Technician Credentialing: A Gateway to Opportunity

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By Tony Wickman, RTPO

Welcome to the fork in the road—this is when we decide how the future unfolds. Over the past year of working with the American Board for Certification in Orthotics, Prosthetics & Pedorthics (ABC), I've seen a lot of discussion about the future of technician credentialing, and I've spent a lot of time thinking about the future of my profession.

I've been thinking for the past decade that the technician's role has been evolving from an entry-level point of ascension into a viable career. In the past, technicians tried to become practitioners and only remained technicians if something got in the way. However, as technology progresses and consumers become more demanding, our role will ultimately call for more knowledge and competence. In fact, it's now becoming too difficult for one person to serve as both practitioner and technician. The two roles have become distinct and similarly difficult. Each has its own challenges. In short, they're separate but equal.

Currently, the highest credential the industry affords a technician is ABC registration, which was developed as an entry-level credential for individuals who had attended a technical-education program. It has blossomed into an all-inclusive credential that is available to any technician with a high school diploma, who has graduated from an accredited technical program or has two years experience in each discipline, and has passed the day-long technician exam. This model served well for many years. Registration was valued because most registered technicians earned more than their non-credentialed counterparts, and it indicated that a technician was serious about his or her work. Registered technicians were seen as more of an asset to their employer and were generally rewarded as such.

In 1997, ABC began to require continuing education for registered technicians in a model that basically mirrored the requirements for other credentialed individuals. This move was lauded by most of us involved in the process because we all wanted the same thing: an increase in the stature of the technician's role. The end of the first MCE cycle revealed something startling: about one-third of previously credentialed individuals failed to meet the new requirements and therefore lost their registration status. Since that time, the number of individuals seeking credentialing has declined; this attrition continues to this day.

Why are technicians no longer seeking this credential? I have asked this of technicians nationwide over the past year. Most technicians don't understand the importance of credentialing as a career move or as a protective measure for the industry. The remaining technicians simply don't care because it doesn't directly impact their job. In my opinion, both of these points have some merit, but both are ultimately wrong.

Credentialing is a gateway to opportunity. If you aren't credentialed, you have no voice in the field. No one knows you exist, and subsequently you don't matter. You can't join most of the industry's most prestigious organizations, you don't get on the mailing lists for continuing education, and you don't get to help steer the ship. Why be a part of an industry that controls you without the opportunity to help shape the direction it goes?

Though some people do their work just to get by, most of us are in this industry because we care about our customers. We want to help people live as actively as technology will afford, and we want the devices we manufacture to afford patients the maximum possible increase in their quality of life. How can we achieve these goals without credentialing and continuing education?

We can't just blame technicians. The whole landscape of this industry has changed. Providers are paying less, materials are more expensive, paperwork eats more of our time, and regulatory changes make it more difficult to get the available technology to the people who need it. For a lot of people, the expense of credentialing is just too great in time and money, and the return on investment isn't there. More and more, the act of credentialing and continuing education is becoming altruistic. Most do it simply because they feel a strong desire to climb whatever mountain is put in front of them. That has to change.

We need to make technical credentialing and continuing education less expensive, and we need to make it mandatory. Several ideas have been put forward to meet these needs. The move to an Internet-based exam has been proposed, and I think it's a good idea. Initially, I wondered how we'd test hand skills over the Internet. In industries as varied as personal exercise training and massage therapy, though, this has been the norm for years. Current technician testing doesn't include hand-skills testing anyway; at least, it doesn't include standards for quality or attractiveness—they're too subjective. We instead test for all the other information and skills required to ensure minimum competency.

I know, I know—mandating credentialing as a component of accreditation is a real can of worms. But think about it—if credentialing was mandatory for accreditation, it would get done. How many times have you not done good things just because you lacked momentum to do them? If you had to do it, you would, and you would benefit from it. Just think about it—that's all I'm asking.

I realize these ideas will not appeal to everyone, but I hope they will be provocative and spur some of you to develop better solutions, because there is more to do. If you like these ideas or hate them, tell me so we can consider your point of view. If you don't speak up now, you may not have another chance. This is a fork in the road, not a dead end—we have to go one way or the other.

Tony Wickman, RTPO, is the CEO of Freedom Fabrication, Havana, Florida. He can be reached at