Responses to practitioner qualifications
chris huff
Description
Collection
Title:
Responses to practitioner qualifications
Creator:
chris huff
Date:
4/11/2003
Text:
Thank you for all that responded. Please lets put this issue to rest, as I do not want to stir up any debates or arguements. I just wanted to know if this was happening all over.
Sincerely,
Christopher Huff CO
I just talked to some of the people at ABC. A CP can cast and deliver
orthotics under the indirect supervision of a CO, so for example this CP
works with a CO he can consult with, he would be able to, but if there is
no CO in his company, then he could not. The CO would be ultimately
responsible for the brace.
This is the priviledging process that ABC talks about in the site
accredidation manuel.
CP's and anyone else for that matter can fit orthoses in states where there
are no licensure requirements. Only a handful of states license orthotist
and prosthetists. The catch is most insurance companies require
ceritfication, although they tend not to distinguish between CO's and CP's.
So they short answer is CP's can get away with fitting orthoses almost
everywhere in the US. Is it ethical? No. Does it violate the ABC cannons of
ethical professional behavior? Probably. Would a consumer, ill fit or
injured have cause for action or complaint? Definetly.
Historically this issue has been ignored in O&P. You have good reason to
ask the question. In our facility CP's do not make or fit orthoses.
If the state in which you live does not forbid it, this practice is
certainly legal and ethical. If the state in which you live has a
licensure program for P&O and the CP is a licensed although not a
certified orthotist, this practice is also legal and ethical.
I went through this with ABC about a year ago. Your answer depends on the
state you are in. If their is licensure, then you must check with the
requirements of the state and how its worded. If no licensure is needed,
then there are no laws to disallow the sale/fitting of orthotic devices by
anyone. You CANNOT represent yourself using the words orthotist, which is
apparently associated only with a recognized certification board. As a CP,
ABC did allow us to fit any device which was deemed off the shelf and not
custom without any problem. They felt custom orthotic devices fell into a
grey area because we are not specifically trained (don't have that special
piece of paper) to do this job. Now with the recent Orthotic Fitters
Program, you should call ABC to verify is you can still deliver off the
shelf items or have to pay them money and take a class to get that special
piece of paper so you can do this.
Why would you think it illegal for a CP to provide
orthotics when a non-certified, non-educated person
can provide them? This is one reason why we need more
states to adopt licensure laws, to protect the
patients from being served by people who are not
qualified by education and certification.
It is very legal in the majority of states. As a matter of fact anyone can do it including the bum on the street.
Ethical by who's standards. ABC has the highest standards and I do not recall seeing anything that says a CP can't do orthotics or that a CO can't do prosthetics.
This has been a sore point with me for years also, and I have been trained as an orthotist as well at one of the universities but not something I do.
I think if the C.P. does quality work, in a state where there are no legal
barriers, then they should go for it! If we are really true to the patient
and have their best interest at heart, then the person who does the best job
should get the work, regardless of their credentials. That is my ethical
take on the subject, of course in certain states/jurisdictions a C.P. cannot
legally BILL for orthotic services. Maybe they can provide them for free
though??? Anyone know???
As experts in the art of pressure distribution, the mechanics of gait
and the engineering involved in the manufacture of custom prosthetic
devices, I personally feel confident in a prosthetists abilities in
applying orthoses. Better a CP dispensing orthopedic items than a shoe
salesman or an intake clerk.
With the exception of states that require licensing, I don't think there
are any legal restrictions on who can administer orthotic devices; and
what's more--many products don't have clear labeling or guidelines as to
whether or not they can be dispensed without a prescription and things
like knee sleeves, ankle splints and tennis elbow straps are being sold
over the counter without so much as recording the customers' names.
As far as ethics are concerned, I didn't read through all the material,
but what I did review on the ABC web site did not seem to indicate that
it is forbidden for a practitioner to administer services outside the
scope of their discipline, rather, it addressed the services that are
administered from within their discipline.
In a hospital, since most orthotic deliveries are billed to the hospital
and covered under DRGs, Bundling or managed care capitation fees,
provider credentialing is not an issue because services are being
administered under a physician's care and the providers are not being
reimbursed directly from the third party payor.
Ultimately, I feel it is inappropriate for orthotic devices to be
administered by anyone other than a CO, or someone under the direct
(present in the room) supervision of a CO. This not being the majority
rule at the present time, a CP is the next best thing to a CO in my book
as long as we are forced to accept things as they are. If this
individual happens to actually be knowledgable about orthotics and does
a competent job, there may be nothing you can do...besides doing it
better, that is.
Hospitals that I have worked in require outside vendors (O&P-
facilities) to be paneled by the hospital for hospital privilages.
That includes fitting and delivery items in their proper category.
So a prosthetist fits prosthetics and an orthotist fits orthoses.
It is probably not ethical, given that the individual has not undergone the training to qualify for competency in another field. This is not to say that they are not capable, but it would be better if they focused on what they have been credentialed in. Depending on what state you live in, this may be illegal. You may want to contact the national office or the Department of Professional Regulation. I live in Florida and we have a licensure law here. I am curious to know more details of this matter if you would be interested in sharing more information.
technically i wouldnt think so. it becomes a scope of practice issue and
i do not think it is in their scope to cross discipline unless they are
certified. but, unless you are in a state with licensure, there may be no
tangible restriction. ethical: no, legal: grey area.
Legal, depends on your state.
Ethical. Canons say: NoGet more from the Web. FREE MSN Explorer download : <URL Redacted>
Sincerely,
Christopher Huff CO
I just talked to some of the people at ABC. A CP can cast and deliver
orthotics under the indirect supervision of a CO, so for example this CP
works with a CO he can consult with, he would be able to, but if there is
no CO in his company, then he could not. The CO would be ultimately
responsible for the brace.
This is the priviledging process that ABC talks about in the site
accredidation manuel.
CP's and anyone else for that matter can fit orthoses in states where there
are no licensure requirements. Only a handful of states license orthotist
and prosthetists. The catch is most insurance companies require
ceritfication, although they tend not to distinguish between CO's and CP's.
So they short answer is CP's can get away with fitting orthoses almost
everywhere in the US. Is it ethical? No. Does it violate the ABC cannons of
ethical professional behavior? Probably. Would a consumer, ill fit or
injured have cause for action or complaint? Definetly.
Historically this issue has been ignored in O&P. You have good reason to
ask the question. In our facility CP's do not make or fit orthoses.
If the state in which you live does not forbid it, this practice is
certainly legal and ethical. If the state in which you live has a
licensure program for P&O and the CP is a licensed although not a
certified orthotist, this practice is also legal and ethical.
I went through this with ABC about a year ago. Your answer depends on the
state you are in. If their is licensure, then you must check with the
requirements of the state and how its worded. If no licensure is needed,
then there are no laws to disallow the sale/fitting of orthotic devices by
anyone. You CANNOT represent yourself using the words orthotist, which is
apparently associated only with a recognized certification board. As a CP,
ABC did allow us to fit any device which was deemed off the shelf and not
custom without any problem. They felt custom orthotic devices fell into a
grey area because we are not specifically trained (don't have that special
piece of paper) to do this job. Now with the recent Orthotic Fitters
Program, you should call ABC to verify is you can still deliver off the
shelf items or have to pay them money and take a class to get that special
piece of paper so you can do this.
Why would you think it illegal for a CP to provide
orthotics when a non-certified, non-educated person
can provide them? This is one reason why we need more
states to adopt licensure laws, to protect the
patients from being served by people who are not
qualified by education and certification.
It is very legal in the majority of states. As a matter of fact anyone can do it including the bum on the street.
Ethical by who's standards. ABC has the highest standards and I do not recall seeing anything that says a CP can't do orthotics or that a CO can't do prosthetics.
This has been a sore point with me for years also, and I have been trained as an orthotist as well at one of the universities but not something I do.
I think if the C.P. does quality work, in a state where there are no legal
barriers, then they should go for it! If we are really true to the patient
and have their best interest at heart, then the person who does the best job
should get the work, regardless of their credentials. That is my ethical
take on the subject, of course in certain states/jurisdictions a C.P. cannot
legally BILL for orthotic services. Maybe they can provide them for free
though??? Anyone know???
As experts in the art of pressure distribution, the mechanics of gait
and the engineering involved in the manufacture of custom prosthetic
devices, I personally feel confident in a prosthetists abilities in
applying orthoses. Better a CP dispensing orthopedic items than a shoe
salesman or an intake clerk.
With the exception of states that require licensing, I don't think there
are any legal restrictions on who can administer orthotic devices; and
what's more--many products don't have clear labeling or guidelines as to
whether or not they can be dispensed without a prescription and things
like knee sleeves, ankle splints and tennis elbow straps are being sold
over the counter without so much as recording the customers' names.
As far as ethics are concerned, I didn't read through all the material,
but what I did review on the ABC web site did not seem to indicate that
it is forbidden for a practitioner to administer services outside the
scope of their discipline, rather, it addressed the services that are
administered from within their discipline.
In a hospital, since most orthotic deliveries are billed to the hospital
and covered under DRGs, Bundling or managed care capitation fees,
provider credentialing is not an issue because services are being
administered under a physician's care and the providers are not being
reimbursed directly from the third party payor.
Ultimately, I feel it is inappropriate for orthotic devices to be
administered by anyone other than a CO, or someone under the direct
(present in the room) supervision of a CO. This not being the majority
rule at the present time, a CP is the next best thing to a CO in my book
as long as we are forced to accept things as they are. If this
individual happens to actually be knowledgable about orthotics and does
a competent job, there may be nothing you can do...besides doing it
better, that is.
Hospitals that I have worked in require outside vendors (O&P-
facilities) to be paneled by the hospital for hospital privilages.
That includes fitting and delivery items in their proper category.
So a prosthetist fits prosthetics and an orthotist fits orthoses.
It is probably not ethical, given that the individual has not undergone the training to qualify for competency in another field. This is not to say that they are not capable, but it would be better if they focused on what they have been credentialed in. Depending on what state you live in, this may be illegal. You may want to contact the national office or the Department of Professional Regulation. I live in Florida and we have a licensure law here. I am curious to know more details of this matter if you would be interested in sharing more information.
technically i wouldnt think so. it becomes a scope of practice issue and
i do not think it is in their scope to cross discipline unless they are
certified. but, unless you are in a state with licensure, there may be no
tangible restriction. ethical: no, legal: grey area.
Legal, depends on your state.
Ethical. Canons say: NoGet more from the Web. FREE MSN Explorer download : <URL Redacted>
Citation
chris huff, “Responses to practitioner qualifications,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/221057.
