The Balancing Act: A 20-Year Review

Technology has come a long way in 20 years. Material and fabrication
innovations have evolved the day-to-day tasks of an O&P professional. At
the same time,
documentation requirements have gone up with more demand on
the practitioner to balance the clinical side of patient care and the business
side of patient care.

  Image: © 2011 Jurica


I have had the good fortune to work with several
CAD/CAM programs including the beta testing of the one I use
now. The use of this technology has completely changed the way I practice
prosthetics. As with most of my colleagues, 20 years ago I would take a plaster
impression of the residual limb and hand modify after filling and stripping the
mold. This laborious process would require hours of time and preparation in an
effort to produce a shape appropriate to meet the patient’s needs. Now,
through the available technology I am able to achieve the same results with a
significant savings of time and labor. What once took hours now takes minutes,
and I believe the results are ultimately better. This method of
fabrication has greatly reduced turn-around times, which
ultimately benefits the patient as well.


Component technology continues to progress at a dizzying rate. It seems
to me that I see new products being introduced at almost every meeting I
attend. I am especially delighted that more advances are being directed toward
the majority of our patient population which is the K-2 and K-3 category. Now
our community ambulators can benefit from advances in material and
biomechanical technology.

I would hope that insurances such as Medicare continue to recognize the
benefits of these technologies and keep pace with the rapid growth in providing
appropriate reimbursement.


Fabrication materials have come a long way in 20 years. The material
that is provided for test sockets allows me to heat and modify the fit as
necessary. Prior to using this material, I would need to refill and re-pull
another diagnostic socket in order to make the necessary modifications to
ensure an optimal fit. This also reduces turn-around times and again benefits
the patient.

In using these systems of fabrication I am also eliminating my exposure
to potentially harmful chemicals and materials. I do little fabrication in my
office which results in a healthier workplace not only for me but my staff and
clients as well. Sales representatives visiting my facility often comment that
it does not have “that smell” found in a typical O&P facility.


Ideally this time savings would result in less stress, more free time,
and much faster turn-around time for fitting. This is mostly true, but what I
find now is the time I save with technology is taken up with the greater
demands of documentation and information gathering necessary to obtain
authorizations for payment.

The past 20 years have certainly produced a change in how we document
our services. I am not averse to these as we’ve always been conscientious
about charting our patient information but it seems to me that more and more of
a practitioner’s time is spent on these processes rather than actual
patient care. I am aware of electronic means of data collection and storage,
but for me, the cost of most programs is not justified for a small office.

I know the aforementioned advances have had a considerable impact on the
way I practice today in comparison to 20 years ago. I embrace new advances that
benefit my clients and ultimately provide me the satisfaction of providing
service to others through this great profession.

Joel J. Kempfer

Joel J. Kempfer, CP, FAAOP is the president of Kempfer
Orthotics and Prosthetics in Greenfield, Wisc. and member of the O&P
Business News
Practitioner Advisory Council.

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