Thornton 1

Alex Thornton

Leigh Gruwell

English 2010-001

22 April 2019

Occupational Therapists at East Alabama Medical Center

According to Swales, a discourse community is defined by six characteristics that a group

share. These characteristics are common public goals, mechanism of intercommunication,

participation to provide feedback, one or more genres, specific lexis, and a threshold level of

members. These characteristics are important in identifying the difference in a discourse

community and a speech community (Swales). In this paper, research will be conducted to

analyze the discourse community of occupational therapists, specifically at East Alabama

Medical Center. The research will analyze three main questions that tie into how occupational

therapists communicate.

1. How do occupational therapists communicate with other OTs?

2. How is communication different with a patient?

3. What kind of documentation is important in occupational therapy?

For the past couple of years, I have been studying rehabilitation and disability studies in

the hopes of becoming an occupational therapist. An occupational therapist is different than a

regular therapist in terms of the many treatments that are done. Occupational therapists can work

with the disabled, those who just had surgery, psych patients, children and many others. The

work of an occupational therapist is more broad than regular therapy and OT’s work with

patients’ cognitive abilities and thoughts rather than just the body (Aota). The focus of this paper

is to explain why this is a discourse community and how they communicate. I have decided to
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dedicate most of my research to my primary sources. My primary sources are interviews with

Stewart Jackson and Larry Hooker, Occupational Therapists at EAMC. I am shadowing many

OTs, but I chose these OTs specifically for the level of their expertise. Stewart is a former

Auburn Professor and more of a novice in the workforce. His thoughts are helpful for research

because he has a fresher mindset and is still assimilating to the community. Larry, on the other

hand, is older and more experienced. He is the senior OT, making him an expert at his skill. His

understanding and time put into this field of study makes him a credible primary source. Though

his documentation is around the same as Stewart’s, his workload is different, and he reviews

Stewart’s documentation. My secondary sources are articles and websites collected on

communication in the workforce.

While shadowing at EAMC, I have been mainly following Stewart Jackson, a former

professor and Occupational Therapist. When interviewing Stewart, I found that communication

is a key aspect in their job and is how they get paid. While a lot of conversation is informal, it

tends to switch to formal when it is time to document important information. Three different

types of communication I will focus on is in notes, patient documentation, and insurance

documentation. According to Stewart, each part is very significant and vital to patient care, “If it

was not documented, it did not happen”.

Informal Notes

The first type of notes are informal and mostly for the occupational therapists on a

specific case. These notes document things such as: how the patient is progressing, what therapy

they did each day, their specific goals, and planning for the future. Informal documentation are

notes to keep everyone up to date on the patient care plan. Even though these notes are more

relaxed, they are still needed for liability. Another important side note of this documentation is
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the privacy act. According to Stewart, The Privacy Act of 1974 provides protection of personal

information collected by the federal agencies. This act is used to maintain privacy of clients and

ensure that other unauthorized personnel is not accessing their files. This means that if an OT is

not on a specific case, it is illegal for them to access a patients file. Other examples of informal

communication between occupational therapists are emails, texts, and phone calls. These are

personal notes that are usually conducted in a more relaxed manner. Personal notes are used in

communication to the OTs themselves. These notes help them stay on track and be able to look

collectively at their work. Though these may not be seen by other OTs, it still communicates the

ideas and work of occupational therapists on paper.

Patient Documentation

While patient documentation is informal, it is more formal than regular note taking.

These forms are usually reviewed with a patient and can take place at the beginning and end of

treatment. For example, Stewart was working with a patient that had double hip replacements. It

was the patient’s last day in the hospital and Stewart was the OT in charge of seeing them out.

He used a piece of paper with directions and instructions on it to guide the patient in the dos and

don’ts outside of the hospital. One of the things Stewart instructed the patient not to do was get

in a bathtub and turn their hip. The paper also included some exercises that would be helpful in

the patient’s recovery. This type of documentation is crucial for the patient and the patient’s

family. By communicating to the patient the risks, Stewart was able to document his part in the

therapy for himself, the hospital, and insurance. Another type of patient documentation is

instructions for energy saving techniques, usually accompanied by tools. Some tools used in this

case included a shoe horn, a sock helper, a pant grabber, and a metal clamp used to reach things

far away. The instructions written are for the patient to be as independent as they can be. In other
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fields of occupational therapy, the patient notes can be different. In the psych ward, Stewart

brought two papers used for stress management. One was called “Opt for Optimism” and the

other was “Unhelpful Thinking Styles”. These notes were strategies for improving mental health

and were very specific to the patients he was working with. Patient documentation is very

beneficial for maximizing treatment (Stewart).

Insurance Documentation

The most formal notes written by occupational therapists are used for insurance

documentation. According to Stewart, what is documented to insurance is how hospitals and

therapists are paid. These notes are logged in to a computer or written for officials to see. As the

senior OT, Larry is in charge of communicating to everyone if there is a mistake in the logs and

looks over the documentation before it is sent in. Insurance documentation takes more time and

uses specific lexis. As stated by Swales, lexis is language used by a specific group (Swales). An

example of lexis in insurance documentation is the technical jargon used by medical

professionals. An occupational therapist’s job at EAMC in this setting is to review their work

carefully and double check for mistakes. Once they revise and log it, the head OT, Larry, reviews

their notes once again before submitting the forms. Occupational therapists communicate

amongst each other, but also with patients, their families, other medical professionals, and

insurance companies.

According to The American Occupational Therapy Association, OTs are a community

that interacts with other communities. Occupational therapy is rooted in mental health and since

then has grown into many specialties. These specialties include providing services to community

mental health centers, homeless and women’s shelters, correctional facilities, senior centers, and

more. OTs communicate with different people from all settings, making their actions even more
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significant. For example, the OTs at EAMC are also available for other cases at other hospitals or

facilities that need their assistance. If there is a need, these OTs will travel to any facility that

needs help in rehabilitation. These occupational therapists are a part of a discourse community

because their communication between each other and the outside world is crucial in how the job

is done.

After studying this major for the past four years and researching this field of study, I have

concluded that the occupational therapists at EAMC are a part of a specific discourse

community. In their community, these OTs have a job to do that is specific in each way. They

help rehabilitate a range of people from psych patients to post operation patients. They have a

specific language that at times uses specific jargon only OTs understand. There is

communication through notes, documentation, texts, emails, out loud, etc. This communication

is key to success because it is how a patient is healed and how an OT makes their money. Most

importantly, these OTs are a discourse community because they have a common goal: to heal

people. After shadowing EAMC, it is clear that all of these OTs have a heart for healing others.

They are passionate about learning new techniques and skills to help better themselves. The

patients are what comes because this community took an oath to first do no harm. These OTs do

their best to learn from each other by communicating their mistakes and keeping an open

discussion of how they can do better. There are rules set in place to help guide the OTs and give

them boundaries. These rules are set to protect the patients and ensure quality care. One quality

that I have noticed this community possess is patience. The occupational therapists practice

patience every day and in turn it has bettered their work and the work of others. This community

works together to ensure that everyone is performing to the best of their ability and striving for
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greatness. All of these attributes are what makes the occupational therapists at EAMC a

discourse community.
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Works Cited (Not complete)

Hooker, Larry

Jackson, Stewart

https://onlinelibrary.wiley.com/doi/pdf/10.1002/oti.63

https://pdfs.semanticscholar.org/778e/5c87e6041903980d25449c9a2972947a351e.pdf

https://www.aota.org/Practice/Manage/Reimb/documentation-dos-donts-tips-from-OT-

managers.aspx