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April 4, 2002
T. C. Saglik Bakanligi
Saglik Bakani Dr. Osman Durmus
Bakanliklar – Ankara TURKEY
T. C. Saglik Bakanligi
Dr. Tahsin Eker
Tedavi Hizmetleri Genel Muduru
Bakanliklar – Ankara TURKEY
T. C. Saglik Bakanligi
Dr. Ismail Toprak
Temel Saglik Genel Muduru
Bakanliklar – Ankara TURKEY
T. C. Saglik Bakanligi
Mustesar Yardimcisi
Ertugrul Candan
Bakanliklar – Ankara TURKEY
T. C. Saglik Bakanligi
Mustesar Dr. Sefa Aycan
Bakanliklar – Ankara TURKEY
Dear Sirs:
The American Society of Hand Therapists (ASHT) has recently been made aware of pending legislation in Turkey relative to the roles and responsibilities of physiotherapists. Given the implications of this legislation, we are compelled to write a letter in support of our colleagues abroad.
It is our understanding that the proposed legislation would impede the hand therapist’s ability to administer standard therapeutic protocols independent of a physician who has specialized in physiotherapy. We believe this practice would undermine the specialized training and education of the hand therapist, which provides the skills and expertise needed to assess and manage a plan of care for each patient.
In the United States, a hand therapist is an occupational or physical (physio-) therapist who, through advanced study, specializes in rehabilitating patients with conditions affecting the hands or upper extremity. These individuals operate both within the standards of practice mandated for occupational and physical therapy, as well as the additional competencies required for hand therapy.
As patient advocates, we support a "continuum of care" approach to the treatment of the hand—one that involves the cooperative effort and expertise of physicians and therapists alike. As advances in surgical techniques and medicine have fostered greater understanding of the upper extremity, the need for specialized therapists to treat these injuries has become evident. This high degree of specialization enables the hand therapist to work more effectively with patients, hastening their return to a productive lifestyle.
Moreover, the collaborative working relationship between hand therapists and hand surgeons (i.e. orthopedic or plastic surgeons) in the United States is fundamental to quality patient care. Such relationships allow for accurate communication regarding the injury, thus ensuring precautionary measures are taken necessary for the therapist to develop an appropriate treatment plan. The proposed legislation threatens this relationship by impeding direct communication between therapists and surgeons. Ultimately, the absence of such dialogue could compromise the safe and effective treatment of hand injuries.
In addition to ASHT, there are three U.S. based organizations that can provide information regarding the competencies and practices of hand therapists. They are the Hand Therapy Certification Commission, the American Occupational Therapy Association, and the American Physical Therapy Association. It is our hope that the Turkish Ministry of Health will examine protocols in other nations prior to introducing this legislation.
On a personal note, I would like to recognize the Turkish Hand Therapist Group for their ongoing commitment to the pursuit of excellence in hand therapy practice. In June 2001, this Group hosted the triennial meeting of the International Federation of Societies for Hand Therapists (IFSHT) in Istanbul. This forum offered hand therapists from around the world an opportunity to network and advance the practice of hand therapy through shared education and collaboration. Following the example of the Turkish Hand Therapist Group, we fully anticipate to continue this trend in global learning, to the benefit of our patients and practice alike.
On behalf of the American Society of Hand Therapists, we appreciate your consideration of the information relayed above prior to introducing new legislation. If there is any additional information we can provide, I would welcome the opportunity to speak to your representatives directly.
Sincerely,
Ginger Clark, OTR, CHT
President
cc: Necdet Sezer, President
Bulent Ecevit, Prime Minister
Prof. Dr. Kemal Guruz, Council of Higher Education
Prof. Dr. Tuncalp Ozgen, Rector of Hacettepe University
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