Private Practice Occupational Therapy in the Skilled Nursing Facility: Creative Alliance or Mutual Exploitation?

Abstract

Occupational therapy private practice appears to play a major role in the provision of rehabilitation services in skilled nursing facilities. A critical look at the meaning of private practice, however, indicates that many of today's private practitioners lack characteristics traditionally associated with that term. Group private practices are well suited to retain the essential qualities of private practice while competing effectively in a corporate environment. They accomplish this difficult task by applying therapeutic principles of growth and change to the complex relationship between the group practice and the skilled nursing facility. Application of these principles allows the occupational therapy group private practice to behave consistently with its professional identity while addressing the competitive demands of the marketplace.

Professional competence for private practitioners in occupational therapy

“…Cossar (1992, p. 160) has suggested that in ‘several respects, trends amongst occupational therapists in private practice are pre‐empting trends in the occupational therapy profession in general’. Although there are published reports about occupational therapy private practitioners from North America and the United Kingdom (Bridle & Hawkes, 1990; Cossar; Faust & Meaker, 1991), there are no Australian studies. Previous studies of private practitioners have involved quantitative methodology with a broad focus on demographic and descriptive data (Bridle & Hawkes; Cossar; McClain et al .).…”

“…For the purposes of the current study, a private practitioner in occupational therapy was defined as self‐employed with the ability to function in an autonomous manner as an independent business person meeting his or her individual tax responsibilities for reimbursement income (Bridle & Hawkes, 1990; Faust & Meaker, 1991; Shriver, 1985). Although a private practitioner as defined here may contract to the private or public sector, a private practitioner is not simply defined as a contractor to the private sector or an employee in the private sector.…”

“…Private practitioners have a long history of working outside departmental processes, organisational hierarchies and formal networks of co‐workers (Royeen, 1980). Thus, they have a history of being self‐directed in dealing with professional issues (Faust & Meaker, 1991). Private practice in occupational therapy highlights the tension between autonomy and isolation that is described in published reports dealing with the role of professional socialisation in assuring professional competence (Collins, 1996a).…”