Seeing the Light at Sunriver: AOPA Plans Ahead

Rental canoes wait in the glassy morning lagoon on the Deschutes River at Sunriver Resort, Oregon. Photo by Thomas Boyd. The adage, "When the going gets tough, the tough get going," can certainly be applied to the orthotics and prosthetics field. As never before, the various O&P organizations are working together, plus brainstorming ways to meet the challenges of an industry embroiled in change. Out of one such brainstorming session has come the American Orthotic & Prosthetic Association's (AOPA's) "Sunriver Initiatives" Project. The AOPA Board of Directors meets each summer for a planning and strategizing conference. Last summer the group met at the Sunriver Resort near Bend, Oregon, hence the name. Tyler Wilson The group brought in a facilitator to help with pre-planning and with the meeting itself. Explained Executive Director Tyler Wilson, "The goal was to take a look at where the O&P field is going, what are some of the forces changing the field, and where are we going to be five or ten years from now. Given that picture, what are the key challenges confronting this field and what can AOPA do?" The group identified four key areas where "we thought the O&P field could step up, look at itself, and really do some work," said Wilson. Wilson stressed that these are five-to-ten year initiatives, so changing the course within six months isn't in the picture, but, by starting right away, the field can better be where it wants to be within the five-to-ten-year timeframe. Business Optimization Processes and Tools The four initiatives are: Business Optimization Processes and Tools; Evidence-Based Care; Developing a Shared Vision; and Differentiation in a Crowded Marketplace. Noting that business management may not be second nature to someone who entered the profession as a practitioner and later became a facility owner, Wilson said that O&P companies need more comprehensive information and guidance in how to best manage their businesses. Key areas include financial assessment and management; human resource management; practice management; and marketing. "It certainly is consistent with our mission to provide the tools facilities need for better management," he observed. Evidence-Based Care "Our sense at Sunriver last year was that this whole area really needs heightened attention, and without greater emphasis, the O&P field is really going to suffer," Wilson said, adding, "This really has to be put at the top of the priority list." The American Academy of Orthotists and Prosthetists (the Academy) has played the largest role in outcomes studies, Wilson noted, and AOPA wants to offer its support and resources to assist. Outcomes studies to provide evidence-based care require much thought and funding, many resources, and the input of many individuals and organizations to move the process along, he explained. "For a long time our field has not done a very good job at establishing the efficacy of various O&P treatments-and that failure has dogged the profession," Wilson stressed. "It is going to jeopardize increasingly the willingness of payers to reimburse appropriately for our services. We feel AOPA has a role to play in helping to further the design, content, execution, and publication of outcomes studies that validate what we do." For each of its initiatives, AOPA is not limiting participation to members of the immediate organization, according to Wilson. "We are reaching out to other people throughout the field." Developing a Shared Vision "Some of the challenges we face are bigger than any one organization can take on," Wilson said. Even though each organization has its own mission and objectives, there is a lot of overlap. "There are many areas in which we can better communicate and coordinate. In the past, our various organizations each tended to go its own way without working together. Originally our goal coming out of Sunriver was to bring the various organizations together to develop a shared vision or consensus about where the O&P field would be in the decade ahead and the far-reaching challenges that would be better addressed through collective efforts. The exercise would be much as our Board did in Sunriver." The field has seen this exemplified in the O&P Alliance on the legislative front, he noted. However, this initiative has taken a right-angle turn from what was initially considered at Sunriver, Wilson explained. He enthusiastically described a planned conference to bring together a cross-section of 40-60 of "the best and brightest" individuals in O&P, rather than focusing on organizations at this point. The objective would be for them to take an in-depth look at where the orthotics and prosthetics field is now and to develop a list of priorities that need to be addressed. "They might come up with the same ones that we did at Sunriver-or they might not," Wilson said, noting that AOPA does not plan to press its own initiatives and conclusions, but simply to bring individuals together for them to discuss and develop ideas. The conference is tentatively planned for late October. Differentiation in a Crowded Marketplace With more and more entrants into the O&P field, which Wilson described as "non-traditional providers of O&P care," it is critical for traditional providers to "really establish ourselves and differentiate ourselves as the highest and best providers of O&P care." There are several ways to achieve this, he pointed out, including accreditation, licensure, and outcomes studies to show that "what we do is going to result in better patient care and better outcomes." He continued, "We are looking at a variety of areas which will establish our legitimacy as the best providers of care." As to implementing solutions to the priorities that emerge from the planned industry-wide conference, the structures and mechanisms are yet to be established, but Wilson suggested that a coordinating coalition, somewhat similar to the government affairs Alliance, might be formed so the various organizations could synchronize their efforts. He noted that a structure might naturally evolve from the various organizations considering the priorities and weighing what they are best geared to handle, and what they are better suited not to spearhead but rather to play a role in and support. But whatever challenges there are and how these are to be met, one thing stands out clearly. The O&P field is not merely wringing its hands and going into "circle-the-wagons" mode, but is pulling together for positive action. O&P is on its way to implementing Einstein's three rules of work: "Out of clutter find simplicity; from discord find harmony; in the middle of difficulty lies opportunity."

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