President of the ACA- statement on qualified providers
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President of the ACA- statement on qualified providers
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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 ½ 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.
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 ½ 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
“President of the ACA- statement on qualified providers,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 26, 2024, https://library.drfop.org/items/show/221051.
