Replies to ABC Assistant question

Replies to ABC Assistant question

Hewey, Bernard

10/14/2010

Below is my original post:

To all in the O&P profession/industry:

 What does everyone think of the very recent decision by ABC to resurrect the Assistant credential? When thinking of this, consider the minimum educational requirements, scope of practice, the objectivity of the employer attestation, the eventual impact on staffing (masters O&P clinicians vs. HS/GED assistants), state licensure, and other issues. Compare all of these issues in aggregate to those of other equivalent allied health professions and determine for yourself what this is all about. I would be very interested in hearing other opinions and discussions. I will post all responses.

Here are the replies so far:

In reply to your post, I would ask you to look a little in the future with what is going on today.
1) Look at the field and staffing today and who is providing what items
2) Read the OIG 2011 work plan for qualified practitioner
3) Read the article about Mr. Cohen and see what the dept of licensure found about his employee and its impact for his boss
4) Determine who needs to comply with the aspects of BIPA Section 427 for a qualified practitioner and the potential implications
5) What do the main O&P bodies feel is the defined qualified provider
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So after this, is this just a way to accommodate the future direction of the field, so the certified practitioner can see patients more efficiently, or are other factors influencing this.


I like the question...Here is what I have.

 * We need this certification now more than ever. (Increased number of patients with less CERTIFIED individuals to provide care)
 * Unfortunately I believe we fell short on the requirements. (I was hoping for bachelors level education. If things are going to master's why doesn't this level incorporate bachelors)?
 * Some owners that need help will sign off at any cost just so they can see/fit/treat more patients. (Increase revenue)
Devil is in the details and that's what I want to see. I think by allowing individuals this very simplistic way to achieve a CERTIFICATION what true value are you bringing to it? A look at P.T.A's they are at least an associates degree and believe they are moving to bachelors also. I like the fact that this gives the CTP, CTO & CTPO CERTIFICATIONS another avenue to become extenders and get techs more involved but only by decreasing the true value. People could and most likely will get hurt when individuals are put into positions that are not trained properly or have the proper education base.
Hope this helps the discussion.



I think the assistant credential is a great idea being brought back into focus. We CPO's spend too much time doing menial things.For instance, setting up for castings, removing casts and cleaning up afterwards. Also would be useful for let's say an in home AFO adjustment 20 miles away. I believe assistants should have a minimum two year college degree
If the qualified practitioner is the limiting factor and the costs to enter business reasonable, as well as the ease of obtaining private contracts, then the assistant aspect is moot. A person with a master's level likely has the drive and knowledge to be successful and able to think.
It is only when vast amounts of people start to hit the bumpy road that things will change. There are outside forces working that will create some issues. For example, senator Grassley just wrote a fairly nasty note to the head of hhs and medicare about the failure of the MAC and others to provide oversight. Things are changing, and the pressure is coming from the top down.
The sad thing is that Medicare and its oversight entrusted organizations to enforce the rules, which have not. How can one expect to have oversight, if the ABC, which one would think would support the practitioner it certifies, does not enforce the certification requirements of the law in their accredited facilities?
Where is the ABC acting to stop the podiatrists from providing diabetic shoes and inserts in areas other than rural health now that they have accepted the pedorthists? Where is the ABC limiting the facility accreditations of the stock and bill, where many from AOPA have stated there are issues? how does the stock and bill conform to the medicare supplier standards and why is there not a separate NPI for each stock and bill location? Is a surety bond needed for each NPI? Are there functional business aspects in the field that go against the anti-kickback statutes constituting many millions of dollars for a few companies?
As you can tell, when oversight does happen, it will be bumpy, hard, and meaningful.
How do we educate the student, so they make knowledgeable choices when the businesses control and own the schools? How do we keep these same students out of jail so they can replace those who do go?
How does the field obtain one unified certifying body to represent the practitioner?
Things will change. Too much is wrong and too many powerful groups are looking.



It is obvious to me what ABC is trying to do. In creating the master degree program they want the same office atmosphere as a physician might have, with the master cpo and several assistants for him to supervise. The only problem I see with this is the master cpo will not want to do much because he or she will want several assistants below him or her. This means that you will need a master cpo and 2 or 3 assistants which will cost to or maybe 3 times it does now. for personnel. I don't have a problem for anyone in our industry in making as much as they can, but where is the money goint to come from. Our hands are tied in the amount we recieve for our services how would we pay for the additional personel. I believe it is a big mistake in the pathway the ABC is going because I believe that it will be even harder to get qualified people to want to come into our industrie. Just some food for thought.


I personally think this is a real good idea as creates another position in our field, a slot that needs to be filled. It will also be interesting to see if the states with licensure, like Florida and Washington, recognize this title/credential/


NCOPE fully anticipates down the road (as ABC transitions this level in) that there will be an educational piece (could be a certificate, could be an associate's degree, etc.) Many details to be worked out and NCOPE has been asked to work with ABC. It actually has the possibility of creating a nice career ladder of technician - to assistant - to practitioner


I think it is another way to dilute the profession. At every turn the our profession is undermined by lowering standards. WE talk out of both sides of our mouth. We say that our patients deserve quality care from competent educated clinicians, yet try to pawn them off to the least qualified person for a particular task. I forget the exact lingo the office of the future-types use for this minimally qualified (read lowest paid) monkey, but I am sure you get my point. Most allied health professions have or are moving toward Masters level entry standards, and singular pathways to credentialing. Not us. I believe you get what you pay for. In 1999 the total for the formal education was around $120,000.00, the ABC Credential was about $300.00, a few years later some got it for $75.00. (SEE HOW THAT WORKS.)



Thank you for your interest in the ABC Certified Assistant credential. Please let me assure you that the ABC Board of Directors made the decision to revitalize the credential after several years of discussion, review of the needs of the profession, and after urging from the profession. The Board believes the model of care and business environment is changing and this credential has a valid place in the continuum of care.

The Task Force that will develop Phases 2 and 3 of the credential's eligibility criteria is made up of representatives which includes an official representative from NCOPE to assist with future educational criteria. Since there are no current assistant level programs we hope to explore the opportunities available to interested individuals, now and in the future.
We look forward to announcing Phases 2 and 3 as they are developed


As demonstrated above, there is a wide range of opinions on this important issue. As this development progresses I hope that everyone who may be effected by the changes communicates their perspectives to the appropriate entities.

Bernard Hewey, CPO