Permission to speak freely

Occupational therapists and assistants are more than my colleagues. They are my former students from the classroom, fieldwork and internships. They are passionate about our profession. They are my co-learners at professional conferences. Today they are my readers, and people whose words I may read one day. They are my pals and partners in crime, as we’ve invented the just-right challenge therapy group or a lab activity. They are the people I can call on at a moment’s notice and who have always responded with hands-on help, words of encouragement and ideas for how to get things done. They are my role models -- the people I never want to disappoint or let down. I see them as compassionate, smart, hardworking and generous to the point of giving until it hurts. I love them all. I really want to write blogs that inspire and energize OT and OTAs. The rub is that I know how very difficult practicing real occupational therapy can be right now. For years, I have been hearing from therapists all over the country and in many different practice settings (SNFs, acute care hospitals, rehabilitation centers, public schools and non-profit agencies, to name a few). They have been warned against providing any services short of or beyond what has been predetermined as billable. Many are threatened with sanctions or termination if they are caught documenting after-work hours, although there are not enough minutes allotted in the day for this. The very notion of providing client-centered, occupationally-focused and holistic care is frustrating and foolish, in these workers’ worlds. I have witnessed the acculturation of my students to this reality, when they would come to my classrooms after their Level I fieldwork experiences looking [...]