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Why I am concerned about the OT profession....

Last post 05-03-2017, 3:51 AM by strong peter. 10 replies.
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  •  05-01-2005, 1:47 AM

    Why I am concerned about the OT profession....

    Just last week, I was watching the Brad Pitt movie, TROY..you know, the epic love story of the Trojan prince, Paris and the Spartan Princess, Helen.  The film features such gory battle scenes and war sequences, where we see the poor citizens of Troy--men, women, and children-getting invaded and finally overcome by the big, bad Spartan army of Greece by way of the now infamous "Trojan Horse."  As I sat there watching this movie, I couldn't help but think..those Trojans kind of remind me of Occupational Therapy practitioners, who have become all but accustomed to having their turf and domain constantly encroached upon.  And those big, bad Spartan warriors remind me of.well, the Physical Therapists who seem to take delight in invading the domains of other medical professions.

     

    If you're an Occupational Therapy (OT) practitioner, and you haven't noticed the recent "advances" made by the Physical Therapy (PT) profession to become the "profession of choice," then you must have been doing one of two things: you've either been rooming with Osama Bin Laden, or you've been comatose for the past 5 years.  Recently, the Senate Bill 2095 was passed which allows Physical Therapists to use the phrasing "functional training" as part of the way they describe their scope of practice.  It doesn't take a rocket-scientist to figure out that this new wording may lead down a road Occupational Therapists better be aware of: a future in which Physical Therapists practice the art of "occupation," and functional rehab. training.  A future in which a Physical Therapist has replaced the long extinct Occupational Therapist , as the rehabilitation provider of choice who is able to train clients to relearn their Activities of Daily Living (ADL).  Also, I would remind people of the push by the PT profession to move to a Doctorate of Physical Therapy (DPT) in both, their schooling and education.  PTs are learning to diagnose and read x-rays.  They are looking to bypass the medical physician completely.  There was a recent featured article in the Chicago Tribune (in the month of April 2005) that highlighted the move by PT programs to a doctorate level.  And of course, this all ties into "Direct Access," which as we all know (or should know by now) will allow PTs to provide their services without the authority or consent of a physician.  Yes, my friends, all this dreaded news is enough to make even the strongest, most resolute OT want to walk the ledge.

     

    In many ways, OTs have only themselves to blame for this.  We allowed this happen.  We allowed PTs to make all these advances.  We allowed them to ride their "Trojan Horse" into our "city."  While OTRs and COTAs bickered with each other over petty little issues (like "what is the true definition of a 'therapist?'"), those busy-as-beaver PTs were quietly forming a unified front to catapult their own profession to the top of the food chain. 

     

    Now, let me give a little information about myself.  I'm an anonymous OT who practices in the Chicago area.  Let's get one thing straight: I love the PTs I work with; I really can't think of one bad thing to say about them.  That's why I have a hard time believing that there are actually PTs out there who lobby for all these crazy causes; that there are actually PTs who think like this (I would love to meet one; to talk with one of these PTs and get into their heads and see what their thought processes are).  I don't want anyone to think that I am "anti-PT"--quite the contrary; I value the services that they provide and think that we should all work together as a TEAM.  Where I take offense is how some PTs have decided to lobby to put other people out of work-people with families to support and mortgages and rents to pay.  "I'm going to put you and your family in the welfare line, but it's nothing personal!"  Not only is that extremely selfish of the PT profession, it's pretty shady.  As an OT practitioner, I'm tired of having my profession "invaded" and "pillaged" by all these PTs who sport this 'Conqueror'-complex. 

     

    Most of all, I'm tired of OTs having to always "defend" themselves against all these PT legislations.  Even if we successfully lobby to stop SB 2095, I can't help but think that in a few months, OTs will almost inevitably find themselves having to defend against another new act lobbied for by PT.  Which begs another question: exactly why is that we OTs are always caught in the "defensive position?"  Why don't we fight fire with fire and take the battle to our would-be conquerors? 

     

    I don't think there's any choice but to do a few things (for starters): 1) Let's elevate our profession to a doctorate level, pronto, 2) We need to keep pushing for Direct Access (as long as PT does it, we need to do the same) and 3) AOTA should amend the OT scope of practice to now include "gait-training," "tissue manipulation," and "joint-mobilization."   Again, that's just a start.  It's not enough for us to sit back and enjoy the status quo; OTs need to be more proactive and be willing to expand the scope of our services.  Let's not be scared of what PT would think about that.  Let's just do it.  We need to send a very loud and clear message to PT: we're not going to take this crap anymore. 

     

    We need to fight back and defend ourselves,

    Anonymous OT 

     

     

     

  •  08-16-2005, 2:02 AM

    RE:Why I am concerned about the OT profession....

    Great post! You outta be working for AOTA, they need  people like you. I especially like the gait training part. Do you think PTs will ever come in early for ADLS? I get frustrated when they 'underrate' how the patient does w/toileting, etc.  In our place, we have a check sheet  on each eval where in addition to writing goals, we sign off on what modalities we plan to use, ie neuromuscular facilitation, Tx. ex, ADLS, splinting, balance, gait, etc. One of the  PTs always writes 'ADL'. So I will sign off OT to work on gait. We do functional room ambulation,  usually OT is the discipline that clears the patient for independence in the room. Our PTs  usually just walk the pt up and down the hall and rarely work on bed mobility. One time, I was the one that trained the pt on how to use the leg lifter: of course PT wrote how the  pt. did w/bed mobility based on my leg lifter training.   
  •  10-10-2005, 6:55 PM

    WHAT IS OT????

    You are on the right track!   I feel the reason we are not as appealing & successful as PTs is because we fail to define ourselves clearly in healthcare.

    Tell me ( in a very simple lay man's language)......What is OT?

    jyoti.
  •  05-18-2006, 4:40 PM

    RE:Why I am concerned about the OT profession....

    To correct the record, SB 2095 did not pass in Illinois.   SB 930 however was signed by the Governor with out language referencing 'functional training.'  That language was deleted because of lobbying by the state association. 

    The final version of SB 930 is available at: http://www.ilga.gov/legislation/94/SB/PDF/09400SB0930lv.pdf

     

  •  11-17-2006, 6:39 PM

    OT in the schools

    I agree - the future of OT is in our hands.  My frustration as a school based therapist has been raging lately.  OT is a very important field in the school sytems.  Administrators are realizing how motor skills affect literacy starting in preschool.  Yet- administrators often fail to see us as the answer to their problems.  The law requires that the schools provide OT- so they do.  But they rarely hire the therapists (in NY anyway), instead relying on an agency to set it all up.  Then the therapist is on their own.  Usually they are forced to work in the halls, in closets, in stairwells!  How is this justified?  How is possible that an OT who works the exact same hours with the same children as a speech therapist has none of the respect from administrators? 

    I am realizing that administrators and teachers are simply unaware of how important OT is and what exactly we do.  They will not consider us valueable if we do not present ourselves as such.  We need to go above and beyond, showing the teachers how we are useful to them, showing adminstration that our input in district curriculum such as art and technology can be instrumental in improving the reading and writing skills of children in the district.  The answer is there:  It's up to us to increase awareness.  If we want things to improve we must do something about it.  I made a pledge to myself to be a better OT this year- to do more in my school and my community to  increase the general awareness of people about OT and it's benefits to children.  Maybe if we all pitch in a little- we can change they way we are viewed!  So let's all do something: present at SEPTA, tell a stranger what OT is, ask your principle if you can present to the staff, anything! 

  •  06-05-2007, 9:10 PM

    OT ambulation and Ordering walking devices

    Question:  Can OTs order Walker cane and other ambulation assitive devices?

    If yes, then please show me evidence and if not then please say why not and where in any legislation does it say that.

    Thanks


    Ranjan Sen OTR CBIS
  •  06-15-2007, 10:55 PM

    RE:OT ambulation and Ordering walking devices

    'Can OTs order Walker cane and other ambulation assitive devices?

    If yes, then please show me evidence and if not then please say why not and where in any legislation does it say that.'

    The answer is yes, as functional mobility is part of our domain - see OT Framework - as well as occupation (anything important to the patient) which may include ambulation-assisting devices. But, if a PT is working with a patient at the time, I defer to them for canes, crutches, and walkers. If it is a wheelchair, I consult with the PT for the appropriate fit.

     


    Audra Ray
  •  06-29-2007, 8:06 PM

    RE:RE:OT ambulation and Ordering walking devices

    I think that OT should head for direct access and stay the wonderful fuctional, real life (i.e. life is not a straight line, a hall way or a treadmill) people that we are.

    Before I became an OT I worked as an activity director on a rehab unit. I was so impressed by the 'down to earth' approaches and creativity of the OT's that I decided to be one.

    As I entered school, I knew very little about the under current that existed between OT and PT. My first lecture I sat there excited and ready to begin my OT journey. I had made excellent grades so far, won many honors and had definite exposure to all disciplines. I know I could have been any thing but I choose OT. Suddenly my instructor said, ' I know you are all here because you couldn't get in PT school...'

    I was so shocked. I wanted to shout out, 'I am here because I love the idea that people can become better by having 'purpose', not by just meeting their physical goals. I would soon wonder if I had chosen a profession where we don't even believe in ourselves.

    I have become a walking advocate of OT. I admit I get tired of explaining occupation. However, I love the look on people's face when they 'get it'. If people are not won by our description of OT, then they can surely be won by our actions and the results that come from applying occupational principles to our work.

    Just today I had a little girl that has a very tight heel cord. She screamed if any one went near her foot. The surgeon had requested aggressive stretching to lead up to surgery and then after. The child was placed in PT at an area rehab center. They decided she would not tolerate the therapy and discharged her. She came to me as a last resort. I almost turned her down because it was a PT thing, but there was no PT and her daily occupations were affected.

    I gradually engaged her in activities like ballet on the ball where all her weight was placed on the affected foot and she never screamed. She has climbed and rode scooters stood on one foot to draw with chalk. All the while getting increased range of motion in the affected foot. Today she stood with the right foot flat on the ball and I laughed because her foot was described as a fixed contracture. I believe occupation made that difference. 

    I know OT's that are the 'gait' people in their facility because there is no PT. If we can do it when there is no PT, then we can do it. Do we need more PAM's, Xray, ultraound etc? Do we need additional gait training? Then let's get it and protect what we started a long time ago.

    If direct access is the key to our survival then I say let's do it.


    I love OT!!
  •  12-16-2007, 3:12 AM

    Re: Why I am concerned about the OT profession....

    We need to increase our presence in the legislature and increase our OT representation. PT has more representatives in legislation than OT thus their presence is definitely felt. Their unified front is strong.

    We need to encourage OTs to increase their knowledge and be well-versed about issues that affect OT practice to become active in AOTA and in legislature. We need more seats in the house that lobby for OT issues.

    It is the only way to change things.  

  •  12-18-2007, 10:33 PM

    Re: Why I am concerned about the OT profession....

    I love being a COTA.I can not imagine doing anything else.  I have heard a lot about PT doctoriate,  If the shortage of therapists exhists then who is going to take up the slack when Pt's are finishing their programs.  I dont believe the physicians are going to wait for the PHD/PTto get out of school.  OT is going to be there DOING therapy.  I have had the opportunity to educate many professionals in the role of OT ( and its not just about gait training).  Most are surprised at what function really is  and all that it intails . It is such a good feeling to watch someone progress from a dependent state to an Independent function and to be able to go home and do the things necessary.to live a normal life.  I think OT's would be well advised to re-open amny of the OTA programs that were closed due to lack of funding, and let the PHD be an elective instead of mandated.  Yes lete include Gait training, muscle manipulatiion in our scope of practice so when all of th PT's are in school we can carry on as we have in the past.
  •  05-03-2017, 3:51 AM

    Re: Why I am concerned about the OT profession....

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