just not a candidate for a Px
Joan
Description
Collection
Title:
just not a candidate for a Px
Creator:
Joan
Date:
6/3/2000
Text:
I have encountered a few clients recently who were on the boarder line of
being a candidate for prosthetic usage. It is not cut and dry in our little
town who makes the final decision on candidacy (should be a team approach,
though). MD's write the scripts and sometimes will start the ball rolling
by writing something like, Evaluate for prosthesis, but they rarely just
tell a patient that are simply not a candidate unless they are REALLY
OBVIOUSLY not.
The patient is wheeled into our office and we have about an hour (on a good
day) to evaluate and determine their fate. This is so inefficient when the
medical history is unclear and often communication is not limited or
unreliable. Often, a PT will have been involved through Rehab and can offer
assistance, but they, too, feel that it is not their place to determine
candidacy. If I suggest that we discuss candidacy and state that a
particular patient does not seem a candidate, the PT will often back me up,
but will rarely make the call first.
So, my question to the list members is this: How does it work with you all?
Who makes the call? It seems that it should first come from the doctor,
second from a PT (if they have spent time with a patient) and lastly from
the CP who spends an hour in evaluation and has limited information. After
all, a CP has nothing to lose in making a prosthesis. It's purely an
ethical decision once that Rx is our hands. I have always believed that
every amputee has at least one chance to prove him/herself- at least with a
low expense temporary. But then I feel awful when I see that it was a total
waste of tax payer money. In a few cases, I have stopped at the check
socket phase and allowed some therapy before continuing. But this sets up
liability issues. It's never easy.
Thanks in advance,
Joan Cestaro, CP
being a candidate for prosthetic usage. It is not cut and dry in our little
town who makes the final decision on candidacy (should be a team approach,
though). MD's write the scripts and sometimes will start the ball rolling
by writing something like, Evaluate for prosthesis, but they rarely just
tell a patient that are simply not a candidate unless they are REALLY
OBVIOUSLY not.
The patient is wheeled into our office and we have about an hour (on a good
day) to evaluate and determine their fate. This is so inefficient when the
medical history is unclear and often communication is not limited or
unreliable. Often, a PT will have been involved through Rehab and can offer
assistance, but they, too, feel that it is not their place to determine
candidacy. If I suggest that we discuss candidacy and state that a
particular patient does not seem a candidate, the PT will often back me up,
but will rarely make the call first.
So, my question to the list members is this: How does it work with you all?
Who makes the call? It seems that it should first come from the doctor,
second from a PT (if they have spent time with a patient) and lastly from
the CP who spends an hour in evaluation and has limited information. After
all, a CP has nothing to lose in making a prosthesis. It's purely an
ethical decision once that Rx is our hands. I have always believed that
every amputee has at least one chance to prove him/herself- at least with a
low expense temporary. But then I feel awful when I see that it was a total
waste of tax payer money. In a few cases, I have stopped at the check
socket phase and allowed some therapy before continuing. But this sets up
liability issues. It's never easy.
Thanks in advance,
Joan Cestaro, CP
Citation
Joan, “just not a candidate for a Px,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 26, 2024, https://library.drfop.org/items/show/214763.