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PT and OT difference
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PT and OT difference - September 3, 2005 6:53:00 PM
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free
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I did not see any one discussing the issue of the difference in practice between PTs and OTs. I was recently asked by a physician while he was making referral to physical therapy that what is the difference between two disciplines and what an OT can do that a PT cannot other than charging for their services seperately?
I tried to explain the difference of the two disciplines on the basis of their goals. But still I think I could not give any single example what an OT can do and it does not fall under the responsibilities of PT. Can anyone give any input on this?
Thanks
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Re: PT and OT difference - September 4, 2005 12:44:00 AM
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Randy Dixon
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I've always wondered why they insist on being different professions.
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Re: PT and OT difference - September 4, 2005 4:37:00 AM
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Jon Newman
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In order for a profession to exist they need to make money. Since billing codes are very limited there are a limited number of ways a profession can look. OT and PT codes are identical except for evaluative procedures. From a coding perspective there is little difference. What is likely to distinguish one from the other is the preponderance of certain codes residing in one profession or the other. ADL's for example are fine for both to do but I'm guessing you'd find that the lion's share of that code is being billed by OT's.
I think OT's come out of school with a different view point on how someone gets from point A to point B despite using similar methods. This might be similar to the difference between DO's and MD's.
Ultimately OT's seem to be at an unfortunate disadvantage politically. PT's seem to be 'number one son' and OT's have to fight for their right to practice. For example, my understanding (which could be incorrect) is that our OT's were told 'NO' to treating shoulders despite it being within their scope of practice. This was decided by our director and medical supervisor (a PT and a DO). If I were an OT I'd be quite upset that my scope of practice is being limited by those who employ me. Actually it upsets me anyway.
I actually think OT's have a greater appreciation for how people learn than PT's (based on their curriculum). PT's seem to be more adept at biomechanics and anatomy in my experience. This is a broad generalization and not specific to knowledge of a single body region or the knowledge of a single professional.
jon
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Re: PT and OT difference - September 4, 2005 7:51:00 PM
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tc
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free,
I mainly try to explain it by difference in goals. This is very generalized, but OTs focus more on ADLs and psychosocial issues. I don't really know how it works with adults, but with pediatrics they will work on behavioral goals, attention to task, sensory goals, tactile, feeding issues and tend to do more of the fine motor activities such as grasp and handwriting whereas PTs focus more on gross motor type activities. Yes, many of these areas do fall under PTs scope of practice, but we cannot be experts at everything. If a child has mulitple issues, they should have treatment with the therapist who is most specialized in that area, meaning they may need multiple disciplines. There is also debate about working on swallowing and feeding between speech therapists and OTs, because speech therapists feel they have more specialized training in that area. Many types of therapies do overlap in areas.
Jon,
I do agree with what you have seen in terms of OTs limitations, but I've also seen it the other way around. In one peds facility it was basically- OTs work on the upper half of the body and PTs work on the lower.
ALso, in the field of early intervention in peds, OTs actually seem to have an advantage. At least in my city, they seem to have historically been the first ones providing things such as developmental evals and treatment, etc. and it is very hard to now convince the entire EI community that PTs are also trained in this area and it doesn't need to be an OT. However, the OTs are the ones running the show per se, by being in the upper level management and deciding which discipline to give the eval to. It is actually quite frustrating, because frequently the OTs will go beyond their scope of practice (in my opinion and in the eyes of many well-trained peds OTs) and work on walking as their primary focus of treatment and write gait goals.
Just another perspective.
tc
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Re: PT and OT difference - September 4, 2005 10:37:00 PM
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Randy Dixon
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We have an OT that will be getting certified in Manual Therapy. I think he will be one of the first. I wonder if this bothers anybody.
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Re: PT and OT difference - September 5, 2005 2:42:00 AM
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Jon Newman
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Hi tc,
I don't think it is a different perspective in that in both cases the powers that be are trying to limit another's ability to practice within their scope but I get your point that all professions do it.
I think OT's, PT's and SLP's all have the same general goal of maximizing participation in activities in life. I know that PT's specifically teach therapy from this model (think Nagi and eventually WHO's). I'm not sure what model other professions teach from.
Still, I think what makes one different from the other is what came to be through local forces (some more local than others) and as tc, et. al. point out, what OT's came to focus on is the elbow and hand for rehab of a thing and (I)ADL's for rehab of a person. OT's are also more likely found in 'mental health' settings than PTs.
jon
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Re: PT and OT difference - September 5, 2005 2:51:00 AM
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jma
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I hear of many OT's specializing in hand therapy. An OT getting certified in manual therapy is something new to me as well. I see nothing wrong for someone expanding their knowledge and skills. We do it as well.
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Re: PT and OT difference - September 5, 2005 4:30:00 AM
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TLB
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It's just another turf battle. One more reason why we need direct access. The OT's are no different than the LMT or the personal trainers all trying to grab what they can, I met an OT the other day who told me he specializes in the spine. Hell if I didn't get into PT school I would have went the OT route, it's much easier and not half the hassle. Some things never cease to amaze me.
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Todd
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Re: PT and OT difference - September 5, 2005 4:08:00 PM
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tc
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Todd- I disagree that OTs are no different than LMTs or personal trainers. They have considerably more education and a license with a scope of practice. No, I do not want them working on anyone's spine, because they aren't trained in that. However, a good OT, working within their area of expertise can do a world of good. Just like any other GOOD practictioner working WITHIN their scope of practice.
tc
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Re: PT and OT difference - September 5, 2005 6:45:00 PM
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cnelligan
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Interesting diaglogue. "Good practice working within their scope of practice." Nice comment of bringing it back to ground zero.
In my 20 years in therapy as an OT and also a rehab consultant, understanding the background, scope and training that all disciplines start with and the many avenues they take in specializing...individuals have areas that they are passionate about. They learn, they grown, they get certified, they don't, they continue to pursue what their populations need...
As an Occupational Therapist the frame of reference that truly separates us from other disciplines in "philosophy" (and again not all O.T's continue rigourously with this only perspective) is the Model of Human Occupation. Whether the patient is a hand patient or a geriatric Alzheimer's patient, we are taught to look at function. We are trained in activity analysis ... we look at the person with a weakness or loss of role and place this in a framework that will follow our continual learning wherever it may go. A shoulder patient if we are competent and skilled in this area, is not the shoulder, they are the 74 year old homemaker who must continue to care for her husband and kitchen and garden and what that shoulder girdle must do for her in life. What she socially, cognitively, neuromuscularly and whatever else is present ...we must assist her in arriving to the outcome she needs in her roles.
I truly believe that all disciplines need to understand each other better...and I have seen repeatedly that we continue to work along side each other without this happening as often as it should. We all Need each other. Not turf wars. Not putting down any discipline. Referring to who is BEST at doing what piece is most critical and supporting each other in all situations. Talk to your co-workers, take the time to learn how to compliment each other.
No path is "easier" and no path is without "hassle". Just talk to any therapist at length...regardless of their discipline.
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Professional Coach
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Re: PT and OT difference - September 5, 2005 7:13:00 PM
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TLB
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[QUOTE] Todd- I disagree that OTs are no different than LMTs or personal trainers.[/QUOTE]I probably didn't covey that message very well. I was trying to say that any other discipline will grab as much as they can when they can (Who can blame them). Simply stating that things are changing and everything is up for grabs no matter the educational level.
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Todd
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Re: PT and OT difference - September 7, 2005 11:00:00 AM
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Ray
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I am going to go out on a limb here and say that the vast majority of rehabilitative treatment can be successfully delivered by a PT and that the OT's general scope of practice could easily be assumed by a PT. Certainly there are differences in philosophy that an OT is rooted in but necessary interventions for a sucessful outcome can be performed by a PT.
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Re: PT and OT difference - October 5, 2005 11:03:00 PM
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Rehab Outcomes
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My two cents..
As a physiotherapist working in occupational health two things are clear:
- physios have a lot to learn from OTs particularly on the front of understanding the factors that affect real function.
- occupational health can benefit from a slightly more clinical and evidence based approach that physios can bring to an industry very traditionally OT based (at least in Australia).
Note that as a director of an occupational injury prevention and management organisation I employ and enjoy working with OTs, and I know they are richly rewarded by collaborating with physios.
Brad
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Re: PT and OT difference - October 7, 2005 4:39:00 AM
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Yogi
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Frankly, I've always thought that OT's and PT's are in general two different types of people. It's hard to describe, and there are degrees of course, but I think that if a PT type accidentally went to OT scholl, it would drive them nuts.
I sort of think PTs are more a "cowboy" type. That may not resonate with some of you, some it may.
Sure I'll get into helping you be able to cook, if you're one that really wants to, but mostly I want you to be able to move, then you can do whatever you want. You deal with your own psychosocial issues, there're not my business.
I know I've gotten flak here before for that. Where I work we have people want to hang around getting rehab forever, when they really need to go home and start living their lives and doing things again. Some problems have to just be dealt with, that's the solution when problems won't go away.
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Re: PT and OT difference - October 7, 2005 5:51:00 AM
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OaksPT
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Yogi,
I tend to agree, it's hard to categorize the type that's drawn to each profession. But from the OT's I've worked with personally, they have tended to be more nuturing, more in tune with the biosocial issues. While I realize the importance of CBT, and believe that it's an integral part of the recovery for some of patients, I leave that domain to others and refer on(in conjuction with PT if indicated)when needed.
Scott
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Scott Oaks PT,DPT
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Re: PT and OT difference - October 11, 2005 4:30:00 AM
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Yogi
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Scott, yep. I think you hit it. PT's are Dads and OTs are Moms. With all the usual variability.
You get the Yogibel prize for something here, unfortunately that one comes with no money attached.
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Re: PT and OT difference - October 11, 2005 5:16:00 AM
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Diane
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Guess that leaves me being an in-betweener. :)
If we are using the mom and dad split, how about this? The dads are mobilipulators and the moms are neuromodulators. Both encourage movment, one tries to force it and the other tries to grow it. Dads are drawn to chiro (the triangle factor in the relationship) and ortho PT, moms are drawn to OT and neuro function.
Is this marriage in trouble?
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