Tuesday, June 06, 2006

Very random notes from LA

OK, I should have known that it was going to be a very random day. I saw Sigmund, tied to the back of a pickup truck, entering I-10 heading toward LA from Santa Monica. I am not lying.

If you have any idea who Sigmund is, then you truly are my compadre.

Anyway, because of a confluence of events I had the opportunity to do some random occupational therapy surfing, and found a few blog entries that were noteworthy and that I wanted to share.

The first was this story about a family who struggled with the cost of occupational therapy services. It seems like they had a reasonable outcome, but I wince when I hear that insurance has denied coverage. I don't know if I am particularly lucky in my geographic region, but I have virtually no denials for the OT services that we provide. However, we are also keenly aware that insurance companies avoid reimbursement for intervention that they deem 'experimental -' as is their policy with sensory integration. In practice, we don't exclusively use sensory integration techniques - and neither do most therapists - so we avoid using those labels altogether. I hear about this issue frequently, and it just makes me wonder if therapists are labeling their services as 'sensory integration' to the insurance companies when it is not necessary or fully accurate to do so. Also, we would have helped this family interact with the school system, which provides free services if the problems are educationally related. That way they could have had a free evaluation, at a minimum.

Anyway, story 2 is a chapter in a book about a mom's impression of occupational therapy that she experienced in an inpatient psychiatric setting. She expresses that as she was already dehumanized by the whole hospital experience she did not feel dehumanized by occupational therapy - and that she wanted to "add to this library of lunatic literature by art." It is an interesting depiction of the service from the end-user perspective, and probably understandable to a lot of OTs. It made me feel sad and angry at the same time.

Story 3 was just plain frustrating. The author describes her experience of being evaluated by and occupational therapist after a surgery. The therapist sounds like she is strongly focused on the occupation of evaluating patients -but ironically the patient goes on to discuss the nature of occupation itself! Reflecting on the therapist's strong interest in surgical scars, she writes, "It made me think about how we all have jobs or hobbies as individuals and our training or passions allow us to derive pleasure in things others don't see." The PATIENT then goes on to ask others in her blog "about your job or hobby. What part of it do people outside the field/interest look at as strange or boring but gives you great pleasure?" This made me chuckle, as I would have preferred hearing that the occupational therapist was just as interested in the patient's occupations as she was interested in the scars. This entry wins "Irony of the Day Award."

Anyway, such was my day. How was yours?

2 comments:

lime said...

hi there, i'm the lady who wrote the third story you linked to. i was pulling it up so i could possibly relink it to another post i am doing and i noticed you had your link so i followed it.

i want to assure you that i was nothing less than completely satisfied with my OT. She was wonderfully knowledgeable and great at explaining answers to my questions about all the inner workings of my mangled lower arm and hand. she was creative about helping me find ways to modify my uses during my rehabilitation and she was devoted to getting me back to MY lifestyle (for example, by tailoring what we worked on to my own goals and advocating for me to have continued therapy when my ROM fell within textbook normal ranges but still wasn't within my personal normal range) not someone else's idea of what my lifestyle was all about. i had very extensive injuries and required 6 and a half months of therapy 3x/week. the surgeon made no guesses as to how much function i would regain. i am proud to report that with the support of such a fine OT (and admittedly being and diligent in my home program) i would say i have about 95% of function back. she was great at helping me to learn to listen to my own body so i'd know when to push further and when to give things a rest.

I understand why you saw irony in my post although my intent wasn't really to comment on the OT experience it was just a very minor interaction during that time that led me to a whole chain of other thoughts which i then milked for a blog post.

just wanted you to know the rest of the story because i'd hate for it to reflect badly on an OT who i truly felt was a godsend...undeniably competent, creative, personable, positive, and professional. thanks:)

Chris said...

I was very happy to have this story clarified! Thanks Lime!