<h1>It's time to take a long look at the big picture.</h1> <img class="" style="float: right;" src="https://opedge.com/Content/OldArticles/images/2004-05_01/Fairley-Miki.jpg" width="192" height="181" hspace="4" vspace="4" /> Where does O&P want to go? How can we make it happen? How important is education? Is certification relevant with respect to licensure? Should licensure actually replace certification? Where does O&P stand relative to other allied health professions--in practice standards, education requirements, levels of practice, i.e. practitioners, assistants, fitters? Where should it stand? <h1>Right now, there seem to be more questions than answers.</h1> Physicians, patients, and payers are increasingly demanding hard facts and data about O&P care outcomes. Where is the needed research to come from? How can the field continue to advance in clinical care and technology? Obviously, the answer lies largely in research. Effective, credible research requires a higher level of education. Will it always be professions outside of O&P who take the lead in orthotic and prosthetic research? Since the collapse of the unification negotiations between the <a href="https://opedge.com/22">American Board for Certification in Orthotics & Prosthetics (ABC)</a> and the <a href="https://opedge.com/92">Board for Orthotist/Prosthetist Certification (BOC)</a>, the <a href="https://opedge.com/2629">OANDP-L listserve</a> and other communication avenues have been bursting with comments--not only about ABC/BOC issues, but where the field is headed. One thought-provoking comment, which is echoed by others, came from John Gibson, CP, LPO: "I think we need to quit trying to justify why this organization is better than that? start behaving like a profession. We need to publish more--for example, why a custom ACL is better than a custom-fitted--and we need to back it up with hard evidence. We need to support the education institutions so that they may be able to actually do research into our field. We need to support the local and national academies and associations and coordinate our efforts, so we are all moving in the same direction." And we need to always remember why the field exists: to help persons with disabilities--whether temporary or permanent, congenital or acquired--to attain the best quality of life possible. A lofty goal--but definitely one worth shooting for! An outstanding example is a young man with three strikes against him: born in a developing country, into a family abandoned by his father, and with a major disability. But Emmanuel Ofosu Yeboah definitely was not counted out. You'll enjoy his story, "<a href="https://opedge.com/2771">Ghanaian Helps Disabled Countrymen</a>". Also some young people enjoyed patient care without the mire of issues and paperwork that surround O&P in the US by working with amputees in Ecuador--plus they stretched their creative thinking abilities (Read, "<a href="https://opedge.com/2772">Young Prosthetists Enhance Skills in Ecuador</a>"). Where is O&P in the US headed? Time--and the actions of everyone involved in the profession--will tell.