-
Entry into the AT field:
1986
-
How I got into the
field
I am a physical therapist who
started work in an inpatient rehabilitation facility. At my first job I recall
sitting around a large conference table with the entire rehab team of ~ 20
people and everyone turned to me when the question was posed "What equipment
does Mrs. or Mr. Jones need to go home?" I remember thinking I did not know I
was the one who had to make that decision - I best learn more about this. That
is when I began to learn that there was a whole world of technology and options
for my patients. I also quickly learned that when someone told me I cannot get
"that" for my patient because it was not covered that I could challenge that
successfully with appropriate rationale and justification. When I found RESNA I
was so excited to find "my people".
-
Important event(s) that influenced
my early decision to get into the assistive technology field
I always say that my entire career in AT evolved
by accident- being in the right place at the right time. Working in a heavily
managed care environment I was increasingly frustrated with the difficulties I
had obtaining the technology I was recommending for my patients. I quickly
learned to seek guidance from colleagues. One of my first educational
experiences in the field of seating and mobility was a Regional RESNA Seating
and Mobility Conference in Phoenix, AZ. Jessica Presperin Pedersen was the
keynote speaker and Janice Hunt Hermann and Dave Dilli were the conference
coordinators. This conference was a pivotal point in my career inspiring me to
continue and focus my practice in seating and mobility. With guidance from
Janice and Dave and their experience with their AT clinic at Good Samaritan
Rehabilitation soon after we opened the Assistive Technology Program of Tucson
at Tucson Medical Center, the first AT program in Southern AZ.
-
Why I chose the AT
field
While traditional PT proved to
significantly help the people I worked with I found myself asking - what
happens when they go home? How do they function and participate the rest of the
time? Can they return to their prior activities and prior level of functioning?
It occurred to me if I could obtain assistive devices to accommodate and
compensate for mobility impairments when the person was not in the clinic that
would have a much longer term impact on that person 24/7. Using an assistive
device- wheelchair or scooter did not minimize the benefits or need for PT but
augmented it! By matching the person with the proper technology they could
engage in a more active and independent life during and after
rehabilitation.
-
My inspiration and
mentor
While there are a number of
colleagues that have inspired me and supported my learning, Jean Minkel has
generously provided mentoring, guidance and coaching since early on in my
career. I consider Jean a treasured long-time friend and attribute much of my
career success to her wise counsel. Over the past 25 years Jean guided me on
everything from direct patient care questions, building a productive full
service AT program and seating clinic, serving on my doctoral dissertation
committee, creating and sustaining a successful private consulting practice and
carrying forward the next generation of work of the RESNA PSB. I am grateful
for all of the time and support Jean has invested in me and hope to pass that
generosity on moving forward.
-
Why the field is important to me
and the central focus of my work
I
find that AT in general serves to level the playing field for all players.
Given the proper tools potential is limitless. I have seen this with the people
who I have worked with to provide seating and mobility services and find this
direct work the most rewarding. While my career has moved me somewhat away from
direct patient care services, I strive to work to ensure that people with
disabilities have continued access to the complex rehab technology that they
need to live active and productive lives. I believe that public policy can
responsibly provide appropriate technology and services to the people who need
it. There remains a lot of work to do in order to put in place the checks and
balances in the form of public policies and best practices. It is time to
professionalize the field of Rehabilitation Technology and develop a qualified
workforce to meet the growing demand. My work focuses on ensuring that people
with disabilities have continued access to the technology that they need and
that there is a qualified and prepared workforce to provide the AT related
services to meet the needs of the public.
-
My memorable successes and
greatest contributions to the field
Almost all of my most memorable successes in the
field relate to individuals who I have worked with to provide independent
mobility. The look of joy and amazement on the face of a person who has never
had an opportunity to independently move themselves is
priceless.
As Chair of the RESNA
Professional Standards Board, I had the distinct honor of working with a
tremendous group of dedicated professionals from the PSB, Certification staff,
and numerous RESNA volunteers. Together we worked to modernize the RESNA
Certification Program: consolidating the ATP and ATS certifications, updating
the Assistive Technology Professional Certification, establishing the Seating
and Mobility Specialty Certification and moving to computer-based
testing.
-
My most memorable
failures
The frustration of
navigating the funding and reimbursement process sometimes seems unending. I
recently had a patient pass away waiting to obtain the power wheelchair he
needed so that he could move out of a nursing home. It broke my heart to know
that the power wheelchair was a covered benefit that he could not get access to
due to red tape. I have committed a great deal of time and effort towards
advocacy work. I recognize that it is not sustainable to fight each battle
person by person. It is the system that needs to be fixed for everyone. That is
where I have channeled my efforts.
-
Significant changes and advances
in the field since I first entered it
The field of AT has evolved to a recognized
specialty area of clinical practice with a well established voluntary
certification program that has gained international recognition. While still
young in evolution the field continues to progress and we are beginning to see
the development of Clinical Practice Guidelines and position papers. While
there is still plenty more to do I am pleased to see the progress we have made
towards professionalizing the field of
AT.
The wide range of AT available has
been the most significant advance to the field over the past 25 years. When I
first started there were very few options available for the patients I saw.
Advances made "custom" products available to the few that were fortunate enough
to work with rehab engineers who could fabricate became more readily available
to all through multiple manufacturers. Today if you can think of it you can
find someone who can make it for you. The problem that limits our success is
access. Still today, not everyone can gain access to the technology that
exists. My work involves challenging the access issues through public
policy.
-
On the future of rehabilitation
engineering and assistive technology
Opportunities abound for us to advance the field of RE
and AT. It is time for our field to mature. We need to develop mechanisms to
bring new people into the field and academically prepare the next generation of
AT Professionals. We need to be at the table of health care reform showing the
impact of AT on the lives of the people who use it, how AT plays a pivotal role
in ensuring people lead active healthy and productive lives, how AT
Professionals can help to lower health care cost and contribute to keeping
people out of institutions and active in the workforce.
-
My role within RESNA and what it
gave back to me
Over the years I have
served numerous roles within RESNA. I first got involved early on with the
Quality Assurance Committee, Publications Committee and Education Committee and
then as Professional Development Coordinator for RESNA developing the
Fundamentals of Assistive Technology curriculum. I have served in many
capacities including Chair of SIG-09 - Seating and Mobility, and Chair of the
RESNA Professional Standards Board. I am currently appointed to the Government
Affairs Committee and the Editorial Board for Assistive Technology. It is
through my involvement with RESNA that I have created an international network
of colleagues. All of my activities within RESNA have contributed to the
success of my career and private practice.
-
On the future of RESNA
Certification. With focus and investment of
resources, RESNA has the potential to develop and be the repository for
professional educational materials to support the AT Professionals in the field
and prepare those interested in developing their expertise.
-
My suggestions for those just
entering the field
People first. What
we do is all about the people. Keep function, independence and participation as
the focus. Act professionally and be fiscally responsible. Rather than fight
each barrier one by one let's work together to make a system that will work
best for most. We spend so much of our life working it is important to find a
career that is fun, challenging and rewarding. I am lucky to have found one I
love, I hope you do to!
