clout

[george boyer]

No Al, we're not talking 'peaches and pears' - I'm talking about people out
there working independently who don't KNOW what they are doing, and for whom
EVERYthing is trial and error.  These people should not be working without
supervision.  This is what we are talking about!  You can be as fuzzy as you
want but please do not undercut what I'm saying, Al.  Yeah, everything is 'trial
and error' including picking your nose, if you want to look at it in an certain
way.

-----But KNOWING what you are doing is NOT 'doing it by trial and error'.  NO
WAY!-----

That is the essence of the lesson.  That is what I'm talking about.  And if the
ACA can't get explicitly involved in this most centrally important evaluation of
the prosthetic effort then we should help them somehow.  I'm not against the
ACA, but their collegiality in the industry is not helping them to serve our
ends.  Maybe they need to form a quasi-separate agency of enforcement.  A move
in that direction would be heartening.  Education and certification are good and
(in most cases) necessary but do not guarantee the production of competent
capable prosthetists, entitled to work independently.

The passivity and 'patient-hood' of amputees is a daunting problem - BUT we are
not all so afflicted, just as not all laboring people were afraid and quailing
under the threats of the goons.  All we need is a coalition of right thinking
people to devise and enforce a mechanism to assure that competence of our
prosthetists is there for every amputee without exception.  Celebrities are fine
but don't hold your breath - think instead of hiring professional organizers.
GB.


AlPikeCP at aol.com wrote:

> In a message dated 4/9/99 11:19:57 PM Central Daylight Time,
> phoenix2 at magicnet.net writes:
>
> << NO, AL PIKE, MY FRIEND - YOU ARE WRONG HERE.  I WAS NOT, NOT, FIT BY TRIAL
> and error. >>
>
> George I am starting to understand what you mean, but I think we are talking
> peaches and pears.
>
> Most prosthetists around my age have had hundreds of sockets that have "fit
> perfectly the first time", this can be easier with AK fittings then BK
> fittings. If this were not the case they would not be in prosthetics. There
> are also factors that the prosthetist cannot control such as shrinkage,
> weight change, and volume changes that can occur between casting/measurements
> and fitting that will cause a socket not to be a "perfect fit".
>
> The Otto Bock ETS (Electronic Test Socket) system is advertised as
> "guaranteed not to fit" and yet this measurement based CAD system produces
> sockets that "fit perfectly" on occasion.
>
> Part of the "fitting" process is the alignment of the prosthesis as the
> amputee walks. We have not advanced in prosthetics to where this process is
> not trial and error. Maybe there is a need to separate the word trial from
> error.
>
> Your idea of an amputee union has merit. Why would a bright individual choose
> to become a prosthetist under the AUA system? The present system is less
> demanding for what would be the same monetary reward, and Medicare is
> starting to limit access to prosthesis by changing the rules and cutting back
> reimbursement for prosthesis. There are even more opportunities opening up
> for prosthetists meeting lesser standards then that required for ABC
> certification. The Veterans Department has just announced that they will no
> longer limit prosthetic services to veterans from only ABC certified
> prosthetists. The ABC prosthetist only policy had been in place for decades.
>
> How much support has there been for AUA from amputees? I have found over the
> years most amputees are passive and compliant to the instructions from the
> medical community, and this has continued under managed health care where the
> amputees are even more compliant to the dictates of the HMOs . There are of
> course exceptions, but they are in the minority.
>
> >>Why do you ignore the larger dimension of my argument?  We are a small
> highly defined group - known by our limb deficit(s) - all we need is a few
> energetic skilled organizers and an
> educational campaign to inform our brother and sister amputees of what can
> and has to be done - and to grab onto and use our CLOUT.>>
>
> George I am not ignoring the larger dimension - I agree with you. Who are the
> "few energetic skilled organizers" that will organize the amputees to take
> the action you suggest. I think a boycott would make a profound statement. I
> have believed for years that what the amputees need is a celebrity to lead
> their cause i.e. Christopher Reeves.
>
> At one time it was proposed by prosthetists and amputees that amputees do a
> public march/display in Chicago during the international meeting of the
> International Society of Prosthetics and Orthotics, this never happened.
> Another such international meeting is scheduled for Boston this Summer. What
> about amputees marching on Medicare offices to bring attention to the cause?
>
> Al