1. On the Provision of Custom Fabricated and Fitted Orthoses and Prostheses
Orthotists and Prosthetists are allied health professionals who provide comprehensive orthotic and prosthetic care. The comprehensive services they provide include evaluation, formulation of treatment plans, fabrication or procurement of an appropriate device, and the provision of continuing care and patient management. Considering the unique blend of medical, engineering sciences, and technical skills necessary to ensure competency in the delivery of comprehensive orthotic and prosthetic care, extensive education directly related to this field is critical to protect the individuals requiring such care.
Educational requirements for orthotic and prosthetic practitioners have increased steadily since 1948 when the first such requirements were created by the American Board for Certification in Orthotics and Prosthetics (ABC). These requirements have increased to reflect the evolving role of the Orthotist and Prosthetist on the allied health care team and as necessitated by the continuing influx of technological advances into the field. The National Commission on Orthotic and Prosthetic Education (NCOPE) has developed and maintained a set of minimum educational and experiential guidelines for the provision of orthotic and prosthetic care. NCOPE, in cooperation with the Commission on Accreditation of Allied Health Education Programs (CAAHEP), grants accreditation to educational programs. CAAHEP is the national standard for accreditation of allied health programs. In addition to Orthotics and Prosthetics, CAAHEP accredits educational programs in 17 other allied health disciplines. The maintenance of sufficient continuing education is also critical as technological and medical advances continue to improve the way orthotic and prosthetic cares are provided. The Academy supports the educational and residency guidelines created by the National Commission on Orthotic and Prosthetic Education and the Commission on Accreditation of Allied Health Education Programs.
Testing ensures competence. The American Board for Certification in Orthotics and Prosthetics has developed the most comprehensive set of examinations in Orthotics and Prosthetics. The educational requirements for ABC practitioner certification are the only orthotic and prosthetic standards recognized by CAAHEP and the American Medical Association. The Academy supports the examinations and standards set by The American Board for Certification in Orthotics and Prosthetics.
There are several states that have passed licensing laws regarding the provision of Orthotic and Prosthetic care. There are differences from state to state in respect to both educational requirements and testing. The Academy believes that licensing may prevent unqualified individuals from providing orthotic and prosthetic care, provided that NCOPE requirements and appropriate testing, such as ABC has developed, are mandated.
It is the position of the Academy that the provision of physician prescribed, custom fabricated and fitted orthoses and prostheses should be directly supervised by or provided by practitioners who have met the NCOPE educational requirements, passed the ABC examinations, and maintained their certification via continuing education as mandated by ABC or the practitioner’s State Licensing Board.
3. On Academy Officers, Directors and Committee Giving Expert Witness Testimony
In order to avoid confusion as to whether an individual testifying is representing the Academy, all Officers, Directors and Committee persons giving testimony as an "expert witness" shall preface any statement they may give with the following:
I am testifying as a private practitioner. I possess credentials from (insert your credentialing body or bodies) and am testifying as an expert in the field of orthotics and prosthetics, but not in any capacity as an Officer, Director or Agent of the American Academy of Orthotists and Prosthetists.
4. On the Minimum Education Essentials & Credentialing for Providers of Comprehensive Orthotic and Prosthetic Services
It is the position of the AAOP that the delivery of comprehensive orthotic and prosthetic services should appropriately match the "minimum" education and experience requirements required by the ABC for orthotic and prosthetic practitioners. These currently accepted ABC standards are embodied within the "Essentials and Guidelines for an Accredited Educational Program for the Orthotist and Prosthetist" developed by the National Commission on Orthotic and Prosthetic Education (NCOPE). These "Essentials and Guidelines" were developed with the support and cooperation of the AAOP, the American Orthotic and Prosthetic Association (AOPA) and the American Medical Association (AMA). They serve as the foundation for the "minimum" education and experience established by the ABC for individuals wishing to pursue a career pathway in orthotics and prosthetics, as an ABC Certified Prosthetist and/or Orthotist.
The development of the NCOPE's "Essentials and Guidelines for an Accredited Educational Program for the Orthotist and Prosthetist" led to formal recognition of Orthotics and Prosthetics as an allied health occupation by the AMA's Council on Medical Education in 1992. This in turn led to a collaborative relationship with the AMA's Commission on Allied Health Education and Accreditation (CAHEA) in the accreditation of educational programs in the profession of orthotics and prosthetics which eventually led to formal recognition of NCOPE's "Essentials and Guidelines" by the AMA's Council on Medical Education in 1993. CAHEA, which is now known as the Commission on Accreditation of Allied Health Education Programs (CAAHEP), is the most widely recognized independent non-profit allied health education accreditation organization in the United States.
In that regard, ABC credentialed orthotic and prosthetic practitioners provide to disabled and/or injured persons a unique medical rehabilitation service that involves a clinical evaluation and assessment that leads to the custom designing, fitting and/or development of an orthosis or prosthesis. An "orthosis" by definition is an external supportive and/or assistive device interfaced externally to the human body for the treatment of neuromuscular and/or musculoskeletal deficit secondary to disease, trauma or a congenital disorder involving the arms, legs and/or spine. A "prosthesis" by definition is an external supportive and/or assistive device interfaced externally to the human body for the replacement of a limb absence secondary to disease, trauma or a congenital disorder involving the arms and/or legs. Given the unique blend of medical and engineering sciences, as well as technical skills that one must possess to ensure competency in the delivery of comprehensive O&P services, the Academy supports the maintenance of minimum education and credentialing requirements of the American Board for Certification in Orthotics and Prosthetics. The Academy further supports the ABC's ethical standard that requires O&P services be prescribed by a physician or an appropriately licensed health care provider.
5. Position Statement on State Licensure
As the pre-eminent professional organization in orthotics and prosthetics, it is the mission of the American Academy of Orthotists and Prosthetists (AAOP) to promote high standards of patient care through education, patient advocacy, literature and research. In keeping with this mission, and as the ONLY professional organization representing practitioners credentialed by the American Board for Certification in Orthotics and Prosthetics Inc. (ABC), the Academy is supportive of the highest standards for providers to ensure quality comprehensive orthotic and prosthetic services for patients.
The Academy believes:
Licensure requirements benefit the patient requiring orthotic or prosthetic services by demanding established criteria for minimum education essentials and experiential requirements. The standards we endorse are embodied within the "Standards and Guidelines for an Accredited Educational Program for the Orthotist and Prosthetist" developed by the National Commission on Orthotic and Prosthetic Education (NCOPE), and are required for certification by the American Board for Certification in Orthotics and Prosthetics (ABC). These standards were also recognized by the American Medical Association's Council on Medical Education in 1993, and by the Commission on Accreditation of Allied Health Education Programs (CAAHEP).
Licensure requirements are in the best interests of the profession in that they give official status to the practice of the profession, establish a recognized scope of practice for Orthotists and Prosthetists, and will be recognized by other healthcare practitioners in the crossover of patient care responsibilities.
Therefore, the Academy endorses state licensure of Orthotists and Prosthetists as the preferred method of establishing patient protection mechanisms through legislated state standards, provided those standards are equivalent to those developed by the National Commission on Orthotic and Prosthetic Education and recognized by the Commission on Accreditation of Allied Health Education Programs.
