In Illinois there are approximately 175 licensed COs and CPOs. Most of them have signed noncompete agreements. That leaves approximately 40 practitioners for smaller practices to consider when hiring. Some of these practitioners only provide prostheses. Some are retired but are keeping their license active. Most of the others work in an institutional department that they will likely never leave.
Noncompetes are widespread in O&P, but the practice suppresses competition by draining the pool of available providers. Noncompetes are traps that can force workers to either stay in a job they want to leave, switch to a lower-paying field, relocate, or litigate.
Chicago Pediatric Orthotics is a single-location private pediatric practice. In the past, we’ve resorted to hiring licensed physical or occupational therapists who are allowed to provide custom orthotics under the supervision of a certified orthotist. The challenge is that PTs and OTs now have doctorates, requiring a high salary with little if any experience providing custom orthotic devices.
The prospect of finding a qualified CO or CPO is nearly impossible due to the restrictive noncompetes that employees are expected to adhere to.
With noncompetes in place for every employee, corporations can pay lower salaries and choose less attractive health insurance because their staff cannot leave, so why try to get them to stay?
Large O&P companies already have lower overhead costs due to bulk purchasing discounts. They have higher negotiated reimbursement prices with insurance companies. They have on-staff attorneys and contracting specialists. It’s all about their bottom line.
Why should a CO or CPO want to sign a noncompete agreement with an employer? They shouldn’t.
In April 2024, the Federal Trade Commission (FTC) issued a rule to promote competition by banning noncompetes nationwide, protecting the fundamental freedom of workers to change jobs, increasing innovation, and fostering new business formation. The rule was overturned and appeals for and against continue.
The National Commission on Orthotic & Prosthetic Education’s (NCOPE) does not look favorably on the use of noncompetes during residency. Based upon legal recommendation, NCOPE cannot ban noncompetition agreements, but they must be fully disclosed and signed prior to the start of the residency program. Requesting that a resident sign a noncompete agreement after the start of the residency is a violation of the standards and may negatively affect the residency program’s accreditation status.
The practice of requiring employees to sign a noncompete is outdated. In a market with plenty of job openings and fewer candidates, it is not an honor to get a job with a company that requires it. Employees working for companies that are acquired through large regional acquisitions have little choice where to go. The big-box employers appear to value the business over their employees.
If O&P does not consider the FTC’s recommendation to discontinue the noncompete trend, we will continue to have practitioners leaving the profession. The rate of burnout is outrageously high. I know many young practitioners who have become disillusioned and left because they felt overworked and underappreciated. Companies shouldn’t be able to squelch practitioners’ dreams of starting a new practice, obtaining a patent for a new product, or moving out of a position that is not a good fit.
Certified practitioners are in high demand and valuable to any employer. Consider the options and refrain from signing on the dotted line.
Patricia Rogel, CO/L, OTR/L, founded Chicago Pediatric Orthotics, Illinois, in 2018.
Image: By Andrey Popov/stock.adobe.com
