FW: [OANDP-L] P&O vs DME

FW: [OANDP-L] P&O vs DME

tony barr

6/4/2004

My read to the question, recently sent to the list serve subscribers below,
is the partial solution begins with forming the foundation of a united
front, which is presented and available NOW by all O&P professionals, thru
joining the Academy.
Start by uniting your badly splintered and divided profession.
With their newly enacted by-laws AAOP can help stop the division that has
occurred for far too many years in the profession. You got to get inside
the system to change the system.

See <URL Redacted>

The voting ballots have been mailed to the Academy's membership and must be
returned to the Academy by June 5, said Academy President Don E. Katz, CO,
LO, FAAOP. A two-thirds majority of those voting must be in the affirmative
for the bylaws to pass, he added.

Although I strongly disagree with the Academy position that state licensed
Orthotists and prosthetists are not eligible for the Active AAOP membership
classification, alternative credentialing eligibility for AAOP affiliate
membership would increase your professional membership(under a strong
platform of promoting state licensure)generate a stronger legislative voice
to separate O&P from DME and unify both credentialed practitioner groups at
a time that is crucial to your profession.I have always had a hard time
recognizing any health care provider as legitimate and properly trained when
they are not required to have a state license. It is the only 'legitimate
health care service I know of that is not regulated in all 50 states.

Isn't the real enemy here to both patients and your credability as a
legitimate health care profession, the unqualified and uncertified
providers that are practicing your profession and the perception by law
makers that O&P is DME?

My take is that this field can be viewed as a united profession under one
professional association and better assure all 50 states get regulated,
provided AAOP would consider a more unified policy on promoting such
efforts!

Perhaps a mere patient of your services,like myself, whom is not a
practitioner nor credentialed, but somewhat familiar with the ongoing strife
and controversy in your profession, can make better make suggestions
without prejudice.

Professional unity via professional unification of both credentials and a
manatory state license thru the Academy not BOC and ABC.

The Academy ,thru a membership by-law change, not via a board of directors
or management committee decision, has allowed BOC practitioners eligibility
to Academy membership. I urge you to support the proposed By-Laws changes.


The NEW Academy can further provide the much needed unity of both
certification credential providers under one professional umbrella and the
leadership(?) of ABC and BOC can sit on the sidelines and see what happened
as the result of their on going feuding and bickering !

A united front of ABC/BOC/and PT practitioners membership in the Academy's
can lead to support and sponsorship of a National Licensure Conference,
which can help all individual states become licensed and the requirement of
a certification is less meaningful.

Yes did you know that PTs OTs and other health care providers,
pedorthotists,podiatrists,physicians,rehab enginers,case managers are
eligible for Academy membership already? Unite all providers of O&P services
under one professional association umbrella.

The NEW Academy as a professional organization of approx 3,000, can show
more strength in numbers, can better unite on defending encroachment of
other O&P providers and stop all of this nonsense.....NOW.
Your profession needs numbers and here lies before you an opportunity.

Now before all you ABC diehards start sending in your posts of disagreement,
keep in mind that many of you were mailed your certificates in the early
years of ABC and all licensure acts in 10 states were passed because 3-5
year grandfather criteria for ABC,BOC and non certified practitioners was
established in every regulated state.

Once licensure acts are enacted in all 50 states, you can better assure
preventing encroachment of your profession and decide where to put
optional certification insignias next to perhaps more meaningful
credentials, LP,LO and LPO.

Don't you think the time has come for your field to be recognized as
professional providers of O&P services and to make the transition from
certified practitioner to licensed health care provider?

The Academy leadership and Academy members agrees.

The point being my friends, as Gary Lamb LPO,FAAOP ,past president of the
Academy and Chairman of the Legislative Advocacy Committee of AAOP,
correctly pointed out in the February 15, O&P Business News.
any state without licensure of O&P has no standing. This means that
physical therapists (and other licensed health care providers) can simply
change their practice act in that state to provide O&P care...Then it
becomes illegal for Orthotists and prosthetists(credentialed or
uncredentialed) to deliver the care they have traditionally provided.

James Cobb BOC
I attended the meeting in the Reno about the ABC-BOC merger talks and have
also been reading most of the posts on this forum as well. I definitely see
both sides of the coin. Here is my side. Every organization has good
points and bad points. I have never been apart any organization nor heard
of one that has satisfied 100 percent of it members. As a community of
professionals we are all facing a grim future of insurance cut backs and
reduction of benefits. We all need to be united in our fight to be allowed
provide patient care. The million dollar question is how can we become
united? We have two major certifying organizations with different avenues
both being allowed to practice the same medicine. Unfortunately both have
been pitted against each other and now our fight is against each other
instead of against legislation. There are a lot of proud practitioners both
ABC and BOC. Each feel stepped on. It has now become personal.

I agree with Mr. Barr that every organization needs a good shaking up.
This shaking up gets every ones opinions out on the table. Communication
is our best tool, the lack of communication is our worst enemy. Every one
in our profession at one time or another has thought or at least heard
someone say that ABC certification is better than BOC. I have personally
read many classifieds that asked for at least BOC certification. This
implies that ABC practitioners utilize a higher standard of care than BOC.
This again starts another thousand arguments and hurt feelings. Point
being, we do need one set standard of practicing medicine, one credentialing
body, and one huge voice shouting together in Washington D.C. I have a lot
of friends ABC and BOC. I have a lot of friends who are doctors, nurses and
therapists. We honestly look weak as a whole in the medical community. We
need to strengthen and unite together. We also need to weed out the weak on
both sides of the ABC-BOC street. Maybe we should think of these points
before merger talks begin again. First, at a minimum all practitioners
must of have completed a residency or a minimum hour trade course to ensure
formal education. The problem with straight OJT is someone can't teach it
if they don't know it. A professors job is to know it, all of it.

Secondly, make everyone immediately retake an examination of their
respective field/s. This will weed out some people; which is a good thing.
Lastly, mandate tests or boards every 4-5 years along with CEU's. If we
are going to unite we must all prove to be equal and then must set high
standards for people to maintain. I really am not trying to anger anyone.
I am trying to get us to think together as a whole for a resolution to the
problem. The government and insurance companies will not wait for us to
sort out our problems. I read a post earlier talking about animals and
getting attacked when we are the weakest. Well friends, our community is
very shaky right now. We need to be looking out for each other not hurting
each other.



Ronald Gingras FAAOP,LPO
I believe it is time for a paradigm shift. Our credentialing should come
from AAOP. The only elected group of professionals that we have. We AAOP
members need to encourage AAOP to feel empowered to assume the leadership
role and responsibility regarding educational standards/credentials in
addition to what they already do.AAOP has taken a leadership role and done a
remarkable job with so many issues for years, to mention a few, education,
research, continuing education, and professional development issues .They
are true to our mission/profession. Our educational issues and the
development of our profession better aligns with AAOP than where they
currently operate from .I believe ABC should only be about the test, not the
standards.
Professional standards should be regulated by professionals exclusively.

Ralph W. Nobbe,FAAOP, CPO
Thanks Tony - for a thoughtful and professionally appropriate solution.This
may be the most viable solution to this seemingly insurmountable problem. If
than Academy can accept the induction of members through alternative
credentialing sources it may prove that this field can rise above the
infighting and truly be professionals and then become a unified front.

I believe professional education and furthering of standards are also in the
long term best interest of the Academy.

Joan Cestraro CP, recently and appropriately pointed out:
the bigger picture here is the fact that ABC practitioners have absolutely
no say in the decisions of the ABC Board- a board that represents US?.They
can (and have) made a decision that affects each of us deeply and we just
have to live with it. It's a done deal and we can do nothing about it
except whine and complain. We cannot vote to oust the board or elect
different leadership next year. We were given no debate in this issue. What
can Practitioners do and where can we turn to unite to democratically elect
a board that will serve the interests of its members and make decisions
based on the opinions of the majority and not a few appointed from within,
good old boys/gals? Isn't that the larger and more important issue NOW?
Let's now focus on WHY we are all frustrated and what we can all do to
prevent such non democratic decisions in the future. We often take for
granted the fact that we live in a democratic society until we are part of
something like this.

Just as important, once united under one professional umbrella you can
separate your services from DME and get on with many projects described by
the NEW Academy's aggressive plans for Project Quantum Leap :

1) the task of educating third party payers and legislators that you provide
a legitimate health care service and patient care along with a product, not
just retail services.

2) Presenting O&P as a career option so we can ensure the viability of the
field in the profession Don Katz ,CO, President of the Academy.

3) Developing a pathway of expansion for O&P Masters and doctoral degrees.

4) resolve the serious dilemma of the deficit in advanced educational
opportunities in O&P.

5)Develop a master agenda for priority topics (like conducting a National
Licensure Conference) and method for planning and conducting consensus
conferences.

Who knows one day perhaps AAOP might even include a consumer/patient member
to your board of directors.
I maybe available and eligible as I am already a honorary member of FAOP,
AND provided the unity of all O&P professionals is embraced by the Academy.

Vote yes for the proposed by-law change and help unite your profession. Its
not a perfect solution to your dilemma but it's a damn good start.

Barr Foundation
www.oandp.com/barr
www.ertlreconstruction.com


-----Original Message-----
From: Orthotics and Prosthetics List [mailto:<Email Address Redacted>] On
Behalf Of <Email Address Redacted>
Sent: Thursday, June 03, 2004 11:54 PM
To: <Email Address Redacted>
Subject: [OANDP-L] P&O vs DME

Dear Colleagues:

I am sure that the following is not only an issue in the state of
Washington, but it is a national issue. We have now had 2 major insurance
companies pretty much give us a 'NON NEGOTIABLE FEE' policy with regard
contract renewal. We either accept the fee schedule which is below Medicare,
or we loose our preferred status and will not be able to regain it in the
future. (Is this even legal I wonder?)

However, the major reason for this attitude, I believe, is because we are
associated with DME and we are not seen as the professionals that we are.
Every other specialty within the realm of Rehabilitation Medicine is seen as
a professional and not DME although they do treat patients with Orthotic
devices.

So how do we tackle this issue? Our national associations should have taken
care of this issue many moons ago and maybe they have tried unsuccessfully,
but we need to change this DME stigma if we want to see longevity of our
profession. We are putting so much effort into raising the standard of
education, introducing residency programs, licensing in many states, etc.,
and I am all for that. But what is the point if our profession is
categorized as VENDORS!

We need to come together as a profession and employ a lobbyist,
representative, I have no idea who can take care of this for us, but we need
to get ourselves deforced from DME. My company will be the first to pledge
funds for this purpose. If we all join in we can do this, as we did with
licensure.

Lets come up with a solution.

John Hattingh LPO