New England Academy Meeting

I had the pleasure of attending the New England Academy meeting in Portsmouth, New Hampshire recently. This has always been an interesting meeting over the years as this is a very cohesive Chapter. At their request, I prepared a philosophical talk with the title "What Is Happening To The Art in Prosthetics & Orthotics?" This has been the topic of many informal discussions in recent years as we all struggle with the negative impact of chronic reimbursement delays, denials, and discounts. The concern that today's business pressures will destroy the "art" in clinical practice is not confined to our field but is, in fact, a concern in many rehabilitation communities.

This was one of those tasks that, despite the effort involved, turned out to be time well spent since it lead me to conclusions that I had not expected. When I started working on this project, I was feeling the same vague sense of frustration as everyone else. But, as I reflected more critically on where the field is evolving, I ended with a more upbeat attitude and at least some glimpse of what our future may hold.

In particular, I became convinced that Evidence Based Clinical Practice will become a powerful force affecting our profession in the coming years. Heretofore, I had been aware of the basic concept but viewed it as too undeveloped to have much practical application to prosthetic and orthotic practice. But, I don't think we can dismiss this trend any longer.

Over the past century, the "art" in P&O has been consistently moving away from fabrication skills and toward making decisions about device configuration and patient management. Today's respected clinician is the person who can successfully treat a diverse array of clinical problems, using prefabricated industrial quality components, so that the patient and referring physician are both satisfied long term with the results from the orthosis or prosthesis. The prior "art" of being able to forge steel or carve wooden feet has been displaced by the "art" of thorough patient evaluation, meticulous fitting, and scheduled follow-up. In the coming decades, I predict that the "art" of applying available scientific information about patient treatment will grow in importance.

Reader Comments: Read all user comments EBCP Dear Mr.Michael, I thank you for 'eyeopener' coments on this subject. Your discussion has led us to grasp this subject at the earliest. May I inform you that your given website of Univ. college Dublin's on-line Hand Book with a 'CAT' revie... read more - KHALID N.NIAZI   7/22/2001 EBCP Hi John This reminds me of ISO 9000 standards it has lots of paperwork but no meat. Otto Bock, I have notice since they implemented these standards they have had a few things that has broken on us. (Tube adaptors) I see that their focus ha... read more - John Russell   6/17/2001