Anyone who knows me knows that ever since I learned what O&P care is I have been advocating for promoting the clinical professionalism that is such a critical aspect of the care you provide. I do not have to tell anyone reading this that improperly fitted devices can cause substantial harm to the patient. The short-term harm can manifest as sores or discomfort, or worse. The long-term harm can manifest as chronic pain or arthritis from compensation for the malfitting device or even limb loss. However, how many medical professionals understand this? Better yet, how many payers understand this?
If I have ever been with you when you conducted a clinical in-service for physical therapists or physicians, and I saw you describe the really cool device you made, I probably beat you over the head with it afterwards!
The story you need to tell is the clinical patient story and how you used your clinical prowess and deductive reasoning to create an effective solution to a physical challenge. Better yet, you tell the story of how you worked with other members of the clinical care team to effectively and collectively meet that patient’s needs.
So, when I see a headline from our primary advocacy group boldly proclaiming that the results of a recent scientific study show that “AFOs improve gait in children with disabilities,” it really gets me riled up. The study even calls the patients “clients.” Just twist the knife now. I am not arguing with the truth of the statement. I am arguing with how it is presented. The clinical aspect of the research is buried at the end of several long, boring paragraphs that no one will ever read.
With headlines and studies like that, what is the need for orthotists and prosthetists? All that study and headline will do is reinforce the uninformed belief that a device is a device and all you really need is a vending machine. Will that be a small, medium, or large, ma’am?
If you consider yourself a clinical professional—no, wait—if you care about the patients served by O&P, you should be contacting your leadership and demanding that they stop promoting device efficacy without leading with a strong tie to competent clinical intervention.
This profession is under tremendous pressure to be commoditized, and it seems as if we are working to accelerate the trend. You want increased reimbursements? What for? You are simply a vendor of devices. The real value comes from the manufacturers, right? Are you just an unpaid salesperson for the manufacturers? Or are you a clinician who has the clinical knowledge and expertise to take a very complicated biomechanical challenge and solve it? Prove it!
If you don’t like where the field is heading, what are you doing to change the course? Are you paying money to support organizations and corporations that are cutting your feet out from underneath you? As Smokey the Bear said, “Only you can prevent forest fires!”
It’s time to throw some water on the situation and prove your clinical value to the patient’s episode of care. Very few people outside of this profession understand what you do. And they are not going to learn if we don’t tell them. The only way to effectively communicate your value, though, is by demonstrating your clinical prowess and your clinical efficacy. When is the last time you saw a cardiac surgeon show off the stent they placed (unless they are paid by the stent manufacturer)?
If you want other medical professionals to see you as a peer, you have to be the one to stand up and let them see your clinical competence. It is time to tie your pay to the value of your patient care knowledge and skills, not a device.
