Eastern vs. Western standards of practice

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Shelly Mesure, MS, OTR/L
Shelly Mesure, MS, OTR/L
梅莎丽 is Shelly Mesure in Chinese. Pretty cool stuff. Don't worry, I'm not going to have it tatooed anywhere, but it's part of my signature with my new job responsibilities. Recently I have joined forces with my consulting company to include developing rehab systems to implement throughout China. It's a pretty amazing opportunity. When this company, Orchestrall, Inc., first approached me, I couldn't understand why they wanted to know about Medicare regulations for China. Luckily, for myself and China, Orchestrall wasn't interested in Medicare regulations, but rather they wanted to learn more about our Western medical model of providing therapy services throughout our entire healthcare system.

China is at a pivotal point in its history and has pledged a significant effort to enhancing their standards of practice to combine Eastern medicine with Western medical models. The Chinese government pays for most of its people's healthcare; however, if you seek additional services, it's all paid privately. Supplemental health insurance is barely at its infancy stages; and healthcare costs are on a completely different spectrum as compared with the United States.

At this time, there are few and far between rehab options. Some of the larger cities, such as, Beijing, are home to the Chinese Rehabilitation Research Centre, CRRC, which was founded back in 1988. Educational programs are very limited, and most rehab-based operations include training curriculums, clinical operations, and research programs. At this time, there is no formal national government certification or licensure programs or requirements for any discipline of therapy.

To put things in perspective, the United States has a population size of approximately 300 million people. We employee approximately 200,000 physical therapists, 110,000 occupational therapists, and 120,000 speech therapists (although many speech therapists are school-based). China is a country of approximately 1.3 billion people; and in my best efforts to calculate rehab professionals I estimate around 30,000 of the combined professions.

Furthermore, the culture of rehabilitation is far removed from our American definition. Physical therapy may only consist of acupuncture or more traditional Eastern medicine treatments. The theory of improving function is overshadowed by the focus on comfort, reducing pain, and providing as much rest as possible. From a cultural standpoint, the family dynamics are very different from our American experiences, and the entire family may assist the healing family member, rather than encourage independence and recovery of function.

Don't worry, my consulting business will always be my primary focus, and the ongoing challenges Medicare issues year-after-year will still be a key component to my blogs. But, as I gain an increased international outlook on rehab, I hope you will find these new subject matters just as informative. Understanding the cultural differences in rehabilitation can help us in our patient interactions. Please contact me at shelly.mesure@orchestrallinc.com if you have any experiences you would like to share.

Shelly Mesure ("Measure"), MS, OTR/L, is the senior vice president of Orchestrall Rehab Solutions and owner of A Mesured Solution Inc., a rehabilitation management consultancy with clients nationwide. A former corporate and program director for major long-term care providers, she is a much sought after speaker and writer on therapy and reimbursement issues.


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Rehab Realities is written by Renee Kinder, MS, CCC-SLP, RAC-CT.  She currently serves as Director of Clinical Education for Encore Rehabilitation and acts as editor of Perspectives on Gerontology, a publication of the American Speech Language Hearing Association.