Occupational Therapy in Primary Care: Determining Receptiveness of Occupational Therapists and Primary Care Physicians to Occupational Therapy in Primary Care

PURPOSE: Primary care (PC) is an emerging practice setting for occupational therapy; however, there are few occupational therapists (OTs) currently practicing in this setting, and there are identified barriers to the inclusion of occupational therapy as a member of the interprofessional integrated PC team. The purpose of this pilot study was to determine whether, if barriers to inclusion are addressed, primary care providers (PCPs) and OTs (occupational therapists, occupational therapy assistants, and occupational therapy students) would be receptive to the inclusion of OTs as a PC interprofessional team member. With the information obtained from this study on these perspectives, OTs can develop improved strategies to advocate for their role in the PC setting to improve patient access to occupational therapy services.

DESIGN: A cross-sectional research design employing a one-time electronic survey was used. Surveys were disseminated to OTs and PCPs through the SurveyMonkey online survey platform (San Mateo, CA). Participants were recruited through the listservs of professional organizations (American Occupational Therapy Association Special Interest Sections, the American Academy of Family Physicians, the Collaborative Family Healthcare Association), emails to known OTs and PCPs, and snowball sampling. A question requiring respondents to state their professional status ensured that the analyzed data included only data from participants who met the inclusion criteria.

METHOD: After reading a brief educational paragraph explaining what occupational therapy can contribute to the PC team, participants in each group completed a survey consisting of five closed-ended Likert-scale questions regarding level of receptiveness to occupational therapy in PC. The PCP educational paragraph additionally addressed billing barriers. There were two optional additional open-ended questions that allowed participants to add information they believed critical to the study. The results were recorded by SurveyMonkey and interpreted by the researchers through statistical analysis and coding and thematic analysis.

RESULTS: All 71 OT respondents met the inclusion criteria. A majority of responses to each question supported the presence of occupational therapy in PC. Primary concerns among OT respondents related to the ability to obtain reimbursement, lack of awareness of other team members regarding what occupational therapy can do in this setting, and the level of competency of OTs in the PC setting. Of the 40 PCP responses, 34 met inclusion criteria. The majority of respondents supported the presence of occupational therapy in primary care, with lack of PCP knowledge regarding the specific roles and responsibilities of OTs in PC settings reported as the biggest concern.

CONCLUSION: Results suggest that when barriers are addressed, OTs and PCPs are receptive to the inclusion of occupational therapy as a member of the interprofessional integrated PC team.

IMPACT STATEMENT: Assessment of the receptiveness of both professions to the inclusion of occupational therapy in the PC setting was critical to determine next steps for increasing the presence of occupational therapy in this setting. The findings of this study provide the occupational therapy profession with actionable information to further develop the presence of occupational therapy in the PC setting as a recognized member of the interprofessional team.

References

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Donnelly, C. A., Brenchley, C. L., Crawford, C. N., & Letts, L. J. (2014). The emerging role of occupational therapy in primary care. Canadian Journal of Occupational Therapy, 81, 51–61. https://doi.org/10.1177/0008417414520683

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