Q&A with Leslie Diamond, OTR, CHT, Director of Hand Therapy in New York City
Leslie Diamond is an occupational therapist and certified hand therapist at ShiftPT, shift-pt.com . She graduated from the University of Wisconsin in 1996 with a BS in Occupational Therapy. After training at the Mayo Clinic, Leslie worked at the Rehabilitation Institute of Chicago for several years. Since moving to NYC, she's been in private practice. Regarding hand therapy, Leslie says, "it's an exciting specialty!"
Q: Why did you go into occupational and hand therapy?
A: In the late 90s, the OT field was exploding. There was so much opportunity and growth at the time that it seemed like the perfect combination of healthcare, science and psychology.
Once I became an OT and saw what hand therapy was all about, I knew it was for me. It's a very effective specialty with immediate, measurable results. At each session, the benefits and improvements are clearly evident, and that is very satisfying for both the patient and me. Plus the design, fabrication and sculpting of splints (molding of thermoplastic) lets me tap into my more creative side! What was once probably the most intimidating part of becoming a hand therapist has turned into my favorite part—there is no substitution for a well-made splint by an experienced hand therapist.
Q: Who gets certified in hand therapy?
A: Either an OT or a PT can get certified in hands, but for some reason it's still overwhelmingly occupational therapists who get their CHT certification. In order to get training in hand therapy, I first needed to get a few years of experience under my belt. While in Chicago I was lucky enough to train with the prominent hand surgeon Dr. Robert R. Schenck in Chicago before moving back to NYC.
Q: When and how did you start at ShiftPT?
A: I saw the need for hand therapy in downtown Manhattan (which is also where I live), so Patrick Walsh (the owner) and I came up with a plan. That was seven years ago, and it's been a productive collaboration ever since.
Q: Typically, what are your day-to-day responsibilities as an occupational therapist?
A: Evaluating and treating patients is my priority and makes up the majority of the day, though insurance issues/paperwork does rear its ugly head all too frequently. I'd say it's 75% hands-on healing/listening to the patients, and 25% paperwork.
Q: What types of patients/diagnoses do you encounter?
A: In our practice I'd say wrist and hand fractures are the most common, followed by tendonitis from repetitive tasks (like typing or texting), and then complications from arthritis.
Q: Are there other areas of interest for you outside of hand therapy you plan to pursue?
A: No way, hands are the best! I think in the future I'd like to take a course in taping (a technique to help reduce pain and promote better movement patterns) or massage.
Q: What do you like and dislike most about your job?
A: I think I like the first session with a new client the best. It's where you gain their trust, show them there is light at the end of the tunnel, and give them some concrete steps to get better. What I dislike the most? Dealing with greedy insurance companies.
Q: Are you currently involved with any research projects?
A: I am not currently involved in any research projects, but I did research and write a paper with Dr. Schenck on the treatment of different types of finger fractures. That paper was presented at the American Association for Hand Surgery in 2000.
Q: Do you feel the role of OTs has changed over recent years?
A: Authorization for therapy is more and more about "outcome measures" than ever before. Now, not only do you need to be an experienced and talented therapist, you need to be able to document the changes to the insurance company. It's much harder than you think to measure progress and describe how that translates to function.
Q: What do you feel is of the greatest concern to OTs today?
A: It's a shame that a patient's treatment plan and recommendations for therapy are driven more by the insurance benefits (or lack thereof) than what the person actually needs. Deductibles have increased, maximum number of benefits has decreased, and the insurance companies are not making it easy.
Q: What is the most important thing you've learned over the course of your career?
A: Reach out and connect with other colleagues as much as you can. Not just with OTs, either; there is so much to learn from other professions! Sure, it's important to stay connected and current with the research, trends and to debate treatment techniques within occupational therapy, but networking with other professionals (or even mentoring less experienced therapists) also helps keep your skills sharp.
Q: What advice do you have for others thinking of entering hand therapy?
A: I think it's an exciting specialty, and if you are fascinated by the complex anatomy of the hand and delicate surgeries they use to repair them, then go for it.
Q: What is one word you would use to describe your specialty?
A: Interesting. People reveal a lot about themselves with their hands!
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