Re: Comment on Qualifications
Tony Barr
Description
Collection
Title:
Re: Comment on Qualifications
Creator:
Tony Barr
Date:
12/14/2005
Text:
Good point Steven but application of any orthotics and prosthetics to those
who have been trained to best provide those services is not necessarily
on target due to a couple of major obstacles.
1) All PTS are state licensed in every state, and not all prosthetists and
orthotists are licensed , certified nor qualified .
Some states may or may not have included in the PTs regulation act within
their Scope of Services, the legal ability to provide comprehensive O&P
services.
2) Even those O&P provders whom are certified (optional in most states) in
one allied health care science in unregulated states, of providing say,
comprehensive orthotic services, can legally perform, provide and bill for
the delivery of comprehensive prosthetic services when they have absolutely
no training in that particular field !
And visa versa. Surley everone can attest that they are two distincly
different health care sciences?
How does certification protect the public or for that matter, the integrity
of your profession?
It amazes me how many O&P providers can be so judgamental with another
licensed health care profession on their ability to properly evaluate and
provide O&P services when :
1) Most O&P providers are unlicensed and even a certification is optional in
the majority of states.
2) Both certification accredidation boards have no restrictions to cross
credentialing nor provide accountability or oversight to their certifees
thru their Cannons of Ethics.
Those of you that may have an interest shouold read Dr.Sidney Fishman's
e-mail to me shortly before his passing.
Dr.Fishman was fondly known by many of his admirers as the Father of O&P
education.
Below he offers solutions and not attacks.Thanks Sidney.
> 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
>
>
>
Tony Barr
-----Original Message-----
From: Orthotics and Prosthetics List [mailto:<Email Address Redacted>] On
Behalf Of Steven L. Fries, CPO
Sent: Wednesday, December 14, 2005 1:42 PM
To: <Email Address Redacted>
Subject: [OANDP-L] Comment on Qualifications
Dear List:
I have read all of the letters related to the issue of PT's wanting to
practice orthotics and prosthetics and would like to suggest, with all due
respect, that it is professionally and clinically inappropriate to engage
in a profession as technologically complex as O&P without formal education,
testing, credentialing and licensure. The saying that you don't know what
you don't know would seem to be applicable in this instance. I do not
wish to offend any of our aspiring PT colleagues, but I must encourage you
to stick to what you know and do best and leave the evaluation,
engineering, design, fabrication and application of any orthotics and
prosthetics to those who have been trained to best provide those services.
Steven Fries, LPO
who have been trained to best provide those services is not necessarily
on target due to a couple of major obstacles.
1) All PTS are state licensed in every state, and not all prosthetists and
orthotists are licensed , certified nor qualified .
Some states may or may not have included in the PTs regulation act within
their Scope of Services, the legal ability to provide comprehensive O&P
services.
2) Even those O&P provders whom are certified (optional in most states) in
one allied health care science in unregulated states, of providing say,
comprehensive orthotic services, can legally perform, provide and bill for
the delivery of comprehensive prosthetic services when they have absolutely
no training in that particular field !
And visa versa. Surley everone can attest that they are two distincly
different health care sciences?
How does certification protect the public or for that matter, the integrity
of your profession?
It amazes me how many O&P providers can be so judgamental with another
licensed health care profession on their ability to properly evaluate and
provide O&P services when :
1) Most O&P providers are unlicensed and even a certification is optional in
the majority of states.
2) Both certification accredidation boards have no restrictions to cross
credentialing nor provide accountability or oversight to their certifees
thru their Cannons of Ethics.
Those of you that may have an interest shouold read Dr.Sidney Fishman's
e-mail to me shortly before his passing.
Dr.Fishman was fondly known by many of his admirers as the Father of O&P
education.
Below he offers solutions and not attacks.Thanks Sidney.
> 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
>
>
>
Tony Barr
-----Original Message-----
From: Orthotics and Prosthetics List [mailto:<Email Address Redacted>] On
Behalf Of Steven L. Fries, CPO
Sent: Wednesday, December 14, 2005 1:42 PM
To: <Email Address Redacted>
Subject: [OANDP-L] Comment on Qualifications
Dear List:
I have read all of the letters related to the issue of PT's wanting to
practice orthotics and prosthetics and would like to suggest, with all due
respect, that it is professionally and clinically inappropriate to engage
in a profession as technologically complex as O&P without formal education,
testing, credentialing and licensure. The saying that you don't know what
you don't know would seem to be applicable in this instance. I do not
wish to offend any of our aspiring PT colleagues, but I must encourage you
to stick to what you know and do best and leave the evaluation,
engineering, design, fabrication and application of any orthotics and
prosthetics to those who have been trained to best provide those services.
Steven Fries, LPO
Citation
Tony Barr, “Re: Comment on Qualifications,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 24, 2024, https://library.drfop.org/items/show/225814.
