I want to thank you for the opportunity to correct you in this forum.
Mr. Bader wrote
> You bet they are, I was at the hearing that Mr. Caracas mentioned in an
> earlier post, in which he described for the board, the “practice” of the
> “orthopedic technologist”, a name I believe coined by Mr. Caracas to help
> promote his new school, yes you read correct, HIS SCHOOL of “orthopedic
> technology”. As I recall, his description of unsupervised fracture casting
> enraged the physician board member, rebutting Mr. Caracas description of
> the normal day to day, “orthopedic technologists” practice as highly
> unethical in general and unethical/illegal for any physician to prescribe
> Wade Bader, COP
> Tampa, FL
I was waiting for mention of my school. Like that matters somehow, since
95% of my students are from out of state.
I wish I could take credit for the term “Orthopedic Technologist”.
The term Orthopedic Technologist is used around the world. It is used by
every NATO country who have been sending their military personnel for
training at Ft. Sam Houston to the Orthopedic Technologist Course , MOS
#91H. I think the school has been running since the 1950’s. Those on the
served in Vietnam (like me) or elsewhere will know what an MOS means.
The Canadian Society of Orthopedic Technologists (CSOT) as well as the
National Association of Orthopedic Technologists (NAOT), the American
Society of Orthopedic Physicians Assistants (ASOPA) as well as the National
Board for Certification of Orthopedic Technologists (NBCOT) (and all the
state organizations that fall under them) would take offense that an
orthotist (or even an orthopedic surgeon) can define their job description
as unethical. The NBCOT is also a member of NOCA (they have approved the
certification exam for Orthotechs) the umbrella certifying agency that also
approves(?) the ABC. There are two liability insurance companies that will
sell malpractice insurance to Orthotechs who work either for a Doctor or in
their own business. Insurance companies routinely pay Orthotechs for
casting and bracing. That includes Medicare. There are special L codes for
just that purpose.
When I testified before the Board, it was to inform them of these
organizations and their job descriptions (which I took from the internet)
and to ask them how they were affected by this new law. I still have
not received an answer to my written request about this. That was about
three years ago. The Board
seemed completely ignorant of the function of an Orthopeidc Technologist and
certainly did not want me to bring it up.
The Doctor was “outraged” because I pointed out to him that Shriners
Hospital, where he worked, was not a good example of a typical orthopedic
practice in Florida. This young orthodoc with little or no private
experience had no clue. And I told him so. I later met him on a plane going
to the AAOS in New Orleans. He seemed fine with it. Maybe he learned
all the Orthotechs that were hired by the Manufacturers to show casting
techniques to the Orthopedic Surgeons at the AAOS. J&J, Smith & Nephew,
EBI, etc. all hire Orthotechs to train Orthopedic Surgeons on casting &
splinting fracture techniques.
I know The Orthopedic Practice where I shared rented office space, had four
orthopedic technologists who did 90% of the casting. That is more typical.
With 750 Private Orthopedic practices in Florida one can assume there are
over 1000 orthotechs doing the same thing. And having trained Orthopedic
Surgeons in casting and bracing for ten years at a NYC orthopedic residency
program, which had orthotechs on staff, I know orthopedic surgeons want
these assistants so they can concentrate on surgery and see more patients
during office hours. It’s an HMO world now.
For 32 years I have worked in ER’s, Hospitals (Joint Disease & Special
& Orthopedic Practices as a Radiologic Technologist, an Orthopedic
Technologist and since 1980, an Orthotist. I have always specialized in
acute care treatment. I know what
an Orthopedic Technologist does. I know what an Orthotist does. They both
should be licensed under this law if a fracture cast is an “orthosis” as
defined by the statutes. That’s my point. The main function of an
orthopedic technologist is to apply fracture casts and bracing. Its not a
small part of their job, it IS their job.
This is prohibited by anyone other than an Orthotist (or exempted
professions)under the Florida statutes. Why? Because the state legislators
were not informed of the job description of an Orthopedic Technologist
by the proponents of the new statutes.
So are the OT’s exempt or not. Are they exempt because they work for an
Orthopedic Surgeon? But does that mean they now have to be “supervised”?
Can an OT change a cast in the office while the Docs in Surgery? Is that
being “supervised”. Can an OT go to a nursing home and change a cast that
has been “dirted” by a patient on an order from the OrthoDoc. I think they
Mr Bader is right. I do have a school. I train Orthopedic Allied
Professionals in casting, wound care, splinting, traction, bracing and
orthopedic xray. My course is approved by the State of Florida, the BOC,
the NATABOC, the ASRT, the NBCOT, the FPTA, the AST and others. This Friday
a new class starts with students from Indiana, Georgia, Illinois and even
Florida. I have had Athletic trainers, RN’s, Orthotic Fitters, Orthopedic
Technologists, LPN’s, Xray Techs, Medical Assistants and even Massage
attend my courses for Continuing Education. I am quite proud that I
receive letters from these people thanking me for improving their skills and
income. All of these students are working for O&P shops or Orthopedic
Surgeons or Hospitals.
The largest orthopedic practice in Florida is opening up a satellite office
in Mr. Baders area. They have Orthotechs who do all the casting and
bracing. Mr. Bader will be getting few (insurance contracted cases), if
any, orthotic patients from this practice. So I believe he also has an
economic impact if Orthopedic
Technologists are allowed to do bracing in this state as part of the
exemption given MD’s employees. He will have a further economic impact if
Orthopedic Technologists are exempt under the “QUALIFIED PROFESSIONAL”
exemption I believe they now have.
So why not just include Orthopedic Technologists in the license statutes?
Add them to the Law. Have the state legislators vote on it. If they were
informed of OT’s in the first place I believe we would not be talking about
this now. Define what they do according to their training just like we did
with Orthodox Fitters.
Makes sense to me.
Charles Barocas, CO, LO
—– Original Message —–
Sent: Monday, September 18, 2000 10:05 PM
Subject: Re: FLAP O&UP LAW
> In a message dated 9/18/00 6:08:05 PM Pacific Daylight Time,
> << I think your first mistake is thinking that the Roth tech is NOT > supervised by the MD. They are supervised by the
> Doctors in my hospital and I will bet they are supervised by the Doctors
> Florida too!.
> Dan Nelson, COP, FASO >>