

The occupational therapy profession is at a crossroads. With factors such as unrealistic productivity requirements, constant insurance reimbursement changes, and a professional identity that is ambiguous to many outside (and within!) the profession. Due to these factors, burnout is at all time high. Add the impact of delivering care with these factors during COVID, it is understandable that occupational therapy practitioners (OTPs) are looking for ways to deal with the current shortcomings of the profession. Some therapists have actually given up and are leaving the profession and not looking back. While others that stay are just getting by, and the quality of care is affected.
The advice to heal the profession from other occupational therapy practitioners runs the gamut from finding another OTP job that is more in-line with your value system to leaving the profession for a role where the skill set of an occupational therapy practitioner will be appreciated and better utilized. There are many clichés we can point out with each suggestion. For those that stay, we all know the common phrase that it is not alright just to survive, you have to thrive. For those that leave, we all know that the grass is not always greener on the other side.
We all chose occupational therapy for a solid reason and rather than look elsewhere for ways to deal with change. Let us look from within. Below are ways we can weather whatever changes occur in the profession.

Join your state or local OT organization. In the state of New York, there are roughly 22,000 occupational therapy practitioners (Source: NYSED). However, the state OT association (NYSOTA) has roughly 400 members. Having lived in another state, the number disparities between practitioners who are also state OT association members were similar. With less than 2% supporting the state’s OT organization, the collective voice when there are issues with legislation, insurance reimbursement, and practice is low. Unfortunately, this results in less success with issues that face the profession. Imagine 22,000 voices advocating against a payment cut versus 400 voices. Additionally, state or local associations have a wealth of continuing education opportunities that more than cover the annual costs. In this hyperconnected world, it is important to have professionals supporting our needs. Cost: About $100 a year ($8 a month!).
Join your national OT organization. The resources that are available from AOTA are extensive. Additionally, the organization has stepped up its advocacy game and has been involved in legislation and reimbursement structure negotiations that protect the occupational therapy profession. One thing that I have learned with law and insurance changes that affect our practice is the devil is in the details…and the details are buried deep in hundred, sometime thousand-page documents. AOTA searches through these documents and find loopholes, pay cuts, service changes, and much more! Once found, and they always find them, the advocacy process begins. Other considerations–practice changes, evidence, research, caregiver resources, and much more. This level of support takes funds (about $20 per month for the practitioner!). For our international friends, there is the Canadian Association of Occupational Therapists and Royal College of Occupational Therapists to name a few that function in a similar advocating and educational function as AOTA.

Support OT research. For someone who enjoys research, it makes sense that this would be one of the options. Research doesn’t have to be laborious. Consuming research does not have to look the same for everyone. Also, research does not have to be just research articles. Professional occupational therapy publications such as OT Practice can also provide much needed knowledge to impact clinical practice.

Choosing Wisely ®. I like roadmaps and Choosing Wisely is a roadmap. This initiative began with the American Board of Internal Medicine (ABIM). The fact that AOTA aligned itself with this initiative is kind of genius when you think about. Imagine if AOTA did not adopt Choosing Wisely ®. Medical professionals would question the effectiveness of our services and our choice to not get involved with a program that focuses on appropriate and quality patient care. The list of 10 recommendations for occupational therapy practice. There is also an excellent video that provides why this is being used and some tough questions for Dr. Glen Gillen on how to apply this initiative in one’s practice. Spoiler Alert: He answers all the questions by providing realistic ways these standards can be applied in any occupational therapy practice.


Find support that promotes the OT profession. Journal clubs, support groups, state organizations, etc. There are a variety of online social media groups that provide support. These are like the Cheers of occupational therapy where “everybody knows your name and they’re always glad you came”. Nothing is better than having a person that can commiserate with issues you pose: rehab models, productivity, etc. However, being in a position where you focus on the negative all the time, will most likely leave you feeling good that you have vented, but does not help you realize how great the profession is. Go outside of your comfort zone and find groups that will support your growth and rekindle your love for the profession rather than those that focus solely on what is wrong with the profession.
What are some ways you are rekindling your love of the occupational therapy profession during this time of change?