Monday, May 23, 2022

Clarifying the Mud (not slinging it)


My fellow US OandP-ers (the rest of the world excuse us once again)

First off what a fantastic Annual AAOP meeting! All involved in the
planning are to be congratulated for a job well done. Now to the

I like to believe I am a linear thinker, given more to rational analysis and
reaching thoughtful conclusions without the benefit of emotional overtones.
Regarding the apparent disagreement over the APPROACH AOPA and AAOP are
taking with regards to PT Direct Access, don’t believe everything you read.
Emotions are running rampant all over the place. And be aware that more
than just “us” are involved in watching the dialog.

It is a matter of approach isn’t it? Am I missing something else here? The
approach that we are all most familiar with is that of opposition to further
sanctioned encroachment into provision of O&P services by less qualified
persons. Emphasis on the word further, cause its already happening folks.
We rightfully oppose any effort to lower educational standards, lower the
bar for qualifications, achieve less than professional care for patients in
need. That is the basis of AOPA’s thoughtful opposition to direct access.
And jointly issued statements of AAOP & AOPA confirm agreement.

Well a very interesting question was posed to the Town Hall crowd (was it a
mob?) last Friday in Orlando…”Who believes that we will further the O&P
cause by cutting direct communications with the APTA?” Nobody agreed that
it is in O&Ps interest to breed further animosity. Is AOPA still on
speaking terms with APTA? We are part of a health care team approach in my
corner of the world and belive it or not, I help PTs and vice versa. And
no, we don’t provide low temperature thermoplastic WHOs either, so the same
goes for you OTs out there paying attention. The Academy is choosing an
approach that keeps the lines of communication open. Good for you. BUT…

My biggest beef over the Academy position is the agonizing semantics of
“…not opposed…at this time…” . My favorite English Prof used to say,
“Don’t never use the double negative.” The subtle double negative of “not
opposed” is so closely related to “in favor” as to lose all significance in
the debate. Also “at this time” is not attached to any conditions. It is
meaningless to say anything important “at this time” compared to stating
when, what and why changing conditions may influence opinions at a later
time!!! Next time the Town Hall meeting should preceed the letter!

So this all begs the obvious question: What is in the patient’s best
interest? Expertise! The definition of which is Education + Experience =
Expertise. Period. Testing and certification only standardizes and
validates what level of expertise has been achieved. (Unless you dilute the
standard ala ABC, but that is a whole other issue, yet strangely related)
If ANY allied health professional honestly can prove that they have
EXPERTISE (education & experience) equal to or greater than mine to pass a
standardized measure then they are certified. Any less than that level of
professional comittment to patient care and you are advocating lowering the
standard of care to allow care by any willing provider, regardless of
expertise. PTs: Without O&P education approaching the NCOPE standard, are
you willing to offer compromised O&P care in the interest of capturing the
revenew stream? Then shame on you who answered yes, but I hope you are in
the minority.

(Deep breath, get control…) The Academy unwittingly contributed to the
argument IN FAVOR of state licensure by this controversy. No national body
be it AOPA, AAOP, ABC, APTA, or XYZ achieves higher MINIMUM standards than
those established by individual states with licensure. Refer back to my
inuendo about the dilution of the ABC credential. Refer to Ron Gingras’
post slamming AOPA over watered down Qualified Provider definitions
contained in CMS language. Those issues are inconsequential to states that
have defined their professional O&P status through licensure. Lord knows I
am not in favor of more government intrusion in my life, but I believe in
high standards of care for patients referred to me. And I am willing to
seek state governments help to define O&P professionalism, if nobody else

States with licensure, you’re insulated from this aren’t you? And in spite
of the initial grandfathering phase which keeps everybody happy in the short
term, your task is to move forward toward a brighter future where O&P has
the same legitamacy as Barbers and cosmetologists.
If this identifies me to somebody out there as oppostition, well it is
purely intentional. But I think as professionals we have so much more to
agree on than to argue over. And if your motivation is honest communication
regarding what is in the best interest of patient care then we are on the
right track. Quality patient care is our first responsibility. And that
should keep you profitable. So I agree with both of your approaches Mr.
Moretto and Mr. Hammontree. We agree to be advocates of high standards for
our clientelle. We need open communication to enable us to move forward.
Our internal disagreements as to approach should not lead us to vidictive
posturing and verbal power plays. PTs/OTs are valuable clinical allies, as
necessary to the team approach as we think we are. And I believe that the
momentum begun by 10 States to enact State licensure in O&P needs to be
adopted by the remaining states to ensure high standards of O&P care for
patients in the entire U.S. for years to come.

Just a final question to AOPA and to the manufacturers, NOMA: What is your
official position on State licensure of O&P? Now we will see some
interesting responses, and lack thereof.

At that, I leave you with a song.

Rick Miller, CO#1587 Rochester, Minnesota

“For What It’s Worth …” Buffalo Springfield (Stephen Stills) Sometime in
the late 60s

There’s something happening here
What it is ain’t exactly clear
There’s a man with a gun over there
Tellin’ me I got to beware

I think it’s time we stop, children, what’s that sound
Ev’rybody look what’s goin’ down

There’s battle lines bein’ drawn
Nobody’s right if ev’rybody’s wrong
Young people speakin’ their minds
Gettin’ so much resistance from behind

I think it’s time we stop, children,
What’s that sound?
Ev’rybody look what’s goin’ down

What a field day for the heat.
A thousand people in the street.
Singin’ songs and carrying signs
Mostly saying “Hooray for our side”

Stop, children, what’s that sound?
EV’rybody look what’s goin’ down

Paranoia strikes deep
Into your life it will creep
It starts when you’re always afraid
Step out of line the men come and take you away

You better stop, hey, whats that sound?
Ev’rybody look what’s goin’ down

>From: Justin Foster
>Reply-To: Justin Foster
>To: [email protected]
>Subject: Re: [OANDP-L] FW: RE: Clarifying the Academy’s Position
>Date: Tue, 22 Mar 2005 22:38:49 -0800
>To the list,
>I couldn’t agree more with Mr. Hamontree. Everyone should let their voices
>be heard! I can’t imagine anything negative about jumping on the listserv
>and stating your humble opinion, or even an idea you have about how things
>are going, and how they should turn… It’s fun, people write back right
>away!!! I should know, I’ve posted on here tons of times with great
>I would however advise those with an opinion, those without an opinion,
>those who wish they had an opinion, those who love prosthetics, those who
>like orthotics but hate PT’s, those who spell FAAOP, those who don’t use
>spell check at all, and even those who accidentally subscribed and aren’t
>sure how to make the e-mails stop… to be conscientious when you post. We
>are all in this together, so let’s see us treat each other with respect!
>carry on, there’s some good dialogue on the way I’m sure…
>all in good fun,
>Justin Foster
>>From: Sam Hamontree
>>91 of the 93 — those I was able to identify as Academy members stated
>>quite strongly that they supported my position below. While that
>>support is quite good for my ego and is appreciated, it does nothing to
>>let the Academy leadership know your feelings.
> ********************
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>OANDP-L is a forum for the discussion of topics
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