Dr.Sidney Fishman / Dr. of O & P Education and my friend!
tony barr
Description
Collection
Title:
Dr.Sidney Fishman / Dr. of O & P Education and my friend!
Creator:
tony barr
Date:
2/15/2005
Text:
> It is with great respect that I honor the life, the recent passing and the
> many important contributions made by the late Dr. Sidney Fishman, not as
> representing myself as a provider, but as a patient wanting to be better
> assured that I and millions of patients requiring proper O&P services
> receive them from only qualified and educated health care professionals.
>
> I am proud to of known and worked with him.
>
> I first had the privilege of meeting Dr.Fishman at the series of CMS /
> Negotiated Rules Committee Hearings which began in 2002 and lasted for
> about a hundred years!
>
> He was appointed as the alternate representative of the American Academy
> of Orthopedic Surgeons. I represented the Barr Foundation.
> Much to his colleagues chagrin, Dr. Fishman, on numerous occasions,
> expressed his concerns with CMS's little understanding of the surgeon's
> and physicians clinical contribution and responsibility to this process
> of determining a O&P provider's qualifications.
>
> It was at these meetings I noticed he was often alone during the breaks
> or he was quickly abandoned in any dialogue he had been having with the
> provider representatives whom were also in attendance and represented
> their interests at the hearings..
>
> I remember on more than one occasion, when I was speaking to a
> practitioner or industry leader during the breaks, as Dr.Fishman
> approached, he would say I gotta go, here comes Dr. of O&P Education !
>
>
> I said to myself what is wrong with O&P education ? That allured me since
> I was often receiving most of my for the sake of the patient
> education and advise from that same provider/credentialing/trade
> industry group of Neg Reg representatives, (must often in the Men's
> lavatory). I thought I would introduce myself to Dr. O&P Education and
> learn more.
>
> Coincidently, unbeknown to me, he had met my father 30 years previously.
> He, like myself, was an amputee advocate 35 years ago, and of all things,
> also believed O&P providers should be educated and that they should seek
> higher degrees of formal education in the O&P field, as do all others in
> any other legitimate health care profession. How crazy is that ? Sounded
> reasonable to me.
>
> Since this PhD had endured 50 more years of experience in this industry
> than I had and probably most of the participants of the hearings, I
> concluded it wouldn't to any harm in learning more about this man and his
> philosophies
>
> Sid and I became quite close in the hundred years during and two years
> following the turf wars in Baltimore, via frequent visits with him in
> Florida, many e-mails and many many lengthy telephone conversations. Like
> many PhDs there was no cutting to the chase in discussions with
> Sidney, so you had to be prepared to listen and to reply intelligently ! I
> think he took great delight in capturing a unrealistic reply or simplified
> solution from me ! The solution was far from simple but turned out to have
> precedence.
>
> He claimed the regulation drum I beat was secondary to mandating
> meaningful formal education requirements. He laughed when I ask why would
> any provider without a mandatory licensure requirement go to the expense
> or have the desire to become formally educated when absolutely no
> education criteria was required in 84 % of the states to legally provide
> O&P services ?! Why would colleges and post graduate universities have
> O&P courses if no one had to take them to progress in the field ?
>
> He was always interested in what I had to say, a mere BA degree graduate
> but one whom required these services and had daily contact with amputees
> that were victims of unqualified care or had minimal or non existent
> coverage.
>
> Although I may have not known him as long as some of you whom were
> fortunate to be educated by him, from a patient advocate's perspective, I
> found he was a wealth of information in providing the significant
> historical background of the industry, and more recently, trying
> desperately to revolve its providers into a worthy recognized health care
> profession.
> Some members on the CMS panel insisted formal education nor hands on
> experience was not necessary for a provider to fit prefabricated and
> central fabricated braces and prosthetic components and that since the
> demand of such specialized services outsourced the supply of providers we
> should lower the qualification criteria from none to less than none !
>
>
> Perhaps the most profound statement that I and as we, as patients,
> manufacturers, physicians, prosthetists ,orthotists , physical and
> occupational therapists should remember, and adamantly support, is his
> quote and excerpt in a May 21, 2004 submission to CMS, attached with a
> host of signatories, that reads like Who's Who of medical directors,
> clinical professors, physicians and Chief of Staffs of major hospitals and
> universities i.e. Shriners,Association of Children's Prosthetic-Orthotic
> Clinics,Hpward University, University of Southern California,Childrens
> Healthcare of Atlanta, Scottish Rite,etc.
>
> With the passage of time, one fact has remained unchallenged-that there
> was, and is, no existing, identifiable single occupational (professional
> or otherwise), in a position to provide the full range of
> prosthetic-orthotic services required by the skeletal and neuromuscular
> disabled population.
>
> Sidney Fishman,Ph.D
> Clinical Professor & Sr. Research Scientist,
> NYU Post Graduate Medical School
> Chairman & Professor,Dept.of Prosthetics& Orthotics,
> SEHNAP,NYU Retired
>
>
> Dr.Fishman was the only one of 26 representatives at the CMS hearings
> that was attempting to bring the various interests together not separate
> them.
>
> He advocated then and up to the time of his passing, that the clinical
> approach developed initially in the mid 1950's under the * Artificial
> Limb Program, conducted by the National Research Council (on behalf of the
> Veterans Administration) be activated to all civilian and adult recipients
> .These clinics consisted of a orthopedic surgeon, a physical or
> occupational therapist, and a prosthetist,all with appropiate specialized
> training in prosthetics. Later ,the clinic membership grew to include
> specialists in Rehabilitation Medicine and Orthotics, as research and
> development in orthotics matured.
>
> More can be read about this in the Prosthetics Research Board National
> Academy of Sciences-National Research Council 1958 publication, titled
> Artificial Limbs.
>
> Some fifty years later this clinic approach serves as the standard
> approach to the prosthetic-orthotic care provided for our pediatric and
> veteran population.
> If we can rely on the records, writings and experiences of the membership
> of the Association of Children's Prosthetic -Orthotic Clinics (ACPOC) as
> well as the Veterans Administration, why not consider this
> multi-discipline approach to the prosthetic-orthotic care of Medicare
> -Medicaid beneficiaries ?
> A reasonable approach, I thought.
>
> I can think of no other individual who loved the profession of O&P as
> much as Sidney, but was gradually loosing respect primarily due the
> profession's indifference and apathy, their inability to unite themselves
> and separate their educational credentials from the grasp of alphabet
> soap and turf wars that strategically unraveled from a handful of
> self serving entrepreneurs in a generally unregulated and unaccountable
> industry.
>
> Every provider whom would like to be EDUCATED and properly informed,
> should read Dr. Fishman's practical and precedent submission to CMS
> titled,
>
> RECOMMENDATIONS TO CMS REGARDING A MEDICAL APPROACH TO THE PAYMENT
> PROVISION FOR PROSTHETIC-ORTHOTIC SERVICES AND APPLIANCES
>
> and his published article
>
> THE EDUCATION OF THE PROFESSIONALLY COMPETENT ORTHOTIST/PROSTHETIST
>
> Dr.Fishman taught me two more important lessons. Its never too late to be
> properly educated.
> And that Dr.Fishman never really did retire !
>
> Thank you Sidney for everything you have done for advancing the need of
> O&P education and ...for me personally.
> Today's O&P providers may not need education to practice their trade but
> you may need more of it to save it !
>
> I leave you with one of Dr.Fishman's e-mails to me as we worked on the
> post Neg Reg/CMS submission which was offered, however not signed on by
> provider /industry groups and associations, prior to its submission to
> CMS on May 21, 2004
>
> Hope you don't mind Sidney. You are a hard act to follow !
>
>
> ==========================================================================
> ===============================================
> Tony: Responding to your encouraging E MAIL, I have revived my statement
> for inclusion in your submission to CMS with the understanding that I will
> take responsibility for its content. Let me have your reactions upon
> receipt and don't hesitate to suggest changes as you see fit. I will then
> do a final version.
>
> Best regards.
> SF
>
> It is readily apparent from the failure of the recent NEG-REG meetings to
> reach any agreements regarding the educational and experiential
> competencies of several allied health groups .(physical therapists,
> occupational therapists and orthotists). to provide custom-made appliances
> for Medicare and Medicaid beneficiaries, that proper patient care demands
> that this situation calls for urgent independent review and study by CMS.
> Bearing in mind the risks of oversimplifying a very complex situation
> which has been some half a century in the making, the following brief
> summary is offered.
>
> As a group the therapists receive a comprehensive. well-documented
> didactic training, and clinical exposure in the rehabilitation of
> individuals with neuro-muscular disorders which are offered within a
> medical setting(hospitals,clinics,medical offices etc.).However this
> includes little training or experience in the prescription, evaluation,
> measurement, custom fitting and delivery of the large number of
> sophisticated appliances required by the large variety of disabling
> conditions.Concurrently,as far as the certified practitioners are
> concerned, the current accreditation standards describe a limited and
> variable didactic training and experience in the medical sciences (i.e.:
> human anatomy, physiology, kinesiology) as well as the clinical
> characteristics of disabling diseases. It is to also to be noted that the
> overwhelming number of O&P certifees practice without any recognized
> academic degree to attest to his professional competence in his field of
> specialization.
>
> A solution may be found in a five year Masters Degree curriculum with a
> Specialization in Orthotics and Prosthetics, offered at existing
> accredited schools of: Allied Health where probably 75 to 80% of the
> necessary liberal arts, humanities as well as basic and medical sciences
> courses are already available to accommodate the additional O & P students
> within existing curricula offerings.. This educational approach becomes
> feasible in view of the recent development in O & P for skilled technical
> workers (a relatively new occupation )to fabricate appliances in
> centralized laboratories based on specifications provided by the
> clinically oriented O&P professional. . Accordingly the length of the
> specialized training required for individuals responsible for clinical
> patient care is being markedly reduced. and can be conveniently obtained
> during the last year or two of the individual's professional education.
> This educational model simply follows the one, successfully developed in
> Dentistry over many years.
>
> The history of the past 50 years presents indisputable evidence that such
> changes will not occur left to the adversarial groups per se, without
> joint leadership, direction and support from the medical community (i.e..
> AAOS & AAPM&R) and most importantly, governmental agencies such as CMS and
> others who fund research, education and /or clinical services in O&P.
>
>
> Sidney Fishman PhD
> Professor & Chairman (retired), Dep't of Prosthetics and Orthotics
> New York University
>
>
>
>
>
>
********************
To unsubscribe, send a message to: <Email Address Redacted> with
the words UNSUB OANDP-L in the body of the
message.
If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
Paul E. Prusakowski,CPO at <Email Address Redacted>
OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list. Professional credentials
or affiliations should be used in all communications.
> many important contributions made by the late Dr. Sidney Fishman, not as
> representing myself as a provider, but as a patient wanting to be better
> assured that I and millions of patients requiring proper O&P services
> receive them from only qualified and educated health care professionals.
>
> I am proud to of known and worked with him.
>
> I first had the privilege of meeting Dr.Fishman at the series of CMS /
> Negotiated Rules Committee Hearings which began in 2002 and lasted for
> about a hundred years!
>
> He was appointed as the alternate representative of the American Academy
> of Orthopedic Surgeons. I represented the Barr Foundation.
> Much to his colleagues chagrin, Dr. Fishman, on numerous occasions,
> expressed his concerns with CMS's little understanding of the surgeon's
> and physicians clinical contribution and responsibility to this process
> of determining a O&P provider's qualifications.
>
> It was at these meetings I noticed he was often alone during the breaks
> or he was quickly abandoned in any dialogue he had been having with the
> provider representatives whom were also in attendance and represented
> their interests at the hearings..
>
> I remember on more than one occasion, when I was speaking to a
> practitioner or industry leader during the breaks, as Dr.Fishman
> approached, he would say I gotta go, here comes Dr. of O&P Education !
>
>
> I said to myself what is wrong with O&P education ? That allured me since
> I was often receiving most of my for the sake of the patient
> education and advise from that same provider/credentialing/trade
> industry group of Neg Reg representatives, (must often in the Men's
> lavatory). I thought I would introduce myself to Dr. O&P Education and
> learn more.
>
> Coincidently, unbeknown to me, he had met my father 30 years previously.
> He, like myself, was an amputee advocate 35 years ago, and of all things,
> also believed O&P providers should be educated and that they should seek
> higher degrees of formal education in the O&P field, as do all others in
> any other legitimate health care profession. How crazy is that ? Sounded
> reasonable to me.
>
> Since this PhD had endured 50 more years of experience in this industry
> than I had and probably most of the participants of the hearings, I
> concluded it wouldn't to any harm in learning more about this man and his
> philosophies
>
> Sid and I became quite close in the hundred years during and two years
> following the turf wars in Baltimore, via frequent visits with him in
> Florida, many e-mails and many many lengthy telephone conversations. Like
> many PhDs there was no cutting to the chase in discussions with
> Sidney, so you had to be prepared to listen and to reply intelligently ! I
> think he took great delight in capturing a unrealistic reply or simplified
> solution from me ! The solution was far from simple but turned out to have
> precedence.
>
> He claimed the regulation drum I beat was secondary to mandating
> meaningful formal education requirements. He laughed when I ask why would
> any provider without a mandatory licensure requirement go to the expense
> or have the desire to become formally educated when absolutely no
> education criteria was required in 84 % of the states to legally provide
> O&P services ?! Why would colleges and post graduate universities have
> O&P courses if no one had to take them to progress in the field ?
>
> He was always interested in what I had to say, a mere BA degree graduate
> but one whom required these services and had daily contact with amputees
> that were victims of unqualified care or had minimal or non existent
> coverage.
>
> Although I may have not known him as long as some of you whom were
> fortunate to be educated by him, from a patient advocate's perspective, I
> found he was a wealth of information in providing the significant
> historical background of the industry, and more recently, trying
> desperately to revolve its providers into a worthy recognized health care
> profession.
> Some members on the CMS panel insisted formal education nor hands on
> experience was not necessary for a provider to fit prefabricated and
> central fabricated braces and prosthetic components and that since the
> demand of such specialized services outsourced the supply of providers we
> should lower the qualification criteria from none to less than none !
>
>
> Perhaps the most profound statement that I and as we, as patients,
> manufacturers, physicians, prosthetists ,orthotists , physical and
> occupational therapists should remember, and adamantly support, is his
> quote and excerpt in a May 21, 2004 submission to CMS, attached with a
> host of signatories, that reads like Who's Who of medical directors,
> clinical professors, physicians and Chief of Staffs of major hospitals and
> universities i.e. Shriners,Association of Children's Prosthetic-Orthotic
> Clinics,Hpward University, University of Southern California,Childrens
> Healthcare of Atlanta, Scottish Rite,etc.
>
> With the passage of time, one fact has remained unchallenged-that there
> was, and is, no existing, identifiable single occupational (professional
> or otherwise), in a position to provide the full range of
> prosthetic-orthotic services required by the skeletal and neuromuscular
> disabled population.
>
> Sidney Fishman,Ph.D
> Clinical Professor & Sr. Research Scientist,
> NYU Post Graduate Medical School
> Chairman & Professor,Dept.of Prosthetics& Orthotics,
> SEHNAP,NYU Retired
>
>
> Dr.Fishman was the only one of 26 representatives at the CMS hearings
> that was attempting to bring the various interests together not separate
> them.
>
> He advocated then and up to the time of his passing, that the clinical
> approach developed initially in the mid 1950's under the * Artificial
> Limb Program, conducted by the National Research Council (on behalf of the
> Veterans Administration) be activated to all civilian and adult recipients
> .These clinics consisted of a orthopedic surgeon, a physical or
> occupational therapist, and a prosthetist,all with appropiate specialized
> training in prosthetics. Later ,the clinic membership grew to include
> specialists in Rehabilitation Medicine and Orthotics, as research and
> development in orthotics matured.
>
> More can be read about this in the Prosthetics Research Board National
> Academy of Sciences-National Research Council 1958 publication, titled
> Artificial Limbs.
>
> Some fifty years later this clinic approach serves as the standard
> approach to the prosthetic-orthotic care provided for our pediatric and
> veteran population.
> If we can rely on the records, writings and experiences of the membership
> of the Association of Children's Prosthetic -Orthotic Clinics (ACPOC) as
> well as the Veterans Administration, why not consider this
> multi-discipline approach to the prosthetic-orthotic care of Medicare
> -Medicaid beneficiaries ?
> A reasonable approach, I thought.
>
> I can think of no other individual who loved the profession of O&P as
> much as Sidney, but was gradually loosing respect primarily due the
> profession's indifference and apathy, their inability to unite themselves
> and separate their educational credentials from the grasp of alphabet
> soap and turf wars that strategically unraveled from a handful of
> self serving entrepreneurs in a generally unregulated and unaccountable
> industry.
>
> Every provider whom would like to be EDUCATED and properly informed,
> should read Dr. Fishman's practical and precedent submission to CMS
> titled,
>
> RECOMMENDATIONS TO CMS REGARDING A MEDICAL APPROACH TO THE PAYMENT
> PROVISION FOR PROSTHETIC-ORTHOTIC SERVICES AND APPLIANCES
>
> and his published article
>
> THE EDUCATION OF THE PROFESSIONALLY COMPETENT ORTHOTIST/PROSTHETIST
>
> Dr.Fishman taught me two more important lessons. Its never too late to be
> properly educated.
> And that Dr.Fishman never really did retire !
>
> Thank you Sidney for everything you have done for advancing the need of
> O&P education and ...for me personally.
> Today's O&P providers may not need education to practice their trade but
> you may need more of it to save it !
>
> I leave you with one of Dr.Fishman's e-mails to me as we worked on the
> post Neg Reg/CMS submission which was offered, however not signed on by
> provider /industry groups and associations, prior to its submission to
> CMS on May 21, 2004
>
> Hope you don't mind Sidney. You are a hard act to follow !
>
>
> ==========================================================================
> ===============================================
> Tony: Responding to your encouraging E MAIL, I have revived my statement
> for inclusion in your submission to CMS with the understanding that I will
> take responsibility for its content. Let me have your reactions upon
> receipt and don't hesitate to suggest changes as you see fit. I will then
> do a final version.
>
> Best regards.
> SF
>
> It is readily apparent from the failure of the recent NEG-REG meetings to
> reach any agreements regarding the educational and experiential
> competencies of several allied health groups .(physical therapists,
> occupational therapists and orthotists). to provide custom-made appliances
> for Medicare and Medicaid beneficiaries, that proper patient care demands
> that this situation calls for urgent independent review and study by CMS.
> Bearing in mind the risks of oversimplifying a very complex situation
> which has been some half a century in the making, the following brief
> summary is offered.
>
> As a group the therapists receive a comprehensive. well-documented
> didactic training, and clinical exposure in the rehabilitation of
> individuals with neuro-muscular disorders which are offered within a
> medical setting(hospitals,clinics,medical offices etc.).However this
> includes little training or experience in the prescription, evaluation,
> measurement, custom fitting and delivery of the large number of
> sophisticated appliances required by the large variety of disabling
> conditions.Concurrently,as far as the certified practitioners are
> concerned, the current accreditation standards describe a limited and
> variable didactic training and experience in the medical sciences (i.e.:
> human anatomy, physiology, kinesiology) as well as the clinical
> characteristics of disabling diseases. It is to also to be noted that the
> overwhelming number of O&P certifees practice without any recognized
> academic degree to attest to his professional competence in his field of
> specialization.
>
> A solution may be found in a five year Masters Degree curriculum with a
> Specialization in Orthotics and Prosthetics, offered at existing
> accredited schools of: Allied Health where probably 75 to 80% of the
> necessary liberal arts, humanities as well as basic and medical sciences
> courses are already available to accommodate the additional O & P students
> within existing curricula offerings.. This educational approach becomes
> feasible in view of the recent development in O & P for skilled technical
> workers (a relatively new occupation )to fabricate appliances in
> centralized laboratories based on specifications provided by the
> clinically oriented O&P professional. . Accordingly the length of the
> specialized training required for individuals responsible for clinical
> patient care is being markedly reduced. and can be conveniently obtained
> during the last year or two of the individual's professional education.
> This educational model simply follows the one, successfully developed in
> Dentistry over many years.
>
> The history of the past 50 years presents indisputable evidence that such
> changes will not occur left to the adversarial groups per se, without
> joint leadership, direction and support from the medical community (i.e..
> AAOS & AAPM&R) and most importantly, governmental agencies such as CMS and
> others who fund research, education and /or clinical services in O&P.
>
>
> Sidney Fishman PhD
> Professor & Chairman (retired), Dep't of Prosthetics and Orthotics
> New York University
>
>
>
>
>
>
********************
To unsubscribe, send a message to: <Email Address Redacted> with
the words UNSUB OANDP-L in the body of the
message.
If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
Paul E. Prusakowski,CPO at <Email Address Redacted>
OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list. Professional credentials
or affiliations should be used in all communications.
Citation
tony barr, “Dr.Sidney Fishman / Dr. of O & P Education and my friend!,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 24, 2024, https://library.drfop.org/items/show/224287.
