The Education of Prosthetists
RENARDWC at ctrvax.Vanderbilt.Edu
RENARDWC at ctrvax.Vanderbilt.Edu
Mon Apr 19 18:03:06 PDT 1999
X-To: Paul T Webber <braceman at cmc.net>
Reply-to: Tony Barr <t-barr at T-BARR.COM>
Paul: I enjoyed your analogy story and agree with most of the
suggestions in your conclusion. However,I would like to point out some
differences of opinion to your comparisons and buyer-beware
PW: (1) The mother cannot see which [loaf of bread] one is which: they
both look, smell, and taste the same. Which one is better? In the
end it doesn't matter, the end result is what matters. It is not how
the sons gained the knowledge to bake the bread-- it is how the
bread turned out. This simple analogy can be used in the O&P world.
It doesn't matter how you received your knowledge as long as you can
use that knowledge to help people.
True! Certification type (alphabet soup) does not equate to
qualification. The real problems of fraud and abuse have been by
charlatans and scammers that hold no certification or qualifications
whatsoever. There has been no recourse.
[ Does this reasoning suggest that a person, such as an ABC prosthetist,
who has invested four years in a university to acquire a ticket to
ride, might, just might, think twice about risking that license by
committing an act of fraud? ]
In most states there are no requirements. No certification--no shingle.
Even a post office box will do to receive a check. Some fabricate in
vans and fabricate in the consumer's driveway! What's the consumers
PW> (2) Testing for minimum competency by certifying agencies has proved
to be a valid method for protecting the public from charlatans. The
market place and the referral sources will decide which product is
better. An incompetent provider of O&P services will not last and
any deceptive or deceitful actions by a provider has been proven to
be dealt with appropriately by the certifying agencies.
False! How can the uneducated consumer be expected to be aware of the
fact that it is perfectly legal for ANYONE to fabricate a prostheses for
an amputee, or a brace for a MS or polio patient, in most states?
Certainly you must agree that a 40-hour manufacturer's course [clip]
cannot provide the same knowledge to the practitioner who obtained a
degree in O&P? Some standards have to be set into place. Certification
agencies can only serve as a overseer to THEIR credentialed
practitioners and generally do not revoke or suspend a certification or
fine their members. [Like so many other professionals]
As pointed out by those initially in opposition to regulation in
Florida, there have been less than a dozen cases reported to BOC or ABC
for faulty workmanship or fraud. Does that equate to 'everything is
alright' in the industry?
One case comes to mind: When a consumer complained to one of the two
certification boards that his prosthetist was not certified, the
certification director sent the non-certified practitioner an
application to become certified!
In Florida, prior to regulation, and in most other states, the only
recourse of a dissatisfied amputee is contacting the Consumer Affairs
Dept., which is generally a division of each state's Department of
Agriculture! [seems to go along with fitting dogs and cows with
The certification process, although originally functioned as a Degree of
Qualification, evolved into a deception degree to doctors, heath care
providers, and consumers, as a license to practice the profession. Soon
it was discovered by health care reimbursers that the certification was
optional to legally practise the profession. Ask your insurance
carriers, surgeons, and politicians if they are aware of the fact that
O&P is not a regulated health care profession!
As insurance carriers became knowledgeable of the fact that there was no
real accountability thru a unregulated profession, they began
withdrawing and limiting O&P coverage. One example of favorable reaction
to O&P regulation in Florida was Florida Medicaid expanding O&P coverage
to adults one month after the bill was passed!!
PW> (3) Let us test for knowledge, insight, and experience. Let's fight
the battles that are most important, the gnawing away of the
proprietary codes by other provider types, and legislation that
means protection of the public from unscrupulous providers outside
the O&P Community.
For once can we delineate ourselves from DME. We are not DME: we
are Orthotic and prosthetic providers. We are a small band of
artisans who have honed certain skills that allow us to simply make
things that help other people. Let's get back to that root.
It is what you do with the knowledge gained, no matter how you got
that information, that counts. The quality of the continuing
education programs for Orthotists & Prosthetists must not only be
maintained but the focus of the education must be to help the
There is a need for research Orthotists and Prosthetists. The
higher educational venues in the country and the world should be
well supported by the whole O&P community. The higher educational
avenues should remain for the growth of the profession. They should
not be the only way to achieve or even measure success or
competency in the field of orthotics and prosthetics.
TRUE! TRUE! Let's get back to the root! Become recognized as a
professional by the Department of Professional Regulation in your state.
Not as a vendor supervised under the Department of Agriculture!!
Support "qualification" guidelines with grandfathering provisions for
those practitioners that have been deemed qualified by their peer's
Let's stop talking of what alphabet soup one belongs and ask if you are
a licensed O&P health care professional. Coverage will open up once
accountability and minimum educational standards are established as they
are in every other health care profession.
Start the trend nationally by supporting mandatory educational standards
for practitioners of custom O&P services seeking medicare reimbursement.
Grandfathering provisions can be negotiated to accommodate all qualified
practitioners. Belong to one national professional O&P organization that
has the quality of the profession and benefit to the consumer as their
More information about the Amp-l