|I applaud AOTA President Florence Clark’s 2011 Presidential address (see www.AOTA.com) in which she discussed competition as it related to the practice of occupational therapy. Clark stressed that it is to our credit that we are compassionate, kind, and honest, but added that these values do not have to preclude competition. “Competition is not mean. But we can’t continue to let others define occupational therapy. That’s not playing nice-it’s playing dead,” she said.
Clark compared OTs to sleeping giants who must stop letting others muscle in. We need to be worthy collaborators rather than support personnel. As she noted, “victories are sometimes won through teamwork but always through competition.” Clark pointed out that in its best form, we compete with, not against others; the stronger the occupational therapy team members are, the better the outcomes.
Competition vs. Service Substitution
An old adage is “to compare is to despair.” That does not have to hold true. Good can come out of looking around at other practitioners. Heidi Grant Halvorson, author of Succeed: How We Can Reach Our Goals, writes that upward comparison can be punishing and make you feel terrible . but also states that you can look upward to learn.
Downward comparison may make you feel superior, may remind you of your good fortune, but could also help you avoid the challenge to do better. To be competitive in today’s environment, you first have to have a good handle on who your competition is and what it has to offer.
I have found from consulting with therapists that they may not realize how competition in health care has changed over the years, most notably in the last five. Traditional, or direct, competition is typically what we are used to. A pediatric OT practice is in competition with another one in town, a physical therapy practice specializing in ortho competes head to head with another. But that condition is not very stable. For many years, Pepsi and Coke were direct competitors for the cola market, and they loved it! Why? Because they each had a 50-percent share of the cola market, they knew and understood each other, and had made peace (and profits) with each having half the market. Then something happened to rock their world. Along came water. The consumer began drinking water instead of soda, and act that we would call service substitution. Pepsi and Coke were blindsided; they knew how to compete with each other, but not with another product. Sound familiar?
Therapists need to realize the extent to which there is service substitution encroaching in health care. Many consumers are looking to other services much like the consumer turned to water. There are personal trainers, athletic trainers, life and wellness coaches, behavioral therapists, even posture coaches to name a few.
Clark shared her confidence that this is OT’s time, based on the rising incidence of polytrauma and TBI; and I would add that the fact that baby boomers now survive and live with many diseases, including cancer, can give our field momentum to be acknowledged and embraced by consumers. She suggested promoting areas where OT is already well recognized, including hand therapy, autism and “wounded warriors.” We can take a competitive edge by sharing published studies emphasizing OT’s effectiveness, increasing grant proposals to NIH, using our experience in home health for falls prevention and energy conservation, and “owning” the appropriate words in documentation to reflect OT intervention.
As holistic as our frame of reference is, we need to look at the whole picture. Make sure you know with whom you are competing so you can better strategically position yourself for long term success and recognition in this increasingly crowded market place.
Pepsi and Coke found a way – they started bottling water. I know we can do better than that!