Ot working under a PT script

[Guest guest]

Whoa . Long before OT's became the hot bed for hands lot of PT's

treted hand related problems. Most of us older guys are generalist in a

given area (ortho, neuro etc)and have a special interest in something.

I am not CHT but 50% of what I do is hand and elbow related. Most of my

con ed is hand related including 3 trips in the last 5 years to the

Philadelphia Hand meeting. Usually the PT's are 10-20% of the crowd. I

simply don't want to prepare for a cetification exam. We also used to

do pulmonary (happiness to me is a clean chest) and other rehab

activities that we have let slip away. Newer PT's all want to

specialize and this is not a bad thing but if you are in a rural

area...well necessity is the mother of invention. Our new therapist

don't want to touch a hand patient. Even a distal radius fx. I guess

thats ok too. Please lets not throw out the baby with the bath water.

Mike , PT

Rehab South, PC

Jasper, AL

[Guest guest]

Whoa . Long before OT's became the hot bed for hands lot of PT's

treted hand related problems. Most of us older guys are generalist in a

given area (ortho, neuro etc)and have a special interest in something.

I am not CHT but 50% of what I do is hand and elbow related. Most of my

con ed is hand related including 3 trips in the last 5 years to the

Philadelphia Hand meeting. Usually the PT's are 10-20% of the crowd. I

simply don't want to prepare for a cetification exam. We also used to

do pulmonary (happiness to me is a clean chest) and other rehab

activities that we have let slip away. Newer PT's all want to

specialize and this is not a bad thing but if you are in a rural

area...well necessity is the mother of invention. Our new therapist

don't want to touch a hand patient. Even a distal radius fx. I guess

thats ok too. Please lets not throw out the baby with the bath water.

Mike , PT

Rehab South, PC

Jasper, AL

[Guest guest]

Whoa . Long before OT's became the hot bed for hands lot of PT's

treted hand related problems. Most of us older guys are generalist in a

given area (ortho, neuro etc)and have a special interest in something.

I am not CHT but 50% of what I do is hand and elbow related. Most of my

con ed is hand related including 3 trips in the last 5 years to the

Philadelphia Hand meeting. Usually the PT's are 10-20% of the crowd. I

simply don't want to prepare for a cetification exam. We also used to

do pulmonary (happiness to me is a clean chest) and other rehab

activities that we have let slip away. Newer PT's all want to

specialize and this is not a bad thing but if you are in a rural

area...well necessity is the mother of invention. Our new therapist

don't want to touch a hand patient. Even a distal radius fx. I guess

thats ok too. Please lets not throw out the baby with the bath water.

Mike , PT

Rehab South, PC

Jasper, AL

[Guest guest]

We have a similar situation. Agree with points below, and furthermore

the OT needs a separate order, or the order should read something to

the effect of " Lymphedema Therapy by PT and OT. "

Dan Gaskell

Rehab Therapy Manager

Carilion Clinic

Roanoke, VA

>

> We have a similar situation at our facility, where sometimes the

lymphedema therapy will be provided by either a PT or OT. There are a

few administrative elements that have to be in place to make it work

effectively (common approach to care, same paperwork, referral

paperwork that allows flexibility, etc.), but--after checking with the

respective licensing boards--the key is that if one discipline treats

a patient evaluated by another discipline, the second discipline does

have to do an evaluation as part of his or her first visit.

>

> As a practical matter, the evaluation consists of considering the

evaluation written by the other discipline, and then either concurring

or modifying the plan of care. It seems complex, but for lymphedema,

with therapists who have similar training, it is a practical way to

meet the requirements of the practice acts and does not take a lot of

extra time for data-gathering. We choose not to charge for the second

evaluation; the charges are only for the therapy provided during the

visit.

>

> Bob Perlson

> Director, Rehabilitation Services

> Asante Health System

> Medford OR 97504

>

> Ot working under a PT script

>

>

> Everyone, I just heard of an interesting scenario and was wondering

about

> what anyone would know.

>

> An occupational therapist who works in a local hospital is certified

in

> lymphedema treatment. She states that she treats lymphedema

patients who have

> been evaluated by either a PT or an OT since she is a " lymphedema

therapist " .

> Also in the hospital there is a LMT who sees lymphedema patients

who have

> been evaluated by physical or occupationa therapists.

>

> They did not mention the billing aspect but I was wondering about the

> practice acts or legal issues. My understanding is that an LMT can

not work under

> a PT or an OT. Also, my understanding is that cross treatment from

another

> disciplines evaluation is against the practice acts as well.

>

> It may be different in hospitals in Florida but I would appreciate any

> comments regarding this situation.

>

> Kunkel MSPT

>

>

>

> ************************************** AOL now offers free email to

everyone.

> Find out more about what's free from AOL at http://www.aol.com.

>

>

>

[Guest guest]

We have a similar situation. Agree with points below, and furthermore

the OT needs a separate order, or the order should read something to

the effect of " Lymphedema Therapy by PT and OT. "

Dan Gaskell

Rehab Therapy Manager

Carilion Clinic

Roanoke, VA

>

> We have a similar situation at our facility, where sometimes the

lymphedema therapy will be provided by either a PT or OT. There are a

few administrative elements that have to be in place to make it work

effectively (common approach to care, same paperwork, referral

paperwork that allows flexibility, etc.), but--after checking with the

respective licensing boards--the key is that if one discipline treats

a patient evaluated by another discipline, the second discipline does

have to do an evaluation as part of his or her first visit.

>

> As a practical matter, the evaluation consists of considering the

evaluation written by the other discipline, and then either concurring

or modifying the plan of care. It seems complex, but for lymphedema,

with therapists who have similar training, it is a practical way to

meet the requirements of the practice acts and does not take a lot of

extra time for data-gathering. We choose not to charge for the second

evaluation; the charges are only for the therapy provided during the

visit.

>

> Bob Perlson

> Director, Rehabilitation Services

> Asante Health System

> Medford OR 97504

>

> Ot working under a PT script

>

>

> Everyone, I just heard of an interesting scenario and was wondering

about

> what anyone would know.

>

> An occupational therapist who works in a local hospital is certified

in

> lymphedema treatment. She states that she treats lymphedema

patients who have

> been evaluated by either a PT or an OT since she is a " lymphedema

therapist " .

> Also in the hospital there is a LMT who sees lymphedema patients

who have

> been evaluated by physical or occupationa therapists.

>

> They did not mention the billing aspect but I was wondering about the

> practice acts or legal issues. My understanding is that an LMT can

not work under

> a PT or an OT. Also, my understanding is that cross treatment from

another

> disciplines evaluation is against the practice acts as well.

>

> It may be different in hospitals in Florida but I would appreciate any

> comments regarding this situation.

>

> Kunkel MSPT

>

>

>

> ************************************** AOL now offers free email to

everyone.

> Find out more about what's free from AOL at http://www.aol.com.

>

>

>

[Guest guest]

We have a similar situation. Agree with points below, and furthermore

the OT needs a separate order, or the order should read something to

the effect of " Lymphedema Therapy by PT and OT. "

Dan Gaskell

Rehab Therapy Manager

Carilion Clinic

Roanoke, VA

>

> We have a similar situation at our facility, where sometimes the

lymphedema therapy will be provided by either a PT or OT. There are a

few administrative elements that have to be in place to make it work

effectively (common approach to care, same paperwork, referral

paperwork that allows flexibility, etc.), but--after checking with the

respective licensing boards--the key is that if one discipline treats

a patient evaluated by another discipline, the second discipline does

have to do an evaluation as part of his or her first visit.

>

> As a practical matter, the evaluation consists of considering the

evaluation written by the other discipline, and then either concurring

or modifying the plan of care. It seems complex, but for lymphedema,

with therapists who have similar training, it is a practical way to

meet the requirements of the practice acts and does not take a lot of

extra time for data-gathering. We choose not to charge for the second

evaluation; the charges are only for the therapy provided during the

visit.

>

> Bob Perlson

> Director, Rehabilitation Services

> Asante Health System

> Medford OR 97504

>

> Ot working under a PT script

>

>

> Everyone, I just heard of an interesting scenario and was wondering

about

> what anyone would know.

>

> An occupational therapist who works in a local hospital is certified

in

> lymphedema treatment. She states that she treats lymphedema

patients who have

> been evaluated by either a PT or an OT since she is a " lymphedema

therapist " .

> Also in the hospital there is a LMT who sees lymphedema patients

who have

> been evaluated by physical or occupationa therapists.

>

> They did not mention the billing aspect but I was wondering about the

> practice acts or legal issues. My understanding is that an LMT can

not work under

> a PT or an OT. Also, my understanding is that cross treatment from

another

> disciplines evaluation is against the practice acts as well.

>

> It may be different in hospitals in Florida but I would appreciate any

> comments regarding this situation.

>

> Kunkel MSPT

>

>

>

> ************************************** AOL now offers free email to

everyone.

> Find out more about what's free from AOL at http://www.aol.com.

>

>

>

[Guest guest]

We have a similar situation. Agree with points below, and furthermore

the OT needs a separate order, or the order should read something to

the effect of " Lymphedema Therapy by PT and OT. "

Dan Gaskell

Rehab Therapy Manager

Carilion Clinic

Roanoke, VA

>

> We have a similar situation at our facility, where sometimes the

lymphedema therapy will be provided by either a PT or OT. There are a

few administrative elements that have to be in place to make it work

effectively (common approach to care, same paperwork, referral

paperwork that allows flexibility, etc.), but--after checking with the

respective licensing boards--the key is that if one discipline treats

a patient evaluated by another discipline, the second discipline does

have to do an evaluation as part of his or her first visit.

>

> As a practical matter, the evaluation consists of considering the

evaluation written by the other discipline, and then either concurring

or modifying the plan of care. It seems complex, but for lymphedema,

with therapists who have similar training, it is a practical way to

meet the requirements of the practice acts and does not take a lot of

extra time for data-gathering. We choose not to charge for the second

evaluation; the charges are only for the therapy provided during the

visit.

>

> Bob Perlson

> Director, Rehabilitation Services

> Asante Health System

> Medford OR 97504

>

> Ot working under a PT script

>

>

> Everyone, I just heard of an interesting scenario and was wondering

about

> what anyone would know.

>

> An occupational therapist who works in a local hospital is certified

in

> lymphedema treatment. She states that she treats lymphedema

patients who have

> been evaluated by either a PT or an OT since she is a " lymphedema

therapist " .

> Also in the hospital there is a LMT who sees lymphedema patients

who have

> been evaluated by physical or occupationa therapists.

>

> They did not mention the billing aspect but I was wondering about the

> practice acts or legal issues. My understanding is that an LMT can

not work under

> a PT or an OT. Also, my understanding is that cross treatment from

another

> disciplines evaluation is against the practice acts as well.

>

> It may be different in hospitals in Florida but I would appreciate any

> comments regarding this situation.

>

> Kunkel MSPT

>

>

>

> ************************************** AOL now offers free email to

everyone.

> Find out more about what's free from AOL at http://www.aol.com.

>

>

>

[Guest guest]

We have a similar situation. Agree with points below, and furthermore

the OT needs a separate order, or the order should read something to

the effect of " Lymphedema Therapy by PT and OT. "

Dan Gaskell

Rehab Therapy Manager

Carilion Clinic

Roanoke, VA

>

> We have a similar situation at our facility, where sometimes the

lymphedema therapy will be provided by either a PT or OT. There are a

few administrative elements that have to be in place to make it work

effectively (common approach to care, same paperwork, referral

paperwork that allows flexibility, etc.), but--after checking with the

respective licensing boards--the key is that if one discipline treats

a patient evaluated by another discipline, the second discipline does

have to do an evaluation as part of his or her first visit.

>

> As a practical matter, the evaluation consists of considering the

evaluation written by the other discipline, and then either concurring

or modifying the plan of care. It seems complex, but for lymphedema,

with therapists who have similar training, it is a practical way to

meet the requirements of the practice acts and does not take a lot of

extra time for data-gathering. We choose not to charge for the second

evaluation; the charges are only for the therapy provided during the

visit.

>

> Bob Perlson

> Director, Rehabilitation Services

> Asante Health System

> Medford OR 97504

>

> Ot working under a PT script

>

>

> Everyone, I just heard of an interesting scenario and was wondering

about

> what anyone would know.

>

> An occupational therapist who works in a local hospital is certified

in

> lymphedema treatment. She states that she treats lymphedema

patients who have

> been evaluated by either a PT or an OT since she is a " lymphedema

therapist " .

> Also in the hospital there is a LMT who sees lymphedema patients

who have

> been evaluated by physical or occupationa therapists.

>

> They did not mention the billing aspect but I was wondering about the

> practice acts or legal issues. My understanding is that an LMT can

not work under

> a PT or an OT. Also, my understanding is that cross treatment from

another

> disciplines evaluation is against the practice acts as well.

>

> It may be different in hospitals in Florida but I would appreciate any

> comments regarding this situation.

>

> Kunkel MSPT

>

>

>

> ************************************** AOL now offers free email to

everyone.

> Find out more about what's free from AOL at http://www.aol.com.

>

>

>

[Guest guest]

We have a similar situation. Agree with points below, and furthermore

the OT needs a separate order, or the order should read something to

the effect of " Lymphedema Therapy by PT and OT. "

Dan Gaskell

Rehab Therapy Manager

Carilion Clinic

Roanoke, VA

>

> We have a similar situation at our facility, where sometimes the

lymphedema therapy will be provided by either a PT or OT. There are a

few administrative elements that have to be in place to make it work

effectively (common approach to care, same paperwork, referral

paperwork that allows flexibility, etc.), but--after checking with the

respective licensing boards--the key is that if one discipline treats

a patient evaluated by another discipline, the second discipline does

have to do an evaluation as part of his or her first visit.

>

> As a practical matter, the evaluation consists of considering the

evaluation written by the other discipline, and then either concurring

or modifying the plan of care. It seems complex, but for lymphedema,

with therapists who have similar training, it is a practical way to

meet the requirements of the practice acts and does not take a lot of

extra time for data-gathering. We choose not to charge for the second

evaluation; the charges are only for the therapy provided during the

visit.

>

> Bob Perlson

> Director, Rehabilitation Services

> Asante Health System

> Medford OR 97504

>

> Ot working under a PT script

>

>

> Everyone, I just heard of an interesting scenario and was wondering

about

> what anyone would know.

>

> An occupational therapist who works in a local hospital is certified

in

> lymphedema treatment. She states that she treats lymphedema

patients who have

> been evaluated by either a PT or an OT since she is a " lymphedema

therapist " .

> Also in the hospital there is a LMT who sees lymphedema patients

who have

> been evaluated by physical or occupationa therapists.

>

> They did not mention the billing aspect but I was wondering about the

> practice acts or legal issues. My understanding is that an LMT can

not work under

> a PT or an OT. Also, my understanding is that cross treatment from

another

> disciplines evaluation is against the practice acts as well.

>

> It may be different in hospitals in Florida but I would appreciate any

> comments regarding this situation.

>

> Kunkel MSPT

>

>

>

> ************************************** AOL now offers free email to

everyone.

> Find out more about what's free from AOL at http://www.aol.com.

>

>

>

[Guest guest]

We have a similar situation. Agree with points below, and furthermore

the OT needs a separate order, or the order should read something to

the effect of " Lymphedema Therapy by PT and OT. "

Dan Gaskell

Rehab Therapy Manager

Carilion Clinic

Roanoke, VA

>

> We have a similar situation at our facility, where sometimes the

lymphedema therapy will be provided by either a PT or OT. There are a

few administrative elements that have to be in place to make it work

effectively (common approach to care, same paperwork, referral

paperwork that allows flexibility, etc.), but--after checking with the

respective licensing boards--the key is that if one discipline treats

a patient evaluated by another discipline, the second discipline does

have to do an evaluation as part of his or her first visit.

>

> As a practical matter, the evaluation consists of considering the

evaluation written by the other discipline, and then either concurring

or modifying the plan of care. It seems complex, but for lymphedema,

with therapists who have similar training, it is a practical way to

meet the requirements of the practice acts and does not take a lot of

extra time for data-gathering. We choose not to charge for the second

evaluation; the charges are only for the therapy provided during the

visit.

>

> Bob Perlson

> Director, Rehabilitation Services

> Asante Health System

> Medford OR 97504

>

> Ot working under a PT script

>

>

> Everyone, I just heard of an interesting scenario and was wondering

about

> what anyone would know.

>

> An occupational therapist who works in a local hospital is certified

in

> lymphedema treatment. She states that she treats lymphedema

patients who have

> been evaluated by either a PT or an OT since she is a " lymphedema

therapist " .

> Also in the hospital there is a LMT who sees lymphedema patients

who have

> been evaluated by physical or occupationa therapists.

>

> They did not mention the billing aspect but I was wondering about the

> practice acts or legal issues. My understanding is that an LMT can

not work under

> a PT or an OT. Also, my understanding is that cross treatment from

another

> disciplines evaluation is against the practice acts as well.

>

> It may be different in hospitals in Florida but I would appreciate any

> comments regarding this situation.

>

> Kunkel MSPT

>

>

>

> ************************************** AOL now offers free email to

everyone.

> Find out more about what's free from AOL at http://www.aol.com.

>

>

>

[Guest guest]

We have a similar situation. Agree with points below, and furthermore

the OT needs a separate order, or the order should read something to

the effect of " Lymphedema Therapy by PT and OT. "

Dan Gaskell

Rehab Therapy Manager

Carilion Clinic

Roanoke, VA

>

> We have a similar situation at our facility, where sometimes the

lymphedema therapy will be provided by either a PT or OT. There are a

few administrative elements that have to be in place to make it work

effectively (common approach to care, same paperwork, referral

paperwork that allows flexibility, etc.), but--after checking with the

respective licensing boards--the key is that if one discipline treats

a patient evaluated by another discipline, the second discipline does

have to do an evaluation as part of his or her first visit.

>

> As a practical matter, the evaluation consists of considering the

evaluation written by the other discipline, and then either concurring

or modifying the plan of care. It seems complex, but for lymphedema,

with therapists who have similar training, it is a practical way to

meet the requirements of the practice acts and does not take a lot of

extra time for data-gathering. We choose not to charge for the second

evaluation; the charges are only for the therapy provided during the

visit.

>

> Bob Perlson

> Director, Rehabilitation Services

> Asante Health System

> Medford OR 97504

>

> Ot working under a PT script

>

>

> Everyone, I just heard of an interesting scenario and was wondering

about

> what anyone would know.

>

> An occupational therapist who works in a local hospital is certified

in

> lymphedema treatment. She states that she treats lymphedema

patients who have

> been evaluated by either a PT or an OT since she is a " lymphedema

therapist " .

> Also in the hospital there is a LMT who sees lymphedema patients

who have

> been evaluated by physical or occupationa therapists.

>

> They did not mention the billing aspect but I was wondering about the

> practice acts or legal issues. My understanding is that an LMT can

not work under

> a PT or an OT. Also, my understanding is that cross treatment from

another

> disciplines evaluation is against the practice acts as well.

>

> It may be different in hospitals in Florida but I would appreciate any

> comments regarding this situation.

>

> Kunkel MSPT

>

>

>

> ************************************** AOL now offers free email to

everyone.

> Find out more about what's free from AOL at http://www.aol.com.

>

>

>

[Guest guest]

I have to echo Ron Carson's sentiments.

I am guessing that CT's practice act has a phrase in it similar to many

States that says something along the lines of " anyone other than a

licensed PT/PTA (OT/COTA) is considered supportive personnel. " IL has a

similar phrase, my concern for Kim is that she is reading that to mean

anyone can support another's practice (POC). While that may be true to

some extent with proper supervision, training etc., the issue that

likely trumps this is that a licensed person is held to the standard of

his/her license. If one holds two licenses, for example ACT/PT, then

the individual is held to the " most restrictive " license .... in

essence the idea is that you can't take off your PT hat to go practice

as an OT aide when you are a licensed PT.

Additionally, and I only skimmed the CT Practice Act, but I see no

provision whatsoever for non-licensed personnel aiding or assisting in

the practice of PT. Indeed Sec. 20-73. ( (1) states " The treatment

of human ailments by physical therapy shall only be performed by a

person licensed under the provisions of this chapter as a physical

therapist or physical therapist assistant ... "

I looked briefly for other legal documentation in CT (rules governing PT

practice or definitions etc) and found none. I think this may warrant a

call to the CT Chapter of the APTA - I assume there is a Legislative

person who has heard interpretations of the provisions in the CT

Practice Act. The State's OT Practice Act may say something different

but .....

My 2 cents (and perhaps a bit more).

Trumbull, PT, MBA

Bloomington - Normal IL

________________________________

From: PTManager [mailto:PTManager ] On

Behalf Of Ron Carson

Sent: Wednesday, March 28, 2007 3:37 PM

To: Palma, Kim

Subject: Re[4]: Ot working under a PT script

I looked at CT's Practice Act here:

http://www.dph.state.ct.us/Licensure/apps/PLIS/PhysicalTherapist/pt_stat

s.pdf

<http://www.dph.state.ct.us/Licensure/apps/PLIS/PhysicalTherapist/pt_sta

ts.pdf>

I seen nothing in these regs about OT's being supportive personnel.

In your previous post, you mentioned APTA documents. Do you have any

resources for such documents?

Sincerely,

Ron

--

Ron Carson MHS, OTR/L

Hope Therapy Services, LLC

www.HopeTherapyServices.com

===============<Original Message>===============

On 3/28/2007, kpalma@... <mailto:kpalma%40echn.org> said:

PK> Ron, this was listed in our CT state practice act - I was surprised

as

PK> well. Trust me, when I called to f/u with the state, no information

was

PK> made available - that's why I called our intermediary which started

this

PK> whole thing of misinformation from them.

PK> After speaking directly with Rick Gawanda - I have notified my staff

PK> that we cannot do this any longer and will use his information as

PK> reference.

PK> I'm sorry if what I said upset so many. I have nothing but the

highest

PK> respect for all my clinical staff, regardless if they are PTs, OTs,

PK> COTA, PTAs or aides - we consider ourselves a team - and I meant no

PK> disrespect in what I wrote, I was just going off what our state

practice

PK> act said.

PK> Kimberley R. Palma

PK> Office Manager - ECHN Rehabilitation Services

PK> Tel: x5579

PK> Fax:

PK> _____

PK> From: PTManager <mailto:PTManager%40yahoogroups.com>

PK> [mailto:PTManager

<mailto:PTManager%40yahoogroups.com> ] On

PK> Behalf Of Ron Carson

PK> Sent: Wednesday, March 28, 2007 1:37 PM

PK> To: Palma, Kim

PK> Subject: Re[2]: Ot working under a PT script

PK> OT's as supportive personnel UNDER PT's, surely you must be kidding,

PK> right? Please provide reference if you will.

PK> Ron