Re: APTA Comments on DMEPOS Quality Standards
Karl Entenmann
Description
Collection
Title:
Re: APTA Comments on DMEPOS Quality Standards
Creator:
Karl Entenmann
Date:
12/8/2005
Text:
Hello Carol,
You walked right into this one.
In your response to Paul Oswalds' concern regarding physical therapists claiming to be qualified to fabricate prostheses and orthoses, you describe exactly why Mr. Oswald and all of us in the O and P profession should be concerned about the official stance of the APTA. You state that PTs are licensed and knowledgeable about prosthetic and orthotic components, appropriate prescription, proper fit, fabrication, and training in control of the device. Then you suggest the dental model, where the PT would measure and take a cast of the residual or affected limb, as a dentist would take an impression of the mouth/teeth to be fitted. Then the casting and measurements would be sent to the prosthetist/orthotist for fabrication of the initial device and the definitive prosthesis or orthosis, as the dentist would send the impression and measurements to the lab (???). The O&P professional could be very involved in the final stages, depending on logistics and agreements between the!
CPO and
the PT. The PT would work with the patient, the O&P professional, and the physician in all - but especially the final - phases of fitting and delivery of the definitive device.
Well thank you, Carol, for including the O and P profession as the lab that fabricates the device for the physical therapists. And you wonder why many in the O and P profession are concerned about the direction the APTA is going in regards to orthotics and prosthetics. I am very happy that a license is required to practice orthotics and prosthetics in Washington State, and I hope more states implement licensing for O and P. We have, and will, continue to moniter the activities of the APTA in Washington. And, we are not being paranoid.
Sincerely,
Karl W. Entenmann, CPO, LPO
Preferred O and P
Federal Way, WA
Sheredos, Carol (NIH/NICHD) < <Email Address Redacted> > wrote:
In my unofficial response to Paul Oswald's comments concerning the APTA statement to CMS regarding PT qualifications to fabricate prostheses and orthoses (see below), I would say -- Stop being so paranoid!
PTs do have a very long history of being involved in the prescription, fitting, and checkout of customized prosthetics and orthotics. (including gait) are - and have been - an integral part of the PT knowledge base. PT state board exams include these aspects of O & P. A physical therapist may choose to concentrate on amputee management, including O&P.
In the practical world, PTs do not get involved in the day-to-day fitting and fabrication of O&P. The APTA statement is very clear in pointing out the limitations of this part of PT practice -- On page 6 of the referenced letter <URL Redacted>, the author - G. Dave Mason, VP of Government Affairs - states that Although physical therapists fabricate immediate post-op castings and fittings and temporary prosthetics, physical therapists do not fabricate final or definitive prostheses. PTs for the most part simply do not get into the business of fabricating definitive prostheses - We do not have the equipment, materials, or time do do so. Every PT I know (I have been in practice for 40 years) would (and does) prefer to work with the prosthetist/orthotist. PTs do not want to be prosthetists or orthotists - Or they would have attended O&P school.
The late Sidney Fishman, Ph.D., had a very workable solution to all of this -- The dental model, where the PT would measure and take a cast of the residual or affected limb, as a dentist would take an impression of the mouth/teeth to be fitted. Then the casting and measurements would be sent to the prosthetist/orthotist for fabrication of the initial device and the definitive prosthesis or orthosis, as the dentist would send the impression and measurements to the lab. The O&P professional could be very involved in the final stages, depending on logistics and agreements between the CPO and the PT. The PT would work with the patient, the O&P professional, and the physician in all - but especially the final - phases of fitting and delivery of the definitive device. The PT is always responsible to the patient, the physician, and to the practice standards in each state. PTs are held accountable for all aspects of practice in which they choose to engage. That includes the degree !
of
involvement in O&P, based on education and experience. To discount this fact is to denigrate the value of licensure.
The continual paranoia of the O&P profession regarding the role of the physical therapist in the O&P field is unwarranted and damaging. We have coexisted and worked together for years, despite the fact that O&Ps have historically been unlicensed. Clean up the O&P house - Obtain state licensure. Forge relationships with PTs. Stop the turf wars and let's move on.
-- Carol A. Sheredos, PT, MA
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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.
You walked right into this one.
In your response to Paul Oswalds' concern regarding physical therapists claiming to be qualified to fabricate prostheses and orthoses, you describe exactly why Mr. Oswald and all of us in the O and P profession should be concerned about the official stance of the APTA. You state that PTs are licensed and knowledgeable about prosthetic and orthotic components, appropriate prescription, proper fit, fabrication, and training in control of the device. Then you suggest the dental model, where the PT would measure and take a cast of the residual or affected limb, as a dentist would take an impression of the mouth/teeth to be fitted. Then the casting and measurements would be sent to the prosthetist/orthotist for fabrication of the initial device and the definitive prosthesis or orthosis, as the dentist would send the impression and measurements to the lab (???). The O&P professional could be very involved in the final stages, depending on logistics and agreements between the!
CPO and
the PT. The PT would work with the patient, the O&P professional, and the physician in all - but especially the final - phases of fitting and delivery of the definitive device.
Well thank you, Carol, for including the O and P profession as the lab that fabricates the device for the physical therapists. And you wonder why many in the O and P profession are concerned about the direction the APTA is going in regards to orthotics and prosthetics. I am very happy that a license is required to practice orthotics and prosthetics in Washington State, and I hope more states implement licensing for O and P. We have, and will, continue to moniter the activities of the APTA in Washington. And, we are not being paranoid.
Sincerely,
Karl W. Entenmann, CPO, LPO
Preferred O and P
Federal Way, WA
Sheredos, Carol (NIH/NICHD) < <Email Address Redacted> > wrote:
In my unofficial response to Paul Oswald's comments concerning the APTA statement to CMS regarding PT qualifications to fabricate prostheses and orthoses (see below), I would say -- Stop being so paranoid!
PTs do have a very long history of being involved in the prescription, fitting, and checkout of customized prosthetics and orthotics. (including gait) are - and have been - an integral part of the PT knowledge base. PT state board exams include these aspects of O & P. A physical therapist may choose to concentrate on amputee management, including O&P.
In the practical world, PTs do not get involved in the day-to-day fitting and fabrication of O&P. The APTA statement is very clear in pointing out the limitations of this part of PT practice -- On page 6 of the referenced letter <URL Redacted>, the author - G. Dave Mason, VP of Government Affairs - states that Although physical therapists fabricate immediate post-op castings and fittings and temporary prosthetics, physical therapists do not fabricate final or definitive prostheses. PTs for the most part simply do not get into the business of fabricating definitive prostheses - We do not have the equipment, materials, or time do do so. Every PT I know (I have been in practice for 40 years) would (and does) prefer to work with the prosthetist/orthotist. PTs do not want to be prosthetists or orthotists - Or they would have attended O&P school.
The late Sidney Fishman, Ph.D., had a very workable solution to all of this -- The dental model, where the PT would measure and take a cast of the residual or affected limb, as a dentist would take an impression of the mouth/teeth to be fitted. Then the casting and measurements would be sent to the prosthetist/orthotist for fabrication of the initial device and the definitive prosthesis or orthosis, as the dentist would send the impression and measurements to the lab. The O&P professional could be very involved in the final stages, depending on logistics and agreements between the CPO and the PT. The PT would work with the patient, the O&P professional, and the physician in all - but especially the final - phases of fitting and delivery of the definitive device. The PT is always responsible to the patient, the physician, and to the practice standards in each state. PTs are held accountable for all aspects of practice in which they choose to engage. That includes the degree !
of
involvement in O&P, based on education and experience. To discount this fact is to denigrate the value of licensure.
The continual paranoia of the O&P profession regarding the role of the physical therapist in the O&P field is unwarranted and damaging. We have coexisted and worked together for years, despite the fact that O&Ps have historically been unlicensed. Clean up the O&P house - Obtain state licensure. Forge relationships with PTs. Stop the turf wars and let's move on.
-- Carol A. Sheredos, PT, MA
********************
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
Karl Entenmann, “Re: APTA Comments on DMEPOS Quality Standards,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 23, 2024, https://library.drfop.org/items/show/225789.
