Against use of physical agent modalities.

It is with an acute sense of the significance of the physical agent modalities issue on the future of our profession that [ fully endorse the position taken and the recommendations made by Wilma L. West and Ruth Brunyate Wiemer (A]OT, December 1991, pp. 1143-1147). There can be no denying that the health care system of today is economically and politically driven. Too frequently, patient treatment plans are influenced by what is reimbursable and under what circumstances rather than by what is best for the patient. [n such a marketdriven, politically motivated system, we often find ourselves pressured into practicing expediency rather than what we know occupational therapy to be. The priority becomes how rapidly we can move patients through the routine and how readily reimbursable we are. In such an environment, there is the risk that our priorities become being able to demonstrate our ability to sustain and add to the profit of the corporation, thus protecting our position and ensuring against being preempted by the physical therapist. Certainly, politics and money are realities of our work today. However, we must deal with these realities from the strength of our unique expertise, not on the coattails of others. Our survival and efficacy lie in demonstrating the political and economic value of authentic occupational therapy. We need to remember that when that has been tried, it has been encouragingly successful. Any modality used by any profession must be distinctly congruent with the philosophy and definition of the profession. Physical agem modalities are consonant with physical therapy; their use contradicts the philosophy and definition of occupational therapy and creates cognitive dissonance for ourselves and others. The argument that in occupational therapy these modalities are simply a means to an end is nOt rational. [ could argue that, because medication of schizophrenic patients facilitates their participation in occupational therapy, I should then, on the basis of such a causal relationship, be allowed to administer the pill. Many other similar examples can be Cited to demonstrate the questionable logic of this thesiS. One further poim within this comext is that loose boundaries work bOth ways-As we move into the territory of others, so then is it their privilege to usurp ours. During dialogues around these issues, I have on several occasions been asked the follOWing questions: Does oprosition to this resolution reflect a certain rigidity, a preference for and comfort with the status quo? Is there a danger thal we set limits to trying new approaches and thus limit exploration of our pOtential and our growth? The imrlication here is that our freedom to grow and develor is stifled if we cannot reach beyond our commonly accepted identity. If we claim the need to employ modalities commonly associated with another profession in order to secure our credibility and position in the health care system, then we fail to strengthen our own identity. The strength, the efficacy of any profession is grounded in the validity of that profession's fundamental principles. We do indeed have a long way to go to first explore and validate occupational therapy and, I suggest, an equally long way to go before the potential of our fundamental parameters is exhausted. It is truly ironic that we continue to devalue the essence of occupational therapy, that we struggle to look more like others than like ourselves when all the while these others are discovering the efficacy of authentic occupational therapy and striving to own it. Gail S. Fid[er, OTR, FAOTA Dallas, PA