Monday, July 15, 2024

Fla O&P Law

Charles Barocas,C.O.

Mr. Bader,

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

or condone.


> 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

list who

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

something from

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

Surgery, NYC)

& 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,

[email protected]

> writes:


> << 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 >>





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