The Healthcare Reform Occupational Therapy

As occupational therapy services diversified, serving a variety of clients in many different settings and with societal influences, the field began to evolve. During the 1990s occupational therapists began to shift away from reductionist medical model toward a more holistic client-centered approach. Services focused on enhancing individuals’ quality of life across the lifespan meaning before, during, and after therapeutic intervention. The profession began to better acknowledge the value of client education, injury and illness prevention, health screening, and health maintenance (Cole & Tufano, 2008). The field created more preventative initiatives, and focused services on improving quality of life and optimizing the independence of

Seven in ten deaths in the United States, are attributable to chronic disease (“Leading Causes” 1). These diseases are not on account of bacteria or viruses, which could be treated with an appropriate prescription or vaccine. Chronic conditions are developed through unhealthy lifestyles and behaviors such as a lack of exercise, poor nutrition, poor sleeping habits, and substance use (e.g. tobacco). Consequently, seven in ten of every death can be prevented with changes in lifestyle. The CDC states that these conditions, “are among the most common, costly, and preventable of all health problems” (“Chronic Disease” 1). Although these conditions have clear and definite causes (knowing the exact reason and “cure” for them), they are becoming more prevalent rather than domesticated. According to Wu and Green, “Between 2000 and 2030 the number of Americans with chronic conditions will increase by 37 percent, an increase of 46 million people” (1). This increase comes with an increase in health care costs: the CDC reported that the U.S. spent three trillion dollars on health care in 2014 (“Health Expenditures” 1). 86% of these costs was associated with these conditions (“Prevention” 1). Despite there being a range of causes of why patients make these choices, one issue that may be less familiar to others is the lack of knowledge in preventative medicine among health care professionals. Current training standards are not adequately educating or equipping health care professionals

The occupational therapy profession shares many objectives across the communities, clients, and families they serve. Some of these aims include: “Developing the field of occupational therapy and enhance the professions capabilities to meet the needs of the entire population, providing evidence on the efficacy of occupational therapy. This includes working with organizations and local communities, incorporating education, research, and practices as a complete whole. In addition, developing a team of professionals that innovates and adapts to the developing health needs of the population” (AOTA, 2013). This includes advocacy efforts with policymakers to ensure continued funding to provide care to individuals (AOTA, 2013). Occupational therapy is a distinctive profession that helps

“An ounce of prevention is worth a pound of cure.” This saying goes to show that investing in preventative care is the only way to effectively reform health care plans in America. It is no secret that there are many issues facing health care; however, the most important issue seems to be the lack of funding for preventative care. Redistributing health care related funds into areas like public health and preventative medicine can increase the overall quality of life for patients. If health care reform revolves around preventative medicine, then America’s standard of health will rise. A healthier society will lessen the demand for expensive life-saving surgeries, thus decreasing the overall cost of health care. The overall solution for this issue would be to set a realistic health care budget that correlates to the United States’ current standard of health, thus majority of the budget focuses on preventative medicine.

This link between occupation, health and well-being (i.e. the fact that people are occupational by nature and that engagement in meaningful occupation is essential to health) forms part of the core beliefs and values – the philosophy – of the occupational therapy (OT) profession (Kramer et al, 2003). OT has its foundations in both philosophy and science, but unlike other medical professions, it was the philosophy that came first

Our healthcare system is in a state of constant change. Just as the industry was adapting to the demands of countless healthcare reforms, the fate of regulations like the Affordable Care Act (ACA) and others like it, dangle in the wind. As the country transitions to a newly appointed administration, there is an increasing level of uncertainty among industry leaders. Federal, state, and local mandates continue to drive the need to improve the quality, costs, and outcomes of care which add to an already overburdened and burnout system. These coupled with our highly secular society who is primarily focused on the treating and curing illness through advanced technology, medications, and procedures has resulted in a

Occupational therapy was founded on the principle that participation in meaningful activity is important to the health of individuals. Mental health is very important to the well-being of an individual and those around them. 450 million people experience mental and neurological disorders around the world. These disorders are the leading 5-10 causes of disability worldwide. As services for individuals with mental illness have shifted from the hospital to the community, there has also been a shift in the philosophy of service delivery. In the past, there was an adherence to the medical model; now the focus is on incorporating the recovery model. (2) Occupational therapy’s focus that taking part in engaging and meaningful activities benefits the mental well-being of the individual.

Over the past decade, government operated and privately owned health care organizations have made improvements identifying patient disabilities, discovering alternative treatments at the patient’s discretion, identifying the cause of diseases, and discovering lifesaving cures. The current United States health care delivery system has undergone enormous changes throughout the years. People the United States utilize health care services for many reasons: to prevent disease, to prevent future illnesses, to eliminate pain, and promote a healthier lifestyle to patients. The Patient Protection and

Occupational Therapist enables people to engage and participate in everyday activities trough occupation. The latter role is not only applicable for individuals but also groups or populations. Eventually, with the increase of the aging population, expensive health care services, occupational therapists will have to incorporate health promotion practices into their actual roles.To cope with this phenomenon and to better meet older adult’s needs, the occupational therapist 's role would benefit from being enlarged.Expanding their knowledge and their practices in promoting health will facilitate their work in other domains.This will help them to shift from an individual to a population approach. To achieve that transition, therapists should be more involved in decisions taken by politicians regarding health and to develop services and programs that promote well-being, health, and quality of life. Also, collaboration with other fields such as schools, workplaces, industries, deputies and organizations will help them spread strategies that promote awareness and enable the population to control and maintain an independent healthy lifestyle. Also, therapists understand that the environment can be a crucial factor on health population. Therefore ,they can put pressure on the government to make public places more accessible to disabled people such as providing the subway of a wheelchair ramp and adapt crosswalks to the blind by adding pedestrian signals that include speakers at

The concepts and principles in the Founding Vision of 1917 and the Centennial Vision of 2007 establish a connection between our past and present. Comparing the two Visions shows that many of our modern day values were first outlined by occupational therapy’s founders a century ago. The Founding Vision reads, “The particular objects for which the corporation is formed are as follows: The advancement of occupation as a therapeutic measure; for the study of the effect of occupation upon the human being; and for the scientific dispensation of this knowledge” (National Society for the Promotion of Occupational Therapy [NSPOT], 1917). Where the Centennial Vision reads, “We envision that occupational therapy is a powerful, widely recognized, science-driven,

World War II was a very influential event on occupational therapy. There was a high demand of occupational therapist in the rehabilitation aspect as soldiers were returning injured from war (Schell, Gillen, and Scaffa, 2014). Occupational therapy took a huge turn in this time as well that influenced the techniques that occupational therapists use in our day and age. Prior to World War II, occupational therapy was considered an art and craft based therapy. During this time, the focus moved to rehabilitation techniques that were scientifically based (Schell, Gillen, and Scaffa, 2014). The wounded warriors were the primary focus during this time in history, and the prevalence and development of prosthetics and orthotics really took off.

Occupational therapy is much more than enhancing activities of daily living to me. I see occupational therapy as helping people achieve daily freedom and making attainable goals to improve their physical and mental health while providing a professional relationship to encourage trust and reliability throughout treatment. Something as simple as tying shoes or being able to grab a fork to eat can make all the difference in the world to the patients an occupational therapist will treat. I have been working at a hand clinic since September and have seen that the small achievements like the tying of the shoes of the ability to bend the finger 10 more degrees puts a big smile on the faces of the patients and improves their outlook and demeanor towards their injury. Encouraging home exercise, helping with self cares, teaching writing skills and helping provide custom splints are all aspects that I have seen with my job and observation of occupational therapy as a whole. When I started my job at the hand clinic a therapist told me that the most basic occupational therapy explanation she could provide me is that occupational therapy is a way of helping others achieve a better level of daily living for things that they want and or need to do in life than when they sought help from therapy.

The Affordable Care Act (ACA) is a radical healthcare reform that aims to provide affordable, quality healthcare for all US citizens. This increased scope of coverage would allow millions more of Americans to use the system. In order to drive down costs from many more individuals, the ACA has planned to increase incentives for preventative public health interventions including primary care physicians. Although this is a fine beginning, I believe the greatest challenge to the long-term success of this reform remains the shift in mindset from a focus in treatment to an equal focus in prevention. Preventative services are vital to a healthcare system. However, the effects of prevention are often long term, and thus are traditionally underappreciated by those who have the disease being prevented. Individuals with the disease also undervalue prevention, as it does not affect their health state. With this mindset, prevention is undermined and will continue to be a challenge for the progression of the ACA.

The policy is a very realistic approach to solve this problem because as more individuals are insured under the ACA and have access to healthcare, they will utilize health facilities and hospitals more frequently for services or procedures and hospitals will have increased occurrences of adverse outcomes, if this is not addressed. Patients are the consumers. They seek satisfaction and quality with services. Quality health care and patient safety should be important to the patients, hospitals, health facilities, physicians, nurses, pharmacists, risk managers, and medical professionals and staff. Medical staff may feel over burdened to comply with the necessary steps to ensure the improvement of patient safety, which may require additional training.

While the United States has some of the best doctors and healthcare facilities in the world we fail at being efficient and effective. Currently there are too many unplanned readmissions, medication errors and hospital acquired infections. The United States health system does not effectively provide preventive medicine for individuals with chronic diseases, and this portion of health care consumers account for the majority of health care costs (Kocher et al., 2010).