Re: Supan repost to moving target
Terry Supan
Description
Collection
Title:
Re: Supan repost to moving target
Creator:
Terry Supan
Date:
12/18/2000
Text:
Members of the O&P Listserver,
Making that mistake in posting my response to Mr. LaCount last Friday has given me a chance to reflect on what I was trying to say. (It also gave me a chance to use my spell checker. ;-}) I'm going to take this in a slightly different direction than where I started to go. But as I said
last Friday, Stan, there is no moving target for professional standards and competency. It has been steady for the last twenty years. The only thing that has changed is the technology that we as prosthetists and orthotists employ. Some of that technology now allows
untrained/undereducated/unsupervised individuals to believe they can provide care.
The ISPO (International Society for Prosthetics and Orthotics), through its consultative status with the United Nations and the World Health Organization, has established educational standard for orthotic/prosthetics caregivers. The reason that most non American members of this list server
don't bother with these discussions is that they have accepted the concept that to provide a prosthesis or an orthosis, you must be educated and trained.
The standards that CAAHEP/NCOPE have developed for education are based on forty years of O&P education here in the States. That American educational evolution was the basis for programs in Canada, Japan, Scotland, England, Australia, Sweden and other countries. The beginning of that
educational evolution was the vision of the leadership of our profession here in the U.S. They knew that all of the research in biomechanics, material science, anatomy and other areas in prosthetics and orthotics was going to change them from the craftsmen and artisans of the polio and
World War era into the professionals of the future.
Those who deny that education are, in part, denying the scientific basis for modern prosthetics and orthotics.
As I said last week, any competent professional must have the knowledge, skills, and abilities of their profession. In O&P that means that you gain the education, you are exposed to clinical experience, and you develop your competency while being supervised. That is the quickest way to
become a professional without harming the very people that you want to help. Anything less and you are selling yourself short.
Since 1948, the ABC's role has been to protect the public by establishing standards of care and then testing individual to make sure they could meet those standards. It later developed standard for the physical location where that care was provide and then recently developed organizational
standards for the companies that provide O&P services. Those standards did not evolve in a vacuum. Besides orthotists and prosthetists, there has been a tremendous amount of input from physicians, therapists, engineers, educators, and government agencies.
The ABC standards, examinations and ethics have always been voluntary. They have always been the highest and have tried to keep pace with the developments within our profession. So yes, the ABC has raised the bar. And in doing so, we created a void here in America that other
organizations have filled. But that was because, as Americans, we chose to have a voluntary standards organization instead of a governmentally regulated profession as in other countries.
To this point, in America, anyone can provide a prosthesis or an orthosis. But they cannot call themselves a Certified Prosthetist Orthotist here in the States. CPO, CO and CP are titles legally protected by the ABC. Because of the high standards of education, exam content and methods,
and canons of ethics, no other O&P accreditation group can claim that they are equal to the ABC.
Stan, the one thing that is changing is that the practice of prosthetics and orthotics is becoming a privilege here in America. As more state require licensure of our profession, the educational standards have become law. All of the Practice Acts either currently or at some future date
will require the same CAAHEP/NCOPE educational standards that the ABC uses. They also either require successful passage of the ABC exam, or contract with the ABC to examine applicants from their state. No other orthotic or prosthetic exam is used, period.
Yes, there has to have been “grandfathering” of individuals that do not have ABC credentials. But they will have to meet the continuing education, practice, and ethical standard of their state or they will lose their license. Yes, other allied health personnel have been “exempted” but if
they cause harm, and they are found to be practicing outside of the scope of practice of their profession, their therapy or medical license could be in jeopardy.
I do not question someone with a BOC credential desire and willingness to help someone with a disability. I sometimes question their lack of willingness to become the best prosthetic/orthotic caregiver they can be when they will not commit to getting the best education that they can. It
will only heighten their love and understanding for their chosen career. That's why, in 1972, I made the choice to get my Associates degree, even though I could have sat for the ABC exam based solely on my military experience and my high school diploma.
On the other hand, I do question the motivation of unsupervised individuals that provide orthoses and prostheses without any credential. They are the major source of the reported cases of Medicare fraud and abuse that this profession has been saddled with. To my mind, their motivation is
purely financial and has nothing to do with improving the lives of individuals with disabilities.
To me, their exclusion is the only “silver lining” the proposed HCFA “qualified provider” statutes have. As an Academy member, ABC practitioner, and member of AOPA, I don't like the least common denominator that the new standards imply. But, I'm also more of a realist now that I have been
in the past. Things happen in politics, and what we wanted as a profession leaves our control when we hand it over to the politicians. At this point there is probably little the AAOP board can do. And, as an accreditation board the ABC really can't get involved with that kind of
lobbying effort. Good, bad or indifferent, it was even out of the AOPA Board's hands since October. Congress passed the budget this last weekend, so we will have to wait and see what they have done with the proposed statutes.
That was my final point. Now, everyone, go ahead and take your shots at me if you want.
Remember though, I have been actively involved with the O&P profession for over 30 years and O&P education for the last 25. There isn't much of that thirty years of this profession that I don't have first hand knowledge about. I'm a past President of the Academy. I'm a former member of
CAAHEP, NCOPE, and ISPO's education committee. I have one year remaining on the ABC Board. I have been a CARF (Commission of Accreditation of Rehabilitation Facilities) Trustee for three years. And, finally, I'm a member of the Illinois Orthotic, Prosthetic and Pedorthic Licensure Board.
Terry Supan, CPO
Professor of Clinical Surgery
SIU School of Medicine
Making that mistake in posting my response to Mr. LaCount last Friday has given me a chance to reflect on what I was trying to say. (It also gave me a chance to use my spell checker. ;-}) I'm going to take this in a slightly different direction than where I started to go. But as I said
last Friday, Stan, there is no moving target for professional standards and competency. It has been steady for the last twenty years. The only thing that has changed is the technology that we as prosthetists and orthotists employ. Some of that technology now allows
untrained/undereducated/unsupervised individuals to believe they can provide care.
The ISPO (International Society for Prosthetics and Orthotics), through its consultative status with the United Nations and the World Health Organization, has established educational standard for orthotic/prosthetics caregivers. The reason that most non American members of this list server
don't bother with these discussions is that they have accepted the concept that to provide a prosthesis or an orthosis, you must be educated and trained.
The standards that CAAHEP/NCOPE have developed for education are based on forty years of O&P education here in the States. That American educational evolution was the basis for programs in Canada, Japan, Scotland, England, Australia, Sweden and other countries. The beginning of that
educational evolution was the vision of the leadership of our profession here in the U.S. They knew that all of the research in biomechanics, material science, anatomy and other areas in prosthetics and orthotics was going to change them from the craftsmen and artisans of the polio and
World War era into the professionals of the future.
Those who deny that education are, in part, denying the scientific basis for modern prosthetics and orthotics.
As I said last week, any competent professional must have the knowledge, skills, and abilities of their profession. In O&P that means that you gain the education, you are exposed to clinical experience, and you develop your competency while being supervised. That is the quickest way to
become a professional without harming the very people that you want to help. Anything less and you are selling yourself short.
Since 1948, the ABC's role has been to protect the public by establishing standards of care and then testing individual to make sure they could meet those standards. It later developed standard for the physical location where that care was provide and then recently developed organizational
standards for the companies that provide O&P services. Those standards did not evolve in a vacuum. Besides orthotists and prosthetists, there has been a tremendous amount of input from physicians, therapists, engineers, educators, and government agencies.
The ABC standards, examinations and ethics have always been voluntary. They have always been the highest and have tried to keep pace with the developments within our profession. So yes, the ABC has raised the bar. And in doing so, we created a void here in America that other
organizations have filled. But that was because, as Americans, we chose to have a voluntary standards organization instead of a governmentally regulated profession as in other countries.
To this point, in America, anyone can provide a prosthesis or an orthosis. But they cannot call themselves a Certified Prosthetist Orthotist here in the States. CPO, CO and CP are titles legally protected by the ABC. Because of the high standards of education, exam content and methods,
and canons of ethics, no other O&P accreditation group can claim that they are equal to the ABC.
Stan, the one thing that is changing is that the practice of prosthetics and orthotics is becoming a privilege here in America. As more state require licensure of our profession, the educational standards have become law. All of the Practice Acts either currently or at some future date
will require the same CAAHEP/NCOPE educational standards that the ABC uses. They also either require successful passage of the ABC exam, or contract with the ABC to examine applicants from their state. No other orthotic or prosthetic exam is used, period.
Yes, there has to have been “grandfathering” of individuals that do not have ABC credentials. But they will have to meet the continuing education, practice, and ethical standard of their state or they will lose their license. Yes, other allied health personnel have been “exempted” but if
they cause harm, and they are found to be practicing outside of the scope of practice of their profession, their therapy or medical license could be in jeopardy.
I do not question someone with a BOC credential desire and willingness to help someone with a disability. I sometimes question their lack of willingness to become the best prosthetic/orthotic caregiver they can be when they will not commit to getting the best education that they can. It
will only heighten their love and understanding for their chosen career. That's why, in 1972, I made the choice to get my Associates degree, even though I could have sat for the ABC exam based solely on my military experience and my high school diploma.
On the other hand, I do question the motivation of unsupervised individuals that provide orthoses and prostheses without any credential. They are the major source of the reported cases of Medicare fraud and abuse that this profession has been saddled with. To my mind, their motivation is
purely financial and has nothing to do with improving the lives of individuals with disabilities.
To me, their exclusion is the only “silver lining” the proposed HCFA “qualified provider” statutes have. As an Academy member, ABC practitioner, and member of AOPA, I don't like the least common denominator that the new standards imply. But, I'm also more of a realist now that I have been
in the past. Things happen in politics, and what we wanted as a profession leaves our control when we hand it over to the politicians. At this point there is probably little the AAOP board can do. And, as an accreditation board the ABC really can't get involved with that kind of
lobbying effort. Good, bad or indifferent, it was even out of the AOPA Board's hands since October. Congress passed the budget this last weekend, so we will have to wait and see what they have done with the proposed statutes.
That was my final point. Now, everyone, go ahead and take your shots at me if you want.
Remember though, I have been actively involved with the O&P profession for over 30 years and O&P education for the last 25. There isn't much of that thirty years of this profession that I don't have first hand knowledge about. I'm a past President of the Academy. I'm a former member of
CAAHEP, NCOPE, and ISPO's education committee. I have one year remaining on the ABC Board. I have been a CARF (Commission of Accreditation of Rehabilitation Facilities) Trustee for three years. And, finally, I'm a member of the Illinois Orthotic, Prosthetic and Pedorthic Licensure Board.
Terry Supan, CPO
Professor of Clinical Surgery
SIU School of Medicine
Citation
Terry Supan, “Re: Supan repost to moving target,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 6, 2024, https://library.drfop.org/items/show/215571.
