What about the United States?

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I just returned from a week-long mission to Haiti with Prosthetic & Orthotic Associates (POA), Orlando, Florida, as part of a team that donated its time to provide prosthetic care for victims of last year's devastating earthquake. Working for five days at the Mission of Hope prosthetics lab just outside Port-au-Prince, we measured, fabricated, and fit seven amputees with prostheses. The experience was rewarding and heart-wrenching; everywhere I looked, I saw so many people in need.

While there is no doubt that many people with amputations around the world need our help, there are many amputees here in the United States who can't afford a prosthesis that would enable them to become active again. So my experience in Haiti got me to wondering, "What about them?"

As an O&P resident at POA, one of the things that has impressed me the most about this company is the work it does with uninsured patients. When Stan Patterson, CP, opened POA in 1999, he vowed never to turn away an amputee due to his or her inability to pay. Fortunately, with the help of POA's patients and other benefactors, he has been able to keep this promise.

Many of the uninsured patients that POA provides care for are between the ages of 18 and 30. Their amputations are often the result of an accident, which leaves them with the unexpected responsibility of having to pay for prosthetic care. Two of these patients are Evan and Drew. While riding a motorcycle near his home in Hawaii, another motorist lost control of her car and hit Evan, severing his leg. He was 16-years-old at the time. Drew, 19, was riding his motorcycle while home from college on Christmas break when he was hit by a car. The driver said she never saw him. He also lost his leg.

Both Evan and Drew were between insurance coverage at the time of their accidents. After their accidents, they were unable to be placed back on their parents' insurance policies because their amputations disqualified them. They now live with the financial burden of obtaining prosthetic care for the rest of their lives.

Evan was able to fund his first prosthesis, but after a few years it no longer fit and needed to be replaced. Today, he owns a small business, but because his amputation is considered a pre-existing condition, the health insurance premiums he has been quoted are unaffordable, and some insurance companies have refused to cover him. POA provided Evan with a new socket, and he was ecstatic to be pain-free and able to resume his active life!

Drew wears a leg we made for him a few months after his accident. He has made a seamless transition back to his active lifestyle and will soon graduate from the University of Florida, Gainesville. Of course, both of these men will need replacement sockets over the years. Because components are a significant part of the cost involved in O&P patient care, POA gets its patients involved and lets them know that their unused components could be put to good use on someone who can't afford them. Then our team donates whatever time and materials are necessary to provide the patient with a well-fitting socket and the components needed to get back to his or her previous activity level.

I asked Stan how POA can afford to do this and still make a profit, and he explained how the process has worked for him: "We put the patient's needs first. We do not set compensation as our main goal. We do what is right, and the compensation follows. Our patients are a tremendous resource. The people who have been helped by POA let others know about us. Word of mouth is a powerful thing. For every amputee we have helped, there are at least two insured patients who have been referred [to us] by someone."

There are several U.S. organizations working to improve the quality and availability of prosthetic care for uninsured or under-insured Americans. Until this aid becomes more widely available, I pledge to do my part to provide mobility, independence, and, most importantly, hope to amputees in need. I encourage you all to do the same. It's possible to do good work and make a profit at the same time. Just think of the impact we could make in the quality of amputees' lives right here in the United States!

Ronald Dickson is a graduate of the bachelor of science in orthotics and prosthetics program at St. Petersburg College, Florida. He is a resident at Prosthetic and Orthotic Associates, Orlando, Florida, and will be sharing his experiences as he completes his residency.

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