How Occupational Therapy Practitioners Can (and Should) Add to the Administrative Team

Dr. Kelly R. Trevino BA, MOT, OTR/L, OTD

Working in an allied health profession, there are many careers that have a clear path to administrative and leadership roles. As a nurse someone can move through multiple areas within the profession, working in hospital based administrative roles such as CNO, nurse manager, or medical director, moving into academia and higher education, as well as into clinical specialty areas in research and medical equipment. Within the education system, teachers are the key figures in movement toward leadership roles within the school, as principle, special education director, or superintendent at a district level. However, within the occupational therapy profession, outside of supervisor or director roles specifically within occupational therapy, there is no clear career path that will end with a formal administrative or leadership role. 

Looking at the level of formal administration, the titles of Chief Executive Officer, Chief Financial Officer, and Chief Operations Officer are at the height of administrative roles. Within the business world, including the business of medicine, often times higher level positions of executive director, administrative directors, presidents, vice presidents, will be the end goal of a pre-determined path that most within the field associate with specific professions. In addition to the assumption that specific professions will end up holding those formal leadership positions, occupational therapy practitioners are in some cases ineligible for these positions per state legislation. Occupational therapists working in the public school system are an example of this type of situation, as they are not included among those professionals eligible to obtain education credentialing required to move into formal administrative leadership roles in most states (Franko, 2023). 

Licensed occupational therapy practitioners have substantial education in the areas of leadership and administration. Most occupational therapy programs incorporate some form of administration and advocacy within their curriculum as a requirement for graduation. The admin and advocacy course at New York University’s MOT program provides an “Overview of the health care delivery system and ethical, organizational, economic, and political issues influencing delivery of care which affect occupational therapy practice” and includes ethics, advocacy, quality assurance, personnel relations, program development, and management (New York University [NYU], 2024). Boston University’s entry level OTD program was ranked as the number one occupational therapy program in 2024 by US News and World Report (U.S. News and World Report, 2024). The program boasts an advanced curriculum in administration and leadership, with emphasis on advocacy and legislation, reimbursement, financial planning, personnel management, leadership, negotiation skills, conflict resolution, and ethics (Boston University [BU], 2024).

Having the opportunity to progress outside of the clinical role, and into a position that is able to enact change and benefit the profession as a whole, is an important part of giving occupational therapy a seat at the metaphorical table. Additionally, without occupational therapists as an option in administration, the continued lack of knowledge surrounding occupational therapy’s vast scope can’t be addressed (Franko, 2023). As with other professions, additional training, certifications, or licensure may be required in order to be considered for a potential role in an administrative position, however some of the required certifications are not available to occupational therapists. Knowledge that the potential for career advancement is a viable option could incentivize occupational therapists to pursue the certifications and credentialing and in turn decrease the potential for burnout, knowing that there is progress toward an upward goal. 

Patient-centered care has a major impact on patient outcomes within the hospital setting, and effective hospital administration is a key factor in building patient centered care (Bhati et al., 2023). As occupational therapists, patient-centered care is the foundation of our education, and what makes us ideal for these positions. However, occupational therapists are often passed up or not even considered an option for administrative roles. Advancement into formal leadership roles is in direct support of AOTA’s Centennial Vision, as well as Vision 2025 and recognition of the profession is the responsibility of the practitioners themselves (American Occupational Therapy Association, 2017; AOTA, 2007). So, what are the steps to bringing more awareness to the profession, and in turn giving occupational therapy a fair chance at administration and leadership in a formal capacity? It starts within the microsystem and moves accordingly. 

Bronfenbrenner’s ecological systems theory (1977) illustrates the relationship between an individual and how they interact with their environments, from microsystem to macrosystem.  Grace Franko (2023) illustrated the ways in which an occupational therapist can utilize ecological systems theory to advocate for bringing the profession into the conversation at the administrative level. The idea of micro through macrosystems can also be applied to what makes an occupational therapist ideal for administrative roles in general. The skills that make a successful administrator are well within the scope of occupational therapy practice. As healthcare continues to expand and develop at a rapid rate, those in administrative and leadership roles will need the skills appropriate to grow their organization to keep up.  One of the primary barriers to implementation of new initiatives and process changes required to keep up with changing healthcare are poor planning with inappropriately aggressive timelines (Longenecker & Longenecker, 2014). One primary and necessary skill of any occupational therapist, no matter the setting, is the ability to build an appropriate and attainable care plane, with both measurable short term and long-term goals, which are easily translated to a larger macrosystem, like a hospital system or school district. 

Whether practicing in schools, hospitals, rehab facilities, or within the community, occupational therapists are skilled in many of the ways necessary to bring functional and positive change. The move toward attaining formal administrative and leadership roles is part of the natural progression of any career, and those who are interested and have the appropriate skills required should be included in the conversation. Occupational therapy practitioners have the baseline knowledge required to eventually move into these roles, and it is the responsibility of those within the profession to advocate for change. Start by meeting with stakeholders and engaging in local administrative groups, moving outward to state level organizations, and law makers. Advocating for the profession is the job of those within the profession, and occupational therapists deserve a seat at the administrative table. 

References

American Occupational Therapy Association. (2007). AOTA’s Centennial Vision and executive summary. American Journal of Occupational Therapy. 61, 613-614. http://doi.org/10.5014/ajot.61.6.613

American Occupational Therapy Association. (2017). Vision 2025. American Journal of Occupational Therapy, 71. http://doi.org/10.5014/ajot.2017.713002

Best Occupational Therapy Programs. (2024). U.S. News and World Report. Retrieved from https://www.usnews.com/best-graduate-schools/top-health-schools/occupational-therapy-rankings

Bhati, D., Deogade, M.S., Kanyal, D. (2023). Improving patient outcomes through effective hospital administration: a comprehensive review. Cureus, 15 (10). e47731. DOI 10.7759/cureus.47731 

Boston University Sargent College of Health and Rehabilitation Sciences Entry Level OTD Curriculum.(2024). Boston University. Retrieved from https://www.bu.edu/sargent/academics/departments-programs/occupational-therapy/entryotd/curriculum/

Bronfenbrenner, U. (1977). Toward an experimental ecology of human development. American Psychologist, 32, 513-531. http://doi.org/10.1037/003-066x.32.7.513

Franko, G.A. (2023). The need for occupational therapist eligibility for formal administrative roles in public school systems. The American Journal of Occupational Therapy, 77 (4). http://doi.org/10.5014/ajot.2023.050215

Longenecker, C.O., Longenecker, P.D. (2014). Why hospital improvement efforts fail: a view from the front line. Journal of Healthcare Management, 59 (2). 

NYU Steinhardt Curriculum, MS, Occupational Therapy. (2024). NYU Steinhardt. Retrieved from https://bulletins.nyu.edu/search/?P=OT-GE%202750