Summary - When Does Selling End and Treatment Begin
Brett R. Saunders
Description
Collection
Title:
Summary - When Does Selling End and Treatment Begin
Creator:
Brett R. Saunders
Date:
11/30/2000
Text:
I recieved some very good, comprehensive replies to this message and one
that speaks for itself, all are below. Thank you to everyone for your input
and from those that truly know the law in Florida for your replies.
Brett R. Saunders, CPO, FAAOP, LPO(FL)
________________________________________________________________
I think, just leave it alone already.
---------------------------------------
It would seem to me that patient care begins when an individual seeks
medical attention and treatment for some disorder, illness or injury. An
evaluation by a physician who then writes a prescription for diabetic shoes
or an LS corset (or an AFO, knee orthosis, LSO or TLSO) would then require
licensed personnel to fill the prescription. Without the medical
intervention, it would have to be considered a retail sale.
--------------------------------------
I believe that selling ends and treatment begins when the use of a
prescription
is utilized. All the items you have mentioned are over the counter items and
have been available to the public without the regulation of a
prescription.As an
ABC certified Prosthetist/Orthotist our code of ethics state that we work
under
the prescription of a medical doctor. I do not think that I have exclusivity
to
fit the items mentioned.... pharmacies and convenience stores all have
access
to sell most of the items mentioned. The manufacture's bottom line is profit
and
so is the store that retails these items. If they can sell them and make a
profit so be it. The difference is that we as certified and in some cases
licensed practitioners, provide a full service facility that services the
patient with no strings attached.
Lets take it one step further and bring in the factory representative. I
believe
that the use of a prescription is utilized most of the time by a factory
representative, but I find that accountability to the patient is lacking.
The
fact that the rep does not have a facility available to the patient for
follow
up puts the patient in an awkward position. It is awkward going back to the
MD's
office where the rep fit the item for follow up rather than a full-fledged
independent facility specializing in custom fitted and custom fabricated
items.
The benefit we have is that we can educate the patient, provide continuity
of
care along side the MD, PT, RN or other medical professional involved. Items
as
simple as a cockup splint if fit and explained appropriately may make the
difference in whether the patient ( Patient is referred to as such
...because
the use of a prescription is required in order for us as Certified
practitioners
to operate.) wears the item and most importantly is actually assisted by the
use
of the devise fit.
I think that the prescription is the secret to all of this. A license for a
person at a store who fits items is meaningless. We as certified
practitioners
will educate the patient more and this education starts with us educating
the MD
as to the benefits of what we provide. Those that do not know how to use us
will
waste their money on items provided solely for profit. They are the
fools...with
the exception of the savvy customer who can purchase a particular item and
is
motivated enough to get the information needed to properly use and heal what
ales them.
-----------------------------------------------------------
My opnion would be that Patient care starts when the consumer asks
for your help as a professional and you take some responsability. (License
needed)
If they walk into the store and buy shoes or insoles or an AFo off the
shelf
- on thier own - they are taking full responsablity. In most of those cases
- the Insurance company won't reimburse them for the cost of the object-
there was no service involved. Most O&P facilities won't even be involved
with this type of sale.
When you are asked to become involved, you are expected to take some of the
responsability and then you can bill for your service and the insurance
company will recognize that. Then you need a license. That would be my
take
on it Brett --maybe just another opinion to add to your confusion.
-----------------------------------------------------------
the key to determining whether or not someone needs to be licensed is found
in s.468.80, F.S. Individuals need to read the definitions of orthotist
and other licensure areas; if they are performing those duties, then they
need a license. Buying items off the shelf without an evaluation or
measurement by someone, pursuant to physician's written prescription, does
not require Florida licensure. The keys are the prescription and the
description of functions in each section of the definitions.
Patient care comes into play when there's a physician's written prescription
involved. Other than that, someone is probably just a customer walking in
off the street to purchase an item off the shelf.
Any licensee who is unclear as to how a statute or rule applies to his or
her practice may petition the board for a declaratory statement. Chapter
120, F.S., outlines these requirements and my office can provide information
to anyone who needs it.
-----------------------------------------------------------
My usual preamble. The following are my personal opinions, not those of the
Board. Nor are they legal advise, only my thoughts and interpretations.
If the corset is other then an elastic abdominal support ... and is used
to
provide support, correction, or alleviation of neuromuscular ... it is
probably an orthosis as defined in 468.80(4). Orthosis may only be provided
by
licensed persons. Doing otherwise is unlicensed practice.
Unmodified shoes and prefab foot care products are also defined in 468.80(4)
and
are exempt from licensure.
If you are doing any of the things defined in the statute you need a
license.
The definitions don't distinguish between prefab and custom, they use
function
to define what is an orthosis.
If you have a retail showroom where non-defined products are sold you don't
need
a license.
Hope this helps.
--------------------------------------------------------------------
that speaks for itself, all are below. Thank you to everyone for your input
and from those that truly know the law in Florida for your replies.
Brett R. Saunders, CPO, FAAOP, LPO(FL)
________________________________________________________________
I think, just leave it alone already.
---------------------------------------
It would seem to me that patient care begins when an individual seeks
medical attention and treatment for some disorder, illness or injury. An
evaluation by a physician who then writes a prescription for diabetic shoes
or an LS corset (or an AFO, knee orthosis, LSO or TLSO) would then require
licensed personnel to fill the prescription. Without the medical
intervention, it would have to be considered a retail sale.
--------------------------------------
I believe that selling ends and treatment begins when the use of a
prescription
is utilized. All the items you have mentioned are over the counter items and
have been available to the public without the regulation of a
prescription.As an
ABC certified Prosthetist/Orthotist our code of ethics state that we work
under
the prescription of a medical doctor. I do not think that I have exclusivity
to
fit the items mentioned.... pharmacies and convenience stores all have
access
to sell most of the items mentioned. The manufacture's bottom line is profit
and
so is the store that retails these items. If they can sell them and make a
profit so be it. The difference is that we as certified and in some cases
licensed practitioners, provide a full service facility that services the
patient with no strings attached.
Lets take it one step further and bring in the factory representative. I
believe
that the use of a prescription is utilized most of the time by a factory
representative, but I find that accountability to the patient is lacking.
The
fact that the rep does not have a facility available to the patient for
follow
up puts the patient in an awkward position. It is awkward going back to the
MD's
office where the rep fit the item for follow up rather than a full-fledged
independent facility specializing in custom fitted and custom fabricated
items.
The benefit we have is that we can educate the patient, provide continuity
of
care along side the MD, PT, RN or other medical professional involved. Items
as
simple as a cockup splint if fit and explained appropriately may make the
difference in whether the patient ( Patient is referred to as such
...because
the use of a prescription is required in order for us as Certified
practitioners
to operate.) wears the item and most importantly is actually assisted by the
use
of the devise fit.
I think that the prescription is the secret to all of this. A license for a
person at a store who fits items is meaningless. We as certified
practitioners
will educate the patient more and this education starts with us educating
the MD
as to the benefits of what we provide. Those that do not know how to use us
will
waste their money on items provided solely for profit. They are the
fools...with
the exception of the savvy customer who can purchase a particular item and
is
motivated enough to get the information needed to properly use and heal what
ales them.
-----------------------------------------------------------
My opnion would be that Patient care starts when the consumer asks
for your help as a professional and you take some responsability. (License
needed)
If they walk into the store and buy shoes or insoles or an AFo off the
shelf
- on thier own - they are taking full responsablity. In most of those cases
- the Insurance company won't reimburse them for the cost of the object-
there was no service involved. Most O&P facilities won't even be involved
with this type of sale.
When you are asked to become involved, you are expected to take some of the
responsability and then you can bill for your service and the insurance
company will recognize that. Then you need a license. That would be my
take
on it Brett --maybe just another opinion to add to your confusion.
-----------------------------------------------------------
the key to determining whether or not someone needs to be licensed is found
in s.468.80, F.S. Individuals need to read the definitions of orthotist
and other licensure areas; if they are performing those duties, then they
need a license. Buying items off the shelf without an evaluation or
measurement by someone, pursuant to physician's written prescription, does
not require Florida licensure. The keys are the prescription and the
description of functions in each section of the definitions.
Patient care comes into play when there's a physician's written prescription
involved. Other than that, someone is probably just a customer walking in
off the street to purchase an item off the shelf.
Any licensee who is unclear as to how a statute or rule applies to his or
her practice may petition the board for a declaratory statement. Chapter
120, F.S., outlines these requirements and my office can provide information
to anyone who needs it.
-----------------------------------------------------------
My usual preamble. The following are my personal opinions, not those of the
Board. Nor are they legal advise, only my thoughts and interpretations.
If the corset is other then an elastic abdominal support ... and is used
to
provide support, correction, or alleviation of neuromuscular ... it is
probably an orthosis as defined in 468.80(4). Orthosis may only be provided
by
licensed persons. Doing otherwise is unlicensed practice.
Unmodified shoes and prefab foot care products are also defined in 468.80(4)
and
are exempt from licensure.
If you are doing any of the things defined in the statute you need a
license.
The definitions don't distinguish between prefab and custom, they use
function
to define what is an orthosis.
If you have a retail showroom where non-defined products are sold you don't
need
a license.
Hope this helps.
--------------------------------------------------------------------
Citation
Brett R. Saunders, “Summary - When Does Selling End and Treatment Begin,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 7, 2024, https://library.drfop.org/items/show/215341.
