Often, when I talk with people about OT advocacy, they are interested but not really sure where to start. They also want to avoid a big time commitment. Here's a few super-quick ways for super-busy people to still take action.
First of all, are you an AOTA member? Because if you care about OT being represented on a federal level especially, then you need to join. AOTA (just like other professional organizations like the AMA) can only claim to represent the practitioners who are actually members, not all the OTs in the country. Also, the political action committee, AOTPAC, cannot take money from non-members. So if you're an non-member OT/A who benefits from the work that AOTA is doing (and you probably do), that would make you dead weight. Don't get offended, just get active. TOTAL TIME: 15 minutes to setup
AOTA has this great resource called the legislative action center. Using this literally can take less than a minute, and still is a way to make a big impact. I get an email from an AOTA staffer describing an action alert- here recently it was the Occupational Therapy in Mental Health Act (HR 1037). (sidenote, when your job title is in the title of the bill, it is a BIG DEAL. Action cannot be delayed.) Staffer sends a link to the action center, and since I am already a registered user, it knows from my saved zip code who all my senators and representatives are. Then it provides me with a form letter (which I usually change, and is why it takes longer than 1 minute) and automatically emails it to all the right people. Baddabing, baddaboom, it's done. Occasionally I get an email (or even a letter!) back from the congressperson's office. And your representatives seriously do care what you think on issues. There are so many bills in and out everyday, they don't read them all, and if a constituent has an opinion, that can sway their vote. TOTAL TIME: 5 minutes to setup, 1 minute or less thereafter
Social media is changing how issues are communicated. As it is now, I get detailed emails from the state legislative staff (by virtue of my Advocacy VP position in my state organization) but I can't read them all in-depth. What I do read are the Stop the Therapy Cap facebook posts, and the updates I get on twitter from the organization and legislative staff. I'm already on those sites, and getting a quick update on where the issues stand as I'm browsing through is so simple.TOTAL TIME: 2 minutes to setup, 1 minute or less thereafter
In the same way that social media has affected our information acquisition, so has mobility/portability. I like things I can do from my phone instead of tied to my computer. So while I know I can look up online various bills and what my reps are doing, there's an app for that- (and it's a free one!) called Congress (Android and Windows) or MyCongress (Apple). The free app helps you find your reps via zip code and allows you to favorite them, giving you quick access to how they're voting, their committees, and a way to contact them. You can also favorite bills to check their status. If you're super involved you can get push notifications on when committees are meeting or when a hearing is going to happen for your bill. TOTAL TIME: 2 minutes to setup, 2 minutes or less thereafter
So many people are afraid to get involved with advocacy efforts. Don't be! By virtue of being an OT practitioner, you are an expert in OT! Share that expertise with the people in power using these quick methods. Feel free to share your preferred ways to advocate or other advocacy questions/concerns you have in the comments below.
Additional resources
Want to do Advocacy? There's Something for Everyone by AOTA
AOTA Advocacy section
Lifehacker article How to Discuss Politics Without Sounding Like an Idiot (has info on the apps)
Showing posts with label advocacy. Show all posts
Showing posts with label advocacy. Show all posts
3.11.2013
Advocate Or Be Replaced
This is an article from the American College of Sports Medicine on fitness trends expected to be sought after in 2013. The stated purpose is to assist their readership (Athletic Trainers, exercise physiologists, personal trainers, "fitness specialists" etc) in continuing profitable business. Here are the top 20 trends that they identified.
This list provides some things to think about. Here are a few that sprung to my mind.
#1: Educated, certified and experienced fitness professionals: sounds like a no-brainer, right? No one wants to think that the person helping them in their fitness quest just walked out of a high school weightlifting class and is now using that as their entire knowledge base. But with a personal quest for certifications and increased legitimacy comes a professional quest for licensure in attempt to get a greater piece of the monetary pie.
#8 Functional fitness: some of this is the Crossfit movement, and some is also code words for "daily activities." We OTs feel very protective of ADL however it is a phrase that is increasingly being inserted into practice acts for physical therapy or athletic training.
#11 Worksite health promotion: There are great OTs who work in industrial settings, though this is still more of a niche or emerging practice area. One piece of wording that you may need to watch for is the term "industrial athletes" which may be applied to military or first responders (firefighters, police, EMT). This may affect whether those individuals would be referred to an OT work-hardening program or an athletic trainer.
#19 Reaching new markets: This makes sense for a business. There's only so much you can do with your current market, and to increase your business, you must bring in some new consumers. Outreach to new markets may include consumers who were not previously service users before, or it may include individuals who were using OT and try to replace that service with something else. There's only so much "insurance money pie" and everybody wants their slice.
Pay attention to who is trying to get licensed in your state, and how they're defining their scope of practice. Does it properly encapsulate their training? Is it going to try to restrict your practice? You might be surprised. I'll admit that I come across as paranoid and defensive, but it's much easier to start from that position and work toward a mutually beneficial middle ground than to assume that every other profession is out to play nice and that we should be nice too. Remember what AOTA President Florence Clark said: It's not playing nice- it's playing dead!
If something is happening in your state and you need assistance, contact the AOTA state affairs group. The staff is excellent at analyzing legislative issues and can help you in responding appropriately. Just one more reason you should be an AOTA member. Also, please consider donating to AOTPAC, they are the only people fighting for OT on a national level.
If something is happening in your state and you need assistance, contact the AOTA state affairs group. The staff is excellent at analyzing legislative issues and can help you in responding appropriately. Just one more reason you should be an AOTA member. Also, please consider donating to AOTPAC, they are the only people fighting for OT on a national level.
11.04.2012
The Presidential Election and the Effect on Healthcare
I normally don't do this. Even with people I speak with in person, I don't get very political. Partly due to the effects of being a blue dot in a red state, partly out of actual politeness and avoiding arguments, and partly because I don't think that most political discourse has an effect on how people actually vote. But as should be obvious from the title and the disclaimer thus far, I'm going to go there today. You have been warned. (as always, I'm sure that my employers -such as they are- and state associations that I am a member of have no voice in what I write, and the views are purely my own)
My father is an economist/history teacher and political discussions were the norm in our household from a young age forward. I now spend a good deal of time interfacing with our state lobbyist regarding how we can best protect and promote OT in my role as VP of Advocacy. I am a registered Democrat, but would more accurately describe myself as a political cynic. I think yard signs should be banned for anyone running for a higher office than the state legislature. I think that the debates should be abolished since they only serve as moments to spit out talking points, cherry picked statistics, and are altogether worthless until you see the Fact-Check. I get super irritated watching both candidates move closer to the center as election day nears and simultaneously knowing that a third-party candidate has no chance at all in going far enough to keep the other two honest. Don't even get me started on the rights of a SuperPAC.
My father is an economist/history teacher and political discussions were the norm in our household from a young age forward. I now spend a good deal of time interfacing with our state lobbyist regarding how we can best protect and promote OT in my role as VP of Advocacy. I am a registered Democrat, but would more accurately describe myself as a political cynic. I think yard signs should be banned for anyone running for a higher office than the state legislature. I think that the debates should be abolished since they only serve as moments to spit out talking points, cherry picked statistics, and are altogether worthless until you see the Fact-Check. I get super irritated watching both candidates move closer to the center as election day nears and simultaneously knowing that a third-party candidate has no chance at all in going far enough to keep the other two honest. Don't even get me started on the rights of a SuperPAC.
So I pay attention to things. And I have to say that I'm disappointed in the campaign so far from both sides. Obviously the negativity does not make for optimal TV viewing (all hail Netflix and DVR!) but even from a purely strategic point of view I think that both have made serious errors. The campaigns have chosen to push repeatedly on little buttons when they had larger ones at their disposal. And from the ads in my region, you'd think the entire election was about abortion, and nothing else. I hate hearing how "this is the most important election of all time" or "this election will change the course of history" or "we couldn't last four years with X". It's all ridiculous, and a lie.
But there are still legitimate topics that will realistically concern people in the coming years. Healthcare should be of large concern for everyone, since it is a service that everyone will eventually need to use, a funding source for many of us, and affects the quality of life for our families and clients. So knowing how the candidates intend to approach healthcare (and reform, because the cat is already out of the bag) is important.
You've heard what they say- "The (insert party here) is trying to destroy Medicare as we know it!" But both sides have proposed changes to how the healthcare system will work. I say system and not just Medicare because Medicare is the driving force behind how other insurances set their coverage and rates. And it's not fiscally solvent. As the baby boomers age, we will have a larger number of people to insure, who are living longer, and fewer workforce members (to both tax and charge higher commercial premiums)- this is a recipe for bankruptcy. Change is no longer optional.
Both campaigns have essentially proposed similar tactics, which shouldn't be surprising if you consider that the ACA was drawn around Romney's plan instituted in Massachusetts. However, they continue to parse words (vouchers! exchanges! Obamacare!) in attempt to make the differences seem more drastic. Both plans would allow you to take federal money to purchase insurance from a marketplace that offers the minimum Medicare/federally defined benefits. The ACA proposes to re-prioritize Medicare monies to start some of the funding for their tasks, and intends to cut costs long-term through preventative care and a board of advisers who propose strategies to cut costs without cutting benefits. There are some lofty goals, and it will be interesting to see how we simultaneously shift to prevention and wellness while cost-cutting. The Republican plan intends to make Medicare a pay-into contribution system, counts on competition to drive down costs, and the government pays a premium cost for any insurance and places overage costs onto the insured person. Unfortunately it becomes quite a gamble for the insured person if competition doesn't reduce costs sufficiently, since they wind up holding the bill, and remember that many Medicare beneficiaries are on a fixed income.
Both plans claim to reduce Medicare spending by the same amount. Neither method has been proven to work. Both plans rely on Medicare cuts- the Republicans intend to use that money for tax cuts and deficit reduction, while the Democratic plan uses that money to fund Medicaid. The word from the Republican camp was that Medicaid (like FEMA and other state-benefit programs) would need to become completely state funded without federal support. Being native to a dirt-poor state, I worry about the feasibility of making that happen without major cuts to an already strapped system.
This is what I think is important, and I base this upon the clients I have worked with over the years. So many of my families depend on Medicaid. If they do have insurance, many times one parent was effectively forced to stay in the same job for fear of not getting the child covered under a new plan due to having a preexisting condition. I have worked long enough to know that all it takes is one accident or completely unexpected health event (e.g. aneurysm, child's cancer,etc) to completely bankrupt a family with or without insurance. I believe in protecting the people who are most disadvantaged- children, the poor, the disabled, the elderly. So though there certainly isn't a perfect option at this point, no golden ticket to magic wonderful healthcare, my vote is to continue the ACA.
This is an important issue, and I would advise you to read more if it concerns you. My sources:
Here's a rundown from Politifact on truthfulness of claims on healthcare.
This one is specifically on the ACA (Obamacare) and claims made by both sides.
and one more specifically on Medicare claims
Both campaigns have essentially proposed similar tactics, which shouldn't be surprising if you consider that the ACA was drawn around Romney's plan instituted in Massachusetts. However, they continue to parse words (vouchers! exchanges! Obamacare!) in attempt to make the differences seem more drastic. Both plans would allow you to take federal money to purchase insurance from a marketplace that offers the minimum Medicare/federally defined benefits. The ACA proposes to re-prioritize Medicare monies to start some of the funding for their tasks, and intends to cut costs long-term through preventative care and a board of advisers who propose strategies to cut costs without cutting benefits. There are some lofty goals, and it will be interesting to see how we simultaneously shift to prevention and wellness while cost-cutting. The Republican plan intends to make Medicare a pay-into contribution system, counts on competition to drive down costs, and the government pays a premium cost for any insurance and places overage costs onto the insured person. Unfortunately it becomes quite a gamble for the insured person if competition doesn't reduce costs sufficiently, since they wind up holding the bill, and remember that many Medicare beneficiaries are on a fixed income.
Both plans claim to reduce Medicare spending by the same amount. Neither method has been proven to work. Both plans rely on Medicare cuts- the Republicans intend to use that money for tax cuts and deficit reduction, while the Democratic plan uses that money to fund Medicaid. The word from the Republican camp was that Medicaid (like FEMA and other state-benefit programs) would need to become completely state funded without federal support. Being native to a dirt-poor state, I worry about the feasibility of making that happen without major cuts to an already strapped system.
This is what I think is important, and I base this upon the clients I have worked with over the years. So many of my families depend on Medicaid. If they do have insurance, many times one parent was effectively forced to stay in the same job for fear of not getting the child covered under a new plan due to having a preexisting condition. I have worked long enough to know that all it takes is one accident or completely unexpected health event (e.g. aneurysm, child's cancer,etc) to completely bankrupt a family with or without insurance. I believe in protecting the people who are most disadvantaged- children, the poor, the disabled, the elderly. So though there certainly isn't a perfect option at this point, no golden ticket to magic wonderful healthcare, my vote is to continue the ACA.
This is an important issue, and I would advise you to read more if it concerns you. My sources:
Here's a rundown from Politifact on truthfulness of claims on healthcare.
This one is specifically on the ACA (Obamacare) and claims made by both sides.
and one more specifically on Medicare claims
Will Medicare as we know it change or persist?
What the Romney-Ryan and Obama Medicare plans have in common
Democrats vs Republicans: 2 approaches to Medicare
What the Romney-Ryan and Obama Medicare plans have in common
Democrats vs Republicans: 2 approaches to Medicare
4.14.2012
April Challenge: Write a letter to a Doctor
Is it just me (and it really might be) but do you know a lot of doctors? Maybe you are a super good marketing person and know all the local docs, maybe you have lived in the same town and always known the doctors, or maybe you’re like me and realize one day that a startling percentage of your classmates/roommates/friends have decided to go to medical school. These acquaintances can be beneficial, and not just when you want to avoid making a real appointment.
In our current environment, the doctor is often the gateway (direct or indirect) to occupational therapy services. Even when legislation for direct access exists, many practitioners still prefer a prescription for services for safety or insurance reasons. Other times, a person may not realize that occupational therapy could help their ailment and it comes up during a PCP visit. So it is advantageous to make sure that doctors that you know are fully aware of what you do.
This can be difficult since many OTs are not “toot your own horn” kind of people. But a letter to a doctor, and especially one who is a friend, doesn’t need to come off in that way. It can provide information about how your practice can benefit their client population. People (even doctor people) are not always aware of what all an OT can do, and if you can make the information relevant to the person’s life or practice, it will be remembered. (See: Elevator Speech)
The other reason that this can be difficult is because there can be a fear of rejection. I was part of a homeless outreach group organized by community medicine students when I was in college. Medical students (literally occupying the SAME building as the OT/PT programs) said that they had been told the therapies were “soft sciences” and to be avoided if possible. (?!?!) Where did this come from? I still don’t know, but it had to be corrected. No one wants to risk not looking like a fully awesome expert, but you can’t allow a belief like that to go unquestioned.
So take the time to send a short note to some of your doctor friends, tell them about OT month and the greatness you provide. Use some of the great resources of the world- facebook, text, or communicate in whatever method you feel most comfortable. If you know their specialty and want to be supercool, figure out when their special celebratory week or month is so you can send a nice message then too.
This is something that I have put off for a long time but pledged to do as part of the challenge. So Joanna, Justin, Brent, Tom, Aunt Vick- watch your inboxes, the magic of OT is coming. :)
4.11.2012
April Challenge: email a legislator
For this edition of Web Wednesday, I invite you to send a brief email to a legislator. Advocacy is an incredibly necessary part of practice, and one part of that is simply cultivating relationships. So take today to reach out to a state legislator, congressperson, or senator.
Visit AOTA's Legislative Action Center to find your federal representatives and get quick contact information. This page will also give you a brief update on any relevant OT issues before the house and senate. States should have a link to individual representatives, if you live in Maryland, click here to find your state delegates and senators.
Visit AOTA's Legislative Action Center to find your federal representatives and get quick contact information. This page will also give you a brief update on any relevant OT issues before the house and senate. States should have a link to individual representatives, if you live in Maryland, click here to find your state delegates and senators.
If you don't have a specific outreach topic, you can still send a note as a constituent to alert them to your profession and general concerns. Remember, you are an OT expert! If you have concerns that your clients have brought up (e.g. limited access to therapy visits) you can mention that as well. One of the best effects of our state Lobby Night has been the relationships that are developed between local therapists and their representatives. This can be maintained through emails or visits when they are back in their home office. A short moment to reach out may prove very helpful to you later.
Action tips during a congressional (or state legislator) recess
Tips for Writing to a Legislator
Action tips during a congressional (or state legislator) recess
Tips for Writing to a Legislator
4.03.2012
April Challenge: Set aside some money for advocacy
I know some people will probably groan at this title, but this is a very important topic. Read on for more info.
Advocacy is an essential part of OT practice. It ensures that OT remains a relevant, covered service for the various populations we serve. It is best practice to advocate for the goodwill of your clients, supporting measures that enhance a specific community or your area as a whole. Everyone can be an advocate and needs to be taking action on a regular basis. We'll touch more on this later.
Some people hold the view that individuals don't need to advocate because AOTA is taking care of that. Obviously, if you read the previous paragraph, you know that I don't agree with the first half of that statement. So let's talk about AOTA's role in advocacy.
AOTA employs excellent lobbyists and policy analysts. These individuals work very hard at a state and national level to monitor legislation that is introduced, analyze potential impact to OTs, and take action to promote our interests. Seriously, these people are awesome at what they do, and I have worked with them numerous times at a state level.
They don't work for free.
(And money from your AOTA membership cannot be used for political action. It's a law.)
This is why you must contribute to AOTPAC. Only the political action committee can use funds to advocate for OT at this level. These funds also support the online tools linked above that allow for practitioners to keep up to date on the issues, and support occupational therapists who are running for any elected office (from school board to POTUS). If you have any doubts about AOTPAC, I would encourage you to talk to Paul Fontana, who gives one of the most engaging talks on the importance of advocacy and support.
As my one teacher said, no one expects you to spend all your time meeting with the legislators, but you should financially support those that do. And a donation does not have to be epic to be purposeful. I challenge you to take this month and set aside a small amount every Tuesday. By skipping one latte or lunch out each week, $5 is easy to save. If you eat dinner out multiple times each week, cutting back once can save you $25. I challenge every reader to save $20-$100 this month, and donate it to AOTPAC.
Let's make it happen!
4.02.2012
April Challenge: Wear OT Gear!
Yay! Let's start this OT Month Challenge off right!
It's Monday, there's only so much effort we can exert. But let's kick it off with a bang. Make sure everyone knows that it's OT Month by wearing some OT gear today. Everyone has a few (or a dozen) OT related t-shirts at the house... I know my mom loves to buy them for me :)
It's Monday, there's only so much effort we can exert. But let's kick it off with a bang. Make sure everyone knows that it's OT Month by wearing some OT gear today. Everyone has a few (or a dozen) OT related t-shirts at the house... I know my mom loves to buy them for me :)
Polos are professional and cheap- you'd be surprised how inexpensive you can get a custom embroidered shirt at a local place. Also if you're looking for an understated touch, OT earrings can be found on ebay and etsy, and if you renewed with NBCOT you'd have a nice lapel pin also.
Buttons definitely attract attention- stick a few of these on your backpack or jacket to catch an eye or two.
What's your favorite "Proud of OT" outfit? the best slogan on a shirt? Show it off in the comments below.
My outfit today, OT polo and earrings.
My outfit today, OT polo and earrings.3.18.2012
OT in DC and common sense
So the great team at AOTA's Federal Affairs branch has made a blog on OTC entitled "OT in DC." It has been very good thus far, and I wanted to make sure to share this post on why documentation is important- "How We Say It Matters." To me, that title is twofold- how we describe our OT services provided matters in getting reimbursed and recognized appropriately; and that there is a question we need to answer for our Fed Affairs folks and the public in general- how OT matters to the community and how that can be communicated.
This post is a great read to remind you that documentation is not just busywork, not just checkboxes, and not just a legal document. It's the proof that services of an occupational therapy practitioner were required and beneficial to the client. There is a common phrase that if it wasn't documented, it didn't happen. This post touches on the fact that clinical reasoning is invisible unless you, the practitioner, write it there. You know you did it, but does every person who could possibly be reading your documentation know that, and know that it was skilled? If we want OT to matter (and if you don't, you're probably reading the wrong blog) then we have to communicate our worth.
Also, on that note, not that anyone does this in writing but this is an important change to make in your oral communication. How often are you complimented for an idea or treatment and brush it off as "common sense?" Vow now to never say it again. If it was "common sense," it would not have required paying an OT to do it. That phrase diminishes all the intense coursework, fieldworks, and clinical reasoning of an OT. It seems "common sense" to you because of the framework you use for clinical reasoning, your experience, your intelligence. Not to be stereotypical, but women sometimes have a tendency to shy away from accepting compliments to avoid standing out or try to emphasize their cooperative tendencies. There is no reason not to accept a compliment to your clinical reasoning skills, you can do so gracefully (even returning one if appropriate) and acknowledge those skills instead of degrading them.
10.25.2011
Our OT Identity
In celebration of World OT Day, we are discussing the Global Identity of Occupational Therapy. It's an interesting topic since there has been a lot of discussion about our national OT identity with the approaching Centennial. I think the best thing that I can share for this topic is my summary of two of the best AOTA sessions from the 2011 conference (and maybe from ever).
Last spring, there were two talks that best fit with the presidential address and stood out as completely awesome. One was "OT Survivor: Protecting Your Turf in a Competitive Healthcare Market" by Pam Toto and the other was "Practicing Authentic OT: Strategies for Becoming a Reflective and Reflexive Practitioner" by Debbie Amini. These ladies are both well recognized in the field. Energy was definitely palpable in both rooms, and I even got to meet (again) Suzanne Peloquin during one session. (If a Slagle lecturer shows up in your room- you know the topic is superb!) By discussing what was reviewed in these sessions, I think we can get great input into our OT Identity.
"What is occupational therapy?"
How often do we hear those words?! Yet Toto points out that each OT area has its own definition. What I do on a daily basis in the school system is nothing like what I used to do in the hospital and that would look nothing like the life of a hand therapist. Even within the hospital, my practice could vary widely from the NICU to the Neuro ICU to the orthopedic floor and so on ad nauseum. Toto said this was like blind men describing an elephant- we tend to describe our practice in a reductionist way of what we regularly do, sometimes missing the big picture of OT. This can lead to confusion from consumers, referrers, and payors. Amini points out that if we want to achieve the Centennial Vision goal of a consistent recognizable image, we much EACH take it as a personal responsibility. The "Authentic" version of OT is client centered and occupation based, with occupation as both an outcome and a treatment. Amini pointed out that this is often an espoused belief of practitioners, but not necessarily an enacted one.
A person may not even realize that they aren't enacting their beliefs until there is an additional level of reflection involved. Amini described reflection as thinking and critically examining yourself, skills, and practice. Reflexive practice takes reflection further by then comparing reflected behavior to espoused beliefs, determine any incongruence, and then act to change the behavior or the belief. This process can be done by personal journaling, mentoring, using the AOTA professional development tool, creating a portfolio, or joining a community of practice. Toto states that one of the best ways to advocate for OT is to practice consistency in areas you address, services provided, assessments and intervention approaches. In doing so, you create an image that others will remember and identify as occupational therapy.
There are perceived challenges to authentic and reflective practice. Amini includes corporate policies, reimbursement, productivity, supply cost, time, and decreased support from peers or supervisors. Toto described threats to our practice: complacency in our documentation (failing to specify our unique practice), viewing OT as a job instead of a career, moving from ADLs to preparatory/adjunctive treatments, accepting the status quo (including that laid down by the boss), and allowing any other service to be a "gatekeeper" to OT. Don't allow other professions to represent you. If your services are special and unique, NO ONE can say OT isn't needed! Remember that documentation is important. It's hard to remember that when you're writing 6 evals a day and don't think they're ever read. But think back to being in school when you learned about how each note was a legal document, the only proof of what really happened with a client. Toto discussed that it is important to use our practice framework language and reference evidence in our documentation. The most skilled part of a person's OT session may not have been the hands-on portion, but the clinical reasoning and decision making you engaged in. And speaking of clinical reasoning- don't short sell our value by saying that it's just "common sense!"
Toto discussed at length the importance of advocacy for OT. We're great at being advocates for our clients to get the best care, but more reluctant to stand up for ourselves. There are a limited number of healthcare dollars, and other groups would love to take our share. We can't be timid and "nice." As Dr. Clark said in her presidential address, if you let others take OT for granted, "it's not playing nice, it's playing dead!" Remember, there is no mysterious "they" who will advocate for you. AOTA and your state association may be able to take action on a government level to defend OT, but without your membership, they are hard pressed to do so. And they certainly won't be coming to all your referrers and coworkers and asserting the OT scope of practice. That falls to each of us. Amini reminds us (especially those AOTA members) to use the official documents as leverage during advocacy efforts.
Toto described that there are two ways to make light- you can be the candle or the mirror. When your client is successful, they need to understand who you were, what you did, and how your intervention has impacted their occupations and participation in life. Discuss and hand out goals. Hand out a business card. Make sure that you identify yourself as an Occupational Therapist and not just an OT or OTA. Have several elevator pitches for different audiences that include evidence. Most importantly, let everyone know the good that you do, so that others may receive your awesome authentic services.
I hope you find these points useful for your daily practice. The field of Occupational Therapy and our consumers will definitely benefit from authentic practitioners. Let's all strive for that in the coming week.
Last spring, there were two talks that best fit with the presidential address and stood out as completely awesome. One was "OT Survivor: Protecting Your Turf in a Competitive Healthcare Market" by Pam Toto and the other was "Practicing Authentic OT: Strategies for Becoming a Reflective and Reflexive Practitioner" by Debbie Amini. These ladies are both well recognized in the field. Energy was definitely palpable in both rooms, and I even got to meet (again) Suzanne Peloquin during one session. (If a Slagle lecturer shows up in your room- you know the topic is superb!) By discussing what was reviewed in these sessions, I think we can get great input into our OT Identity.
"What is occupational therapy?"
How often do we hear those words?! Yet Toto points out that each OT area has its own definition. What I do on a daily basis in the school system is nothing like what I used to do in the hospital and that would look nothing like the life of a hand therapist. Even within the hospital, my practice could vary widely from the NICU to the Neuro ICU to the orthopedic floor and so on ad nauseum. Toto said this was like blind men describing an elephant- we tend to describe our practice in a reductionist way of what we regularly do, sometimes missing the big picture of OT. This can lead to confusion from consumers, referrers, and payors. Amini points out that if we want to achieve the Centennial Vision goal of a consistent recognizable image, we much EACH take it as a personal responsibility. The "Authentic" version of OT is client centered and occupation based, with occupation as both an outcome and a treatment. Amini pointed out that this is often an espoused belief of practitioners, but not necessarily an enacted one.
A person may not even realize that they aren't enacting their beliefs until there is an additional level of reflection involved. Amini described reflection as thinking and critically examining yourself, skills, and practice. Reflexive practice takes reflection further by then comparing reflected behavior to espoused beliefs, determine any incongruence, and then act to change the behavior or the belief. This process can be done by personal journaling, mentoring, using the AOTA professional development tool, creating a portfolio, or joining a community of practice. Toto states that one of the best ways to advocate for OT is to practice consistency in areas you address, services provided, assessments and intervention approaches. In doing so, you create an image that others will remember and identify as occupational therapy.
There are perceived challenges to authentic and reflective practice. Amini includes corporate policies, reimbursement, productivity, supply cost, time, and decreased support from peers or supervisors. Toto described threats to our practice: complacency in our documentation (failing to specify our unique practice), viewing OT as a job instead of a career, moving from ADLs to preparatory/adjunctive treatments, accepting the status quo (including that laid down by the boss), and allowing any other service to be a "gatekeeper" to OT. Don't allow other professions to represent you. If your services are special and unique, NO ONE can say OT isn't needed! Remember that documentation is important. It's hard to remember that when you're writing 6 evals a day and don't think they're ever read. But think back to being in school when you learned about how each note was a legal document, the only proof of what really happened with a client. Toto discussed that it is important to use our practice framework language and reference evidence in our documentation. The most skilled part of a person's OT session may not have been the hands-on portion, but the clinical reasoning and decision making you engaged in. And speaking of clinical reasoning- don't short sell our value by saying that it's just "common sense!"
Toto discussed at length the importance of advocacy for OT. We're great at being advocates for our clients to get the best care, but more reluctant to stand up for ourselves. There are a limited number of healthcare dollars, and other groups would love to take our share. We can't be timid and "nice." As Dr. Clark said in her presidential address, if you let others take OT for granted, "it's not playing nice, it's playing dead!" Remember, there is no mysterious "they" who will advocate for you. AOTA and your state association may be able to take action on a government level to defend OT, but without your membership, they are hard pressed to do so. And they certainly won't be coming to all your referrers and coworkers and asserting the OT scope of practice. That falls to each of us. Amini reminds us (especially those AOTA members) to use the official documents as leverage during advocacy efforts.
Toto described that there are two ways to make light- you can be the candle or the mirror. When your client is successful, they need to understand who you were, what you did, and how your intervention has impacted their occupations and participation in life. Discuss and hand out goals. Hand out a business card. Make sure that you identify yourself as an Occupational Therapist and not just an OT or OTA. Have several elevator pitches for different audiences that include evidence. Most importantly, let everyone know the good that you do, so that others may receive your awesome authentic services.
I hope you find these points useful for your daily practice. The field of Occupational Therapy and our consumers will definitely benefit from authentic practitioners. Let's all strive for that in the coming week.
4.23.2011
OT in HD: Presidential Address
AOTA President Florence Clark opened the 2011 AOTA Conference with an excellent presidential address describing the need for OTs to compete. 
(Photo credit to Cheryl Crow, videographer extraordinaire, from the OT Connections Gallery)
We live in a world of competition. Especially now, in a time of health care reform where decisions are being made about what services are necessary in the future, we as occupational therapy practitioners need to be engaging competition with (not against) others to ensure our role in promoting occupational fulfillment to the public. Competition needs to be acknowledged. It drives innovation and can improve practice. It's not going away, so get comfortable with it. Victories are won often by teamwork, but always by competition. But, as Dr. Clark said, "let's face it- we're nice." OT attracts people who are cooperative and kind. But if you let others take OT for granted, "it's not playing nice, it's playing dead!"
"HD OT" requires power, and we as a profession need to embrace our collective power. We can't stand alone, but together, we have a power that can't be ignored. As a group, we are witnesses to the "transformative power of occupation" and this must be shared with the public! The public mindset is shifting toward wellness and participation, which is a foundation concept to OT. One example is the case of Congresswoman Giffords. Per Dr. Clark, it was not so much of a question of 'would she walk again?' but one of 'would she run again- for Congress?' People are concerned with the ability to fulfill a role- one of the things that makes life worth living!
Dr. Clark drew some analogies to Rocky, who demonstrates caring and competitiveness, sensitivity and toughness. We have to be "in the ring" during the healthcare debates. We have to bring our "playbook." That includes evidence on our effectiveness, increased grants, decreased hospital readmissions and documentation. Our documentation should not over-emphasize motor-based components, but embrace our multifaceted approach dedicated to the whole person, environment, and occupation. We need to be intensely involved in advocacy to make the message heard- that Occupational Therapy helps people LIVE LIFT TO ITS FULLEST!
A recurring theme of President Clark's address was to strive for "arete," an ancient Greek concept referring to excellence, effectiveness, fulfillment. We each need to strive for everyday excellence in our work, with our clients, and how we represent ourselves. Fire up your competitive juices!
Dr. Clark's message goes hand in hand with 2 other excellent sessions I attended and will share at a later date. I hope that the call to "arete" resonates with you.
1.07.2011
Looking forward to 2011
Goodbye 2010. I don't have the energy for a LONG year in review, but...
I will touch on a few ups and downs of the year.
Firstly, let me thank all readers. I really appreciate the comments (that aren't plugging fake universities or spam in other languages) because I like to see that there has been an effect from my efforts. I don't look at the stats often, but glancing today, I see that since I started tracking in 2008, pageloads have increased by 20,000- more than 300%! WOW! And the cross-posts in the sister blog on OT Connections have brought in an extra 50-350 viewers each time, with one anomaly (thank you 1-minute update). It's really exciting to see how this blog has grown and spread, and gets me thinking about some plans for the future (more on that later). So a BIG THANK YOU to each of you, and please always feel free to comment or email me with suggestions.
Most popular pages on this site continue to be Writing Goals and a Case Study With Goals, which is understandable since this is one of the more difficult skills in OT that is not hands-on. I do intend to spend some time getting back to the 'roots' of this blog and posting about decision making, goal writing, and treatment plans. Perplexingly, a rather random What a Week post is the most read on the mirror site, with the exception of my post about Glee that got picked up by 1-minute update. Ironically, some of the posts I spent the MOST time on (e.g. Metacognition and Serial Casting Case Study) don't seem to be as popular, but I don't have tracking to that degree so I can't be positive. I did get several thoughtful comments on my most emotional post (Struggling as an OT for my Family) so I appreciate that deeply.
2010 was the first AOTA Conference I've been to as a practitioner, and even the first I saw after fieldwork. It was great to re-energize and network with other therapists. I think that as you are in the profession longer, you become more aware of others in the field, so I spotted dozens of OT Celebrities this year and got to talk with many, which was awesome.
It was interesting to see all the uproar in AOTA this past year with the potential organizational changes. As we are heading into election season again I see the new blogs and OTC memberships cropping up and it's always notable to see who sticks with it. Props to Bill Wong for continuing to post, and also to Florence Clark for taking up the mantle of the President's Blog.
There were some serious downers last year. We lost my husband's grandmother to Alzheimer's Disease in the summer, which was very difficult for the family. Then over the holidays, we had several additional hospitalizations of our family members, which have yet to completely resolve. Health is so very fragile and some families are like a house of cards... I am learning to take pleasure in contentment and tranquility, because it can all be very fleeting.
I struggled on my final rotation of the year on the cardiopulmonary floor, made extra difficult by the chronic nature of those diseases. It is hard to watch others' independence fade as their bodies fail, and I felt like the efforts I made brought about little change. There were some truly tragic stories in the ICUs that even made attending rounds difficult. I did my best for them, but I am so thankful to be back with a more stable patient base.
As the year ended, I realized that I am no longer really a "new practitioner." Granted, most of my experience is consolidated in one practice area, and I certainly don't know all there is to know about the acute care setting, but I now have a valuable level of skill. I feel like I could go to any adult hospital confidently and be a skilled member of their team. I caught multiple strokes and other medical problems, which makes me feel bad at the time (I hate to see people doing poorly) but it makes me feel that I am a competent professional doing my best to look out for my patients. I progressed with treating pediatrics by taking on outpatients for a few months and doing some feeding interventions for the infants. I was really proud to recognize self-soothing in the baby I evaluated my last day, because even though it's simple, it shows that I am retaining what I've learned though my time to practice is sporadic. I also had my first true fieldwork student, and I don't think I screwed up too badly or she would not have sent beignets. :)
I have a lot to look forward to for 2011. My goal is to spend less time typing notes at home (which is awful!) and more time being able to participate in my "OT extracurriculars"- this blog, OTC, twitter, association stuff. I am now the VP of Advocacy Relations for the Maryland OT Association and things are already in full swing. We are planning for Lobby Night in Annapolis, and would certainly love your company if you're able to attend. I am looking forward to the AOTA Conference in Philly (a mere 2 hours away) and the MOTA Conference (a mere 15 minutes away). I really enjoy how close Baltimore is to fun and excitement, so I know there will be more trips to DC and NY this year too.
Happy, healthy, awesome new year to all.
I will touch on a few ups and downs of the year.
Firstly, let me thank all readers. I really appreciate the comments (that aren't plugging fake universities or spam in other languages) because I like to see that there has been an effect from my efforts. I don't look at the stats often, but glancing today, I see that since I started tracking in 2008, pageloads have increased by 20,000- more than 300%! WOW! And the cross-posts in the sister blog on OT Connections have brought in an extra 50-350 viewers each time, with one anomaly (thank you 1-minute update). It's really exciting to see how this blog has grown and spread, and gets me thinking about some plans for the future (more on that later). So a BIG THANK YOU to each of you, and please always feel free to comment or email me with suggestions.
Most popular pages on this site continue to be Writing Goals and a Case Study With Goals, which is understandable since this is one of the more difficult skills in OT that is not hands-on. I do intend to spend some time getting back to the 'roots' of this blog and posting about decision making, goal writing, and treatment plans. Perplexingly, a rather random What a Week post is the most read on the mirror site, with the exception of my post about Glee that got picked up by 1-minute update. Ironically, some of the posts I spent the MOST time on (e.g. Metacognition and Serial Casting Case Study) don't seem to be as popular, but I don't have tracking to that degree so I can't be positive. I did get several thoughtful comments on my most emotional post (Struggling as an OT for my Family) so I appreciate that deeply.
2010 was the first AOTA Conference I've been to as a practitioner, and even the first I saw after fieldwork. It was great to re-energize and network with other therapists. I think that as you are in the profession longer, you become more aware of others in the field, so I spotted dozens of OT Celebrities this year and got to talk with many, which was awesome.
It was interesting to see all the uproar in AOTA this past year with the potential organizational changes. As we are heading into election season again I see the new blogs and OTC memberships cropping up and it's always notable to see who sticks with it. Props to Bill Wong for continuing to post, and also to Florence Clark for taking up the mantle of the President's Blog.
There were some serious downers last year. We lost my husband's grandmother to Alzheimer's Disease in the summer, which was very difficult for the family. Then over the holidays, we had several additional hospitalizations of our family members, which have yet to completely resolve. Health is so very fragile and some families are like a house of cards... I am learning to take pleasure in contentment and tranquility, because it can all be very fleeting.
I struggled on my final rotation of the year on the cardiopulmonary floor, made extra difficult by the chronic nature of those diseases. It is hard to watch others' independence fade as their bodies fail, and I felt like the efforts I made brought about little change. There were some truly tragic stories in the ICUs that even made attending rounds difficult. I did my best for them, but I am so thankful to be back with a more stable patient base.
As the year ended, I realized that I am no longer really a "new practitioner." Granted, most of my experience is consolidated in one practice area, and I certainly don't know all there is to know about the acute care setting, but I now have a valuable level of skill. I feel like I could go to any adult hospital confidently and be a skilled member of their team. I caught multiple strokes and other medical problems, which makes me feel bad at the time (I hate to see people doing poorly) but it makes me feel that I am a competent professional doing my best to look out for my patients. I progressed with treating pediatrics by taking on outpatients for a few months and doing some feeding interventions for the infants. I was really proud to recognize self-soothing in the baby I evaluated my last day, because even though it's simple, it shows that I am retaining what I've learned though my time to practice is sporadic. I also had my first true fieldwork student, and I don't think I screwed up too badly or she would not have sent beignets. :)
I have a lot to look forward to for 2011. My goal is to spend less time typing notes at home (which is awful!) and more time being able to participate in my "OT extracurriculars"- this blog, OTC, twitter, association stuff. I am now the VP of Advocacy Relations for the Maryland OT Association and things are already in full swing. We are planning for Lobby Night in Annapolis, and would certainly love your company if you're able to attend. I am looking forward to the AOTA Conference in Philly (a mere 2 hours away) and the MOTA Conference (a mere 15 minutes away). I really enjoy how close Baltimore is to fun and excitement, so I know there will be more trips to DC and NY this year too.
Happy, healthy, awesome new year to all.
10.09.2010
Coming Soon- World OT Day!
When I saw this link listing the schedule of online speakers for World OT Day (10/27/10) I started to get really excited!
There are some very famous OTs on this lineup, including Karen Jacobs, Kit Sinclair, Erik Johnson, Michael Iwama, and the current president of the World Federation of Occupational Therapists, Sharon Britnell. Props to Merrolee Penman, who appears to be behind the effort.
I am always seeking to learn more about occupational therapy and think that seeing the world perspective will be very interesting. I'm not sure if these sessions can be accessed at a later time- I will be working and sleeping through most of them. However, here's what I plan to catch (times EST):
2pm: Erik Johnson "Occupational therapy within a military setting" I got to see a short video from Erik during the 2010 AOTA Conference and follow his blog, so I think this will be a pretty interesting and worthwhile session. I'm going to see if we can get a group together to watch at work, and if that doesn't fly, I'm going to take a late lunch and break out the headphones.
5pm: Michael Iwama "The Kawa model: Heralding a new paradigm in occupational therapy" I don't know a lot about the River Model and think this will be a good introduction.
The following presentation 6pm "Re-Connecting: Using Facebook for Social Networking after an Acquired Brain Injury" looks interesting, but I have to get on the bus and get home sometime, so I'll probably have to miss it. (Same goes for 2, 3, 4, 7, 8, 9 which all occur during sleepytime)
7pm: Lindsay Eales & Roxanne Ulanicki "iDance: Transformative Occupations" Looks very unique and awesome, I expect to see many more OTs involved in dance, gymnastics, and other wellness outlets in the future.
8pm: Annette Rivard "The power of professional commitment" self explanatory
9pm: Sharon Brintnell "Images of now and visions for the future" also self explanatory. If you've ever been to an AOTA conference and felt the energizing rush following the president's speech, you know how instrumental that can be for taking momentum home with you and putting new learning into practice. I expect nothing less from our WFOT leader.
It seems that watching these sessions would count towards renewal through NBCOT under "attending workshops/courses/independent learning" (refer to renewal PDF) and depending on your state may count for license renewal as well.
Don't forget that week is also the time for OT Wikiflash, a time for mass editing of Wikipedia to better reflect Occupational Therapy. If you're new to wiki editing, get registered and play in the sandbox now so you can be ready. This is a great way to achieve our Centennial Vision goal of being "widely recognized." I've previously lauded a pediatric blogger for her prolific work on Ehow; Claire Hayward, Anita Hamilton and Will Wade have been active in promoting this event.
There are some very famous OTs on this lineup, including Karen Jacobs, Kit Sinclair, Erik Johnson, Michael Iwama, and the current president of the World Federation of Occupational Therapists, Sharon Britnell. Props to Merrolee Penman, who appears to be behind the effort.
I am always seeking to learn more about occupational therapy and think that seeing the world perspective will be very interesting. I'm not sure if these sessions can be accessed at a later time- I will be working and sleeping through most of them. However, here's what I plan to catch (times EST):
2pm: Erik Johnson "Occupational therapy within a military setting" I got to see a short video from Erik during the 2010 AOTA Conference and follow his blog, so I think this will be a pretty interesting and worthwhile session. I'm going to see if we can get a group together to watch at work, and if that doesn't fly, I'm going to take a late lunch and break out the headphones.
5pm: Michael Iwama "The Kawa model: Heralding a new paradigm in occupational therapy" I don't know a lot about the River Model and think this will be a good introduction.
The following presentation 6pm "Re-Connecting: Using Facebook for Social Networking after an Acquired Brain Injury" looks interesting, but I have to get on the bus and get home sometime, so I'll probably have to miss it. (Same goes for 2, 3, 4, 7, 8, 9 which all occur during sleepytime)
7pm: Lindsay Eales & Roxanne Ulanicki "iDance: Transformative Occupations" Looks very unique and awesome, I expect to see many more OTs involved in dance, gymnastics, and other wellness outlets in the future.
8pm: Annette Rivard "The power of professional commitment" self explanatory
9pm: Sharon Brintnell "Images of now and visions for the future" also self explanatory. If you've ever been to an AOTA conference and felt the energizing rush following the president's speech, you know how instrumental that can be for taking momentum home with you and putting new learning into practice. I expect nothing less from our WFOT leader.
It seems that watching these sessions would count towards renewal through NBCOT under "attending workshops/courses/independent learning" (refer to renewal PDF) and depending on your state may count for license renewal as well.
Don't forget that week is also the time for OT Wikiflash, a time for mass editing of Wikipedia to better reflect Occupational Therapy. If you're new to wiki editing, get registered and play in the sandbox now so you can be ready. This is a great way to achieve our Centennial Vision goal of being "widely recognized." I've previously lauded a pediatric blogger for her prolific work on Ehow; Claire Hayward, Anita Hamilton and Will Wade have been active in promoting this event.
4.22.2010
Blogging Against Disablism Day
May 1, 2010 is this year's Blogging Against Disablism Day. Though I will be at the AOTA Conference (and I hope you will be too) I will try to set up an entry in advance.
Blogging Against Disablism day will be on Saturday, 1st May. This is the day where all around the world, disabled and non-disabled people will blog about their experiences, observations and thoughts about disability discrimination. In this way, we hope to raise awareness of inequality, promote equality and celebrate the progress we've made. ... At the same time, do not feel you have to use the same language that I do, even to talk about "disablism". If you prefer to blog against disability discrimination, ableism or blog for disability equality, then feel free to do so.For more info: Diary of a Goldfish
4.09.2010
Podcast with AOTA Presenter Kelly Casey
Welcome to the First-Ever OTNotes podcast!
Featuring Kelly Casey, Occupational Therapist from The Johns Hopkins Hospital in Baltimore, who is presenting multiple topics at the AOTA Conference. (Get it? That's why we're using the special "speakers-only" badge for this entry) The audio is 22 minutes, please forgive the technical quality and instead focus on the awesome discussion points offered.
Here are some links to helpful information in case you're not taking notes:
Kelly's Topics:
Cognitive assessments discussed:
- Cognitive Assessment of Minnesota
- Executive Function Performance Test
- JFK Coma Recovery Scale
Centennial Vision Statement
Featuring Kelly Casey, Occupational Therapist from The Johns Hopkins Hospital in Baltimore, who is presenting multiple topics at the AOTA Conference. (Get it? That's why we're using the special "speakers-only" badge for this entry) The audio is 22 minutes, please forgive the technical quality and instead focus on the awesome discussion points offered.
Here are some links to helpful information in case you're not taking notes:
Kelly's Topics:
Thu, Apr 29,
Culture Change In Acute Care: An Interdisciplinary Approach to Creating Respect For Therapies
Thu, Apr 29,
Movement Towards The Centennial Vision: Steps Of Post-professional And Entry Level OTDs
Fri, Apr 30,
Assessing Cognitive Disorders: Integrating Standardized Assessments In Acute Care
Cognitive assessments discussed:
- Cognitive Assessment of Minnesota
- Executive Function Performance Test
- JFK Coma Recovery Scale
Centennial Vision Statement
We envision that occupational therapy is a powerful, widely recognized, science-driven, and evidence-based profession with a globally connected and diverse workforce meeting society's occupational needs.
2.10.2010
Snowy Day Thoughts
I am pretty well trapped here at home under several feet of snow.
I felt a little bad calling off work, but they haven't plowed my parking lot and barely touched the street outside the apartment. I really didn't want to walk 2 miles through the snow on the ground (and still coming down hard) to get to the metro (which is running on a delayed schedule) to get to my shuttle bus (also on a delayed schedule) to get to work and then possibly not be able to get back. And now they've actually pulled buses from the roads, and SNOWPLOWS due to dangerous conditions. It's just a little over the top.
I do feel like I made the right decision yesterday though... instead of my usual drive-metro-shuttle bus trip, I got up EARLY (I've been waking up at 5am for a few weeks unintentionally), drove to work and paid to park. Despite driving 30 miles instead of 4, I got home before the worst of the snow started. It was already pretty bad driving at that point, several of the roads having large piles in the middle of the road that got caught on my car's undercarriage, and turns being made hazardous by snow piles taller than my car.
So I'm taking my day off to try to catch up on some fun stuff... reading, finishing my puzzle, but I had a couple OT things to share.
Been trying to come up with some fun OT Month things to do... we are talking about having a carnival at work to promote awareness and need to come up with fun events, favors, etc. I would like to have some ways to increase interest in OT outside of the hospital staff too. I thought about wearing my OT t-shirts to work, but I try to keep all but my scrubs from the germs of hospital-land (to the point that my scrubs are kept in a separate hamper and washed separately from all other clothes). I just got a cute little OTR pin from NBCOT, but it may be a little too little to attract attention. Thoughts?
The other thing that I am currently finding interesting is the proposed restructure of the AOTA governance. This is found in the previous issue of OT Practice (here for members) and causing quite a stir. The theory is that the current structure of the RA and ~dozen large committees is unwieldy and not encouraging quick action, leadership development, or involvement from the membership. The plan is to dramatically shrink the RA, and get more participation from the membership at large through volunteer opportunities and ad hoc committees.
As I said, people are up in arms. This is an interesting OTC thread on the topic with a few people "in the know" in the fray. Here's another, it just hasn't developed much yet.
Personally, I have no attachment to the RA. I observed a portion of a meeting as a student delegate and was not impressed (bored out of my skull might have been more accurate). However, my conference roommate thought that it was really cool and wanted to become a member someday. Elections to the RA in my state were almost always unopposed and run by the same person. I don't recall getting any updates on RA progress at conferences or through state association newsletters. Since I didn't have a close back and forth relationship with my RA rep (not a bad thing necessarily either) I don't know that I will miss out on anything by decreasing the number of members.
I do agree with the theory that it's hard to break into the AOTA leadership... you see a lot of big name people running for offices again and again. So opportunities within the new COOL program that are easy access will make it easier to get feedback from some new blood. From a casual observance of AOTA releases and annual meeting conduct, I could tell that a lot of the work was being done by ad hoc committees instead of standing committees, so I don't know that we're losing much in that department either. I don't know that having the ASD classified as an organizational advisor makes much sense either. As a former member of the ASD, my involvement was limited to one day of mostly being presented to, not really involved with anything until we started the Centennial Vision talks. I'm sure the steering committee is more involved, but some of them aren't even students.
Lots to think about and bring forward to your reps before the AOTA Conference at end of April. Read up on the issue. Talk it out online, especially on OTC. And don't forget to vote in the AOTA elections before March 3.
I felt a little bad calling off work, but they haven't plowed my parking lot and barely touched the street outside the apartment. I really didn't want to walk 2 miles through the snow on the ground (and still coming down hard) to get to the metro (which is running on a delayed schedule) to get to my shuttle bus (also on a delayed schedule) to get to work and then possibly not be able to get back. And now they've actually pulled buses from the roads, and SNOWPLOWS due to dangerous conditions. It's just a little over the top.
I do feel like I made the right decision yesterday though... instead of my usual drive-metro-shuttle bus trip, I got up EARLY (I've been waking up at 5am for a few weeks unintentionally), drove to work and paid to park. Despite driving 30 miles instead of 4, I got home before the worst of the snow started. It was already pretty bad driving at that point, several of the roads having large piles in the middle of the road that got caught on my car's undercarriage, and turns being made hazardous by snow piles taller than my car.
So I'm taking my day off to try to catch up on some fun stuff... reading, finishing my puzzle, but I had a couple OT things to share.
Been trying to come up with some fun OT Month things to do... we are talking about having a carnival at work to promote awareness and need to come up with fun events, favors, etc. I would like to have some ways to increase interest in OT outside of the hospital staff too. I thought about wearing my OT t-shirts to work, but I try to keep all but my scrubs from the germs of hospital-land (to the point that my scrubs are kept in a separate hamper and washed separately from all other clothes). I just got a cute little OTR pin from NBCOT, but it may be a little too little to attract attention. Thoughts?
The other thing that I am currently finding interesting is the proposed restructure of the AOTA governance. This is found in the previous issue of OT Practice (here for members) and causing quite a stir. The theory is that the current structure of the RA and ~dozen large committees is unwieldy and not encouraging quick action, leadership development, or involvement from the membership. The plan is to dramatically shrink the RA, and get more participation from the membership at large through volunteer opportunities and ad hoc committees.
As I said, people are up in arms. This is an interesting OTC thread on the topic with a few people "in the know" in the fray. Here's another, it just hasn't developed much yet.
Personally, I have no attachment to the RA. I observed a portion of a meeting as a student delegate and was not impressed (bored out of my skull might have been more accurate). However, my conference roommate thought that it was really cool and wanted to become a member someday. Elections to the RA in my state were almost always unopposed and run by the same person. I don't recall getting any updates on RA progress at conferences or through state association newsletters. Since I didn't have a close back and forth relationship with my RA rep (not a bad thing necessarily either) I don't know that I will miss out on anything by decreasing the number of members.
I do agree with the theory that it's hard to break into the AOTA leadership... you see a lot of big name people running for offices again and again. So opportunities within the new COOL program that are easy access will make it easier to get feedback from some new blood. From a casual observance of AOTA releases and annual meeting conduct, I could tell that a lot of the work was being done by ad hoc committees instead of standing committees, so I don't know that we're losing much in that department either. I don't know that having the ASD classified as an organizational advisor makes much sense either. As a former member of the ASD, my involvement was limited to one day of mostly being presented to, not really involved with anything until we started the Centennial Vision talks. I'm sure the steering committee is more involved, but some of them aren't even students.
Lots to think about and bring forward to your reps before the AOTA Conference at end of April. Read up on the issue. Talk it out online, especially on OTC. And don't forget to vote in the AOTA elections before March 3.
6.11.2009
Quickie Acute Care Stories
It's hard to remember the stories from my job now since I pass in and out of peoples' lives much quicker and can zombie zone-out trying to make it through a ridiculously scheduled day. Like yesterday morning, when I found myself staring at 11 potential evals with no one to share. In the zone. Anyhow, here are some memorable moments...
3 Primary Runners for "Patient of the Day!!"
- Mr. X is 1 month s/p CVA that was not treated well at his hospital and received no rehab, now presents w/ visual deficits. He talks about his eyes dilating in and out, changes in light and dark, and not being able to see well. Finally he says, "I can only see half your face." Trying to figure out if this is a hemianopsia or other field cut, I ask which side. And his reply is, "the one with the big pimple."
- Mrs. Y is s/p fall and starting to have some memory problems, but is well tended to by her family. She says, "my daughter diagnoses me very accurately. She knew I had kidney failure while my doctor was still running blood tests." The PT asks, "is your daughter a doctor?" and she replies, "no, she uses the internet."
- Mr. Z is admitted for COPD, but apparently has no functional deficits and the shortness of breath isn't kicking in very quickly during activity. Unable to evaluate him during the morning as he had eloped out of the hospital, off the campus, and down to the gas station for a coffee and a newspaper. (independent community mobility- check!)
I just don't think you can write fiction to accurately display the craziness of the real world.
I was happy about Mr. X though because I happened to be sitting in on rounds and the PA was saying what a good vision workup OT had done with him, which made me feel good as vision is not my specialty. (Thank you Gutman and Schonfeld, I never would have remembered it without you). Later in the week, I was attending a different set of rounds and they were discussing a pt. w/ eyesight that had deteriorated due to cancer and suggested a low vision consult, and it was a good opportunity to educate the case manager, social worker, and doctor, as none of them had any idea that OT could do so much in the field. So, a few vision victories there.
Touching on the original point again, it is hard to blog after work now. The acute care life can be quite stressful and there's such pt turnover that I do mind-dump a lot. That and the use of the laptop all day makes it difficult to work on it in the evening as well. Really trying to avoid repetitive strain injuries, and it is becoming quite difficult. I do have a lot of good jotted down ideas that will get typed up eventually, but I've been restricting my blog access until I get a (for now) secret project accomplished. I am also in the midst of 7 straight weeks of full weekends- either I travel or someone traveling to me- and that leaves less time for other stuff too. Like my exercise goal, which is now back somewhere in the precontemplation phase... GIANT sigh.
Until next time- enjoy the crazy things life brings you today!
3 Primary Runners for "Patient of the Day!!"
- Mr. X is 1 month s/p CVA that was not treated well at his hospital and received no rehab, now presents w/ visual deficits. He talks about his eyes dilating in and out, changes in light and dark, and not being able to see well. Finally he says, "I can only see half your face." Trying to figure out if this is a hemianopsia or other field cut, I ask which side. And his reply is, "the one with the big pimple."
- Mrs. Y is s/p fall and starting to have some memory problems, but is well tended to by her family. She says, "my daughter diagnoses me very accurately. She knew I had kidney failure while my doctor was still running blood tests." The PT asks, "is your daughter a doctor?" and she replies, "no, she uses the internet."
- Mr. Z is admitted for COPD, but apparently has no functional deficits and the shortness of breath isn't kicking in very quickly during activity. Unable to evaluate him during the morning as he had eloped out of the hospital, off the campus, and down to the gas station for a coffee and a newspaper. (independent community mobility- check!)
I just don't think you can write fiction to accurately display the craziness of the real world.
I was happy about Mr. X though because I happened to be sitting in on rounds and the PA was saying what a good vision workup OT had done with him, which made me feel good as vision is not my specialty. (Thank you Gutman and Schonfeld, I never would have remembered it without you). Later in the week, I was attending a different set of rounds and they were discussing a pt. w/ eyesight that had deteriorated due to cancer and suggested a low vision consult, and it was a good opportunity to educate the case manager, social worker, and doctor, as none of them had any idea that OT could do so much in the field. So, a few vision victories there.
Touching on the original point again, it is hard to blog after work now. The acute care life can be quite stressful and there's such pt turnover that I do mind-dump a lot. That and the use of the laptop all day makes it difficult to work on it in the evening as well. Really trying to avoid repetitive strain injuries, and it is becoming quite difficult. I do have a lot of good jotted down ideas that will get typed up eventually, but I've been restricting my blog access until I get a (for now) secret project accomplished. I am also in the midst of 7 straight weeks of full weekends- either I travel or someone traveling to me- and that leaves less time for other stuff too. Like my exercise goal, which is now back somewhere in the precontemplation phase... GIANT sigh.
Until next time- enjoy the crazy things life brings you today!
5.02.2009
Recession Job Market
For the third part in the little mini-series on job hunting (here's the links in case you missed searching or interviewing for an OT job) I would like to address the topic of job-hunting in the midst of a recession.
The recession is not making big headlines this week, perhaps because the doomsayers have realized that we are probably not going to end up in another great depression or a post-apocalyptic nation focused solely on survival. However, it is still a topic on people's minds, especially when discussing a job search.
Occupational therapy made the headlines by landing on Time's 150 Recession-Proof Jobs list. OTRs come in at #18, and OTAs at #72. Rehab/Healthcare jobs in general were well represented on this list- PTs, PTAs, Therapy Aides, SLPs, and also RNs, LPNs, Athletic trainers, Massage and Respiratory therapists were all in the top 120.
We now interrupt this entry with a quick little note about political advocacy here. It's likely that athletic trainers have climbed their way onto the 'recession proof' list through their efforts to redefine their scope of practice on a political level. Since any individual can now be considered an "athlete," they now have a much wider base of clients to work with and places to seek employment- like outpatient rehab clinics. Recreational therapists, on the other hand, are not on this list, perhaps because they have been cut out of some Medicare legislation affecting reimbursement and their necessity to be employed in certain environments. Right now, they're trying to become a covered, required service under Medicare for additional settings. Just a little word about how you can't live as a therapist in isolation- political action is required if you'd like to continue having a job and being relevant to the rehab world. As one of my teachers said, if you don't have the time to do it, at least kick some money to the people that are working on it at your state and national associations. We now return you to your scheduled blog entry.
One thing that surprises me about the job list is that OTAs are not higher on the list, or even higher than OTs. I would think using more OTAs could be more profitable for many organizations, as long as there are not a superfluous amount of evaluations to be done as opposed to treatments. My current job is obviously one of those places since we get about 1200-1500 orders for OT/PT/SLP evals each month, so there are only 2 OTAs and 1 PTA. OT Practice recently had an article celebrating 50 years of OTA education, and the associate's degree remains a cost-effective way to get into occupational therapy.
Despite the accolades the profession has been garnering, I think that the only people who say that OT is 'recession proof' are those not currently working in healthcare. Many sites are in the midst of a soft or full-on hiring freeze. Some hospital units are closing completely, orthopedic units are trying to step up the service due to decreased elective surgeries- My old hospital was trying to see acute orthopedic surgery pts 3x for PT and 2x for OT everyday; a friend at a hospital-based SNF was trying to see subacute ortho pts 2x for PT and 1x for OT each day, which is causing their depleted staff to work overtime everyday. (Obviously the second group is salaried, keep that in mind during your job search.) PRN (as needed) nurses and therapists are seeing a dramatic cutback in use of their services, which used to be a pretty lucrative way to earn money without a full time commitment.
Though it may be callous to gripe about cutbacks on perks, that too has become the reality. Sign-on bonuses (taxed very high anyway) are getting cut. CE money is often getting cut, which is a shame, because high intesity courses that give a lot of hours are more expensive. It stands to reason that therapists might choose to stick close to home and maybe go for something based less on the knowledge they will receive and more within their price range. I don't know that it's technically fradulent to pursue CEs outside your realm of practice, but it is professionally discouraged. It wouldn't fly in my current state, since they have to preapprove everything you go to. Money for therapy supplies is likely getting slashed in budgets, so you may have to appeal to grants to get the fancy new equipment. Another cutback is in the retirement arena- matching 401K funds are dwindling. My current company still has a pension plan, which I thought had all gone kaput long ago, but they are keeping that and tossing out the matching funds.
If you work for a hospital, then at least your healthcare benefits are fairly safe. After all, they can't just deny you admission to the hospital. However, I have heard of some places charging an extra fee if your spouse's employer also offers health insurance but you chose instead to go with the hospital's plan. The wording was that the hospital couldn't afford to subsidize the rest of the county's healthcare costs. The other issue related to healthcare is that it can be hard to job-swap since a person would face up to 3 months without any benefits, especially if you have a spouse or family depending on you for coverage. If you're single with a chronic health condition (especially including pregnancy) then the issue has to be weighing into your decision as well. Related to that, it's good to pick an area that has multiple job offerings, so that you don't have to pick up and move if you want to work somewhere new. In a related situation, it would be very difficult for my husband to find a new job, so when I accepted my new position, we had to live somewhere that would be a reasonable commute for both of us. Part of the reason that we chose to move to Baltimore instead of back where our parents live is so that he could keep his job- trying to move and find 2 new jobs is stress that we're not ready for yet.
Though this post is a bit of a downer, don't be mistaken, there are OT jobs out there. You may have to take a position that isn't your dream job, but there will likely be plenty of positions available in hospitals, SNFs, and large facilities. There will probably be fewer openings in schools (these are usually limited anyway since people tend to keep those jobs when they get them) and small private practice facilities. There are also likely to be fewer openings in OT college towns since there is always a fresh supply of therapists available. But when there is a legitimate opening at any location, the current therapists will likely be stressed by trying to deal with the workload and they will want to fill their position. And if you're just starting OT school, don't be put off by the cost of the degree. Student loan debt is better to have than other types, people have used those loans for international travel and buying cars and still come out ahead. And since there will be some type of OT job available when you graduate (not necessarily a perfect one, or one that pays $100,000/year) you will be able to pay back your loans.
The jobs are out there, good luck to everyone that's looking. I have to guess that they will be a little harder to land in May or December, so you may want to start your search pre-graduation if you're expecting to get a job right after school is out. Happy hunting, everyone!
The recession is not making big headlines this week, perhaps because the doomsayers have realized that we are probably not going to end up in another great depression or a post-apocalyptic nation focused solely on survival. However, it is still a topic on people's minds, especially when discussing a job search.
Occupational therapy made the headlines by landing on Time's 150 Recession-Proof Jobs list. OTRs come in at #18, and OTAs at #72. Rehab/Healthcare jobs in general were well represented on this list- PTs, PTAs, Therapy Aides, SLPs, and also RNs, LPNs, Athletic trainers, Massage and Respiratory therapists were all in the top 120.
We now interrupt this entry with a quick little note about political advocacy here. It's likely that athletic trainers have climbed their way onto the 'recession proof' list through their efforts to redefine their scope of practice on a political level. Since any individual can now be considered an "athlete," they now have a much wider base of clients to work with and places to seek employment- like outpatient rehab clinics. Recreational therapists, on the other hand, are not on this list, perhaps because they have been cut out of some Medicare legislation affecting reimbursement and their necessity to be employed in certain environments. Right now, they're trying to become a covered, required service under Medicare for additional settings. Just a little word about how you can't live as a therapist in isolation- political action is required if you'd like to continue having a job and being relevant to the rehab world. As one of my teachers said, if you don't have the time to do it, at least kick some money to the people that are working on it at your state and national associations. We now return you to your scheduled blog entry.
One thing that surprises me about the job list is that OTAs are not higher on the list, or even higher than OTs. I would think using more OTAs could be more profitable for many organizations, as long as there are not a superfluous amount of evaluations to be done as opposed to treatments. My current job is obviously one of those places since we get about 1200-1500 orders for OT/PT/SLP evals each month, so there are only 2 OTAs and 1 PTA. OT Practice recently had an article celebrating 50 years of OTA education, and the associate's degree remains a cost-effective way to get into occupational therapy.
Despite the accolades the profession has been garnering, I think that the only people who say that OT is 'recession proof' are those not currently working in healthcare. Many sites are in the midst of a soft or full-on hiring freeze. Some hospital units are closing completely, orthopedic units are trying to step up the service due to decreased elective surgeries- My old hospital was trying to see acute orthopedic surgery pts 3x for PT and 2x for OT everyday; a friend at a hospital-based SNF was trying to see subacute ortho pts 2x for PT and 1x for OT each day, which is causing their depleted staff to work overtime everyday. (Obviously the second group is salaried, keep that in mind during your job search.) PRN (as needed) nurses and therapists are seeing a dramatic cutback in use of their services, which used to be a pretty lucrative way to earn money without a full time commitment.
Though it may be callous to gripe about cutbacks on perks, that too has become the reality. Sign-on bonuses (taxed very high anyway) are getting cut. CE money is often getting cut, which is a shame, because high intesity courses that give a lot of hours are more expensive. It stands to reason that therapists might choose to stick close to home and maybe go for something based less on the knowledge they will receive and more within their price range. I don't know that it's technically fradulent to pursue CEs outside your realm of practice, but it is professionally discouraged. It wouldn't fly in my current state, since they have to preapprove everything you go to. Money for therapy supplies is likely getting slashed in budgets, so you may have to appeal to grants to get the fancy new equipment. Another cutback is in the retirement arena- matching 401K funds are dwindling. My current company still has a pension plan, which I thought had all gone kaput long ago, but they are keeping that and tossing out the matching funds.
If you work for a hospital, then at least your healthcare benefits are fairly safe. After all, they can't just deny you admission to the hospital. However, I have heard of some places charging an extra fee if your spouse's employer also offers health insurance but you chose instead to go with the hospital's plan. The wording was that the hospital couldn't afford to subsidize the rest of the county's healthcare costs. The other issue related to healthcare is that it can be hard to job-swap since a person would face up to 3 months without any benefits, especially if you have a spouse or family depending on you for coverage. If you're single with a chronic health condition (especially including pregnancy) then the issue has to be weighing into your decision as well. Related to that, it's good to pick an area that has multiple job offerings, so that you don't have to pick up and move if you want to work somewhere new. In a related situation, it would be very difficult for my husband to find a new job, so when I accepted my new position, we had to live somewhere that would be a reasonable commute for both of us. Part of the reason that we chose to move to Baltimore instead of back where our parents live is so that he could keep his job- trying to move and find 2 new jobs is stress that we're not ready for yet.
Though this post is a bit of a downer, don't be mistaken, there are OT jobs out there. You may have to take a position that isn't your dream job, but there will likely be plenty of positions available in hospitals, SNFs, and large facilities. There will probably be fewer openings in schools (these are usually limited anyway since people tend to keep those jobs when they get them) and small private practice facilities. There are also likely to be fewer openings in OT college towns since there is always a fresh supply of therapists available. But when there is a legitimate opening at any location, the current therapists will likely be stressed by trying to deal with the workload and they will want to fill their position. And if you're just starting OT school, don't be put off by the cost of the degree. Student loan debt is better to have than other types, people have used those loans for international travel and buying cars and still come out ahead. And since there will be some type of OT job available when you graduate (not necessarily a perfect one, or one that pays $100,000/year) you will be able to pay back your loans.
The jobs are out there, good luck to everyone that's looking. I have to guess that they will be a little harder to land in May or December, so you may want to start your search pre-graduation if you're expecting to get a job right after school is out. Happy hunting, everyone!
10.01.2008
notes from the listserv
As an AOTA member, I subscribe to a couple of special interest listservs in an effort to get smarter semi-randomly. Yet, I often want to unsubscribe for one of two reasons:
1. Failure to observe internet/listserv etiquette. Perhaps I'm a spoiled person, having had internet access since I was 10, but there are some basic rules that people should observe online when their words come into my sphere. Please!!! Don't type in caps! Use a subject in your emails! Send a direct reply to the sender if your message does not contribute to the entire discussion (e.g. "thanks" or "can you send that to me too?").
2. OT Trolls. Yes, they exist. They seize on an opportunity to argue, in detail, about whether Person A is doing OT, what the difference between OT and PT is, whether the original poster was being a good OT or not... ad nauseum. I've wondered about suggesting that a new listserv be created just so that people can keep their biased partisan arguments about OT ("OT's can't walk people! That's PT!" vs "It's better to walk them than to do a stupid craft or game!") somewhere else. Perhaps I wouldn't be so irritated about this fight about the OT domain if we didn't have a practice framework that detailed an outline for therapy, or if this exact same fight didn't already happen a few months ago when the last RA motions were up for debate, or if it didn't all look suspiciously like one person stirring the pot in an effort to get more attention to their website and ideas.
An open call to stop this foolhardy "debate" if you can call it that. Functional mobility is part of the OT practice act. Enabling and Prepartory activities are part of our treatment framework. Crafts and games are at the foundation of the profession from the Reconstruction Aides. All of the arguers are right. And wrong, because limiting your practice to only one of these areas is not OT either. OT is a beautiful profession because at its core is the belief that engagement in meaningful occupation will promote health. Don't limit yourself as a practitioner, or you will limit us all, and our clients.
1. Failure to observe internet/listserv etiquette. Perhaps I'm a spoiled person, having had internet access since I was 10, but there are some basic rules that people should observe online when their words come into my sphere. Please!!! Don't type in caps! Use a subject in your emails! Send a direct reply to the sender if your message does not contribute to the entire discussion (e.g. "thanks" or "can you send that to me too?").
2. OT Trolls. Yes, they exist. They seize on an opportunity to argue, in detail, about whether Person A is doing OT, what the difference between OT and PT is, whether the original poster was being a good OT or not... ad nauseum. I've wondered about suggesting that a new listserv be created just so that people can keep their biased partisan arguments about OT ("OT's can't walk people! That's PT!" vs "It's better to walk them than to do a stupid craft or game!") somewhere else. Perhaps I wouldn't be so irritated about this fight about the OT domain if we didn't have a practice framework that detailed an outline for therapy, or if this exact same fight didn't already happen a few months ago when the last RA motions were up for debate, or if it didn't all look suspiciously like one person stirring the pot in an effort to get more attention to their website and ideas.
An open call to stop this foolhardy "debate" if you can call it that. Functional mobility is part of the OT practice act. Enabling and Prepartory activities are part of our treatment framework. Crafts and games are at the foundation of the profession from the Reconstruction Aides. All of the arguers are right. And wrong, because limiting your practice to only one of these areas is not OT either. OT is a beautiful profession because at its core is the belief that engagement in meaningful occupation will promote health. Don't limit yourself as a practitioner, or you will limit us all, and our clients.
3.20.2008
Don't forget to vote!
Deadline for feedback on RA motions is March 28- that's next Friday, AOTA members.
You can find info about the RA motions in the March 10 issue of OT Practice, or this page which has links to all the papers and reports. You can voice your concerns to your state rep by filling out this survey.
I attended part of an RA meeting as part of my stint as a student delegate. Honestly, I find meetings in general to be pretty boring and this was no exception. I am not willing to learn parliamentary procedure and hash out word by word details of various motions that I find to be soporific. Thankfully, there are some people who are willing to take on this responsibility, but without feedback, they are on their own for decisions. While some consider most of the RA motions to be of no concern, it should be noted that there has been a lot of heated debate on the Phys-Dys listserv about Motion 1. These motions can affect the future of OT practice, so it's worth taking 20-30 minutes to give your rep some feedback about what you want for your future. Do it soon though!
You can find info about the RA motions in the March 10 issue of OT Practice, or this page which has links to all the papers and reports. You can voice your concerns to your state rep by filling out this survey.
I attended part of an RA meeting as part of my stint as a student delegate. Honestly, I find meetings in general to be pretty boring and this was no exception. I am not willing to learn parliamentary procedure and hash out word by word details of various motions that I find to be soporific. Thankfully, there are some people who are willing to take on this responsibility, but without feedback, they are on their own for decisions. While some consider most of the RA motions to be of no concern, it should be noted that there has been a lot of heated debate on the Phys-Dys listserv about Motion 1. These motions can affect the future of OT practice, so it's worth taking 20-30 minutes to give your rep some feedback about what you want for your future. Do it soon though!
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