FW: [OANDP-L] APTA Comments on DMEPOS Quality Standards
Robert Rhodes, CPO
Description
Collection
Title:
FW: [OANDP-L] APTA Comments on DMEPOS Quality Standards
Creator:
Robert Rhodes, CPO
Date:
12/7/2005
Text:
Good afternoon, Everyone,
I think the key word in this communication is Checkout. This was a procedure, if not devised, at least promulgated by NYU in which a PT was to Check-out the work of the orthotist or prosthetist before it was delivered to the patient. I was lucky enough to have attended Northwestern where this procedure was seen as demeaning. In orthotics we didn't Check anything and in Prosthetics, Mr. Gehl said, The good prosthetist always checks out his own work.
When I first went there we attended an orthotic clinic in RIC that the orthotist didn't even attend. He took the orthosis to the door, gave it to a PT who took it into the clinic, fit it and brought it back to the orthotist with instructions (if there were any). The orthotist never saw the patient for fitting!
The Dental Model, as described, puts the orthotist or prosthetist in the role of the technician and the PT in the role of the dentist.
I would hardly call this model workable for today's orthotist and prosthetist. I can see, however, that if a PT, or group of PT's, only have an outdated view of orthotists and prosthetists, such a model would make very good sense to them.
IMHO
Robert
--
Robert L. Rhodes, MPA, CO
Clinical Director, MSOP
Eastern Michigan University
-------------- Forwarded Message: --------------
From: Sheredos, Carol (NIH/NICHD) < <Email Address Redacted> >
To: <Email Address Redacted>
Subject: [OANDP-L] APTA Comments on DMEPOS Quality Standards
Date: Tue, 6 Dec 2005 20:51:17 +0000
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
TE=/CM/ContentDisplay.cfm>
<URL Redacted>
E=/CM/ContentDisplay.cfm, 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
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
entDisplay.cfm&CONTENTID=3D27264>
<URL Redacted>
ntDisplay.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.
<URL Redacted>
Paul Oswald CPO
Director O&P Program
OSU-Okmulgee
918-293-5327
<Email Address Redacted>
I think the key word in this communication is Checkout. This was a procedure, if not devised, at least promulgated by NYU in which a PT was to Check-out the work of the orthotist or prosthetist before it was delivered to the patient. I was lucky enough to have attended Northwestern where this procedure was seen as demeaning. In orthotics we didn't Check anything and in Prosthetics, Mr. Gehl said, The good prosthetist always checks out his own work.
When I first went there we attended an orthotic clinic in RIC that the orthotist didn't even attend. He took the orthosis to the door, gave it to a PT who took it into the clinic, fit it and brought it back to the orthotist with instructions (if there were any). The orthotist never saw the patient for fitting!
The Dental Model, as described, puts the orthotist or prosthetist in the role of the technician and the PT in the role of the dentist.
I would hardly call this model workable for today's orthotist and prosthetist. I can see, however, that if a PT, or group of PT's, only have an outdated view of orthotists and prosthetists, such a model would make very good sense to them.
IMHO
Robert
--
Robert L. Rhodes, MPA, CO
Clinical Director, MSOP
Eastern Michigan University
-------------- Forwarded Message: --------------
From: Sheredos, Carol (NIH/NICHD) < <Email Address Redacted> >
To: <Email Address Redacted>
Subject: [OANDP-L] APTA Comments on DMEPOS Quality Standards
Date: Tue, 6 Dec 2005 20:51:17 +0000
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
TE=/CM/ContentDisplay.cfm>
<URL Redacted>
E=/CM/ContentDisplay.cfm, 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
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
entDisplay.cfm&CONTENTID=3D27264>
<URL Redacted>
ntDisplay.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.
<URL Redacted>
Paul Oswald CPO
Director O&P Program
OSU-Okmulgee
918-293-5327
<Email Address Redacted>
Citation
Robert Rhodes, CPO, “FW: [OANDP-L] APTA Comments on DMEPOS Quality Standards,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/225834.
