Angry About Lack of Scope Clarity in US Occupational Therapist Profession
TLDR: If you as an OT we’re sued or if your license was reprimanded, how would you legally defend that you have been treating cervical spines, knees, jaws, ankles, or other body areas that many say are not within OT scope of practice?
For 20 years I have tried to do what is right as an OT. It’s gotten harder and harder every year. Fraud is everywhere, our integrity as practitioners and as human is challenged every day. Now, I’m about to lose my job because I will not practice out of our scope. This current issue is not one of corporate greed, however. It is caused by a lack of clarity in our OT programs (ACOTE), lack of clarity by AOTA, NBCOT, and great ambiguity by our State practice acts.
Some random anecdotes:
I had a level II student tell me the other day- “My professor said OTs can treat anything on the entire body”
I’ve personally seen OTs doing ultrasound and manual therapy on knees
OTs treating TMJ disorder
OTs doing lumbar and cervical spine manipulations and interventions
Ten years ago, a clinic pressured me to rehabilitate a neck fracture. I’m not talking about bed positioning, w/c positioning, adls, I’m talking about cervical manipulations, exercises, stretches, etc. I refused and defended my position with a statement I found on AOTAs website. I highly regret I did not download or screenshot this statement for my records today. The statement read something like this to the best of my recollection (I am paraphrasing)
“Regarding treatment of lumbar and cervical pain: OTs scope should be defined by what is taught in OT school, what is traditionally done by OT (vs PT or other professions), and what is defined by your State practice act. OTs traditionally address lumbar and cervical issues through positioning interventions, environmental assessments, postural assessment and education, and adaptive strategies for ADLs.” OTs should not be performing cervical or lumbar interventions other than the ones listed above that are more in line with our scope”
Kicking myself in the ass for not saving that article. Anyone else have that article?
I know a lot of you OTs out there are working on necks, backs, maybe ankles, knees, jaws, and feel it’s justified. If you were sued or reprimanded in any way, how would you justify that these interventions are within your scope?