When we talk about the lower limb in O&P, we often focus on the high-tech innovations such as microprocessor knees (MPKs) and powered orthoses that have marked the last 25 years, especially as access to MPKs has been extended to K2 ambulators. But clinicians are also met with challenges of providing care at the other end of the spectrum with simpler devices and lower reimbursement rates; it’s those considerations that we turn our attention to in this issue devoted to lower-limb care.
MPKs have become the gold standard for people with transfemoral amputations and are a great choice for many patients, but no solution is universally applicable. “The Place for Non-MPKs in a High-Tech World” discusses the situations and the options when a non-MPK is the most appropriate solution for a particular patient.
While they don’t garner many headlines, AFOs are the most commonly provided orthoses. They are an effective intervention for a variety of conditions, but their reimbursement rate often does not reflect their value—or prosthetic reimbursement for devices addressing the same anatomical region. This discrepancy and its history are analyzed in “When a $50 Margin Doesn’t Make Sense: Uncovering the History of the HCPCS.”
Trust is an essential element in any healthcare interaction. We often think about this in terms of whether we trust our doctors to present us with options about treatment or tests. But we might not give as much thought into our responsibility in the equation—for example, if we say we exercise several times a week because we’re too embarrassed to admit that’s more like several times a month, or we simply overestimate how often we’re exercising because it seems like more than it is, the doctor does not have accurate information to guide our treatment. “The Truth Will Out: Memory and Lying in Patient Reports” explores how this applies to O&P care and how clinicians can reframe their approach to these misreports of nonadherence.
Happy reading.
Andrea Spridgen
