Beyond the Seat: From Being Overlooked to Being Unignorable

Also titled: How occupational therapy can stop arguing for inclusion and start designing itself into relevance

Occupational therapy spends a lot of time talking about being ‘overlooked.’ But being overlooked isn’t a visibility problem—it’s a design problem.

We’ve built a profession that is extraordinarily self-aware and socially conscious, but not always system-literate. We’re fluent in the language of empathy, occupation, and participation but often ill-equipped to translate that into the economic, technological, and policy structures that drive decision-making. How did that happen?

When OTs ask, “Why don’t companies hire us for product design, UX, or consulting?" the answer isn’t bias. It’s fit. The market doesn’t know what to do with occupational therapy rhetoric (jargon) because we rarely show up with the frameworks, data fluency, and deliverables those systems require.

Talk to an engineer, and you hear systems. Talk to an OT, and you hear an apology and an elevator speech.

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A Campus Reality Check

If you want to see what relevance looks like, walk across a campus like Rochester Institute of Technology. You’ll find students - few of them future rehabilitation clinicians - designing sensors for crutches, developing new materials for 3D printing, building VR rehabilitation games, and engineering EEG interfaces for wheelchairs.

And so much more.

None of them were waiting for permission. None of them were asking for a “seat at the table.” They were just doing the work. Meanwhile, many in our own profession sit back waiting for a gilded invitation - a policy letter, a job posting, a recognition campaign - that signals it’s finally “our turn.”

That approach has clearly not worked. The future doesn’t wait for professions that need to be validated before they act. The future belongs to the ones who are already building.

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Beyond Complaint: From Deserve to Deliver

The professions that shape industries don’t ask to be included; they design, prototype, and publish their way into indispensability. Engineers don’t request a seat in rehabilitation. They develop the hardware. Data scientists don’t request acknowledgment in healthcare; they build the analytic systems hospitals depend on.

If OTs wants to join those spaces, they must deliver the same way through contribution (and not just appeal). And not by giving TED talks for goodness sake.

That means shifting from “We could help” to “Here’s what we’ve built.”

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The Comfort of Complaint

The ‘we’re overlooked’ narrative feels safe because it preserves identity. It’s easier to blame invisibility than confront our own gaps. But that posture keeps us pedagogically and professionally inert. It allows programs to graduate students who can discuss “occupation” beautifully but can’t map a workflow, analyze data, or co-design a device.

We claim expertise in function yet too often ignore the functional systems that define how healthcare actually works. We insulate ourselves from relevance by being 'big talkers.'

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Designing for Relevance

To become unignorable, we have to design ourselves in.

That begins in education, where the OTD must evolve from a prolonged master’s degree into a doctorate that is focused on translational science. Coursework should expose students to:

  • Systems design and implementation science

  • Human-centered technology and adaptive design

  • Data literacy and policy fluency

  • Entrepreneurship and venture translation

Not every OT needs to be a technologist, but the profession must become translatable across systems.

The next generation of OTs have to create change - not just adapt to it.

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Building What We Teach

This is precisely the kind of transformation we’re trying to operationalize at RIT.

Our program philosophy begins with the idea that humans are occupational beings and that students are no exception. Learning itself is an occupation: purposeful, creative, and experiential.

Grounded in the Arts and Crafts heritage of occupational therapy, our curriculum emphasizes making as a way of thinking. We honor the discipline’s roots in craftsmanship and purposeful activity, but we extend them into RIT’s broader culture of design, technology, and innovation.

Students are building systems of occupation and not just reflecting on occupation. Through hands-on projects, collaboration with engineers and designers, and exposure to the technologies shaping rehabilitation, they learn to see OT not as a support service, but as a design discipline in its own right.

We see art and design not as ornamentation but as epistemology: creative engagement is how students come to understand complex systems and generate new knowledge. That’s why our philosophy commits to integrating technology, scholarship, and experiential learning at every stage of the curriculum because these are the conditions where relevance is designed (and not requested, or even worse, begged for).

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Stop Arguing for a Seat. Build the Room.

We need to design a new OT educational architecture. We do this by educating students to stop waiting for recruiters to “realize” what OTs can do. We need to show students the way by building tools, services, and partnerships that they can’t function without. We have to stop writing letters of inclusion. Instead we have to teach them to write protocols, patents, and publications. Students have to stop asking where OT belongs and instead design systems that make that question irrelevant.

The path forward isn’t louder advocacy - it’s a new architecture.

I know this can happen. Just today, while sitting in my office and minding my own business, I received a concept paper from a local OT who wants to innovate a really dynamic proprioceptive biofeedback system for self-regulation and tic awareness. It’s grounded in occupational therapy theory, built from her own patented tool, and aimed squarely at human performance and well-being. This is what being unignorable looks like - when your ideas don’t wait for permission, when you combine clinical insight with creative engineering, and when you send something so fresh and fully realized that it instantly makes people want to be part of it.

My current framework is that when you build something the world needs, you’ll never have to ask for a seat again.

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