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What Exactly is Occupational Therapy?

Paperwork helped me find my voice as an occupational therapist.

Many occupational therapists struggle to describe the profession to patients, other health-care providers, and health insurance companies. Oftentimes, occupational therapy (OT) is incorrectly billed as physical therapy (PT), and some insurance companies do not even cover occupational therapy, reasoning that physical therapists can do everything necessary to address patients’ rehabilitation needs.

For 17 years, I worked as an occupational therapist with patients who developed breast-cancer-related lymphedema. My patients would often ask, “What’s the difference between occupational therapy and physical therapy?” For many of those years, I would say, “In this area of practice, there’s not much difference. You will get the same care from me as from a physical therapist.”

In 2008, the shift to electronic medical records gained steam, and digital record-keeping became the standard practice in health care. When the rehab department of my hospital needed a volunteer to create a template for electronic lymphedema notes, a document that would be shared by both OTs and PTs, I eagerly volunteered for the task in order to ensure that they encompassed my needs for practicing as an OT.

As I thought about what critical information should be included in the notes, I realized that documenting patients’ medical history, the circumferential measurements of their arms to quantify their swelling, their general functional abilities, and their therapy procedures was not sufficient. I thought about how much time I spent during evaluations asking about my patients’ roles, routines, and activities and identifying how their emotional reactions to developing a chronic, sometimes-debilitating condition impacted their ability to participate in therapy. When patients were reluctant to commit to therapy, I would spend time developing a plan that would fit into their busy lives. If a PT had created the lymphedema notes, they would not have included space for those crucial aspects of an OT assessment and plan of care.

In other words, by creating a template for the electronic paperwork, I discovered what it meant to be an occupational therapist!

Sara Cohen
New York, New York


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