at 8:38 PM, Ron Carson rdcar...@otnow.com wrote: Does anyone else think that PT is WAY, WAY over utilized in home health? I do! -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
Re: [OTlist] Over Utilization of PT in Home Health
Hey Ed and others: There is no doubt in my mind that in the world of adult phy-dys, OT is GREATLY under utilized. For me, the question is not if, but why! Unfortunately, I don't think it's related to our name. Ron - Original Message - From: Ed Kaine aloft@gmail.com Sent: Thursday, July 09, 2009 To: OTlist@otnow.com OTlist@otnow.com Subj: [OTlist] Over Utilization of PT in Home Health EK Hi Ron; EK I think the better question is Does anyone think OT is under utilized in EK most health care settings? I think there would be so much that PT could EK learn from OT about functioning in a home environment. There are probably EK many PTs who do a great job in the field. EK As you may imagine... I think they have their very understandable name going EK for them. EK Recently I made the argument that it is OT who should be consulted in the EK case of a fall at home. Why not PT? Was it not the functional environment EK that they fell in? Ot was likely due to something they were doing (like EK getting into the tub) rather than any type of gait abnormality. This falls EK more into the problem solving mindset of an OT. Most of the mobility issues EK we come across in a hospital are :Functional Mobility issues rather than EK significant need for gait training. EK Though I have a few more consults coming in for OT now I have the problem of EK very minimal staffing that will lead to a difficulty in meeting the demand. EK I have the problem of staffing OTs because administration does not EK understand what we can do. EK Yours in Occupational Therapy and Functional Therapy, EK Ed Kaine, OTR, RFT EK President of the League of Functional Therapists EK On Thu, Jul 9, 2009 at 8:38 PM, Ron Carson rdcar...@otnow.com wrote: Does anyone else think that PT is WAY, WAY over utilized in home health? I do! -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com EK -- EK Options? EK www.otnow.com/mailman/options/otlist_otnow.com EK Archive? EK www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
