Expanding the Pedorthic Scope of Practice

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What is a pedorthist? This question not only intrigues other allied healthcare professionals, but even the professionals and certified pedorthists who compose the Pedorthic Footcare Association (PFA) board of directors. Perhaps the answer can be found among PFA's board. The current board reflects a diversity found within the industry: At least one board member is a retail pedorthist who has never billed insurance, there are a number who combine various practitioner business models, and there are some who are clinical pedorthists with no retail affiliation.

In my own practice, I have always had an orthopedic component and have incorporated some retail functional bracing and orthotics for rehabilitation and biomechanical correction. In terms of revenue streams, I've relied on a mixture of payer sources that include Medicare, private insurance, and private pay. I have tried to use my full scope of practice as a touchstone guide to a working pedorthic business model. Although a large number of pedorthists work in clinical settings, many own or work in retail-based businesses and shoe stores. As president of PFA, my focus has been accepting and understanding the potential expansion of the pedorthic scope of practice to include the retail component. That is also why, over the last year, PFA's board has met to continually define its mission statement and determine how practitioners who are expanding into a retail setting can work with PFA to continue to incorporate the pedorthic process into that model.

It can be difficult to define both of these professional models on a practice spectrum, but as an organization whose mission is to promote a practitioner's individual right to practice pedorthics, we are determined to do it. PFA's goal for the future is to incorporate opportunities for both groups of these dedicated practice pedorthists to feel PFA's support. With this in mind, and in light of the changing face of our profession we are currently organizing and charging PFA's board to develop and accomplish this expanding new goal in our ongoing mission.

PFA wants to develop and offer an ongoing educational opportunity that will provide pedorthic certification enhancement. Toward this end, PFA is formulating an educational opportunity for certified pedorthists that will advance their hands-on skills and knowledge to allow them to incorporate an AFO component appropriately in their practice. This additional education will also help pedorthists to better understand how these devices fit within the pedorthic scope of practice, while helping them to expand their businesses and assist their patients more fully. Secondly, PFA is working to establish a retail committee to be included in its standing committees of the board. An information gathering meeting was planned during this year's PFA Annual Exhibition and Symposium in Boston, Massachusetts.

For pedorthists, there is some good news on the horizon from many who are looking to expand business opportunities, especially with diabetic shoes. I feel that there will be an expansion in the use of the Therapeutic Shoe Bill through Medicare with those durable medical equipment (DME) companies receiving the competitive bid for diabetic supplies. The need for certified pedorthists will surge due to these DME companies looking to expand their revenue base and adding therapeutic shoes to their product line. Most of these companies are seeking to hire certified pedorthists for their diverse knowledge and expertise in this area.

When you examine the diverse directions that many of my colleagues have taken in their respective practices, you get a picture of an industry on the verge of great change. With PFA's dedication to further educational development and the ability to expand the profession, the certified pedorthist is poised to become a cutting-edge expert in lower-limb modalities.

Jay Zaffater, CPed, BOCPD, is president of the Pedorthic Footcare Association.

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