The Wherewithal to Change

 Hi all,

I am writing to clearly express my reasons for believing in the recommendations of the Membership Participation Ad Hoc Committee's proposal for reorganization of our governance structure.

If you do not think we need to change our AOTA governance structure, then why have greater than 70% of occupational therapy practitioners and students chosen not to be members of the organization even with the advent of aggressive marketing, extensive interviews and surveys of nonmembers, reshaping member benefits, and emphasis upon professionalism in entry-level education? Who will be the life-time members of the future after baby boomers retire as the average length of continuous membership has shrunk to 4 years? How many total members will we need to advance the profession based on a metric of each individual being a member for 4 years or less? Why is it that we have more members over 60 than we do under 30? What is it about the membership value proposition that needs changing? What competition do we face in trying to obtain the interest and loyalty of new members while at the same time increasing retention of existing members? We must remember that we cannot mandate membership like we did in the past when AOTA was also the certifying body for the profession.

As I near the end of my Presidency, what are the lessons I have learned, particularly when you examine our membership issues in conjunction with all that has occurred in the world surrounding us, such as a global economic recession? Here is what I have learned and want to pass on to all our leaders and members. Even in the best of times, it is a given that there are limits to human and financial resources. As a steward of membership investment in our Association, it is my duty in conjunction with members of the Board of Directors to make strategic decisions about how we will use our resources for the greatest impact in achieving our Centennial Vision goals and objectives. The proposal from the Membership Participation Ad Hoc Committee is about increasing the membership value proposition in that we know members feel valued when they are involved to their level of satisfaction (not too much and not too little). They want to be asked to participate in important ways. While our membership percentage to nonmembers may be higher than other organizations, we are a small profession in total. Therefore, this percentage does not translate into the human and financial capital needed to accomplish our important work for the profession and the clients we serve. If you examine the member survey informing the Membership Participation Ad Hoc Committee, 80% were satisfied with their level of involvement. This means that 20% are not, which is decidedly more than the percentage of those currently involved (6%). Why would we not go after this 20% who want more involvement? Why would we not advocate change when our current structure limits who can be involved?

The reorganization conceptual proposal is about focusing the work of our volunteers on the issues and challenges in the external environment. For instance, what current organizational structures are responsible for tackling ways that efficiently create impact in successfully resolving tough reimbursement issues, scope of practice challenges, healthcare policy questions, gathering evidence, creating research capacity, pushing for educational excellence, facilitating growth in practice, and supporting and developing emerging practice areas? These are tough questions because the key word is impact. For instance, perhaps the greatest impact in terms of creating diversity in the profession is for educational groups within the organization to marshal their efforts in advocating for federal support of faculty development, of student loan programs, and of student loan forgiveness programs.  I cannot identify any standing committee in the volunteer sector of the organization, despite its many bodies, that would see these activities as a core responsibility.

Further, the kinds of impacts we now need to have must occur without delay. In the past, we had time to allow impact to build slowly over many years.  We could experiment with a variety of Association strategies until we got it right. Membership energy must be mobilized quickly. Specialized ad hoc committees need to be assembled with immediacy and given priority, such as, for example, to address the coming storm over Medicaid. Can we free up the human and financial capital to launch aggressive advocacy in every state in which this is occurring? Today’s issues demand expediency and laser-focus. And the process of recruiting the best talent to produce the most powerful results must be accelerated.  We do not have the luxury to simultaneously operate complicated structures with diffuse agendas while we also try to focus on the Centennial Vision priorities. It is time to redirect resources if we are to truly go for impact.

Penny Moyers Cleveland

AOTA President

Published 13 Mar 2010 7:13 PM by Penelope Moyers
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Comments

# re: The Wherewithal to Change

Saturday, March 13, 2010 3:14 PM by Ron Carson

"then why have greater than 70% of occupational therapy practitioners and students chosen not to be members of the organization even with the advent of aggressive marketing, extensive interviews and surveys of nonmembers, reshaping member benefits, and emphasis upon professionalism in entry-level education?"

This is a great question. While I don't KNOW the answer, I'm pretty sure that it has very little to do with governance.

In my opinion, OT practitioners do not have a strong identification with their daily practice nor the profession. The lack of identity is reinforced by the current health care system where OT is almost a non-entity.  In general I do not believe most OT's have pride in being an OT. Thus, they are not motivated to join either their State or National organizations.

I fail to see how a governance change will alter this situation.

# re: The Wherewithal to Change

Sunday, March 14, 2010 8:51 PM by Penelope Moyers

When you read and study leadership, it is obvious that if you want to increase the size of an organization, you don't just go after one individual at a time. Instead you go after leaders who then bring in their colleagues. That is in fact what AOTA leadership has been doing. During the past 4 years, membership has increased dramatically so that we have grown from about 36,000 members to now 41,000 members. Now we are launching retention efforts with some success. But, the overwhelming evidence is that people want the Association to mean something to their practice and to help them with their everyday world. This means focusing on very practical issues such as reimbursement, documentation, effective and efficient intervention and assessment, etc. Because we have so many practical issues to solve, a governance structure that involves many more people and focuses their work externally is a great advantage.

I am an optimist as I work with some fantastic students and faculty. These students are eager to lead and contribute, but must be mentored into careers that include leadership. It can be done.

Thanks for your response. In another posting you were supportive, so don't get negative. Every problem raises fantastic possibilities!

Penny Moyers Cleveland

AOTA President

# re: The Wherewithal to Change

Monday, March 15, 2010 4:23 PM by Bill Wong

I agree with what Dr. Moyers said.  Sure, I have some leadership skills coming into my OT school program (this of course varies for each student).  But, the components were like random puzzle pieces because they came from my observation of other successful leaders as well as from the leadership literature I have read prior to coming to OT school.  OT school, I would say, served as the glue that puts everything together... which not only applies to my development as an OT (if I were to lead a treatment), but also my occupation as a young adult leader who loves to do ministry work.

The main thing I learn in OT school in leadership is that "It's great if you have a grand vision, as a grand vision could consist of many points.  But, be prepared to think of different ways to guide your followers from one point to another.  Also, don't be frustrated if there's lack of progress.  Sometimes your expectations might be too high, but sometimes people are just not as motivated as you even if a lot of people agreed with you that your expectations are reasonable."

Of course, as you noted in my blog, sometimes I can't give up just because things didn't go my way time and time again.  After all, some people can get into leadership on their first tries.  Then there are people like me who are waiting for their big break.  I can't control what people think, but what I can control are to get myself out there, continue to accumulate leadership experience, and maintain a belief that I will breakthrough one day.

I believe that our profession will be in great hands (though I am more than a little about Dr. Clark's upcoming term as president).  If OT programs in the country can continue to get students who has some leadership experience, change will happen before you know it.

# re: The Wherewithal to Change

Wednesday, March 17, 2010 5:40 PM by Ron Carson

"Thanks for your response. In another posting you were supportive, so don't get negative. Every problem raises fantastic possibilities!

Penny Moyers Cleveland

AOTA President"

Dr.Moyers, I really don't appreciate the above comment.  I'm not on this or any other forum to be "positive", I'm on here to share my honest opinion, be positive or negative. Maybe that's part of our profession's problem, everyone is too worried about being "positive". If AOTA leaders are looking for "positive" comments then they aren't really looking for the truth because the truth is usually a combination of negative and positive.

# re: The Wherewithal to Change

Thursday, March 18, 2010 1:44 PM by arfulton

The issue is equally about governance and internal advocacy. The restructuring of AOTA to facilitate member involvement - at all levels of practice and experience - is important because it opens the doors to emerging leaders.  But even then, leaders will primarily emerge out of the pool of current members.  To attract practitioners to become members, OTs need to advocate for AOTA among their peers.

I agree with your statement about mentoring, Dr. Moyers.  Mentoring relationships (formal or informal, individual or group) are one of the best ways for one person to learn the role of another person.  Without personal guidance from current leaders to their protégés, leadership roles may seem daunting.

Realistically, of course, not every student is passionate and determined to be a leader.  Many of us students are naive to what goes into leader roles/positions, and don't realize what AOTA membership offers. But in general, I think students have a fresh, positive outlook, and WANT to be better, to learn, to grow. An organizational push for mentoring could result in leader development as well as advocacy for AOTA membership.

# re: The Wherewithal to Change

Tuesday, March 23, 2010 12:43 AM by Penelope Moyers

I don't think we have an option but to lead. We are in the minority in this country in terms of having a graduate education if we are occupational therapists, and a strong technical education if we are occupational therapy assistants. We should be giving back to society. Leading is not associated with position in any organization. People can lead from where they are as long as they have passion and motivation to see things change for the better. It takes energy to lead and is easier to stay in the status quo. Some great accomplishments have occurred from our students both at the national and state levels. Mentoring of younger professionals cannot be ignored but it has to be from people who really have an interest in working with new professionals and who have a gift for developing others. Mentoring can come from many sources and does not have to be from one individual. Sometimes, one person can say and do the right thing at the right time to make a difference in your life. Thank you for your comments.

I appreciate all who contribute on this forum; however, I realize that sometimes in trying to get a message across, it may be taken in the wrong way from what it was intended. (I'm sorry Ron Carson for offending you.)

Penny Moyers Cleveland

AOTA President