Due to the advancements in technology and education in the O&P field, the American Board of Certification in Orthotics, Prosthetics and Pedorthics (ABC) Scope of Practice Committee, made up of 12 ABC credentialed individuals, reconvened to update their Orthotics, Prosthetics and Pedorthics Scope of Practice. In January 2009, the committee produced its first Scope of Practice in 6 years. The 22-page document clearly outlines and defines the roles and responsibilities all ABC credential holders can competently execute.
“A lot of people don’t really understand what the Scope of Practice document is used for,” William Barringer, CO, FAAOP, member of the ABC Scope of Practice committee told O&P Business News.
According to the 2009 Scope of Practice, the document “defines several aspects of the orthotic, prosthetic and pedorthic professions including the delineation of the scopes of practice and the responsibilities of ABC credentialed individuals.”
“The Scope is used by schools and educators, practitioners, other professions and licensure boards,” Dennis Janisse, CPed, member of the ABC Scope of Practice committee said. “Licensure is very important when it comes to credibility in the eyes of insurance companies. Especially when it comes to reimbursement claims.”
The O&P industry is currently in the process of licensing every state, according to Barringer. In his view, documents such as the Scope will help bring more understanding of the O&P specialty in states where licensing is being considered. By showing state legislatures and licensing boards these documents, the role of orthotists and prosthetists will be better understood. Practitioners will be held to higher standards, which will lead to better O&P service and care for the patient.
The document also highlights the tasks of the O&P professionals, which includes pedorthists, fitters, technicians and assistants.
“Certified individuals need a document that clearly and comprehensibly describes their roles and responsibilities,” Catherine Carter, executive director of ABC said. “Anyone involved in the allied health profession that needs to know the tasks and responsibilities of the O&P profession, can learn those roles through our document. It’s a document that is helpful for those inside the profession and those outside the profession.”
With advanced technology and education, a practitioner’s job requirements may overlap into another closely related health care profession.
“All health related fields have a Scope of Practice and in all health related fields, there is some overlap,” Barringer said.
An example that has been mentioned is the close relation between the O&P field and PT.
“There is some overlap between the roles of physical therapists and O&P,” Carter said. “A Scope of Practice can help define that overlap.”
Carter explained that although the Scope can be used to point out the overlap, the ABC Scope only defines the roles of the O&P profession. The document does not discuss practicing in other professions. According to Barringer, while many practitioners are duel-credentialed in both PT and O&P, in reality, the two professions are quite different.
“If you read PT’s Scope of Practice and ours, we may mention a PT-related task, but there is not much overlap,” Barringer explains. “So if someone says O&P has a lot in common with PT, I think if you read what we are competent to do and what they are competent to do, there is a large discrepancy.”
While overlap may be legitimate, conflicts do arise. If there is a conflict between two fields, state governments or licensing boards mediate, interpret the Scope of Practice documents and make the final decision on who should be practicing on the patient.
“I have never had to face another profession and say we do this and draw a line in the sand,” Barringer said. “Although it does happen. I hear about it all the time between other professions.”
The 2009 edition of ABC’s Scope of Practice is primarily based on the 2003 Scope and a document called the Practice Analysis. According to Barringer and Janisse, the Practice Analysis is a snapshot of what the everyday practitioner does and the tasks they can and should be able to complete based on their training and education.
ABC does not have a set schedule to update the Scope document. However, ABC and its board of directors are constantly aware of the changes in technology, levels of education and opportunities for advancement in the O&P field, according to Carter.
“As those factors are changing, we are reviewing the Scope to insure that it remains contemporary,” Carter said.
Despite being based on its previous version, the 2009 Scope, according to Barringer and Janisse, is a much more detailed version than the 2003 Scope of Practice. Pedorthists were not in the 2003 document because ABC was not credentialing them at the time. This year, a section is devoted to pedorthists and the tasks they are required to perform. Barringer noted the 2009 Scope covers not only the O&P practitioner but also the practice for all different credential holders. In the previous document, that was not spelled out in such detail.
“When you look at this version, you will see bulleted lists for each credential,” Carter explained. “It’s not necessarily different than it was before, but it is much more comprehensive and descriptive. It is a little more in depth.”
The 2003 Scope, according to Barringer, highlighted the devices practitioners used as much as the skills it takes to use those devices. While that familiarity is important, the Scope should be practice driven, not device driven, in Barringer’s view.
“It’s based on the knowledge and the skills to be competent,” Barringer explained. “I think the old one was divided between knowledge skills and devices.”
With President Barack Obama aiming for a complete overhaul of the health care system, a new Scope may need to be created in the near future to compensate for any impact the reforms have on the O&P industry.
“We update it periodically to reflect upon the advances that have been made,” Janisse said. “Our profession is continually changing.”— by Anthony Calabro
For more information:
- ABC Scope of Practice Task Force. Orthotics, prosthetics & pedorthics scope of practice. American Board of Certification in Orthotics, Prosthetics and Pedorthics Inc. 2009; 1-22
- ABC Scope of Practice Task Force. Orthotics, prosthetics & pedorthics scope of practice. American Board of Certification in Orthotics, Prosthetics and Pedorthics Inc. 2003; 1-15