We can't just blame these corporations for all of this," she says. "We have to shoulder as therapists some of the responsibility because we've allowed this to get this bad." ~Kristi Emerson, COTA/L

As therapists, whether we are actively practicing or in a nonclinical role such as a manager or director, we literally make hundreds and sometimes thousands of decisions a day.  We are presented with patient treatments and have to adjust what we are doing moment by moment based on the patient's response.  Which task will prepare for my patient's session today?  Which goal will I focus on today? If my patient moves in this manner, how do I adjust my treatment task?  If my patient responds in that manner, how do I adjust my task?
 
When performing an evaluation, we have to decide what goals are best, what modalities are appropriate, what treatment situations are best.  We have to decide what frequency and duration is appropriate for the individual we are evaluating.  What goals are important to our patient, what is their priority? What co--morbidities influence the main diagnosis we will focus on?
  
As managers and directors, we have to decide how to assign patients and therapist schedules.  We have to decide what kind of staffing budgets allow.  Is the staff performing efficiently and doing their jobs appropriately? How do I provide the best functional working environment for staff to allow their patients the best care?  Can we order equipment and what equipment do we order?  How do we coordinate attending a meeting? And how am I going to do all this paperwork?

There are 3 key questions you should ask yourself with each and every decision you make.

1.  Is it best for the patient?
2.  Is it ethical?
3.  Is it legal?

If you can answer yes to these questions, then you should be ok. I recommend keeping a copy of your state's practice act with you at all times.  Treatments and billing that you are asked to do should not challenge your state's practice act.

Keep a copy of AOTAs code of ethics with you at all times.  Treatments and billing that you are asked to do should not challenge AOTA's code of ethics.

Know the different insurance rules.  You may assume supervisors or managers will understand the various insurance requirements and trust that they will only ask you to do treatments and billing that are within insurance guidelines.  This is not always the case.  You need to educate yourself on what is legally billable, whether it is for Medicare/Medicaid, Worker's Compensation or other private insurances.  

​You are responsible for the integrity of our profession." ~LeeAnn Holt, OTR/L, OTD

Kristi Emerson

LeeAnn Holt