Oooh, they make me so mad sometimes.

Sometimes you've really got to have some chuzpah (or however you spell it) to be an Occupational Therapist, because it feels like everyone else is trying to tear you down. Or I guess tear you down isn't the right way to put it, but they just sort of dismiss you, like their service is valuable but yours isn't. My supervisor has had a history of struggling with the physio outpatient service...not that they are overtly separatist or rude or mean or anything, but there have been issues in terms of who gets new referrals. Consultants and their teams of doctors have a bad habit of using an OT referral form, but writing "hand physio" as the reason for the referral, so even though it is an OT referral some of them have been "stolen" so to speak by the physio team in the past.

I recently had a lady call in to say she wasn't going to keep her next appointment, and in fact would not be coming for any more sessions with me because her physio had told her she doesn't need to see me anymore. Although there is some crossover, the OT hand therapy service would not exist if we were nothing more than a duplication of physio services! Regardless of my own opinion on the obvious differences between our services, in the NHS, anything that can be cut, will be cut. I have also recently taken on a patient only a year or two older than me who has already had physio for awhile, been discharged from physio, and was only given a referral to see me by the doctor because she wasn't happy with the end result, and he didn't know what else to try. It was kind of like, well, we've done everything we possibly can for you, and out of sheer frustration finally said, well, there is an OT, I suppose I could refer you to her.

The icing on the cake was a phone call this morning from a lovely patient...she saw the specialist hand surgeon yesterday. He discharged her and told her she's got about as much back in her arm as she is going get. So she asked about her OT sessions and he told her not to bother! She was a bit thrown off and rang me today to ask about it. Since we see people for as long as they are making progress, and when I saw her two days she had improved, I told her she was welcome to continue coming, which she has decided to do. But honestly!!! Your self esteem could take a dive if you weren't the type of personality to get fired up by this kind of thing instead. Why on earth do you make referrals to a service that you don't think is of benefit to your patients? And what business is it of yours to decide when a patient should finish therapy?! Once a referral is made to me, that patient is mine as much as yours, and what I do with them is in conjuction with what you are doing, true, but also separate. Agggghh!!!!!!!!