An article in the March issue of The O&P EDGE explored the value of certified orthotic, mastectomy, and therapeutic shoe fitters to the O&P profession. This edition of EDGE Direct includes expanded insight about the value of fitters from O&P experts.
Todd Stone, CPO, is COO of Teter Orthotics and Prosthetics, Traverse City, Michigan. The company has 14 certified orthotic and/or mastectomy fitters-12 of whom the company sent to school. Stone says those 12 were typically technicians or administrative staff who had been with the company for a while, excelled in their current positions, and showed an interest. Teter O&P also has a written credentialing process, and the fitters are under supervision-usually verbal-for those patients who require some level of customization of their off-the-shelf bracing.
“Rather than having the high salary guy fitting splints or simple items, it was more cost effective to use fitters,” Stone says. “Then we would use the clinicians for the custom, more involved patient care.”
Additionally, the first group of employees to take the fitter coursework was so large that the course was held at a Teter O&P office, saving the company lodging and travel fees.
David Sickles, CPO, CPed, COO of the Center for Orthotic & Prosthetic Care (COPC) of North Carolina, says the company has had certified fitters on staff for about eight years, including staffing the Duke University Hospital’s breast center boutique with a full-time certified mastectomy fitter.
The company also has an O&P clinic at the hospital that sees a lot of patients with diabetes who are in need of soft foot orthotics and therapeutic shoes. “It’s very, very busy. One [patient] right after the other,” Sickles says. The fitters are well trained, qualified, and good at what they do, Sickles says. Nevertheless, if a fitter gets a difficult case, there is a certified orthotist or certified prosthetist available to help. The practitioner also cosigns the fitter’s notes. This practice model allows COPC’s practitioners “to practice and work with the more complex patients, the custom AFOs and spinal bracing and prosthetics,” he says. He likens having practitioners and fitters on staff to a medical practice staffed with physicians and physicians’ assistants.
Jeffrey Brandt, CPO, CEO and founder of Ability Prosthetics & Orthotics, headquartered in Exton, Pennsylvania, says he originally wasn’t in favor of having fitters and assistants on staff. “Ability has always been predicated on providing comprehensive care that was focused on the crux of why we went to school and this whole effort to sanctify our educational requirements the last 15-20 years.”
However, with more hospital contracting wherein the majority of the work is providing off-the-shelf devices requiring minimal adjustment, he started rethinking the company’s structure and the benefits of having lower-cost employees on staff. “So when we looked at the analysis of the business…, I really have no choice but to start to provide a lower cost employee to deliver that work,” he says.
At the time of this writing, he was in the process of hiring an orthotic fitter. “Make no mistake,” he stresses. “At Ability we still want you to possess the highest credential out there for your level of training and job responsibilities.”