Diversifying into other professions can be a wise career decision — as long you’re truly diversifying and not turning a discipline into something else. While that sounds ridiculous, it might actually happen in occupational therapy.
Occupational Therapy Vs Public Health
According to a certain source, the Occupational Therapy Practice Framework (OTPF) – 4th Edition now gives more emphasis to the provision of services at the population level compared to the 3rd edition. I haven’t read the OTPF-4 yet as I haven’t bought a copy. Still, that’s not surprising because the OTPF-3 already included advocacy as one type of occupational therapy intervention. The OTPF-3 defined advocacy as “efforts directed toward promoting occupational justice and empowering clients to seek and obtain resources to fully participate in daily life occupations. The outcomes of advocacy and self-advocacy support health, well-being, and occupational participation at the individual or systems level” (American Occupational Therapy Association, 2014).
That part about advocacy is dangerously close to public health. I’m an international health student in graduate school, so I should know. The inclusion of advocacy in the OTPF as a type of intervention will dictate the content of occupational therapy curricula in the undergraduate and graduate levels. For occupational therapy to remain as a relevant discipline, occupational therapists (OTs) must strive with all their might to differentiate their healthcare profession from public health. That battle should first be won in the academe.
Occupational therapy historically focuses on helping INDIVIDUAL PATIENTS achieve as much independence as possible in daily living activities. We OTs enable patients to achieve functional outcomes through remediation, compensatory strategies, task modification, and environmental modification. On the other hand, public health focuses on helping GROUPS OF PEOPLE prevent diseases and access healthcare services should those people end up with medical conditions. Public health accomplishes this by equipping POPULATIONS with the knowledge, skills, and attitudes for managing the social determinants of health. Of course, OTs can work in public health. But occupational therapy, in itself, is primarily about patient management. In that light, undergraduate and graduate occupational therapy programs should mainly produce CLINICIANS, not anything else. Producing research about occupation-based assessments and interventions should be their focus. OTs who wish to dive deeply into public health can always take up advanced studies in that field. Meanwhile, occupational therapy schools should concentrate on advancing patient care.
The Town of San Andres
For example: San Andres is a fictitious far-flung province in Luzon, Philippines. It has only one OT and one public health specialist. Like other areas in Luzon, San Andres is experiencing a rise in COVID-19 cases. In this pandemic, the OT will help recovered COVID-19 patients to regain their independence in daily activities such as feeding, dressing, cooking, and working. On the other hand, the public health specialist will equip the residents of San Andres with the skills, knowledge, and attitudes that will prevent them from getting infected with the coronavirus. Public health specialists will also lead healthcare teams in reforming the healthcare system’s service delivery model so that the San Andres residents may continue safely accessing medical services during this pandemic.
Public health and occupational therapy are as important as the other in closing health inequities. But how do you bridge the gaps? For social justice proponents, closing health inequities requires the government to give people equal access to privileges. The problem though is that healthcare workers (HCWs) adhere to different kinds of political ideologies. We have no consensus about the extent to which the state can intervene in our affairs. On a more practical level, I don’t think OTs will be happy about the additional taxes and regulations that will be imposed upon them just to fund distributive programs with questionable effectiveness.
The COVID-19 pandemic has exposed the reality that not all clinicians make good public health specialists. And that’s completely fine! It only means that they have chosen to focus on their clinical specialties. Likewise, public health specialists do not necessarily have the skills of excellent clinicians. That’s alright too. What’s important is that both camps avoid presuming that they can usurp each other’s roles or that non-medical professions are less important. When they do succumb to hubris, they make all sorts of dogmatic yet ridiculous pronouncements that can worsen any situation. Read the tweets of many HCWs if you want examples of arrogance. You’ll see for yourself that self-aggrandizement might just be the death of us all.
REFERENCE:
American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain & process – 3rd edition. American Journal of Occupational Therapy, 68, S1-S48.
(Photo by Gayatri Malhotra)
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