US Politics

US Politics

The following are responses received after my query of every Academy Board
member Via E Mail of their personal positions regarding the consolidation
issue. I have omitted the names of the Board members as the responses were
made privately.
I feel these answers were well thought and came from the heart. I would
encourage all Academy members to take the time to read them, regardless of
your personal position, pro or con on the issue.



}} My job as an Academy Board member is to support the profession, that I
love, through the activities of the Academy. Pursuing the concept meant
many hours, with other practitioners who also love the profession, working
together to see if a better way to represent our small profession to the
world, could be designed. Our goal was to keep the membership informed
along the way, present them with the information compiled and let each member
make their own personal decision. This is your profession, your Academy, it
should be your decision. We all have our opinions. Not because we know
something that you don't, but because we have been staying informed by the
information that has come out. This is a democracy, and we have a right to a
private vote. If you have questions about the information provided to you, I
will certainly answer any questions, to help you decide if consolidation is
right for the profession. Our job was to present the information to you to
help you decide. We hoped we had done that, if there are specific questions
that I can answer to help you make your decision more educated, please feel
free to call me.


}}I will begin by stating that the issue of consolidation is one which was has
created a significant level of stress at the board level of all the
organizations involved. We are facing a time of critical change. It is
quite apparent from the public response and input that no matter if we
proceed with consolidation or not, change IS necessary and must occur.
The discussions throughout the last year have been strictly focussed on the
controversial issue of consolidation. Consolidation has been interpreted by
many of the members of these organizations as the only option which is
available. Some have questioned whether all the options have really been
presented to the membership Although it hasn't been clearly defined as
such, consolidation is just the option that the boards chose to consider at
this time, but there are also other scenarios that could occur which would
also facilitate change.
The elected leadership of this profession has a very important task and
responsibility. We must evaluate events, opportunities, and situations in
order to make choices which will ultimately affect the future of this
profession, its practitioners and the consumers of our care. The
consolidation effort is one which forces each and every one of us to
evaluate our views of what an orthotist/prosthetist really is-are we
professionals, or employees of an industry?
After speaking with a number of founding fathers and past leaders of the
Academy, it is apparent that the struggle for identity as either a
profession or industry is not new. It has existed for years, and not
only in the United States. A recent conversation at Interbor with a young
professional from the UK revealed that this identity crisis is universal,
and has caused constructive and necessary division between industry and
profession in the UK as well.
Many practitioners who have approached me consider themselves
professionals and recognize a real need to maintain a unique and separate
identity from the industry side of the orthotic and prosthetic world. They
feel as if words Orthotics and Prosthetics do not necessarily represent
them, but rather the words Orthotist and Prosthetist. They feel a strong
need to belong to an organization which is comprised of, represents, and
focuses only on the concerns and needs of Orthotists and Prosthetists.
They feel that the concerns of Orthotists and Prosthetists are at times are
very different from those of the business side of orthotics and
prosthetics, while at times there are common items of concern.
People have expressed concern with statements such as we are all the same
which have been made in the past, and they feel that the statement is quite
flawed. They feel as if that statement is fine at a meeting of minds where
all the individuals are both prosthetist/orthotist and business owners, but
they feel as if that only represents a percentage of the profession which
just happens to be the vocal minority in leadership roles.
I have been asked questions such as Where is the representation for the
practitioners in the trenches? Where is the representation for those who
are at home running the show while people like you are away playing
politics? How about those of us who are working as well paid professionals
because of a love for our profession who care more about what new
componentry is available for us to take better care of our patients/clients
rather than worry about what organization they need to send money to every
year? Questions like these prompted me to think very hard about the true
responsibilities that we hold as leaders in the professional organizations.
Through more discussions and various postings to OANDP-L, I have noticed an
apparent lack of understanding regarding our current professional and trade
associations that has led to confusion in the marketplace. People who are
not as fine tuned politically continually misunderstand the distinction
between AOPA, the Academy and ABC. This confusion has been stated as one of
the reasons to consolidate-to simplify the situation. Some members I have
spoken with feel that this is NOT the best solution. Suggestions have been
made to me that a better solution would be work harder to differentiate the
organizations so that people understand the unique characteristics more
clearly. A comment in a recent posting presents an argument which may be
worthy of discussion. That argument is to physically separate the
organizations as much as possible. Some feel as if it would be easier for
the individual organizations to focus on their own missions and goals if
they didn't have to worry so much about offending the people in the next
office. Some feel as if this separation would also create a definite
differentiation between the organizations which would allow members and
potential members to eventually gain a better understanding of what each
organization does for them.
One practitioner provided me with a very simplistic example- lets imagine
that the credentialing organization ABC was located in New York, the
professional association for ABC practitioners known as The Academy was
located in St. Louis, and the Business and Trade organization known as AOPA
was located in Washington, DC. There would be distinct phone numbers,
distinct operations, and a more clear differentiation of what each
organization does since you would have to call different area codes to speak
with people about different matters. It would become apparent that if you
don't send your renewal fees to New York, your certification would not be
renewed. If you had business questions, you would NOT call the Academy in
St. Louis, but rather the AOPA office in DC. He felt that a physical
separation would help clarify the distinct differences between the
organizations which make them unique, as well as force the organizations to
become streamlined in their operations in order to provide quality services
at an affordable price to members. This is definitely not
consolidation...but is it a valid alternative?
The questions remains--- Is the current lack of clarity regarding the
delineation of the organizations among professionals due to the
similarities of the functions of the organizations, or due to the confusion
which exists because they all share the same building, phone numbers and
receptionist? There is currently no answer to that question. Our
professional organizations need to see change, there is no question about
that. Consolidation MAY be the answer. Consolidation may NOT be the
answer.
As an Academy board member, I am committed to supporting the right of each
individual Academy member to have a vote in the direction of the profession.
I also support the right of voting individuals to have heard that there are
other opinions and other discussions, and that consolidation is not
necessarily a do or die situation. If we do NOT consolidate, the
professional organizations as we know them today WILL be forced to change.
They cannot stay the same and expect to survive with the rapid changes that
are taking place in the world of healthcare today.
Contrary to some postings on OANDP-L, determining that consolidation is not
the answer does not represent that we want to stop the world from spinning
and get off, but rather that some other form of change is necessary. For
some practitioners, what is perceived as just changing the name of, and
restructuring the leadership of the National Office structure does not
demonstrate enough change for them to be believe that the best interest of
the profession for the next 20-30 years is going to be addressed. By
saying NO to Consolidation, members are challenging the leadership to
begin the process of addressing another form of change which may not
compromise the practitioners sense of professional identity. By saying
YES to consolidation, members are challenging the leadership to begin the
process of completely starting from scratch, and finding a way to make the
orthotist and prosthetist work seamlessly with orthotics and prosthetics
in one streamlined organization.
Some practitioners have expressed the feeling that we may just be repeating
history by returning to a situation which is not much different than where
the profession/industry was 25+ years ago, prior to the development of the
Academy. They have expressed that even though we have leadership within
the three organizations today who are able to work together at this point in
no way guarantees that the evolution of the new association will remain in
line with the intentions of those who have written the current bylaws. As
we have seen, nothing is in written in stone, and that requires trust and
understanding between the various membership categories of the new
organization. To quote Ronney Snell from an interview with the O&P Business
News... If we assume the programs of both the Academy and AOPA are
mutually important, a new Board of Directors would be challenged to deal
with all the issues.
Membership will have to elect leadership that can be effective and timely in
decision making. Consensus building, mutual respect, and the ability to
agree/disagree will need to rise to a level I have not seen should
consolidation become a reality. - Ralph R. Ronney Snell, C.P.

Some recent postings express a concern that this trust/mutual respect will
be very difficult to maintain and some question the viability due to the
nature of professional politics. Likewise, some have expressed concern
that the checks and balances will become to dependent upon internal
mechanisms of the new organization.

Some practitioners feel that since we have a selection of more like minded
leadership, now is the best time to really consider dissolving the
organizations as we know them and starting with a clean slate. Many
responses to viewpoints in opposition to consolidation depend upon a trust
and idealistic view that we will continue to respect each others positions
throughout the future, making it difficult for the focus of the new
organization to shift from its proposed focus.
Some practitioners fear that the financial aspects involved with the
integration of business and profession make it unreasonable to expect that
there won't be a motivation to recruit individuals with similar business
interests to leadership positions within the organization versus the
recruitment of individuals with purist or idealistic professional values.
I know that I have not actually answered your question as to how I am voting
on this issue, but I have presented a compilation of discussions and points
that may be considered the flip side of consolidation in order to help
you make a more informed decision. I hope that this will also make the point
that leadership has not necessarily been forced to ONLY speak words which
are the STRICT company line. The opinions that have been discussed in my
mail are a representation of thoughts and opinions of many practitioners,
and they represent a well rounded view as it relates to the issue of change
within our profession.
This vote is extremely important, and it is critical that each and every
individual votes his/her conscience on the issue without feeling influenced
by anyone in leadership positions. The facts and opinions are available
which should help people make an honest decision. Whatever the outcome of
the vote is, I believe that the leadership will do the best that they can to
make things work, and that they will be open to your comments and concerns.
Always feel free to contact me regarding any issues that you would like
brought before the rest of the Academy board. We are open to your comments
and suggestions on what you would like to see from your professional
organization.



}}This consolidation issue has been an extremely charged issue as I knew it
would be when it first was discussed. Let me clarify a little bit about
where I see myself in this issue of consolidation.

I have been an Academy member since 19xx. My passion for the Academy and
it's mission and purpose has grown many fold since that time. All along the
way, I have had the pleasure of working with outstanding individuals who have
given of themselves to this profession and particularly to the Academy. This
current Academy Board of Directors include some of the finest people in this
profession. I admire, respect and trust each and every one of them deeply.
These individuals, including myself, have personal opinions on a variety of
issues which ARE discussed at Board meetings. Does it mean we always agree
with each other all the time - no. But it is done in a very professional and
respectful manner.

With that said, I will answer your question in regards only to the Board
decision on Consolidation which stated that the Academy Board of Directors
support consolidation. The Board had a vote on the statement of support for
consolidation and a (majority) of the Board of Directors voted in favor of
supporting consolidation. I, however, had reservations regarding many issues
and voted at the Board level AGAINST the Academy Board stating that it
supports consolidation.

I do support the process of pursuing and bringing the issue to the Academy
membership in order for them to make an informed decision for or against
Consolidation because we, as the Academy and as a profession, must decide
which road to take with our organizations (consolidate or plan for the future
individually). The health care arena is changing and we must adapt but we
must do this with prudence.

All of the information you have regarding the consolidation effort and your
own personal passion for the profession should allow you to make an informed
decision on whether or not consolidate. My vote as an Academician, I
believe, is personal and was based on the information presented to me, my
passion for this profession and where I believe it should go. Your vote
should be no different.

I hope I have answered your request to at least some satisfaction and would
be willing to speak with you regarding this response if you feel it necessary.

I admire your passion for the Academy and the profession and hope that we may
meet in person someday to further discuss the future of P & O.



}}Let me answer this way. First let me say that I will not share my private
vote with you. But I will express the issues pro and con as I see them.

 This has been one of the most difficult and debates that I have experienced
on two separate tenures on the board. But I believe that the people who have
drafted the by-laws and framed the new organization are people that I have a
great deal of respect for. Folks like Bill Barringer, Mike Schuch, Charlie
Prithum, Bob Brown, Bill Teauge, Stephanie Langdon-Bash, David J., etc., etc.
These are folks, all Academy members, who are above reproach, these are not
moguls or tycoons, many are institutional members. There is no ulterior
motive here they are pursuing what they think is best for the future of the
profession. Having said that, it is important to know that I truly believe in
my heart that there is no secondary or hidden agenda.

Control of the board. If you read the by-laws carefully and then study the
demographics of the industry the individual member will always have control
of the board. In fact we will also control the business side because
privately owned o and p facilities still comprise just under 2/3's of all the
facilities in the US. So I am not concerned about control of the new
organization. Actually the new org. will likely look more like the Academy
than AOPA once the dust settles.

Next a combined org. should be able to react more quickly to the demand of
lobbyists and leg. committees we eliminate 2 boards and 2 exe. directors this
is good.

I'm not sure I agree that Reg. Assistants should have a vote the same as me.

I'm a bit puzzled as to why a combined org. doesn't have a pro-forma that
represents greater savings. But those are the figures we have to work with at
this time. I have a feeling that if diligent a new org. could streamline
structure to permit substantial savings over the long run. This just seems
like common sense to me however I've been wrong before.

We will loose our identify as a professional society- this will happen -and
it bothers me to think that this will happen. Do the other benefits outweigh
this? I don't know. This is a very tough issue.

We will be controlled by the Big Two. Will not happen-unless we let it
happen. The board is actually stacked in our favor.

We will be less effective legislatively if we unite. I just don't by the
argument that two sep orgs. supporting one another is more effective than one
unified org.

I think those are the more common issues that exist but if there is one you
would like me to address just write me back. I promise to respond promptly.

Finally let me say that I will probably cast my vote on the last day. This is
a very tough issue that I do not take lightly. Is it a cut and dry yes or no
decision- not for me. I realize that there are folks who are against
consolidation on principle they would oppose it no matter what. This I think
is a very narrow view. We must consider carefully and then vote or conscience
and our heart.

The other thing I truly believe is that we will be OK no matter what the
outcome. I say so because I have a tremendous amount of faith in the members
of our profession.