In the process of building Nota, we talked with OTs about the issues they deal with related to documentation and running a practice. They helped us with feedback on different screen designs and capabilities. As we got to know them, we couldn’t help but notice OTs are working in many different settings and have developed a wide variety of ways to run, build, or work in a practice. With everything they have given us, we wanted to return the favor and give back to everyone. We thought it would be interesting to share these stories on our blog. Today we are launching our first series. We’re calling it “OT Stories”. We’ve gone back to some of those who worked with us, and talked with them again. This time though, we’re not talking about Nota. We’re sharing their stories about how they first became interested in Occupational Therapy, their work experience, and how they are currently practicing.
Our goal is to share the stories, and give others some insight to the ways people are putting Occupational Therapy to work. If someone makes a new connection, or gets inspired by reading about an interesting idea, that’s amazing and we are happy to be part of it. If you read one of the stories and are interested in sharing yours, get in touch at firstname.lastname@example.org. We’d love to talk with you.
Angee is a Occupational Therapist who works with pediatric clients, with a specialization in sensory integration. She lives in the San Francisco Bay Area with her husband and their two children. She’s currently splitting her work time between working in a small clinic three days each week and also seeing her own patients in their homes one day per week.
We had a great discussion with Angee about how she got started in Occupational Therapy, the many steps her professional life has taken, and where she would like to take it in the future.
When did you first become interested in the work an Occupational Therapist does, or the types of activities which make up Occupational Therapy?
I always thought I wanted to be a teacher, until I got into High School. My Dad, who worked in a Hospital, was interested in helping me figure things out, and he encouraged me to spend some time getting to understand some of the different jobs people do in a hospital. Since he worked there, I had spent a lot of time in that environment, and I felt very comfortable, which I understand is not the way a lot of people feel about hospitals.
I started in the outpatient rehab department, and thought I wanted to be a Physical Therapist. Then, one day I was watching one of the therapists work. She was the only OT in the outpatient clinic, she was a hand therapist, and she had all kinds of cool gadgets and games. I started spending more time with her, which lead me to start looking more into OT, and I realized how much I liked that type of therapy work. As I went into OT school, once I did a pediatric rotation, I loved it. Going back to wanting to be a teacher, I had always loved working with kids. A lot of people think they want to do it, and then they try it and they don’t really want to do it, but I enjoyed working with kids then and I still do. So that is how I became a pediatric OT.
The next part of my specialty area, I fell into by accident. When I graduated from OT school, my boyfriend, who is now my husband, took a position in Southern CA and asked me to move out when I graduated. When I was getting ready to move, I just looked up places near his work for pediatric OT. I found a place which was two blocks away from his office, which happened to be hiring! I ended up joining that practice, and it turns out they are the ones who do all the training for sensory integration. I happened upon it and I have been doing it ever since.
For my training, I went to University of Missouri, and I was the last graduating class out of my University to have a Bachelors Degree. They did some of the masters level curriculum on us because they were transitioning, which I thought wasn’t very nice! I did all my volunteering in High School and when I was in school. The Sensory Integration training I did through my first job was through USC.
What was it like completing your training with a Bachelors in an industry which was changing just as you were entering it?
I was worried for a while, and did wonder if I was going to have to go back to school. The entry level requirement now is a Masters and many people coming through are getting a Doctorate. It turns out, there were a couple of things which really made a difference for me, because I specialized early in my career. The place where I first worked in Southern CA, gave me great experience. They had an early intervention program, working with the 0-3 population, we did school-based work, we did sensory integration in the clinic, and they also had a great social skills program. I worked in all of those programs and it ended up that I got a lot of really good experience really young. Then, after 3 years of working in those areas, I was promoted to be a supervisor at the clinic, which I did for 3 more years. So I was also able to get management experience really young. Between the early sensory integration training and the experience I got in management, I’ve been able to stay competitive in my field.
That early experience gave me a great foundation, so when my husband’s job transferred us up to Northern CA, for the first time, I took a job as a contractor for a school district. In this job I was driving a lot to get to my work, and one day on my long commute I thought, “Why don’t I just start my own? I should just start my own therapy company?” So I did it! I built up a group of patients and I did that for a few years.
Then, we transferred back to Southern CA with my husband’s job, and I went back to the original place where I worked. I went in as a supervisor. I did that for another few years, and then the company went through some changes. The main education and research reason I was there started to change, so I decided it was time to go. At that point I applied to be an OT at the Children’s Hospital of Orange County. Because of my experience, I didn’t have the right clinical experience for what they needed at the OT level, but because I had several years experience as a supervisor, the hiring manager called and asked if I would be interested in interviewing to be a clinical coordinator instead, that is their management position. It was a little weird that they told me I wasn’t really qualified for the job I’d applied for, but they called and offers me a better, higher paying one! So I did it, and I did that job for about 2.5 years. It was really fun and challenging. I did inpatient work, outpatient work, learned a lot about the medical base, which I hadn’t done since college, and I was managing 17 OTs. I did that until we moved back to Northern CA again. Which is where I am now.
I gained so much specific experience early in my career, I was able to continue to be competitive and ultimately did not feel the need to go back for more education. I feel really lucky. I’m a believer you sometimes get pushed in the direction you need to go and it makes sense later.
You went to work in a practice, worked in another practice, a commute drove you to open your own practice, you returned to work in a previous practice, and then went to work in Hospital. Is there anything you haven’t done?
It’s true! I’ve been all over. I think I’ve worked in every pediatric setting for OT, which has been extremely helpful. I even did some maternity work for California Children’s Services. I have been in a lot of different locations and worked in a lot of different situations: Employed in a practice, Contracted in many situations, Self-employed, and working in a hospital.
With the range of things you’ve done, in your current situation you are making a choice to do contract work and build up you own practice. What were your feelings about making that choice, considering the options available to you and given your range of experience?
I decided after leaving the high stress job and environment in LA, I wanted to dial it back. Luckily, I was in a position I could do that. When I was working at the Children’s Hospital, I was commuting 16 miles, which in LA time is 45 minutes to 1.5 hours, depending upon the day. I had 2 small kids, and the Hospital was going through layoffs. Three people in my role were asked to run the department. At the end I was under a lot of stress. My husband’s company moved us again to Northern CA, and he was going to stay much longer. Knowing he was going to be in a position for longer, we were also in a position I didn’t have to work full time. I decided I’d go back to what I was doing part time and to contract in the practice where I had worked when we first lived in Northern CA. The woman who owned the practice happened to have an OT who was leaving, so I went right back to a place I’d been. It’s a good situation. I set my own hours, and right now I only work Tuesday through Thursday in the practice. As my daughter is now turning three, I started feeling I wanted to chase my passion of having my own thing in my community.
There are only a few places in my community, but I found families were really looking for someone to come to their home. I decided to pick-up a few clients, and it’s been building from there. I get excited about growing my own practice, and making the transition to having entirely my own. I have a lot of ideas, which I think can be really helpful for the community and I’m excited to reach a point where I can make those happen. For example, there are no recreational programs for kids with special needs. Most recreational activities, like gymnastics or karate, the instructors know the activity, but they don’t have the expertise to handle kids who have sensory needs.
I find when I’m passionate about something, it’s not soul-sucking, like when you work just to make money. I’ve found I get a lot of enjoyment out of planning sessions for the kids I’m working with on my own now. Part of it is that I’ve had to get creative to see clients in their homes, without all the wonderful equipment we’re used to having. I’ve been fortunate to be able to take it at my own pace. I’ve started a waitlist, because I’m not yet ready to start working on Fridays, once I’m ready I need to take the plunge and get away from the contract work and start building my own. It’s one of those risks where I don’t really know, “If I build it, will they come?”
I was ready to be my own boss, after managing 17 therapists, I was ready to take care of myself. I would like to have my own space, where I can work with these people, who have the training in an activity, and I could help them work with the kids who have sensory sensitivity or can’t follow directions. I also think there is a need for offering something to kids who are now older on the spectrum who are 17, 18, 19, 20. They are too big for the equipment in a gym, they still need a little help finding those meaningful activities, but there is no where for them to go find them. I have a lot of ideas, and I hope over time to be able to grow into something unique for my community. Part of it is also that over time, getting down on the floor is hard. I can’t imagine how hard it will be for me in 10 years, so I’d like to have several other things available. Well see where it goes!
It sounds like the practice you want to build is more of a platform, rather than just replicating the type of practice setting where you have worked int he past?
Yes, I think a lot about, “If I get a space, how many ways could I use it?” There is a whole realm of which has not been tapped into, at least in this area. There are so many cool programs which could be developed with other specialty areas. I’ve heard of things like a fully functioning farm for kids on the spectrum, where the grow their own food and they run a restaurant. Like that, there are so many things we can do for these kids who are going to grow up and be adults.
I don’t know what it’s going to look like, but I’m waiting now to get to a place where my daughter is a bit older, and my own child care costs come down. Then I’m looking forward to taking the risk of developing something different. For these people whose parents can’t find anything to do that gives the me the sensory benefit they need. For some kids it’s art, for some it’s rock climbing I’d love to have the kind of place where I could explore these things.
What do you see for the future of OT as a profession?
Thinking of the history of OTs, we have moved and shifted as opportunities arise. There is a huge need for OTs. It’s very competitive to get into school. What they are finding is OTs in the hospital setting are burning out. So, I feel like people are seeking out these more intimate settings. People get into the profession to work with people, not to do paperwork.
I think we’re seeing a lot more therapists going out on their own. Schools are limited in how they are reimbursed, so schools aren’t qualifying children who really need help. This drives parents to go the medical route, but the kids don’t always qualify for help medically either. But parents still see the issues like, kids can’t stay up with their reading or they are falling apart as soon as they hit the door when they get home. These parents will do whatever it takes, and this is why they end up coming to these private practices to get help.
Some people are working with pediatric and geriatric clients because they want the variety. It’s important to find a balance, because through things like the pediatric OT Facebook group, I’m seeing things about therapists burning out from doing these productivity types of jobs in schools and hospitals that people are leaving the profession to do something more artistic or creative, like opening an etsy shop. Some are even trying to combine OT with more creative activities.
I don’t know if the future will be more community based programs. Places like, “Rock the Spectrum” are popping up all over the place. Sensory gyms without the OT, you buy a membership and go in with your child to play, based on a program from your therapist, to get the type of input they need.
Some opportunity is also coming from the kids who were diagnosed with autism in the 1980s who are now adults, and there isn’t a lot out there for them. Finding bridges for jobs, activities, and hobbies and things to do with their time.
What are things that give you satisfaction of your work as an OT?
The biggest one is I’m making a change for not only a child, but also for their family. That’s the reason I do it day in and day out, even though it’s physically exhausting and the paperwork and all that stuff. Watching these children develop skills, especially some of these older kids who’ve never had help. They struggle with self-esteem problems, they feel dumb, and feel like the least coordinated kid at PE. To watch them make these changes and watching what it does for them, and also what ti doe for their family. Some families who can’t get their child ready in the morning without multiple meltdowns. They can’t take them to the grocery store, they can’t take them out anywhere. It’s exhausting! It impacts the entire family. To have these parents, even after just a few sessions say, “Oh my gosh, we were able to eat at a restaurant this weekend.” These little things that a lot of us take for granted. The most exciting part of what I do is to make a difference in the lives of these families. The other thing I really love is that is mixes the science with the art. It’s a mixed degree, and in OT school we took basket weaving and wood working. The history of OT comes from occupation, hobbies, and being creative. I love the anatomy, physiology, the neurology, all the scientific stuff. What’s really fun is taking a child and looking at the science of the body and coming up with fun creative activities to accomplish what we’re trying to accomplish. It’s a lot of fun planning my sessions. Particularly since it’s kids, the sessions are play-based. That is part of also why I’m so interested in creative combinations of business models as well. It’s combining the art and the science with I really enjoy.
I actually have some friends who are working in other areas, and they are using their free time to find things to do where they feel like they are helping other people. I feel really fortunate to get that reward from what I do for my work. Especially since I’m passionate about it, sometimes it doesn’t feel like work.
With your experiences, what would you tell someone to consider, if they had a range of experience and were looking for their next opportunity?
The biggest thing is you have to be open to doing something out of your comfort zone. I think it’s important in life for growth. It keeps you happy in your career and it helps the profession grow. It’s also important to be open to knowing what you need in your life. Especially if it’s something where have an interest or you feel passionate. Maybe I need to take my own advice when were talking about growing a practice!
There is a therapist who does surf therapy for Veterans. She stumbled into it from pediatrics. She’d never worked with veterans, or with PTSD, but now it’s this awesome program. She was featured in Outside magazine. Really awesome things come from working outside that daily comfort zone. I think its important to follow your nudges and dig into it even if it seems scary to do it.
This is so funny, because as I think about it, I’ve been really good about pushing others, and so I’ve been good about giving the advice, if I take the advice, I don’t know, we’ll see what happens. I guess my advice is you just have to go for it. Write that down so I can look back on it and I can tell my self, “You just need to go for it!”