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Licensure: Advice from Battle-Hardened Warriors
By Judith Philipps Otto Joe Elliott, CP, BOCPO, Hanger Prosthetics &
Orthotics, Birmingham, Alabama: "I think the best thing to
do, if I were in a state that didn't have licensure and I was
interested in it, would be to contact people who had been through
it.
"I spoke to the Louisiana association in June 2005, and the
message was, "You're going to get tired of hearing this, but the
first thing you're going to need is money. Then you'll need
something else, and then you need money. Then you'll need another
something else, and then you need money. It's a very expensive
process--you can plan on spending $100,000 over one, two, or three
years to get it accomplished. That money has to come from
somewhere, and that means the people in that state have to pony up
contributions in order to get bills through the legislature."
Marc David Kaufman, CPO, Atlanta Prosthetics &
Orthotics, Atlanta, Georgia: "Be ready to have a
battle--but it's fun, and gets you introduced to the political
process. You really need three to five committed individuals with a
lobbyist to get it done; that's probably the biggest thing. One
person is not going to be able to do it.
"If we want our profession to be regarded as a profession and
not be identified individually as the brace man' but rather as more
scientifically and medically oriented professionals, then this is
really a good step for our profession.
"There will certainly be opposition from NOMA [National Orthotic
Manufacturers Association]--be ready for it. That's where you need
a good lobbyist--to work with their representatives or discover a
way to avoid excluding them completely. They have a lot larger
lobbying group and a lot louder voice than we do, so it's important
to know what they're going to be fighting against.
"Before you even get started, look at all of the allied health
professions in your state and get a copy of their practice act.
Find out who is allowed to actually practice orthotics and
prosthetics. You might find that if you don't research that
information up front, you can write all your rules and regulations,
but it's going to be for naught if it's already covered in the
other allied health professionals' practice acts.
"If their act was in effect first, it doesn't mean that you
can't practice what they've defined as their scope of practice, but
it does mean you can't take their scope of practice away."
Mike Allen, CPO, LPO, FAAOP, Allen Orthotics &
Prosthetics Inc., Midland, Texas: "Had we known what was
going to happen during the last hours of our legislative process,
then no doubt about it, we would have improved and increased the
intensity of our educational efforts. We probably would have
identified others--not necessarily allies--but those groups that
opposed us, e.g. pharmacists who were claiming that they would be
put out of business if the orthotics and prosthetics licensing bill
passed. So there was misinformation there that needed to be
corrected--and was corrected during the
second initiative.
It's a long-drawn-out process. In Texas, the legislative session
is every two years, so there's a lot of time invested. A more
comprehensive, thorough education of the legislators, correcting
misinformation, would have saved us a lot of blood, sweat, and
tears.
"Gather as much information as possible and become knowledgeable
in the history of licensure efforts. It's important to understand
where folks have come from, the bridges that they have crossed, the
difficulties they have encountered, to help lessen the obstacles
you will meet. Learn from the positive and negative experience of
others--which may be less costly than learning from your own
experience."
Terry Supan, CPO, FAAOP, FISPO, Orthotic &
Prosthetic Associates of Central Illinois, Springfield:
"Basically, there are three things to remember: 1) Put together a
team within your state to be the driving force behind licensure.
This probably needs to include somebody in the state capital that
can get the people closer. 2) Talk to people who have been there
already. Get their support or get them to give you some assistance
or advice on part or all of it. 3) Do it, and do it quick. This is
something that needs to be done to protect the consumers of
orthotic and prosthetic services. If you truly believe that
education is a cornerstone for proper care, and that's been the
cornerstone for all other parts of medicine for all these years,
then you need to do that for O&P in your state.
"It's not going to get any easier as time progresses. And the
more states that do it at the same time, the greater the chance
that your opposition's forces will be spread thinner." 
Table Of Contents - January 2006
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