Q&A: Occupational Therapy vs Physical Therapy

In this podcast, we talk with Brianna Brim, MOT, OTR/L, CPAM, CLIPP, director of the Occupational Therapy Institute (OTI) and an assistant professor of Occupational Therapy (OT). Second-year OT students — Bradley Hess, Aditi Kadakia and Rachel Boas — join in. They talk to us about the difference between OT and physical therapy (PT) and why they chose Salus University’s OT program.

Q: Can you please explain what an OT does and how it differs from a PT?

Brim: We get this question a lot. And, I think one thing that's important to say is, I like to think of OT and PT as sister professions. I think OT and PT a lot of times work best when we get the opportunity to collaborate just like OT and SLP (Speech-Language Pathology) work great when we get the opportunity to collaborate as well. So, a lot of where the delineation comes from in PT and OT, a lot of times actually comes from the conversation about duplication of services. I kind of want to say that to start it off, because I think it makes sense. A lot of times if someone's getting PT and OT, we collaborate to split the load, right? So that we're working on some things and they're working on some things and we're not billing insurance twice for the same thing.

That’s super important. So sometimes when people say things like, "Oh, PT does gross motor and OT does fine motor, a lot of the times, it's not that either profession can't cross over into those realms, it's really that we've talked to each other and made a decision such as, "Nope, let's split up and conquer the most ground in the most amount of time for this particular patient." Theoretically though OT, a lot of times, our goal is daily function. We really work a lot on skills that people don't necessarily think about every day - a lot of things like dressing, cooking, cleaning, handwriting, going to the bathroom, those kinds of things that are really crucial to your daily existence for most folks, but we don't necessarily think about all of the time, whereas PTs a lot of time are going to focus on some of the larger movement patterns, including walking, stairs, and balance in a very contextual way.

Both professions together though really are able to assess the body, head to toe and work on strength and pain and range of motion. It's just how we do those things are often a little bit different, because OTs use a lot of what we call occupations or just things that occupy your time to try to facilitate that improvement in strength, range of motion, where PTs framework is very bio mechanical a lot of the times, in that they're working on doing that range of motion versus doing a functional activity to get that range of motion. Hopefully, this explanation, clears it up a little.

Q: So now pivoting over to the students, why did you choose OT over PT or perhaps a different healthcare career?

Hess: I'll jump in and answer that question first. I know personally I chose OT over every other healthcare profession, because of the unique holistic and client-centered approach that OT brings to the table when treating our patients. And, I also just want to mention how much I love that we get to work towards getting our patients back to the meaningful occupations that they really want to be doing.

Kadakia: So to kind of jump off of what Brad said, I really picked it for the client-centered approach too. Also like Brianna mentioned, we can work on things like dressing, grooming and bathing, which are things that are sometimes overlooked, but are so important to a client's everyday life and are things that they want to focus on first. I think that's really important to them and it helps motivate them in therapy too. And, I really think that it's really rewarding to see them being able to do those things again.

Boas: Going off of what Aditi said, I know personally for choosing OT was more of an experience base. I was able to do some observations with local clinics. Specifically there was a few OT sessions where I was able to witness the gradual development of a child being able to zipper their jacket. And, they were so excited when they finally got it, that it was one of the most rewarding things to watch. So, I completely agree. Just building that independence and of seeing someone be able to get to that point where they finally meet their goal is really exciting. Even just in just regular communication with people, even then. So, I mean, personally, that was just more of a experience-based reasoning.

Q: Can you describe how Salus' OT program prepares students to work with other healthcare providers like PT?

Brim: We do have a little bit of practice built-in, through some of the interprofessional opportunities. So the rehab best friends is, I like to call them PT, SLP and OT. We do try to get our students together once throughout the program to work specifically with PT and SLP on some kind of targeted group project. So this year we kind of looked at telehealth across Pennsylvania and some of the legislation and access issues and how we would work with the patient. This next year we're going to be looking at a particular case study of a patient and having our students work with the PT students from Arcadia (University) and the SLP students from our program to kind of work through that case together. What would we be doing? How would we be collaborating? So we get that kind of nice practical experience and if COVID keeps at bay, we probably will actually get to do it in person, which will be excellent.

I think that's the one thing, also, when we're looking at our curriculum, we try to talk a lot about global understanding of what this client is going to look like, what this client is going to be experiencing difficulty with before we even see them, just knowing, what are commonalities of this procedure, or this diagnosis, and that makes interprofessional practice so much easier, because if we've already done the work on our own to anticipate, we go in with a plan already of how we're going to split the load with someone else.

It makes co-treating easier. It makes collaboration easier and the nice thing is now within several miles, we have our SLP clinic, our OT clinic, and then Arcadia just opened a pro-bono PT clinic as well. So now we actually have the opportunity to share patients and that's been great for our students who have been able to rotate through OTI and kind of know that this person actually is getting this PT, and this is what they're working on. And, this is how we've talked about that behind the scenes. So, we're excited to even just continue to expand those partnerships, for sure.

Q: Is there anything you would say or suggest to a perspective student who might be interested in OT, but is debating it over PT or maybe another healthcare career?

Hess: I would tell them that OT is the perfect field because you can take it in a million different paths and work in so many different settings. Just to give a few examples of different settings, there's outpatient hands, acute care, or even working with horses in equine therapy. Ultimately the sky's the limit with OT and you can almost work with anyone in anything you'd like to do.

Kadakia: To jump off what Brad is saying, I would also recommend since the OT scope is so broad and you can work in so many different settings, it would be beneficial to shadow as much as you possibly can, in as many settings as you can. And, even though you might not be able to get to every single one, you can also follow different occupational therapy blogs, or a lot of people have social media pages that really go into more detail about different settings. So, I think that would be really helpful to decide.

Boas: And, even on a research base too, I know of a few people who would sit down and really pan out all of the differences between all the different professions and what exactly they do, what their roles and routines are. So, even just throughout our studies, we learn how to build occupational profiles for clients, but even just being able to sit down and identify what you like to do and what your overall goal is for your career and sort of in a way building your own occupational profile, is a really good way to be able to sit down and figure out if OT is the best career for you, and then going forward with other career choices or even choosing OT. But obviously, I mean, we have a little bit of a preference to OT.

Q: Does anyone have anything else they would like to add that they didn't touch upon today?

Brim: With OT there's really, like the students have said there are a lot of different directions that you can go with OT, which is some of the beauty of it, because you can make your career match a little bit, maybe what you need at a certain point of your life. So you can specialize in a lot of different things across your career versus certain professions. Like if you do decide that medicine is for you, changing specialties is really, really difficult. You're kind of stuck with what you're stuck with. The nice thing about OT is we have the ability to work across practice areas. So like, if you look at my background, I started out in hand and upper[2]  quarter, and then at the same time was working in acute care and acute rehab. And, I was doing both of those.

And, then I decided to specialize in Parkinson's disease, because I had some patients and I decided I wanted to get into aging in place and I did that. So there's a lot of flexibility and a good way to explore passions that you have, at any one point in your life. And, the nice thing is the framework and the educational model and even just how our practice model works. It makes it easy to do those things. And that's one of the beauties of OT is, we can work in a lot of places and we have a lot of skillsets that translate over to a lot of different abilities in working with clients from all ages. So, there can be a lot of flexibility in the career once you get the knack for what OTs do.

To learn more about the OT program at Salus, you can visit salus.edu/occupational-therapy.