Attention all P&O licensed practitioners. This includes fitters and
pedorthists as well as orthotists and prosthetists.
House Bill 0515 was recently filed by Rep. W. Travis Cummings which will
greatly impact your practice as well as diminishing the value of your
education and training.
This bill expands the scope of practice of Physical Therapy without any
additional requirements for education or training. It also allows PT’s to
prescribe O&P, apply, and fabricate all P&O. Below is the link to the
entire bill.
http://www.myfloridahouse.gov/Sections/Documents/loaddoc.aspx?FileName=0515__.docx&DocumentType=ll&BillNumber 15&Session 15
The language that should concern you is located on page 3, section 2, line
64 – 67. This is what it says:
*therapeutic massage, prescription, application,**and,as appropriate,
fabrication of assistive, adaptive, *
*orthotic, prosthetic, protective, and supportive devices and equipment;*
Why is this language offensive?
1. First it allows Physical Therapists having no formal education or
training in Orthotics and Prosthetics to prescribe O&P devices.
Prescribing of O&P devices should be left to physicians, in consultation
with Licensed O&P practitioners, who are familiar with the entire patient
history and any contraindications that may be present.
2. The fitting and application of O&P devices requires specialized
education and training, as well as the tools and equipment to accommodate
the patient’s safe and comfortable use of the device. Physical Therapist
do not posses this specialized education and training, nor do they have the
necessary tools and equipment to facilitate patient safety and comfort
while fitting or applying an O&P device. Not having the knowledge to know
when something doesn’t fit, and not having the tools to correct any misfits
they would stumble upon, fosters an attitude of “good enough” instead of
providing the patient with the ultimate in comfort and safety.
3. Physical Therapist are not trained to fabricate O&P devices, nor do
they have the knowledge of materials and the equipment to use these
materials. At best they will be “Order Takers” having some other entity
doing the actual fabrication of the device. This puts the patient in
danger. Not knowing the limitations of materials and how they interact
with the patient’s body equates to patients being subjected to unsafe
conditions.
4. Financial Harm – Most insurance plans have very strict guidelines as to
the number of O&P devices a plan patient may receive per lifetime and
within a five-year period. When the PT with no education and training is
allowed to treat patients for O&P services they are shortchanging the
patient. When the device is found to be inappropriate, doesn’t fit, is
uncomfortable, or breaks due to poor materials selection then it’s the
patient who is out-of-luck. The insurance carrier will deny further
coverage, the PT surely won’t return their ill-gotten profits, and the
patient is out-of-luck and on the hook. Do without or dig into their
savings (if they have any) for a device that should have been provided by a
knowledgeable practitioner under their insurance coverage.
To be licensed in Florida Prosthetists and Orthotists must have a Master’s
of Science in O&P. This will include at a minimum three years of formal
education in orthotics and prosthetics. O&P education, in addition to
formal “book” work, includes at least two years during which the student
learns how to use the tools of the profession, the materials used,
material’s limitations, quality control, and most importantly how to adjust
a devise so the patient is safe and comfortable.
After this extensive education, highly specialized in the theory and
practice of orthotics and prosthetics, the student enters into a two year
residency, one year in each field.
Only after this extensive specialized education and structured residency is
the student allowed to sit for a rigorous national board exam, ensuring the
student possesses the knowledge and training to provide for patient safety
and comfort.
The Physical Therapist possesses none of this specialized education or
training. Yet they are asking you, the Legislators, to grant them the
privilege of treating patients with orthotics and prosthetics by a mere
stroke of the pen, not by the hard-won knowledge and experience required of
others. This is both discriminatory and unfair to the licensed O&P
practitioners who have endured the hardships and expense of education and
training to attain the privilege to treat the citizens of Florida in a safe
and appropriate manner.
This bill must go through 4 committees before it can come to the floor of
the House for a final vote. You have a chance to affect if this bill
becomes law by acting quickly and vociferously.
You must act quickly and urge your colleagues and patients to do likewise.
If these bills make it out of committee without having the offensive
language removed, it is much more difficult to defeat.
If you are in Cummings district phone his office and express your feelings
about this bill. Ask him to drop the offensive language and explain why.
Even if you do not live in his district you should phone and email him to
voice your opinion and ask the offensive language be dropped.
I include the addresses of the four House Committees. Going to these sites
allows you to connect with each of the Members of the committee. You can
then easily email each member to voice your opinion. If you live in any
Member’s district take the extra time to phone their office and voice your
opinion, this carries extra weight.
HB 0515 Sponsor W. Travis Cummings
http://www.myfloridahouse.gov/Sections/Representatives/details.aspx?MemberIdE40&SessionIdv
Health Quality Subcommittee
http://www.myfloridahouse.gov/Sections/Committees/committeesdetail.aspx?SessionIdv&CommitteeId(60
Health Care Appropriations Subcommittee
http://www.myfloridahouse.gov/Sections/Committees/committeesdetail.aspx?SessionIdv&CommitteeId(34
Health & Human Services Committee
http://www.myfloridahouse.gov/Sections/Committees/committeesdetail.aspx?SessionIdv&CommitteeId(57
Health Quality Subcommittee
http://www.myfloridahouse.gov/Sections/Committees/committeesdetail.aspx?SessionIdv&CommitteeId(60
A companion bill was introduce in the Senate, SB710, by Sen. Denise
Grimsley. At this writing no committees have been assigned.
Everyone should email her to voice your opinion, and if you live in her
district you should also phone her office in addition to emails.
Text of SB710:
http://www.myfloridahouse.gov/Sections/Documents/loaddoc.aspx?FileName=0710__.DOCX&DocumentType=ll&BillNumber 10&Session 15
The offensive language is again on Page 3, but Line 73 – 75.
