One Size Does Not Fit All
April 2018 Issue
O&P professionals generally place a great deal of emphasis on the customized nature of the devices and services they provide to the people with whom they work, thus eschewing a one-size-fits-all approach to treatment. However, they may not actively apply this same philosophy when choosing which outcome measurement to use for a particular intervention, how to address the people they treat, or which sources they look to for guidance in treatment guidelines.
As one of this issue's pediatric care topics, in "Updated Evidence on the Efficacy of AFOs in Children With Cerebral Palsy: The Good, the Bad, and the Ugly," Phil Stevens, MEd, CPO, FAAOP, summarizes current literature that indicates AFO use does have positive effects for children with cerebral palsy (CP). But, he also reveals there are problems with quantifying the efficacy, not because there is none, but perhaps because the researchers are attempting to use global measurement tools that are not appropriate for the situation. While the U.S. healthcare system's current emphasis on value leads to increasing use of global health indices to compare the efficacy of interventions between diagnoses, Stevens argues that those measures may not be specific enough to the population of children with CP to accurately document an effective intervention.
The issue's second feature, "Patient, Client, or Customer: What Should We Call the People We Work With?," addresses terminology and how it impacts relationships and perceptions of O&P as a profession. As the article explores the specific and implied meanings of the various terms used to describe the practitioner-patient relationship, as well as studies and surveys that have been conducted on the subject, a key takeaway that emerges is that the correct verbiage is situational and largely dependent on the preference of the person receiving the treatment or device.
The synopsis of the Congress of Neurological Surgeons' evidence-based guidelines for the treatment of pediatric positional plagiocephaly that appears in the final feature in this issue reminds us that sources outside O&P can provide significant insight into the justification for services the profession provides. Knowledge of the guidelines established by other types of healthcare providers can strengthen O&P professionals' positions within their practices, as they present support for clinical care.
Although it is laudable, and even necessary, to work toward common outcome measures, terminology, and sources for best practices, this issue reminds us that it is equally important not to lose sight of the nuances that demand a more specialized approach.