Occupational Therapy in Primary Care

Occupational Therapists belong in primary care - our unique skill set is beneficial in all aspects of healthcare, not just the rehab setting or after a deficit or issue has already arisen. Within our scope of practice it clearly indicates that health promotion and prevention are cornerstones of OT.

If we look at pediatrics, for example, evidence supports that the earlier the intervention, the better the outcomes and the more successful our client is with goal attainment. However, many pediatric clients are simply missed or fly under the radar because they do not present in a typical fashion or they are slightly "quirky" but meeting their milestones. Enter into any mom's group on facebook and the plethora of misinformation is truly frightening - parents may have no idea that their child could benefit from therapy until it's indicated in preschool or early elementary. This in itself is cause for alarm - as our educators are catching idiosyncrasies in performance before our primary care doctors, in some cases.

What if an OT was on staff at the pediatricians office - offering screenings with a focus on development, visual perception and sensory processing? After all, this is our specialty, is it not? What if OTs were proactive instead of reactive?

In 2013, the AOTA released a publication on their website discussing the "Triple Aim" initiative. The purpose of the Triple Aim initiative was to "reduce costs, improve population health, and improve patient experience". Again, this was released in 2013 - it is now 2020 and I do not know of any OTs working in primary care in my area. Here is the link: https://www.aota.org/publications-news/aotanews/2013/primary-care-promote.aspx

Are we, as OTs, doing our part to exert out skill set and knowledge base as crucial in preventative care? I think the answer is a hard no. I think that the fact that we not only have to constantly define our profession to other practitioners, but also defend our place at the table clearly indicates that there is a broken link in the chain. Are we not assertive enough? Not aggressive enough?

Not to mention - there is always the question of reimbursement - who will pay for this? As a profession how can we chisel out our place in primary care? There are so many barriers in our way. First of all productivity - if we are striving for 90% productivity, how do we have any time to do anything else? We don't. The second barrier is insurance standards - in many cases our hands are tied on what will be reimbursed and what won't be reimbursed. Thirdly, documentation - this takes up a huge part of the work day and is often taking over break times and lunches.

I think the first step is OTs taking on more administrative roles - we need more OTs in management and administration. We need more OTs who are willing to step outside of their current role and enter into the world of private practice. This is an area that chiros and our PT counterparts have never balked at. This is important because it allows us to take control over specialty areas and market ourselves as more than rehab professionals.

I'm interested in other therapist's point of view - how do we overcome the barriers and break into new realms of health?