Re: President of the ACA- statement on qualified providers
Philip P Tamoush
Description
Collection
Title:
Re: President of the ACA- statement on qualified providers
Creator:
Philip P Tamoush
Date:
4/11/2003
Text:
Barvo, Paddy!! This message should also be sent to the California
legislature committee which is currently considering a bill by APTA to
authorize physical therapists to prescribe prostheses and orthoses. We
need to hear more from ACA on such matters when they occur throughout the
country. We live in a consumer-oriented society and ACA can have a
critical and important impact on decision makers. Thanks for finally
getting into the NegReg committee with meaningful input. Phil Tamoush,
former member of the ACA Board
On Fri, 11 Apr 2003 10:23:56 EDT <Email Address Redacted> writes:
> BRAVO PADDY and the ACA!
> Paddy is certainly qualified to speak on the subject of qualified
> providers
> and here is what she told the Negotiated Rulemaking Committee this
> week:
>
> CENTERS FOR MEDICARE AND MEDICAID SERVICES
> NEGOTIATED RULEMAKING COMMITTEE MEETING
> PUBLIC STATEMENT
> Amputee Coalition of America President
> Paddy Rossbach, RN
> April 7, 2003
>
> Dr Hill, Commissioner Sylvester, Commissioner Lobel and members of
> the
> Negotiated Rulemaking, thank you for allowing me to speak on behalf
> of the
> more than 1.2 million individuals living with limb loss in the US.
> My name is
> Paddy Rossbach, I am the President and CEO of the Amputee Coalition
> of
> America, the leading national nonprofit consumer organization for
> individuals
> living with limb loss in this country. I am a registered nurse and
> have been
> an amputee since the age of six. First let me say that when I heard
> the
> reason why it is now necessary for the ACA to make a position
> statement at
> these proceedings, I was absolutely astounded. In my more than 45
> years
> practicing as a licensed registered nurse, and 59 years as an
> amputee, I have
> never encountered a Physical or Occupational Therapist who either
> wished, or
> felt that they were trained, to fit and fabricate prostheses. For
> the past 19
> years I have been working with amputees of all ages hand in hand
> with the
> entire team of health care professionals who prepare them to lead a
>
> functional, productive lifestyle of their choice. Each individual
> on that
> team has a unique skill for which they have been trained. It is the
>
> combination of those skills that leads to a successful outcome for
> the
> amputee. However, the surgeon must have a basic understanding of
> prosthetics
> and a close relationship with a Prosthetist so that he or she can
> make an
> educated decision about the type of surgery or placement of incision
> to
> ensure a positive prosthetic outcome. In the same way physical and
> occupational therapists must have a basic understanding of how
> prosthetic
> components work so that they can train the amputee in their use. But
> that
> basic knowledge in no way prepares them to make the prosthesis. Of
> course
> there is a common path in the education process. As a nurse I also
> studied
> anatomy, physiology, surgical techniques etc, but does that qualify
> me to be
> a surgeon? Would anyone really want me to perform a surgical
> procedure on
> them � I don�t think so. Today, with the tremendous advances in
> techniques
> and technology, health care providers are becoming more and more
> specialized
> even within their own field of expertise, and certainly would not
> want to
> practice outside of that field. I would like to ask everyone around
> this
> table, how many of you are wearing a prosthesis? How many of you get
> up every
> day, put the cut off part of your limb into a hard plastic socket
> and try and
> maneuver around potholes, uneven ground, subway steps � or any
> steps for that
> matter � speeding taxi cabs, school playgrounds, snow and ice, and
> on top of
> that compete in the workplace with individuals who do not have a
> disability?
> How many of you know that many amputees expend 2 � times the energy
> of
> someone without an amputation to walk at half the pace, and although
> there
> are many reasons for this, several are simply due to poor fit and
> alignment
> of the prosthesis. Fabricating a prosthesis is not just a matter of
> putting a
> few components together like a tinker toy. The single most important
> part of
> a prosthesis is the socket, or the part the amputated limb must fit
> into.
> Prosthetics is a very specialized field, the practitioner must be
> able to
> clinically assess each individual�s specific physical and
> emotional needs at
> a particularly vulnerable time in their life. They must recommend
> care and
> technology-appropriate prosthetic components, and in addition, must
> design,
> fabricate, fit and maintain increasingly complex artificial limbs
> that will
> maximize the amputee�s current and potential physical needs and
> activity
> level. Each of us, and by us I mean amputees, has unique needs, from
> babies
> born with a limb deficiency to teenagers having an amputation for
> cancer, to
> our troops losing their limbs in combat, to the elderly losing limbs
> because
> of vascular insufficiency or diabetes. However, one need we all have
> in
> common is the need to be as active as possible, as it is well
> documented that
> people living sedentary lifestyles are at risk for a range of
> secondary
> conditions which include: obesity, diabetes, the loss of a further
> limb,
> cardiovascular disease, depression, back pain, and even some forms
> of cancer.
> But in order to be active we must have access to comfortable,
> technology-appropriate prostheses. While I have the greatest respect
> for the
> work of physical and occupational therapists � in fact I firmly
> believe that
> a successful outcome for amputees is as much due to the prosthetic
> rehabilitation carried out by these individuals as it is to the work
> of
> fabricating and fitting a prosthesis by the prosthetists � I do
> not believe
> they have the knowledge or the training to successfully fabricate
> and fit
> artificial limbs. So, I leave each one of you with this question, if
> in the
> future your child contracts bacterial meningitis and loses all four
> limbs, or
> your husband, wife, mother or father suddenly becomes an amputee,
> who would
> you want to fit them with their artificial limbs, someone who has
> been
> specifically trained to do just that, a Prosthetist, or someone who
> has been
> trained in the skills of rehabilitation, a physical or occupational
>
> therapist? I, and many others in this room today, am an example of
> what can
> be achieved with appropriate care and technology. I trained as a
> nurse,
> specialized in the O.R where I frequently pulled double shifts, on
> my feet
> for 16 hours at a time. I ski, scuba dive, run marathons, show
> horses and
> recently learned to roller blade. I am a fully functional wage
> earning, tax
> paying human being � because I have benefited from the best of
> care. I cannot
> begin to imagine what my life would have been like if this were not
> the case.
> I believe everyone should have the same opportunity. One of the
> teenagers
> with whom I worked at Sloane-Kettering wrote an essay for early
> admission to
> Harvard about how it felt to lose a leg to cancer. His definition of
> the word
> amputation was:
> A word which connotes such extreme traumatic finality, the actual
> physical
> loss of a part of one�s body, never again to be seen or felt, gone
> forever.
> Losing a limb is indeed a tragedy, but not being cared for by a
> healthcare
> professional trained to perform a specific intervention, such as
> surgery,
> prosthetics, rehabilitation, ect. is a far greater tragedy, and one
> that is
> completely avoidable.
> Respectfully submitted,
> Paddy Rossbach, RN
> President & CEO
> Amputee Coalition of America.
> Phone: 1-888-AMP-KNOW / 1-888-267-5669
> <A
>
HREF= <URL Redacted>> <URL Redacted>
</A>
>
> We need to support those who support us.
> Do yourself and your patients a favor- get involved and support the
> ACA.
> Jack Richmond- Amputee, proud supporter of the ACA and qualified
> practitioners.
>
>
>
>
>
>
>
legislature committee which is currently considering a bill by APTA to
authorize physical therapists to prescribe prostheses and orthoses. We
need to hear more from ACA on such matters when they occur throughout the
country. We live in a consumer-oriented society and ACA can have a
critical and important impact on decision makers. Thanks for finally
getting into the NegReg committee with meaningful input. Phil Tamoush,
former member of the ACA Board
On Fri, 11 Apr 2003 10:23:56 EDT <Email Address Redacted> writes:
> BRAVO PADDY and the ACA!
> Paddy is certainly qualified to speak on the subject of qualified
> providers
> and here is what she told the Negotiated Rulemaking Committee this
> week:
>
> CENTERS FOR MEDICARE AND MEDICAID SERVICES
> NEGOTIATED RULEMAKING COMMITTEE MEETING
> PUBLIC STATEMENT
> Amputee Coalition of America President
> Paddy Rossbach, RN
> April 7, 2003
>
> Dr Hill, Commissioner Sylvester, Commissioner Lobel and members of
> the
> Negotiated Rulemaking, thank you for allowing me to speak on behalf
> of the
> more than 1.2 million individuals living with limb loss in the US.
> My name is
> Paddy Rossbach, I am the President and CEO of the Amputee Coalition
> of
> America, the leading national nonprofit consumer organization for
> individuals
> living with limb loss in this country. I am a registered nurse and
> have been
> an amputee since the age of six. First let me say that when I heard
> the
> reason why it is now necessary for the ACA to make a position
> statement at
> these proceedings, I was absolutely astounded. In my more than 45
> years
> practicing as a licensed registered nurse, and 59 years as an
> amputee, I have
> never encountered a Physical or Occupational Therapist who either
> wished, or
> felt that they were trained, to fit and fabricate prostheses. For
> the past 19
> years I have been working with amputees of all ages hand in hand
> with the
> entire team of health care professionals who prepare them to lead a
>
> functional, productive lifestyle of their choice. Each individual
> on that
> team has a unique skill for which they have been trained. It is the
>
> combination of those skills that leads to a successful outcome for
> the
> amputee. However, the surgeon must have a basic understanding of
> prosthetics
> and a close relationship with a Prosthetist so that he or she can
> make an
> educated decision about the type of surgery or placement of incision
> to
> ensure a positive prosthetic outcome. In the same way physical and
> occupational therapists must have a basic understanding of how
> prosthetic
> components work so that they can train the amputee in their use. But
> that
> basic knowledge in no way prepares them to make the prosthesis. Of
> course
> there is a common path in the education process. As a nurse I also
> studied
> anatomy, physiology, surgical techniques etc, but does that qualify
> me to be
> a surgeon? Would anyone really want me to perform a surgical
> procedure on
> them � I don�t think so. Today, with the tremendous advances in
> techniques
> and technology, health care providers are becoming more and more
> specialized
> even within their own field of expertise, and certainly would not
> want to
> practice outside of that field. I would like to ask everyone around
> this
> table, how many of you are wearing a prosthesis? How many of you get
> up every
> day, put the cut off part of your limb into a hard plastic socket
> and try and
> maneuver around potholes, uneven ground, subway steps � or any
> steps for that
> matter � speeding taxi cabs, school playgrounds, snow and ice, and
> on top of
> that compete in the workplace with individuals who do not have a
> disability?
> How many of you know that many amputees expend 2 � times the energy
> of
> someone without an amputation to walk at half the pace, and although
> there
> are many reasons for this, several are simply due to poor fit and
> alignment
> of the prosthesis. Fabricating a prosthesis is not just a matter of
> putting a
> few components together like a tinker toy. The single most important
> part of
> a prosthesis is the socket, or the part the amputated limb must fit
> into.
> Prosthetics is a very specialized field, the practitioner must be
> able to
> clinically assess each individual�s specific physical and
> emotional needs at
> a particularly vulnerable time in their life. They must recommend
> care and
> technology-appropriate prosthetic components, and in addition, must
> design,
> fabricate, fit and maintain increasingly complex artificial limbs
> that will
> maximize the amputee�s current and potential physical needs and
> activity
> level. Each of us, and by us I mean amputees, has unique needs, from
> babies
> born with a limb deficiency to teenagers having an amputation for
> cancer, to
> our troops losing their limbs in combat, to the elderly losing limbs
> because
> of vascular insufficiency or diabetes. However, one need we all have
> in
> common is the need to be as active as possible, as it is well
> documented that
> people living sedentary lifestyles are at risk for a range of
> secondary
> conditions which include: obesity, diabetes, the loss of a further
> limb,
> cardiovascular disease, depression, back pain, and even some forms
> of cancer.
> But in order to be active we must have access to comfortable,
> technology-appropriate prostheses. While I have the greatest respect
> for the
> work of physical and occupational therapists � in fact I firmly
> believe that
> a successful outcome for amputees is as much due to the prosthetic
> rehabilitation carried out by these individuals as it is to the work
> of
> fabricating and fitting a prosthesis by the prosthetists � I do
> not believe
> they have the knowledge or the training to successfully fabricate
> and fit
> artificial limbs. So, I leave each one of you with this question, if
> in the
> future your child contracts bacterial meningitis and loses all four
> limbs, or
> your husband, wife, mother or father suddenly becomes an amputee,
> who would
> you want to fit them with their artificial limbs, someone who has
> been
> specifically trained to do just that, a Prosthetist, or someone who
> has been
> trained in the skills of rehabilitation, a physical or occupational
>
> therapist? I, and many others in this room today, am an example of
> what can
> be achieved with appropriate care and technology. I trained as a
> nurse,
> specialized in the O.R where I frequently pulled double shifts, on
> my feet
> for 16 hours at a time. I ski, scuba dive, run marathons, show
> horses and
> recently learned to roller blade. I am a fully functional wage
> earning, tax
> paying human being � because I have benefited from the best of
> care. I cannot
> begin to imagine what my life would have been like if this were not
> the case.
> I believe everyone should have the same opportunity. One of the
> teenagers
> with whom I worked at Sloane-Kettering wrote an essay for early
> admission to
> Harvard about how it felt to lose a leg to cancer. His definition of
> the word
> amputation was:
> A word which connotes such extreme traumatic finality, the actual
> physical
> loss of a part of one�s body, never again to be seen or felt, gone
> forever.
> Losing a limb is indeed a tragedy, but not being cared for by a
> healthcare
> professional trained to perform a specific intervention, such as
> surgery,
> prosthetics, rehabilitation, ect. is a far greater tragedy, and one
> that is
> completely avoidable.
> Respectfully submitted,
> Paddy Rossbach, RN
> President & CEO
> Amputee Coalition of America.
> Phone: 1-888-AMP-KNOW / 1-888-267-5669
> <A
>
HREF= <URL Redacted>> <URL Redacted>
</A>
>
> We need to support those who support us.
> Do yourself and your patients a favor- get involved and support the
> ACA.
> Jack Richmond- Amputee, proud supporter of the ACA and qualified
> practitioners.
>
>
>
>
>
>
>
Citation
Philip P Tamoush, “Re: President of the ACA- statement on qualified providers,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 6, 2024, https://library.drfop.org/items/show/221049.
