The Truth about Licensure
By Jeff Fredrick, MS, CPO Licensure: is it progress or elitism? Profession
growth, or unfair restriction? However you see it, licensure is
here to stay - at least in Florida. If it successfully regulates
the profession in this very politically visible state, no doubt
licensure will follow in other states besides the eight which
currently have it. What is the truth about licensure? Is it a
friend or foe? The answer to this depends on the practitioners view
of the profession.
If licensure is based on the highest credentials achievable,
lesser credentialed practitioners will be excluded. In the short
term, this seems unfair. However, the generous grandfather
provision in Florida's law provided a remedy for those who felt the
American Board for Certification in Orthotics & Prosthetics'
(ABCs) formula for professional credentialing was more than they
were willing to pursue.
Recent journal articles addressing encroachment suggest
education and professionalism are the best means of preserving our
turf. Those who decry licensure because they have not upgraded with
rising professional standards play into the hands of non-O&P
practitioners who feel they are better educated to promote
good O&P outcomes.
In the end, the value of licensure may be best addressed by our
growing competition: medical doctors and physical and occupational
therapists. So long as education and credentials remain a rationale
for encroachment, it is in our professional best interest to
upgrade. In Florida, licensure has produced a more educated and
professional (licensed) orthotic and prosthetic community than we
had a decade ago.
Don't Lose Out
"Unfair playing field! Unnecessary exclusions! No one ever told
me about licensure!" It is best to examine such accusations more
carefully. I remember a CPO with a distinguished career who
achieved her certification when ABC only required an AA degree. She
allowed the grandfathering phase to expire before she applied for a
Florida license. Her options were limited by her tardiness, to say
the least. She could sell her house, close her 20-year practice,
and move to a state without licensure, or stop working and go back
to school. She could no longer practice in Florida. It was a tough
thing to watch.
Some people complained when ABC credentialing evolved from an AA
degree to a BS/BA. It is called "growth" and our profession needs
it badly to compete with other hungry members of the clinical team.
This practitioner was as skilled, if not more so, than most.
However, if she was not "professional" enough to pay attention to
the law and the availability of the grandfathering window, maybe
she would be as prone to miss something else as important to her
career that might ultimately harm a patient?
The Florida licensure credentialing process is based upon, but
separate from, ABC or BOC [Board for Orthotist/Prosthetist
Certification]. All the information about the law is available
online. ABC or BOC certification is not equivalent to
Florida licensure standards. For those who practice in other states
contemplating licensure, please pay attention! Read the law! Apply
immediately and take advantage of grandfathering clauses if you do
not meet the projected standards.
Is Licensure Fair?
Fair? Licensure couldn't be more so to all of us who expect
medical/rehabilitation practitioners who provide services for our
families to have the highest credentials. Licensure is fair to our
patients and every practitioner who meets the standards and wants
to maintain our fair share of the rehabilitation market. Licensure
promotes practitioner growth that will guarantee the health of our
profession for years to come. Sure, it would be easy to leave the
standards where they are. No one would be happier about this than
all those other professionals who would like to take over our role
in the rehabilitation market. Like it or not, the playing field is
changing. To stay in business, we must change with it - good advice
for those among our own who decry licensure, because they are
unwilling to accept higher standards of orthotics and prosthetics
as their own. Jeff Fredrick, MS, CPO, is director of Hanger’s Rehabilitation for Development (Hanger RFD) and branch manager at Hanger Prosthetics & Orthotics, Tallahassee, Florida. 
Table Of Contents - February 2005
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