Clear as Mud
A reader, Linda, who commented on my 4/28/09 entry questions my characterization of case management as an advanced practice. She agrees with me that case management is an integral part of OT practice, and that OTs should "assert themselves as the excellent, well-rounded case manager that they already are." However, she also suggests that by referring to case management as an advanced practice, I will hold OTs back from "starting something". I'm not sure what that "something" refers to, but my live conversations with many OTs so far suggest that the lack of understanding about what case management is results in practitioners holding themselves back.
I don't exactly disagree with Linda's position that OTs can be case managers "right out of the box." The issue from my perspective is that until academic OT programs more uniformly include the specifics of case management in their curricula, OT practitioners are neither equipped for the complexities of case management, nor for keeping occupation at the forefront of case management interventions and plans for which they're responsible, until they've got some real-world experience. That doesn't mean new-grad OT practitioners shouldn't do case management, or shouldn't apply for jobs where case management is the primary responsibility or job title. I just think that OT practitioners need to recognize what they don't already know about case management as it is defined by non-OTs, especially as long as OT is under-represented among case managers, and under-utilized in health and human services. Also, having met several OTs practicing as case managers who think they've stopped practicing OT, I question the level of understanding of either OT or CM "alone", much less as an integrated service.
That said, there can very well be situations in which OTs are "intrinsically" qualified, given the diversity of case management practices and contexts. I was part of a group of OTs that successfully made that very point relative to Minnesota's workers' comp. system; and wrote about the issues and process by which we prevailed. So by all means, make your case. Here are just a couple of ways:
- Email the Commission for Certification of Case Managers (CCMC) if you're interested in participating in the Role and Function Study CCMC will be starting soon. You will receive notification of when the study begins (online).
- Do a research project on points you want to make about OT and CM. CCMC offers a $10,000 grant each year for research related to case management.
In the meantime, please add your voices to those who have commented on my blog so far.