Over the past month, two of my OPIE blogs have focused on decision-making. As you may be aware, I do talk to many people in the field, and I try to find patterns in the stories I hear. A troubling one is reemerging. Like all things, the O&P profession seems to be cyclical in nature. History surely repeats itself! I know I stress the need for empirical evidence—data—to make decisions, but sometimes it is more fun to write a blog like this based on anecdotal evidence, rumor, hearsay and feelings. Anyone who knows me knows that I am passionate about the professional, clinical care aspects of O&P. For as long as I have understood what you do (the first time I was exposed to O&P was more than twenty years ago), I have stressed the importance of communicating your clinical intervention versus the device you choose.
I was pleased to see a recent article where other, more powerful voices than mine are starting to echo my longstanding soapbox issue about focusing on the knowledge, skills, and aptitude you bring to bear on the patient to improve their well-being. It is high time you highlight that in your clinical documentation, your professional presentations, and your communications with your referral sources. There are intense market pressures that want to squeeze all of O&P into the commodity market, and there are many in this field who are going along with that by focusing on the device type provided to the patient. This neglects the critical clinical intelligence used to determine the most appropriate biomechanical intervention to achieve the desired result while minimizing the risk of adding future complications to the patient.
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