S10 E9 - Sliding Doors: The Moments That Shape an OT Career

Some moments in your OT career stay with you. A decision, a client or even a comment from someone else can change the direction of your career or the way you think about your role.

This week, Sarah, Alyce and Nikki share some of their own ‘sliding doors’ moments, from career decisions that changed their direction to clinical experiences that reshaped how they understood their role as OTs. They also unpack recent NDIS developments around students on placement, functional capacity and changes approaching from 1 October.

The career decisions that change everything

Sometimes a career-defining decision starts with realising it is time to leave. Sarah reflects on the workplace experience that ultimately gave her the push to step away from a role she once thought she would never leave and start Verve OT.

Alyce shares turning points of her own, including professional development that challenged the way she thought about clinical intervention and a period away from Occupational Therapy that ultimately led her back to the profession and into building her own practice.

Looking back, neither could have known exactly where those decisions would lead. Sometimes it is only years later that you can see how one choice changed the trajectory of your career.

When you can’t change the outcome

Nikki shares the story of a man with rapidly progressing motor neurone disease who desperately wanted to leave hospital and return home. After considerable work to organise equipment and make his discharge possible, he made it home on a Friday afternoon and died the following day.

At first, Nikki felt that everything they had done had made no difference. Her manager helped her see it differently: they could not change the fact that he was dying, but they had changed his experience by helping him spend that final time at home.

That moment changed Nikki’s understanding of what making a difference can look like and influenced her later work in palliative and end-of-life care. It also highlights the role good supervision can play in helping OTs process difficult experiences and make sense of what they mean for their practice.

The small things can be the big things

Not every meaningful OT outcome looks impressive on paper. Nikki shares how one family still considers a simple toilet rail one of the most valuable things she has done for them, despite years of other intervention.

Sarah recalls a client telling her that the biggest thing she had provided through a home modification process wasn’t the modification itself. It was hope that life might become easier.

These moments are a reminder that OTs don’t always know which part of their work will matter most to someone. Particularly as service systems and funding models change, recognising these smaller wins can help keep the focus on what can make a meaningful difference for the person in front of us.

Can you bill for students on placement under the NDIS?

New NDIS guidance has raised fresh questions about students on placement. Earlier guidance stated that allied health students could deliver specific supports under supervision but that their work could not be directly claimed because placements were unpaid educational opportunities.

The current NDIS guidance says allied health students and provisional psychologists can provide services under the supervision of a qualified allied health provider, with participant agreement. It also says service agreements should outline how the arrangement could provide greater flexibility, such as a lower hourly rate or additional service hours.

What remains less clear is exactly how those services should be billed. The wording appears to have shifted again, but there is still enough ambiguity that providers will need to consider how they interpret and apply the guidance in practice.

A changing definition of functional capacity

A recent SDA matter prompted questions about how the amended definition of functional capacity is already being applied under the NDIS.

The definition considers a person’s ability to undertake an activity without assistance from other people or assistive technology, with particular provisions around commonly used AT and assistance for children. This raises questions about what the definition could mean when considering the functional impact of disability.

There is still more to unpack about how this will be applied in practice, particularly for OTs completing functional capacity assessments. It is an area to watch as further information becomes available.

What’s changing from 1 October?

There is plenty for allied health providers to have on their radar as 1 October approaches, including changes to classifications under the Health Professionals and Support Services Award and the upcoming ban on card surcharges.

Thriving Kids activity is also expected to begin in New South Wales, although there are still questions around exactly how and when service pathways will roll out.

For NDIS providers, there is also uncertainty around upcoming support determinations and what the high needs pathway will look like. With several changes happening at once, OTs and business owners will need to stay across further guidance as it becomes available.

Key takeaways

• Career-defining moments can come from unexpected decisions, challenges and clinical experiences
• Good supervision can help OTs reflect on difficult experiences and shape their future practice
• Small interventions can have a significant impact, even when they seem simple from an OT perspective
• NDIS guidance around students on placement has changed again, but questions remain about how services can be billed
• Changes to the definition of functional capacity may have implications for OTs completing functional capacity assessments
• Several changes are approaching from 1 October, including award classifications, card surcharges and NDIS support determinations

Links

Guide to working as an allied health provider: https://www.ndis.gov.au/providers/working-participants/allied-health-professionals/guide-working-allied-health-provider