Sad day for me!

Darya Shahrokhi

Description

Title:

Sad day for me!

Creator:

Darya Shahrokhi

Date:

12/3/2020

Text:

Today was a sad day for me! I had a 47 y.o patient who had a car accident 4 years ago, with brain damage, and left side paralyzed. Today she was referred to me by her physical therapist for AFO and wrist brace evaluation. She has foot drop and severe wrist flexion contracture. These are all symptoms of hemiplegia and although usually there is no treatment for it, but we can manage the symptoms.

HOWEVER & unfortunately in the last 4 years, she never received any orthotic management! Nothing at all!

As far as her lower extremity, after fitting a simple carbon fiber AFO, she walks way better with no foot drop and more knee stability.

But PLEASE look at the image of her wrist; severe rigid flex. contracture; no active/passive ROM.

Why? Is it because:
Her MD didn’t know about the wrist braces?
Or knew but didn’t want to take enough time to order one?
Or didn’t think that we can keep the wrist in neutral position with very simple wrist brace?
Or any other reasons?
4 years ago and after injury, her MD could just refer her to an orthotist or Target, Walgreens, CVS, … and order $10-20 cockup and prevent flexion contracture.

I want to say that in the last 10 years working in the States as a CPO, I saw a lot of patients with pretty same issue, mostly foot drop, who never been referred to orthotist to be evaluated for orthotic management, therefore dealt with disabilities.

The question is WHY?
Because of us as an orthotist/prosthetist? Should we see MDs more and explain for them what we do? And how we can change their patients’ life?
Because MDs do not believe on how our products can help patients?
Because we as an orthotic/prosthetic providers are not usually on MDs head?
Because of our associations who should be more active in the medical field?

My experience going out to see and talk to the MD:
At the first attempt the front desk says that doctor doesn’t have time to see a rep today. If I am lucky, they schedule a lunch meeting which is basically providing lunch for 10-20 people and if I’m super lucky, talk to doctor for 2 minutes. And that’s it. Even when I go back for follow up after a week, I hear the same: “doctor is busy and doesn’t have time to talk to the rep”
Are we actually rep? I am the owner of the company who is credentialed and want to show products that they never heard about it, that can change their patient’s life.

I was talking to a friend who is a neurologist at Kaiser. I told him if he orders carbon AFO. He never heard about it. The reason is Kaiser has contract with few companies (Kaiser denied to sign a contract with me as a new provider) and because of low reimburse, they never told/showed carbon AFOs.

I would like to hear your opinion. What do we as a practitioner need to do? How can we be more in touch with MDs? How can we improve O&P in the community? There are a lot of people around us who get benefits from our specialty and our products.

***** If someone from COPA is reading this:
I can not afford the membership joining COPA at this time, however I am volunteer for ANY help I can do to improve O&P in CA or nationwide; just let me know.

Thanks for reading this and hope to get back advices.
Regards,
Darya Shahrokhi, CPO


                          

Citation

Darya Shahrokhi, “Sad day for me!,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/255174.