On persevering in leadership and its relevance to free speech


An interesting quote was attributed today to Amy Lamb, the President-Elect of the American Occupational Therapy Association.  Here is the quote as it appeared on Twitter:



I initially consider that the timing of such a statement that "No means not now" could possibly be related to the recent decision by the US Senate to refuse to support the Cardin-Vitter amendment that would repeal the Medicare outpatient therapy cap.  Therapy leaders have been trying for many years to get the cap repealed and it was a stinging defeat.

I asked for additional context and clarity about the quote and was informed that it was generally stated as an important leadership principle.

The reason why this caught my attention is because of my own experience with the way that the occupational therapy profession deals with divergent opinions.

In 2013 I attempted to reach out to a former Ethics Commission Chair to discuss ongoing concerns with the Social Justice construct.  That Chair was not interested in any conversation, and instead of receiving a note from that person I received a letter from an AOTA attorney that stated, "I understand your perspective on the Social Justice provision of the Ethics Code, and would note that it is settled business at this time."  From the tone of that letter, the philosophy in play was clearly that 'No means no.'  In fairness, that attorney also stated that there might be opportunities to discuss matters when the Code was re-written (in 2015), but that turned out to be a false promise because there was virtually no dialogue allowed with the Ethics Commission members during the current revision period.  In fact, that lack of dialogue and unwillingness to engage the membership contributed to rather serious errors that have been pointed out regarding the Code that was just approved by the RA.

Another example was in conversation with another OT leader about a banal debate in 2014 regarding patient vs. client terminology.  Specifically, I was stating that a lack of philosophic consistency is present in our terminology and ends up getting reflected in our meandering and inconsistent focus on our definition of practice.  In that conversation I was told that "I would describe the “name” issue as essentially resolved in OT and a non-issue."  Again, since the conversation was not of interest to the leader, it was clear that 'No means no.'

These two examples demonstrate clearly that divergent opinions are not always welcome and that sometimes there is a disinterest in even hearing other people's opinions.  When people tell you that something is 'settled' or 'already decided' that is a rhetorical method that cuts off conversation.

In a rather stunning juxtaposition of the 'No means no' methodology there has been evidence of conduct that indicates that 'No means no' only when it is expedient to the beliefs of those in charge.  Specifically,  the OTA Ad Hoc Entry Level group conducted a study that clearly demonstrated the membership's disinterest in moving the OTAs to a bachelor-level degree, but then still advanced a motion to explore how to be successful if a change is ever desired.  There have been several statements by leaders about the entry level OTD issue that show a similar lack of interest in member input - 'The decision has already been made' and 'The entry level OTD is happening like it or not.'  These kinds of statements clearly show that 'No means no' only when applied in certain directions.

So the public statement that acknowledges the value of persevering is something new and I am hopeful that this philosophy will be applied evenly, particularly when members speak out about important matters.  This becomes important because of the new Code of Ethics that states that 'negative online comments' may constitute an ethics breach if someone believes that those comments serve to stifle conversation.  Obviously, persevering and lobbying a position to one person could be considered 'badgering' by someone who holds an opposing view.  This is a very dangerous provision in the new Code of Ethics that could be used to limit the participation of members.  Someone could simply state that another person's opinions are 'badgering' and 'limiting the speech of others.'  Such a provision is a serious threat to free speech.

This is why it was so interesting to see the statement about persevering in leadership.  I am very hopeful that this statement will be universally applied and that this might signal a new day for the way that occupational therapists deal with conflicting professional opinions on the important matters of the profession.

If 'no' actually means 'not now,' and if persevering is a value, then people should be encouraged to persevere in their opinions and lobbying whether or not anything has been 'settled.'  That is the ultimate value of free speech.

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