Outspoken OT

Episode 9: Meaning vs. Medicine: OT’s First Fight (1790-1899)

Episode 1: OT Started as Rebellion (1790–1899) In this first episode of the 8-part “Occupation Under Pressure” series, we go back to the days before occupational therapy had a name — when meaning, craft, community, and dignity shaped healing long before healthcare systems tried to reduce it to checkboxes and units. We explore the philosophical and sociopolitical roots of OT from 1790 to 1899, including the Moral Treatment Movement, settlement houses, the arts-and-crafts era, and the rise of graded activity in tuberculosis sanatoria. This episode reveals how occupation originally functioned as identity-building, purpose-restoring, skilled engagement — not “ADL practice.” Then we connect the past to today’s challenges: our profession’s confusion about what occupation actually is, the rise of ADL-only thinking, and how insurance systems now weaponize that misunderstanding against us. Finally, we close with a small but powerful action step to help practitioners reclaim occupation as meaningful work, not just functional task performance. If history has taught us anything…it’s to stay outspoken. 🔥 Key Topics The true origins of occupation-based healing Why early OT was built on craft, purpose, and contribution How medicine’s rise created the first battle between meaning and measurement Where the “ADL = skilled” myth really came from How modern documentation and AI auditing distort our roots What clinicians can do right now to reclaim authentic occupation ⚡️ Action Step Choose one client this week and document a meaningful, identity-building occupation — not an ADL — using the real historical logic of our profession. 📚 Series Source Occupation Under Pressure: A Sociopolitical History of Disability, Power, and the Occupational Therapy Profession

Episode 8: HR1 Exposed Us: The Financial Crisis OT Should’ve Seen Coming

“OT Left Off the List: What HR1 Just Exposed About Our Profession” In this extended, no-filter episode of Outspoken OT, Michelle breaks down exactly what is happening with federal student loan reforms — and why the “One Big Beautiful Bill Act (HR1)” is a turning point for occupational therapy. This isn’t just a financial update. This is a profession-wide reality check. You’ll learn: 🔹 What HR1 actually changed Grad PLUS loans eliminated New borrowing caps for graduate vs. professional programs OT placed in the lower-funded “graduate” category 🔹 Why OT was left off the “professional degree” list and how that outdated 1998 list still governs modern healthcare funding. 🔹 What this means for OT students and future practitioners Reduced access to federal loans Higher reliance on private lenders Major threats to diversity, access, and the workforce pipeline 🔹 Why other professions (including nursing, PT, PA, SLP, education, architecture, and more) are also affected and how their advocacy is bringing national attention to this crisis. 🔹 How this connects to the last decade of professional decline Michelle draws a straight line to: shrinking reimbursement exploding prior auth requirements rising tuition AI auditing OT’s internal identity battle and years of silence that left us vulnerable 🔹 Why HR1 is the wake-up call OT cannot ignore This bill didn’t break OT — it revealed the cracks we’ve been avoiding. 🔹 Concrete actions you can take today From AOTA advocacy to school accountability to supporting students and redefining OT’s identity. ⭐ Who this episode is for: OT students worried about paying for school Educators, faculty, and program directors Clinicians watching the profession shift under their feet Anyone who cares about the survival, sustainability, and visibility of OT 🗣️ In Michelle’s words: “This is not just about loans. This is about who we are as a profession — and whether we’re finally ready to be loud.”

Episode 7: The Petition that Predicted the Pipeline Crisis

In this episode of Outspoken OT, host Michelle Eliason, MS, OTR/L unpacks the data behind the 2023 OT Petition and National Survey — a grassroots effort that captured thousands of voices from across the profession. Practicing OTs, OTAs, students, educators, and even those who have left the field all said the same thing: the system designed to produce and protect competent occupational therapy practitioners is breaking down. Michelle explains what experts would call a pipeline crisis — when the sequence from education to employment to retention begins to fail. From inconsistent curriculum and unpaid fieldwork to unsafe productivity demands and loss of medical identity, she traces the threads connecting burnout, inequity, and professional erosion. This isn’t a rant — it’s workforce data and lived experience combined. It’s about accountability, reform, and refusing to normalize dysfunction as “the way it is.” In this episode: What the 2023 petition and survey revealed about the OT workforce Why “pipeline crisis” isn’t a buzzword — it’s a system diagnosis Michelle’s hard take on complacency and silence in the profession Practical ways we can defend, rebuild, and realign occupational therapy Key message: We don’t have a talent problem. We have a structure problem — and the only way to fix it is to start talking about it out loud. As always, stay outspoken about the things that matter.

Episode 6: Equality’s Out, Equity’s In — But What Does That Mean for OT?

In this episode of Outspoken OT, host Michelle Eliason, MS, OTR/L dives into the American Occupational Therapy Association’s 2025 Code of Ethics and its two major updates: replacing equality with equity and adding advocacy as a core professional value. What sounds like a simple word change actually signals a deeper philosophical shift for occupational therapy — from fair processes to fair outcomes. But what does that mean for clinicians? How do we balance advocacy, neutrality, and scope of practice without drifting into politics or losing clinical clarity? Michelle unpacks the differences between equality and equity, explores what “advocacy” really means in a clinical context, and challenges OTs to reclaim advocacy as a therapeutic skill — not just a social talking point. Whether you’re an educator, clinician, or student, this episode will help you think critically about how ethical frameworks shape practice, policy, and the profession’s future. 📬 Contact Michelle - DM: @Buffalo.OT - Email: USOTconcerns@gmail.com - Follow for more unfiltered conversations about the future of occupational therapy. >>>>>>Stay curious. Stay critical. Stay Outspoken.

Episode 5: We Are Giving Our Own Profession Away

Today’s episode dives deep into one of the biggest professional conversations happening right now — the ongoing tension between occupational therapy and physical therapy — and what it reveals about how we’ve been talking about ourselves for decades. We start From the Feed, where Chris Nahrwold’s viral post in the Practical Occupational Therapy Facebook group challenges the old phrases like “PT helps you walk, OT helps you do the things once you get there.” He asks the hard question: Are PTs limiting us, or are we limiting ourselves? Then in My Hard Take, Michelle breaks down some of the most repugnant, self-limiting catchphrases OTs keep repeating — from “We do the fun stuff” to “We’re like PT, but for your hands.” She explains how that kind of language quietly undermines the science, rigor, and value of the profession. Next, we take a look back to 1981, when AOTA President Mae D. Hightower Vandamm delivered her fiery presidential address “Flight Control.” Decades before social media debates, Vandamm called out the same pattern — warning that OTs were “too soft in defending our turf” and that “we freely give away our skills.” Her words still ring true today. Finally, Michelle closes with “What Now?” — four practical, actionable ways OTs can start changing the narrative right now: Don’t agree when others minimize OT. Keep growing — especially as a communicator. Guard scope with science and evidence. Stop giving away your expertise. Key Takeaway Occupational therapy doesn’t need rescuing — it needs reclaiming. When we speak with clarity, communicate with science, and stop handing away our identity, no one gets to define us but us. Resources Mentioned Practical Occupational Therapy Facebook Group Mae D. Hightower Vandamm, “Flight Control,” AJOT (1981) John Maxwell, The 16 Undeniable Laws of Communication