What happened in the The OT Think Tank

Wow, what a fabulous gathering we had for the OT Think Tank this week. Thirty nine (39) occupational therapists joined from most states of Australia. Most (81%) were OT business owners and most (88%) sole practitioners.

The Think Tank was a zoom call I offered on 9^th July 2024 as a place to connect in real time (if not actual real life) in response to the general sentiment of Australian occupational therapists who are working with National Disability Insurance Scheme NDIS funded clients. After the new price arrangements were released – with NO increase in the OT rate for 6 years!!! There have been a LOT of OTs struggling.

I don’t work with NDIS funded clients, but I do work with OTs who provide services within the NDIA system. And I DO care about what our works feels like for US, the occupational therapists. Work is my jam! And after 31 years as an OT in workplaces – in injury management, work health safety management, wellbeing strategy and influencing what it takes to create good work I feel pretty concerned when OTs are struggling.

 I asked some questions about our energy for our occupational therapy work at both the beginning and the end of our time together (100 minutes). And look at this! There was a 23.4% increase in energy level! That a good intervention. In all honesty this is the work I think I do well – gathering OTs, holding space, facilitating conversation, connecting with hope and supporting action.

Exploring revenue streams

At the bottom of this page is a link to connect to a google spreadsheet where we can co-create a map of the various funding systems under which OTs are often remunerated in Australia. I’ve started this, including the systems mentioned in the NDIS price review report. I think this will be a useful resource for OTs wanting to diversify our revenue streams BUT it requires co-creation. I am a 1 person business, and I only know what I know. For my part I’ve created the ‘innovation’ tab to start to identify the more creative revenue ideas that aren’t dependent on our traditional systems.

How I can help - I DO have a diverse perspective 

In 1996, in my 2^nd year working as an OT I started a post-grad diploma in OT at La Trobe University and I researched the experiences of OTs working for non-traditional employers – this has been my interest for my whole 31 years as an OT and I’m excited to feel the groundswell of OTs wanting to explore innovation and emerging areas of practice. I can help you!

Join me in nature to nurture yourself and your OT career

If you want more of this – time with other OTs, and conversation with me then join me at one of our nature retreats on the land we nurture, The Sanctuary in South Australia. I have 2 retreats in September. One specifically for therapists, health care professionals and educators (we all need this) for rest, recovery, relaxation and nurturing. The other one for intentionally working on your OT business and offer, inspired by nature. This is the highest level of access to my time and attention that you will get as we live together for 3-4 days and have as much conversation (or not) as you like. All the details are here on my website, or contact me for a chat.

What OTs are feeling right now  

This is what I’ve been seeing and reading over the last couple of weeks from OTs, including what we were hearing ‘in the tank’.

• Despair and disbelief that the maximum NDIS fee rate was not raised for our profession despite advocacy by the OT Association and individual organisations and OTs who made submissions to the price review process.
• Frustration at the methodology used – influenced by market rates as a process where OTs do not ‘show up’ as charging a rate higher than the NDIS $193.99 so there’s no ‘market’ or ‘wages’ pressure to raise our price limit. As many OTs have been suggesting – ‘maybe we’re just too nice’. Or maybe we’re just trying to provide services for clients with limited capacity to pay, especially those without funding for services, so we charge well below the NDIS rate for many private paying clients.
• Fear and uncertainty about change and how sustainable business will be.
• Occupational therapy businesses closing their doors.
• Concern about how sustainable it is for our wellbeing to work under ongoing financial strain and working long hours to deliver services under this and other funding schemes.
• Wonderings about the market for occupational therapy – whether there is a glut of OTs in the market, whether the market prefers lower priced less qualified service providers. Questions about what OTs will be doing?
• Dissatisfaction with the way occupational therapy work has evolved since the NDIS scheme began – a focus on assessment and report writing and les on delivering therapy to create change and support clients to achieve their goals. A deep concern about WHERE and HOW occupational therapists, especially new graduates, will develop high level skills.
• A very big concern about how people struggling with poor mental health will access services.
• A sadness about the loss of employment opportunities in organisations or businesses that provide a range of experiences, mentoring, training, supervision and a network of occupational therapists to learn from and with.
• Acknowledgement that trading as a sole trader is often more profitable than having employees but also isolating, lacking in connection, community, peer learning, supervision, skill development and not financially viable to become a registered provider.
• A deep passion and commitment to providing services for members of our community who genuinely do not have a capacity to pay out of pocket.
• A groundswell of support and coming together around how it feels and a desire to support each other.
• A curiosity and desire to innovate and to better articulate the value of OT services 

Calls to action to

• Review and improve billing for services – to actually bill for the time it takes and limit service provision to approved quotes etc.
• Encourage OTs to be more vocal and involved in price review and consultation activities (despite being soooo busy delivering the work)
• Explore AI assistance to improve efficiency

Funding streams and the 'out of the box' OT career I've created

While we had SOME conversation about non-NDIS funding streams and schemes, there was less of this than I expected (and maybe I could have facilitated that differently)

I didn’t share a whole lot about the way I’ve earned money over my OT career, but here’s a tiny snapshot

• Some employment as a workplace rehabilitation/OT consultant
• Most of my career employed by large employers/organisations (Victoria Police, electricity/gas/water distributor in NSW, community pharmacy organisation) and evolving my offer over 30 years from return to work injury management, sick leave/absenteeism management, workplace health promotion, work health safety management & injury prevention, workplace mental health and risk management for psychosocial hazards, contributing to design of employee Reward & Recognition programs; Diversity, equity, belonging strategy and sustainability policy. ALL of this as an occupational therapist (with some additional qualifications), but all through the lens of making work healthy safe and engaging.
• As an entrepreneur in my Nature OT business – coaching andsupporting OTs internationally to create nature based services; delivering forest bathing/nature connection experiences and workshops in public festivals, for organisations as part of their wellbeing approach, at the SA Zoos and botanic gardens, local councils and for National Parks and Wildlife. My sources of revenue are diverse and I am a HUGE fa of the many opportunities for occupational therapy in everyday life, outside of the systems we have often worked in.

What next?

Here are some resources to support you

Solo practitioners

Michelle O’Sullivan

Solo Private Practice Allied Health Professionals – with currently running chats about NDIS billing

https://www.facebook.com/groups/569107757283784

NDIS OT Community of practice (facebook)

https://www.facebook.com/groups/169374070225641

Billing

Sarah Collison – NDIS billing  (clear, ethical billing), navigating ALL in the NDIS

https://www.verveotlearning.com.au/Navigating-Billable-Time-and-the-NDIS

Clare Batkin – follow on Linked in for conversations about billing, valuing our services

https://www.linkedin.com/in/clare-batkin/

e.g., NDIS billing

https://www.linkedin.com/posts/clare-batkin_free-ot-letter-template-ndis-pricing-activity-7215831831684734976-3n0s?utm_source=share&utm_medium=member_desktop

Brad Williams

Template letter to clients re billing

Letter: https://thebecomingcollective.ck.page/075c328049

Workshop: https://thebecomingcollective.com/the-reconnect-and-realign-workshop-for-ots/

The Reconnect & Realign Workshop for OTs:

4 Keys to Reignite Your Passion and Purpose, Even if You Feel Like Throwing in the Towel

For occupational therapists who love and believe the profession but have lost that confidence, passion and energy for the work.

When: July 16th 11am - 12:30pm ACST

Considering subcontracting to a registered business?

Nicole Nott

Praktis Allied Health

https://praktis.com.au/

Ardent – Margeaux Batholemew-Carle

e.g., https://www.linkedin.com/posts/margeaux-bartholomew-carle-95331353