I'm Carol Siebert. I've been an occupational therapist for more than 25 years. I LOVE being an OT.
My views of occupation and of occupational therapy have been shaped by many things. I'll share four of those here:
1) My experience as a person with a chronic condition. Dealing with a health condition (and our frustrating health care system) should never get more attention, energy or importance than having a life! Living Life to It's Fullest means that managing a health condition is just one aspect of living life. As a person, a patient and as an OT, I know that. But it's clear that too much of our healthcare system is based on the assumption that being a patient-a compliant patient-- is more important than having a life. For me, OT is about living life while managing one or more health conditions.
2)The work I was doing when I discovered OT: working in a group home with young adults with profound intellectual and physical impairments. This is where I learned the concept of Dignity of Risk. In a nutshell, that means being human is about having choices and taking chances-there's more to life than being safe. Those clients are the reason I am an OT. My boss (Jan, a social worker), is the person who taught me the meaning of "change agent."
3) The guidance of professors who were wonderful mentors and powerful OTs. They taught me that OT is as much about thinking, reasoning and advocating as it is doing--and that our profession is most powerful when it deals with the most commonplace. Yes, in many ways OT is rocket science. Thanks especially to Cathy Nielson and Marlys Mitchell.
4) An early practice encounter that forced me to learn about payment and policy. I learned-and continue to learn--that our practice does not exist in a vacuum. Just as our patients and clients live in a dynamic social, physical and cultural world, our practice exists in a dynamic social, economic and political world. Those factors and forces that influence practice fascinate me. I choose to use a term Barb Schell associated with this aspect of practice: "pragmatics" to refer to the many factors that affect our practice beyond those driven by a given patient or client's needs and priorities.
Most of my career has been in some form of home care or community practice. I've directed an adult day program, practiced in home health, consulted in home modifications, taught in an OT curriculum on practice environments, health conditions, gerontology and administration and policy. Most recently I've worked on a community health project serving low income older adults and Medicaid recipients. I am a policy geek--and thanks to the internet I can look up Medicare regulations, licensure provisions or reimbursement criteria so I am prepared to respond when someone tells me "OT can't . . . " or "OT shouldn't . . ."
OK, enough about where I'm coming from. Those who know me know that sometimes I just have to connect a bunch of ideas that are buzzing around in my brain and get them down in words. This blog is my occasional effort to do just that. Let me know what you think!
Recently the AOTA Board of Directors Issued a position statement regarding entry level at the OTD level. I have a number of concerns about the Board's action and the statement itself:
I know most of the AOTA Board members personally, and I respect that they gave thoughtful consideration, individually and collectively, to their decision to issue the position statement. But I think the action and the statement itself is ill-advised. AOTA's history as a professional organization is dominated by a focus on ourselves and those we serve, and a lack of attention to the interests of other stakeholders. So I find myself once again asking the question--how does this position affect the interests of stakeholders beyond practitioners and patients? What about OTs in other countries whose opportunities to share their expertise with us are further limited? What about potential OTs with modest finances who will not be able to afford an entry level education--or graduates who will feel forced to take positions that are exclusively technical to pay off crushing educational loans? What about the decision makers at institutions of higher learning who decide the fate of existing and future educational programs? What about the growing consolidation of employer entities in post acute settings who can wield significant political and economic pressure on both education and on licensure? There are many more external stakeholders to consider. There is also an internal issue to resolve- the role of the AOTA Board of Directors in regard to issuance of position statements on professional policy.
Thank you very much for sharing your thoughts and perspectives on the issue of moving to a single point of entry for the occupational therapist.
I have reviewed the currently approved articles of incorporation, the Bylaws, the Administrative Operating Procedures and the policy manual.
The Board has not established professional standards or policy which is the function of the Representative Assembly as a designated body of the Board. It has not called for any action item by the Assembly. It has not established standards for educational programs or affected the policies, rules or procedures for conducting accreditation reviews or making accreditation standards which is delegated to ACOTE as an Associated Advisory Council of the Board and has autonomy in those functions.
The Board issued an opinion that relates to the strategic direction of the profession and current trends in practice and education and has called for member input and dialogue. By the nature of the statement it is an opinion on current association policy. I see all of this as clearly within the purview of the Board of Directors.
While in a legal sense all documents approved by a body of the Association are “official” the statement issued does not match any of the titles of types of official documents that are routinely reviewed and approved by the Representative Assembly or a body of the RA.
I would be interested in hearing more detail about your concern over issuance of a position statement by the Board of Directors and how you see it in conflict with the approved description of roles or responsibilities of the Board.
Again, thank you for your thoughtful comments describing your concern over having a single point of entry for the occupational therapist at the doctoral level. I appreciate your perspective and your experience very much.
Carol, I really appreciate you bringing up the challenges that a change in USA entry level education will create for international relationships, and the perceptions of US OT by internationally trained OTs. From my perspective, considering impact on global connections is an essential part of the discussion of entry level education going forward. Sue
I couldn't have said this better myself! I have many of the same concerns. I received my OT degree overseas and would not have been able to practice in the US if these changes had been implemented when I graduated. Also, a PhD will not make a difference in the day-to-day patient treatment that I provide or the salary that I am paid.