APTA Comments on DMEPOS Quality Standards
Sheredos, Carol (NIH/NICHD)
Description
Collection
Title:
APTA Comments on DMEPOS Quality Standards
Creator:
Sheredos, Carol (NIH/NICHD)
Date:
12/6/2005
Text:
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. PTs are licensed and knowledgeable about prosthetic and orthotic components, appropriate prescription, proper fit, fabrication, and training in control of the device (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>> <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. 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. 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
_____
Date: Mon, 5 Dec 2005 08:55:39 -0600
From: Oswald, Paul Trent < <Email Address Redacted> >
Subject: PT statement
This is from the APTA website. Brazen comes to mind. Am I the only one who is taken back by the statement that the PTs should not be held to the same standard as O&P and DME providers? Food for thought! Are we choking yet?
APTA Comments on DMEPOS Quality Standards
APTA stressed physical therapists' qualifications and long history of successfully furnishing patients with customized orthothics and prosthetics, as appropriate, in comments < <URL Redacted>> http://www.apta.org/AM/Template.cfm?Section=3DOther_Issues&TEMPLATE=3D/C=M/ContentDisplay.cfm&CONTENTID=3D27264 submitted this week on proposed Medicare quality standards for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). Pointing out that the Centers for Medicare & Medicaid Services (CMS) did not consult therapists and other relevant parties in the development of the standards, APTA contended that the same standards should not apply to physical therapists enrolled in Medicare as apply to orthotists/prosthetists and DMEPOS companies.
The Association argued that licensed physical therapists already follow strict guidelines and are qualified to furnish customized orthotics and prosthetics to their patients as appropriate.
< http://www.apta.org/AM/Template.cfm?Section=3DCurrent_Issue#article27275 > http://www.apta.org/AM/Template.cfm?Section=3DCurrent_Issue#article27275
Paul Oswald CPO
Director O&P Program
OSU-Okmulgee
918-293-5327
<Email Address Redacted>
PTs do have a very long history of being involved in the prescription, fitting, and checkout of customized prosthetics and orthotics. PTs are licensed and knowledgeable about prosthetic and orthotic components, appropriate prescription, proper fit, fabrication, and training in control of the device (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>> <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. 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. 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
_____
Date: Mon, 5 Dec 2005 08:55:39 -0600
From: Oswald, Paul Trent < <Email Address Redacted> >
Subject: PT statement
This is from the APTA website. Brazen comes to mind. Am I the only one who is taken back by the statement that the PTs should not be held to the same standard as O&P and DME providers? Food for thought! Are we choking yet?
APTA Comments on DMEPOS Quality Standards
APTA stressed physical therapists' qualifications and long history of successfully furnishing patients with customized orthothics and prosthetics, as appropriate, in comments < <URL Redacted>> http://www.apta.org/AM/Template.cfm?Section=3DOther_Issues&TEMPLATE=3D/C=M/ContentDisplay.cfm&CONTENTID=3D27264 submitted this week on proposed Medicare quality standards for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). Pointing out that the Centers for Medicare & Medicaid Services (CMS) did not consult therapists and other relevant parties in the development of the standards, APTA contended that the same standards should not apply to physical therapists enrolled in Medicare as apply to orthotists/prosthetists and DMEPOS companies.
The Association argued that licensed physical therapists already follow strict guidelines and are qualified to furnish customized orthotics and prosthetics to their patients as appropriate.
< http://www.apta.org/AM/Template.cfm?Section=3DCurrent_Issue#article27275 > http://www.apta.org/AM/Template.cfm?Section=3DCurrent_Issue#article27275
Paul Oswald CPO
Director O&P Program
OSU-Okmulgee
918-293-5327
<Email Address Redacted>
Citation
Sheredos, Carol (NIH/NICHD), “APTA Comments on DMEPOS Quality Standards,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/225790.
