Pursuing licensure is more difficult in a state which has a very low population of O&P providers, and hence has less dedicated manpower to support the legislative initiatives and fewer members to share the costs, which are considerable. However, there still are ways to successfully pursue a licensure program or its equivalent.
"Even in the least populous states, with a small percentage of practitioners to patients, there is still a need to protect the consumer and insure that competent professionals are providing their care," points out Jim Rogers, CPO, FAAOP, Orthotic & Prosthetic Associates, Chattanooga, Tennessee, and head of the Licensure Task Force of the American Academy of Orthotists and Prosthetists (the Academy).
"Patients should always be assured that they are getting competent care in such an important medical specialty." Rogers continues, "Now, is it financially cost-effective--? Perhaps those are the states that wait until the completion of the process in other states and then rely on the experienced states for help. Right now it's a state-by-state issue. I would like for licensure to be embraced by the profession, creating a movement gaining enough momentum that there is a commitment to accomplish this for everyone; we're all in it together."
Joseph Elliott, CP, BOCPO, Hanger Prosthetics & Orthotics, Birmingham, Alabama, suggests that even if a state has only a very small number of practitioners, making the licensure effort more difficult, it can be accomplished by other means, perhaps by aligning with some physicians' group. "Licensure is beneficial to the individual practitioner and to the profession--and therefore I can't see any reason not to do it. The mechanics of doing it may differ, but I can't see any reason not to do it."
He admits that with only 140 licensees, Alabama finds the cost per practitioner very expensive. "That's controlled, however, by the way your state sets up the board. In Alabama, every board has to be independent, and yet every board has to be established and run under the administrative code of the state of Alabama."
Mike Allen, CPO, LPO, FAAOP, Allen Orthotics & Prosthetics Inc., Midland, Texas, notes that there are alternatives to licensure that would offer the same public protection: mandatory certification in the form of a registration program, which mandates certification as the prerequisite or the requirement for registry. "Those are inexpensive programs that can be established within existing state agencies, for example, through the state's department of health and human services, or whatever that agency's name may be. The agency can simply promulgate rules requiring specific educational training and experience standards, without the cost of boards, etc."