Saturday, May 25, 2024

Bringing PT’s and others who bill O&P under our credentialing bodies

Michael Arnette

The only way to have other fields such as PT and OT’s required to meet O&P standards is to bring a small percentage of them in under our credentialing umbrella. Especially those who are already practicing O&P without credentials.

Here is an article I wrote that was featured in O&P Edge a couple months ago:

What does a certification in O&P do to protect patient’s from being provided prosthetic and orthotic care by non-credentialed allied professionals such as PT, OT, RN, and physician staff? It’s a question O&P professionals have been asking for years: How can we feel confident that our certifications will have a competitive advantage in providing prosthetic devices and care when other medical providers are legally permitted to do so without the education we have worked for?

Orthotists and prosthetists long ago gave up the fight for certain orthotics markets, including most off-the-shelf (OTS) products, custom knee bracing, cervical and spinal bracing, and pediatric custom bracing. How can we keep from losing more? We cannot legislate other healthcare professionals out of provision, however we can allow them to police themselves. What if the American Board for Certification in Orthotics, Prosthetics and Pedorthics (ABC) and/or the Board of Certification/Accreditation (BOC) created a temporary pathway for Physical therapists, Occupational therapists, and Podiatrists who are employed by practices that bill prosthetic codes (and only those practices that already bill L-Codes)to become certified in O&P? These professions are already billing for a growing number of custom items that we provide, so we have nothing to lose. We would have more to gain by allowing this pathway because the same therapists and physicians who earned certification would then have an incentive to police the provision of custom prosthetics in the future. How the pathway would be provided should probably be left up to our O&P credentialing bodies.

O&P providers are also saddled the mammoth task of separating customized O&P care from of the shelf DME. Here are some thoughts for our credentialing boards to consider: With BOC closing its pathway for O&P clinician certification, ABC and BOC can partner once and for all divide clinical custom prosthetics and orthotics from OTS durable medical equipment (DME). This would allow our credentialing agencies but separate and play a vital role in separating DME from custom O&P provision.

Here is what it could look like: ABC and BOC could change specializations. ABC could become the certifying agency for clinical care (prosthetists, orthotists, pedorthists, assistants, and technicians). In this case, ABC would handle accreditation for all clinical providers who have these professionals on staff. In turn, BOC could become the certifying agency for fitters (mastectomy fitters, therapeutic shoe fitters, and orthotic fitters) and DME facilities. ABC could maintain a five-year window of alternative pathway for any physician, therapist, or clinician to sit for the BOC or ABC exam to demonstrate clinical competence in O&P. While it is debatable how many would take advantage of this alternative pathway, it is a sure thing that these newly credentialed O&P providers would help protect our field from non-certified providers out of self-preservation.

In summary, a merge of this nature could take a “two birds, one stone” approach by both creating allies from within the allied health team and separating DME from customized O&P care at the credentialing level.

Michael Arnette, BOCPO, LPO Progressive Prosthetics

Michael Arnette, BOC Certified Prosthetist/Orthotist

Progressive Prosthetics and Orthotics

9511 E. 46th St.

Tulsa OK, 74145

Office: 918.663.7077

Cell: 918.724.6256


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