Central Fabrication: Its Role in Quality Patient Care

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By Frank E. Friddle Jr., CO

With the buzzwords "Quality Patient Care" being the driving force for the Negotiated Rulemaking process, I feel the need to express the concerns I have as an owner of a central fabrication facility in regard to this topic. Being the third-generation practitioner in my family, I am well aware of what makes the certified O&P practitioner the utmost "qualified" professional to dispense orthotic and prosthetic care. Education, experience and ongoing training are the undeniable foundations that we rely on daily as certified practitioners.

However, since the emergence of numerous central fabrication facilities offering practically every conceivable orthotic and/or prosthetic device imagined, quality of patient care takes on a new facet. The qualifications of the technicians or practitioners that own or operate central fabrication companies are not in question.

I feel it is common knowledge that therapists lack the fabrication skills needed to provide quality and adequate orthotic and prosthetic devices, as well as the other skills used by certified O&P practitioners. The simple solution to this problem for therapists is to employ the services of a central fabrication facility. Personally this is where I draw the line. It is my belief and a policy of my company that we require a certified practitioner (in the discipline in question) to be a fulltime employee of the facility for whom we are fabricating a device. Providing orthotic and prosthetic devices to allied healthcare professionals not trained and educated in the proper use, fitting, and adjusting of such devices is surely putting quality patient care in jeopardy.

As a central fabrication owner who restricts for whom I fabricate, I feel I have increased the possibility that some patient somewhere has a better chance of receiving the quality of care that he deserves. I truly hope that the many other excellent central fabrication companies delivering O&P devices throughout the country share my thoughts.