Young Turks: Who Are They Now?

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By Miki Fairley
Boomer

Boomer

Hall

Hall

Highsmith

Highsmith

Jacobsen

Jacobsen

Stevens

Stevens

Last month, The O&P EDGE article, "Young Turks: Where Are They Now?" touched base with O&P professionals who were featured in the December 2002 article, "The Young Turks: How Are They Impacting O&P?" But who are today's young Turks? While the potential future leaders of the O&P profession are too numerous to cover in the pages of our magazine, The O&P EDGE asked just a few of these rising stars what they see in the future and how they are helping to create that future.

  • Ellie Boomer, CPO, received her certification from the American Board for Certification in Orthotics, Prosthetics & Pedorthics (ABC) in 2005 and works at the National Orthotics and Prosthetics Company (NOPCO) location at the Children's Hospital of Boston, Massachusetts.
  • Michelle J. Hall, CPO, FAAOP, works at Gillette Lifetime Specialty Healthcare, St. Paul, Minnesota, and received her ABC certification in 2006.
  • M. Jason Highsmith, PT, DPT, CP, FAAOP, is an assistant professor in the School of Physical Therapy & Rehabilitation Sciences, University of South Florida, Tampa, and earned his ABC certification in 2006.
  • Aaron K. Jacobsen, CPO, LPO, received his ABC certification in 2009 and is a prosthetist/orthotist specializing in pediatric care at a Hanger Prosthetics & Orthotics office in Omaha, Nebraska.
  • Phillip M. Stevens, MEd, CPO, FAAOP, works for Hanger Prosthetics & Orthotics in Salt Lake City, Utah, and received his ABC certification in 2005.

Besides these clinicians, who are already luminaries in their field, we also talked with a young practitioner who is just launching his career.

Although they have not yet reached the pinnacle of their careers, these professionals, like many other young Turks in O&P, have already accomplished much in advancing the profession through research and education as well as implementing new technologies and evidence-based practice (EBP) into everyday clinical care.

Leading the Way

O&P-related research is increasing in both quantity and quality, Stevens notes. "With advanced degrees becoming more common in the field, the quality of that research also is improving." However, he adds that the challenge will be in translating the knowledge gained through research into daily clinical practice by showing how these findings impact clinical decision-making. "We need to remember that the purpose of the research is to improve patient outcomes. Academic publications in journals that most of our clinicians will never see don't meet that objective. We need to take steps to make sure that relevant research findings are broadcast in a medium to which day-to-day practitioners have both access and interest."

Advancing O&P research and education seems to go hand-in-hand with participation in professional organizations. Stevens and Highsmith are co-chairs of the American Academy of Orthotists and Prosthetists (the Academy) Research Council's Secondary Knowledge Committee. The committee is developing resources such as critically appraised topics (CATs), and brief literature-based answers to specific clinical questions.

Boomer is vice-chair of the Academy's Craniofacial Scientific Society and is enthusiastic about its initiatives. "We've been working hard to develop more information and courses on deformational plagiocephaly and post-operative treatment to help clinicians," she says. "I'm really excited about that!"

Hall serves as vice president of the Academy Board of Directors, is a Research Council chair, and is a member of the Gait Society and the Lower Limb Prosthetics Society. She also has served as National Commission on Orthotic & Prosthetic Education (NCOPE) Regional Residency Liaisons Committee chair and as a member of NCOPE's Residency Outcome Committee, helping to align the residency standards with the transition to the entry-level master's degree.

Hall's research interests have garnered her two Thranhardt Awards: in 2007 she received the Academy Thranhardt Award for research, and in 2008 she received the American Orthotic & Prosthetic Association (AOPA) Howard R. Thranhardt Award, which recognizes individuals who are commited to advancing O&P education and research.

Individuals Help Shape a Profession

Volunteering in professional organizations can lead to making an impact on a national or even international scale. "You're able to put your finger on the pulse of what's happening in the profession, what's important to the profession, and how to advance the profession," Highsmith says. "You can have a role in some of the initiatives. Giving back to the profession that's given to us helps set the stage for future generations."

For example, Hall realized how eager Latin American colleagues are to access knowledge resources available only in English. She thought, "Why not translate some Academy resources into Spanish?" This led to the creation of a small task force of representatives from the Academy, the International Society for Prosthetics and Orthotics (ISPO), the U.S National Member Society of ISPO (USISPO), and Latin American practitioners. "The task force recommended specific topics for translation based on available online SSC [state-of-the-science conference] and Online Learning Center [OLC] modules that were of greatest interest to our Latin American counterparts," Hall explains. "The first two modules will be offered to all Spanish-speaking ISPO members to determine interest in this type of education. If there is interest, we hope to offer more translated OLC modules to allow these practitioners an opportunity to gain a greater depth of knowledge in particular areas."

Sharing Knowledge On Stage

Sharing research studies and clinical expertise at national and international conferences and seminars has provided exciting career highlights for many of the up-and-comers interviewed for this article. For instance, Boomer presented on cranial-remolding-orthosis patient care at the 12th ISPO World Congress, held in Vancouver, British Columbia, Canada, in 2007. "It was so exciting for me to go to an international venue and talk about this subject and to hear what others around the world have been doing," she says.

Stevens recalls, "I'll never forget the morning I came downstairs to check my e-mail and found an invitation to participate in the ISPO's upcoming consensus conference on the orthotic management of cerebral palsy in Oxford, England ["Recent Developments in Healthcare for Cerebral Palsy: Implications and Opportunities for Orthotics," September 2008 (ispoint.org/images/docs/publications/ispo_cp_report.pdf)]. The opportunity to prepare my material and collaborate with some amazing professionals from the United States, Canada, the United Kingdom, Scotland, Australia, and elsewhere was fantastic." He adds, "I've also been honored by invitations and opportunities to present at educational conferences in Canada and the Dominican Republic. I've been to Central America a few times, where I worked alongside our colleagues from Costa Rica, El Salvador, Honduras, Guatemala, and Panama. I'm always struck by their dedication and passion for what they do."

Some of our interviewees' goals focus on education and research. Highsmith, who has published frequently in academic journals and presented at professional meetings, says, "I want to continue working to advance the science and education in the field and mentoring the next cadre of researchers, which I hope to do more of in the future."

Hall is pursuing a master's degree in biomedical engineering at the University of Minnesota, Minneapolis. "I'd really like to increase my time in research and academic endeavors and have the skill sets to do that," she says. Hall is especially interested in investigating the effects of various orthotic and prosthetic treatment modalities on adults with child-onset disabilities because of the paucity of O&P research in this area.

Patients, Colleagues Brighten Careers

Technological advances, education, and research including outcomes studies all converge on a single goal: improving patient care. So it's no wonder that these young professionals regard patient care—restoring function and improving patients' lives—as one of the most rewarding aspects of their careers.

"Most people in this field are doing it because they love to improve the quality of life for their patients," Jacobsen says. "Seeing an improvement in someone's gait or scoliosis x-ray or head shape brings tremendous satisfaction."

"Often, those outside our field comment that it must be depressing to work with the populations we service," Stevens says. "They are often surprised when I tell them that it's quite the opposite. Many have overcome potentially fatal setbacks. They are grateful to be alive and eager to live. We experience highlights on a fairly regular basis, whether it's seeing someone take their first steps following a transfemoral amputation or seeing a patient with upper-limb loss write their name for the first time with a prosthesis. There's no shortage of highlights in what we do."

Professional relationships likewise rank high. "In general, the professionals in this industry are genuinely good, compassionate people," Stevens says. "It's been a privilege to interact with them, whether it's in the treatment room or in educational endeavors."

"We have a wealth of creativity in this field, and it's fun to learn from the people who constantly find ways to improve their outcomes," Jacobsen adds.

New Generation Impacts Mainstream

Researchers, creators of new technologies, educators, and leading members of national organizations are the trailblazers of the O&P industry. However, it's the hundreds of O&P companies—from mom-and-pop single locations to multi-facility regional and national O&P businesses—that provide the bulk of the care for thousands of patients. They are the consumers of research and the implementers of new technologies. With each new generation of professionals come new priorities and new and reinvigorated approaches to O&P patient care. Harry Lawall III, CO, is just one of O&P's "next generation." Harry III received his ABC certification last year and is excited about joining his older sister Andrea Lawall Roque, CPO (certified in 2006), as he becomes the third generation of Harry J. Lawall & Son, based in Philadelphia, Pennsylvania. The firm was founded by his grandfather Harry Sr. and father Harry Jr. ("Bud").

Although mourning the passing of Bud just over a year ago and Harry Sr. in 2007, family members in the business are carrying on their legacy. "I look forward to helping my uncles [Wayne, John, David, and Christopher Lawall] and other employees continue to provide excellent patient care and see our company grow," Harry III says. "My sister also continues to help our company excel."

The company has grown to include a staff of 200 and 16 patient care centers. Harry III is working in the Lawall office at the Nemours/Alfred I. DuPont Hospital for Children, Wilmington, Delaware.

Opportunities versus Obstacles

While research and technology have surged ahead, funding and reimbursement have been sinking in today's troubled economy. "We're seeing a decrease in reimbursement, coverage, and government funding," Boomer notes. "Probably that trend will continue because national and state governments are running out of money." Thus, there will be an increase in private insurance coverage, she feels, with patients likely paying more with high deductibles and co-pays.

"We've been seeing revolution, rather than evolution, in prosthetic technology mainly due to funding for military amputee research," Highsmith says. "Technological advancement peaks during wars as financial resources are poured in, then goes into valleys between conflicts, so those dollars could be winding down." Because of the immense strides made in developing high-tech, functional prostheses, Highsmith hopes funding will continue to keep up the pace of progress.

Highsmith points out another tug-of-war: evidence-based practice standards of patient care versus what Medicare and private payers will reimburse. "It's frustrating because if we have found through outcomes studies that for a particular condition certain technologies elevate function to the point they should be the standard of care, but finances prevent people from receiving that standard of care, then we're backing away from evidence-based practice," he says. "If we're serious about both the science and functional perspectives of our patients, we need to look at the economic side—find what is the most functional for the best price. Then somehow it has to become legislative policy. Is our patient care going to be about best practices or best finances?"

Sharing Insights

For those who are just beginning their O&P careers, Boomer advises them to "pick a really good residency site—not just a job, but rather a site that will give them the training and foundation they need." Her own residency at Mary Free Bed Rehabilitation Hospital, Grand Rapids, Michigan, introduced her to cranial remolding, which has become her specialty.

Jacobsen also found this to be true. His work at the University of Washington, Seattle, as a research engineer ignited his desire to pursue a career in O&P. His residency at Dynamic Orthotics and Prosthetics, Houston, Texas, under president Tom DiBello, CO, LO, FAAOP, fanned the flames and honed his skills. His paper on short-term, residual-limb volume change was named by the Academy as among the "Best of the Resident Directed Studies," and has been published online at www.oandp.org. Jacobsen has gone on to participate in the Research Education Committee and the Outcomes Research Committee of the Academy and serves as an NCOPE residency liaison.

Jacobsen also has developed an office-note computer program, which has been used extensively at Dynamic O&P to document patients' treatment and progress. He says he is currently building the program into "web-based clinical software that will attempt to bring evidence from the literature into the clinical setting."

Highsmith says, "You need to be a role model for your patients, family, and those you mentor. For instance, if you advocate an active, healthy lifestyle, you need to live it. Provide quality patient care, use evidence-based practice, be involved in professional associations, keep up with contemporary practices." He also urges a balanced lifestyle regarding work and time for family, recreation, and a spiritual component.

Today sets the stage for tomorrow, and the new generation of young Turks is playing a powerful part in shaping the future of the O&P profession. As advances in technology, education, and research soar upward, tough economic realities threaten to bring them back down to earth. Exciting opportunities along with formidable challenges are confronting O&P. Whatever the future holds, the motto of the U.S. Army Corps of Engineers in World War II may well fit O&P's up-and-comers: "The difficult we do immediately; the impossible takes a little longer."

Miki Fairley is a freelance writer based in southwest Colorado. She can be reached at
Editor's note: To read about more young Turks, see the February 14 edition of EDGE Direct.