Dear Physician Letter... from Ed Skewes

Dear Physician Letter... from Ed Skewes

Wil

11/2/2012

Hello Colleagues and Guests,

In reading the Dear Physician letter recently posted by Ed Skewes, one
thing becomes clear. The regional CMS physicians have never practiced in
a for-profit setting, or they are simply trying to wage war between
patients, physicians, and prosthetists. Perhaps, both. For sure, they
seem to be succeeding with the latter. It would be very helpful if these
physicians would write and publish a sample medical record dictation
for lower limb prosthetic assessments. They should also include the
detailed prosthetic prescription in their sample. Then, the rest of us
would know how to comply with their policies. Better yet, a You-tube
video demonstrating their process of evaluation and prescription for a
lower limb amputee would be even more helpful.

The moral of the story is this. Until we get Medicare to authorize the
O&P practitioner as the legitimate evaluator for comprehensive O&P
care, things will continue to spiral downward and out of control in the
world of orthotics and prosthetics. Frankly, I don't think our amputee
citizens, in particular, have a clue as to what is about to happen with
their care. When the federal government starts telling physicians which
arm they can inject medicine into and on what days, we can take a line
from Houston, we have a problem. That is essentially what is happening
to the physicians right now regarding prosthetic care. The only folks
who profit and benefit from these CMS policies and regulations are the
folks who work for the federal government. Their salaries are paid
regardless of the outcomes, good or bad. It's as if they are running a
for-profit corporation at the detriment of the citizens they supposedly
represent.

There is a proposed O&P patient survey located at oandpsolutions.org
under documents, then survey. It would be interesting to hear some
feedback about such a survey. If folks are in favor, we need to get it
going. If it's not clear to you, please email me a note and I'll try to
clarify the process. Eventually, we need to present data to CMS and the
legislative bodies that support the importance of O&P care, as well as
the professional credentials held by orthotists and prosthetists. This
survey is but one prong of a multiple pronged plan to gather this evidence.

While I am at it, one more thing. I have been informed that it may be
possible for O&P practitioners to get the professional status within the
medical community. Here is my question. Does anyone have knowledge as to
how physicians, nurse practitioners, physician's assistants, physical
therapists, occupational therapists, athletic trainers, etc., were
granted the right to use CPT codes? Who made this decision and what was
the basis? As you can likely see, this puzzle gets more complicated as
we move along. But let me remind you of something similar. Do you
remember when a podiatrist could not perform surgery or admit patients
to a hospital? Even the AMA could not keep them out. Why then should O&P
professionals not be recognized within the medical community as
professionals? When we get to the bottom of this story, we will be well
on our way to turning the tide in favor of patients, physicians, and
orthotists and prosthetists.

Wil Haines, CPO
MaxCare Bionics
Avon, IN 46123