O&P Professionals: Worthy of a License?
By Anthony T. Barr  It's fortunate for the O&P profession and
patients receiving their services that the National Association for
the Advancement of Orthotics & Prosthetics (NAAOP) and the
American Orthotic & Prosthetic Association (AOPA) have led the
legislative fight to protect their interests.
Perhaps the "mixed bag" solution, identified by NAAOP in the
Medicare Reform bill recently passed by Congress and posted on the
oandp-l listserve, could be resolved more appropriately via a
combined and unilateral effort of profession and patient.
I have often wondered why the American Academy of Orthotists
& Prosthetists (AAOP) and the Amputee Coalition of America
(ACA) have not been more involved in these legislative efforts--in
particular, by disseminating news and updates about the ongoing
negotiations with their membership.
It seems to me that patient advocacy groups and the professional
associations working together would have more impact on lawmakers
when representing their membership groups than trade associations,
such as AOPA and NAAOP, which may appear to be
self-serving--representing manufacturers and other business
interests.
The interests and differences of DME and O&P must be
recognized, separated, and presented as separate to lawmakers.
Doing this would more effectively protect the profession and
patients from unfair reimbursement and inadequate insurance
coverage. It has been very difficult to make that distinction when
there are DME members that belong to these same trade industry
associations, since these associations also represent comprehensive
O&P interests.
The requirement of mandatory licensure and regulation of the
O&P profession and every O&P provider in every state would
make that distinction clearer, thus assisting efforts to promote
legislation to benefit O&P professionals and patients.
In the listserve post, NAAOP failed to include "licensed" in its
discussion of O&P practice standards. The NAAOP post said,
"Within the competitive bidding framework established under the
original House and Senate bills, standards for quality and
accreditation of providers would apply to all DME. However, the
final bill extended this provision to all O&P as well. This
provision appears to trump' the protracted Negotiated Rulemaking
dispute in favor of the position that all O&P care must be
provided by healthcare professionals certified/accredited in the
practice of orthotics and prosthetics. The provision will need to
be analyzed further to understand its full implications, i.e. its
impact on the failed Negotiated Rulemaking process, but it appears
to be very favorable to NAAOP's position on the issue of the
definition of a qualified provider.'"
Only ten of 50 states have meaningful licensure laws for O&P
providers, but physical and occupational therapists are regulated
in every state. Are patients of occupational and physical
therapists more deserving of having their care regulated than those
of O&P professionals?
I am hopeful that NAAOP, the Academy, and AOPA may reconsider
supporting regulation to properly identify O&P professionals as
legitimate healthcare providers who deserve a state license to
better separate themselves from the providers of DME. Is the
O&P field not worthy of requiring a license to practice as do
all other legitimate healthcare providers?
This is my "two-cents worth" as I beat the pro-regulation
drum!
Anthony T. "Tony" Barr is president of the Barr
Foundation, Boca Raton, Florida. The foundation is dedicated to
helping improve the lives of persons with amputations. For more
information, visit www.oandp.com/barr 
Table Of Contents - January 2004
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