the 'bottom line'. a rant.

I hate hate hate how everything is about the 'bottom line'  ...aka dollars and cents.
Throughout my past two years of OT school, I can't tell you how much it was drilled into us about getting the patient's occupational profile and taking time to interview them and really learn what occupations are meaningful to each individual. That is the basis of occupational therapy- being client centered and using the occupations that the client finds meaningful as the means and ends in treatment.

I'm getting frustrated already with how the whole payment system works and what is considered 'billable' and whats not, productivity demands yada yada yada...

Between all of the paperwork and stuff dealing w/ the $$, there just is no time to really get to know the patient. No time to spend more than 10-15 minutes on an Eval (apparently OTs in my facility can't bill for time spent doing evals so it doesn't count as 'productive time'), no time to develop an occupation profile- and the eval form they use don't even include a spot for the occupational profile anyways! I want to spend time with the patient before beginning treatment so that I can really tailor the sessions to what THEY want to do, not what I think they would want to do.

I find that the OT I am with pretty much has the same goals for every patient..and while self care and IADLs are VERY important..there are other things that the patient may really want to work on that she doesn't include in the goals (short or long term)....I don't feel like we ask the patient what they want to focus on enough.

Now, I know that as the OT's we are the 'experts' and are the ones who set up and grade activities for the patients needs, but I just feel like the patient should have a say in their goals and what the tx sessions focus on in general.


So basically, I just wish there was a balance between the business aspect of OT and the foundational quality of OT as being client-centered.


// end rant.