Should You Consider a Portfolio Occupational Therapy Career?
Hear from Louise, who qualified as an occupational therapist in 2006 and specialises in adult physical conditions, including lower limb orthopaedic injuries and lower limb amputees. She has been an expert witness for eight years and has practiced privately since 2016. In addition, she is a Quantum trainer for Somek & Associates and trains new experts in the medicolegal process.
"When I first graduated as an occupational therapist, I clearly remember all those feelings of excitement, optimism and hope. Fast forward ten years of working in statutory services, across acute and community settings, and those feelings had largely evaporated. However, by no means was my career in the public sector unrewarding. It provided me with the essential grounding and skills I needed to start my career as an occupational therapist. Having had the opportunity to work alongside some fantastic clinicians, I came to a point in the NHS where it could no longer offer me the career progression, the cerebral challenges, and “stretch” that I craved. I consider myself extremely fortunate that I took the step into private practice.
Sadly, my experience in the public sector is not uncommon. The Royal College of Occupational Therapists commissioned a Workforce Survey in 2022-2023. This shed some light on the potential reasons why some therapists are choosing to leave the profession early. Some key themes which emerged were work-related stress, feeling undervalued, being unable to provide the standard of service they would like and a poor work/life balance. One therapist commented “being told not to work to gold standard due to capacity issues provides a huge amount of stress” (RCOT, Occupational Therapy Under Pressure 2022-2023).
Had I known then, what I do now, I would most likely have taken the plunge into private work much sooner. Of course, questions like "Will I be good enough? Am I expert enough?" plagued me initially. But those doubts were soon outweighed by the opportunities that came with private work.
My private work is on a self-employed basis as an expert witness and an associate, working on behalf of a number of companies including The OT Practice. This provides me with access to a regular stream of referrals and a caseload in a range of clinical areas, which match my clinical expertise and experience. This allows me to align my clinical specialisms with my expert witness caseload, to ensure I remain credible as an expert in my practicing field, and maintain my duties under the Civil Procedure Rules pertaining to expert witnesses. Working with a company such as The OT Practice, has also meant that I have not needed to spend time advertising or finding private clients to treat, although this is of course a route which can be taken if preferred. They also have a clear and user-friendly administrative system, meaning that I have more time to focus on my clients rather than managing invoices, for example.
Working as an Expert Witness
My career as an expert witness with Somek & Associates has given me the opportunity to grow and develop in a way which would never have been possible within statutory services. As an expert witness I am instructed by solicitors to undertake a comprehensive assessment and provide a report to assist the Court with personal injury / clinical negligence cases. This helps the legal teams establish how to quantify the monetary value of compensation claims. Being aware that you need to make clear, robust, well-reasoned recommendations, which may be scrutinised in Court, makes you a better clinician.
Somek & Associates offer unparalleled guidance, with access to trainer support at all stages of the litigation process. All the trainers are expert witnesses and therefore they understand the complexities of the legal process. In addition, there is a large team to assist with all aspects of case litigation, including proof reading of reports.
Reflection of Independent Practice
When I reflect back over my experience in private practice, it has been extremely varied. In addition to rehabilitation with clients to increase independence with meal preparation or personal care, I have had the opportunity to enable clients to return to their leisure interests, something which just was not possible within the NHS setting. Interventions have ranged from assessing a client’s ability to safely access a swimming pool following a motorbike accident, to rehousing assessments for lower limb amputees. Other examples include working with individuals with sight impairments, with a focus on accessing the community, and a return to cycling with a client who sustained polytraumatic injuries following a road traffic accident.
The opportunities to promote independence obviously need to be robustly clinically reasoned. However, without the budgetary constraints implemented by statutory services, the opportunities for achieving meaningful outcomes for the patient and the occupational therapist alike are more achievable in private practice.
Why a Portfolio Career?
My initial reaction to the idea of a portfolio career, would have been “no, that’s not for me”. The idea of trying to juggle several roles all at once, sounds terribly stressful. In reality, having the autonomy to tailor your own career and professional development is incredibly empowering and having a portfolio career brings with it a number of benefits.
- Flexibility - It allows me to work more flexibly; within multiple part-time roles, instead of one full-time substantive post.
- Professional development - Working in a number of roles concurrently, allows me to choose clients and cases which are relevant to me as a clinician and meet my own learning needs. It offers the possibility for me as a clinician to finely hone my skills, and have much more control over my career and development as a clinician.
- Rewarding - It allows me more thinking and research time, to ensure that I give my clients absolutely 100% of my time and expertise, resulting in a sense of pride and satisfaction.
- Financial - Having a number of income streams, means that you have the option, during times when referrals slow down, to rely on another form of income. In my experience, if you work hard, and manage your deadlines successfully, you are unlikely to be short of work. Working on a self-employed basis for different companies also means that I do not need to chase for payment of invoices – this is all done for me!
People often say to me, they would never leave the NHS because of their pension security. My answer to that is always that having a portfolio career can be extremely financially rewarding, providing scope to invest in pension contributions privately. There is enormous potential for financial security, if you consider all your options. As a lifelong learner, I value the opportunity to grow and develop, to try new things. A portfolio career offers me the opportunity and time to be able to focus on finding the right learning pathway for me, as a clinician.
Having a broad range of experience across community, acute settings and private practice, I have come to the conclusion that the importance is finding what works for you as a therapist – we are all as individual as our patients.
Maria Tierney, daughter of Martina Tierney (founder of Seating Matters), sums it up nicely, when she points out that the recruitment process for occupational therapists often leads them directly into posts which may not be an area of their choice, and may limit future options. Therefore, it is crucial that occupational therapists consider the wide range of career options available to them, and take measures to explore those options. I agree wholeheartedly with Ms Tierney, when she says that occupational therapists need enthusiasm for their jobs to be able to give it their best; “happy and successful OTs help make happy and successful patients” (Tierney, Martina, The Power of OT: Heartfelt Stories from Occupational Therapists, 2024, p. 266)
Someone once said to me that if the idea of doing something that both excites you and terrifies you, that is an excellent reason to do it! When the alternative is feeling undervalued, or the risk of “burn out”, I would say it is an easy decision to make!
Louise Martinez Occupational Therapist, Expert Witness and Quantum Trainer with Somek and Associates
References; RCOT https://www.rcot.co.uk/sites/default/files/Workforce%20survey%202023%20-%20Demands%20and%20impacts.pdf
Who are Somek & Associates
Somek and Associates, part of Frenkel Topping Group, is one of the largest medico-legal consultancies in the UK and is a leading provider of highly professional trained expert witnesses including occupational therapists, care experts, nurses, midwives, physiotherapists, speech and language therapists, and other allied health professions. With over 28 years working in the industry, Somek is renowned for acting with integrity, independence and professionalism, and for having a balanced portfolio of Claimant/Defendant instructions. Occupational therapists play a fundamental role in clinical negligence and personal injury litigation cases, by providing expert opinion evidence to assist the courts in reaching decisions. Somek are proud to offer OTs a self-employed expert witness role that is professionally rewarding, highly remunerated, and enables you to work flexibly from home to fit around your existing clinical role/family commitments. If you would like to learn more about expert witness work with Somek and Associates, please visit https://www.somek.com/site/expert-witness/become-a-somek-associate/ and send us an enquiry!
