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Prosthetists & Orthotists vs Physical Therapists: Colleagues or Combatants?

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Old 10th March 2006, 11:58 PM
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Default Prosthetists & Orthotists vs Physical Therapists: Colleagues or Combatants?

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While specific to the USA context, there are some interesting snipets in this discussion from O & P Edge

Physical Therapists: Colleagues or Combatants?
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Almost universally, credentialed orthotists and prosthetists acknowledge physical therapists as clinical colleagues on the rehabilitation team and agree that the two professions are complementary and integral to best patient care. However, that's as individuals and fellow clinicians. From an organizational and legislative perspective, it's another story.

"The 'problem' is with the organization [the American Physical Therapy Association], not with the therapists in the trenches," Terry Supan, CPO, FAAOP, FISPO, says succinctly. And Supan should know. He and colleague Mike Brncick, CPO, who also was interviewed for this article, are battle-scarred veterans of the failed Negotiated Rulemaking Committee Meetings (NRM, or "NegReg") in 2003. The committee was formed to assist then Health & Human Services (HHS) Secretary Tommy Thompson in implementing the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA), which includes provisions aimed at protecting Medicare patients from receiving orthotic and prosthetic care from unqualified providers.

Since, as Shakespeare noted, "the past is prologue," the present-day legislative battlefront between physical therapists and orthotists/prosthetists regarding Medicare physical therapy direct access legislation and increased physical therapy scope-of-practice provisions at the state level grew from BIPA and the NRM. The controversy centers around the educational and experience requirements for fitting prosthetic patients and the more complex orthotic cases which require highly trained patient evaluation, custom orthotic design for the specific patient, along with skilled follow-up care and adjustments.

Most certified prosthetists and orthotists acknowledge that physical therapists, as well as athletic trainers, physician assistants, and other allied health professionals, have the skills to fit many prefabricated orthoses, especially since many of these have improved in quality. But caring for amputees and orthotic patients with more complex conditions requires much more intense education and training--and continuing education to keep up with rapidly changing new technology and clinical research in O&P, most credentialed O&P practitioners believe.......
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Old 11th March 2006, 05:55 PM
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THANKS. Nothing like a little turf war to make for a good read.
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Old 20th March 2006, 01:20 AM
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I love this:
Quote:
Almost universally, credentialed orthotists and prosthetists acknowledge physical therapists as clinical colleagues on the rehabilitation team and agree that the two professions are complementary and integral to best patient care. However, that's as individuals and fellow clinicians. From an organizational and legislative perspective, it's another story.
It could have read:
Quote:
Almost universally, [insert any profession's name here] acknowledge [insert another profession's name here] as clinical colleagues on the team and agree that the two professions are complementary and integral to best patient care. However, that's as individuals and fellow clinicians. From an organizational and legislative perspective, it's another story.
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Old 30th March 2006, 04:53 PM
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Dynamic Chiropractic News has an interesting story on borrowing from Physical therapy:
Can the Chiropractic Profession Find a Road Map to Cultural Authority From Physical Therapists?
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Chiropractic continues to suffer from an overemphasis on philosophical and hypothetical beliefs while reliable, evidence-based approaches are ignored. Clinical practice and future research should be informed by both experience and evidence. Is our profession striking the right balance between forming hypotheses (retrospective experience) and testing those hypotheses (prospective evidence)? Cultural authority requires that chiropractic shed the image of the charlatan engaged in premature advocacy and overclaim of unreliable, unproven health care beliefs. A road map for this strategy has been refined, to a high degree, by a related health care field – physical therapy.

An editorial in the October 2005 Journal of Orthopedic and Sports Physical Therapy (JOSPT) quotes the American Physical Therapy Association's (APTA)'Vision 2020:1,2

"By 2020, physical therapy will be provided by physical therapists who are doctors of physical therapy, recognized by consumers and other health care professionals as the practitioners of choice to whom consumers have direct access for the diagnosis of, interventions for, and prevention of impairments, functional limitations, and disabilities related to movement, function, and health. To achieve this goal, APTA's Board of Directors suggests that we should focus our efforts on five key areas: professionalism, direct access, the doctor of physical therapy, evidence-based practice and practitioner of choice. Because a majority of first professional degree programs have now transitioned to the professional doctoral degree and physical therapists can provide direct access care in 39 states, it is clear that we are quickly moving toward the Vision 2020. However, it would be helpful to reflect on where we are as a profession and what it is, exactly, that we want in our journey toward the goals set forth by our national organization."
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