Standards Of The Orthotic & Prosthetic Profession: Education, Certification, Licensure
21 Apr 2017
The term “professional,” regardless of the field, evokes certain expectations — advanced, specialized education…demonstrated skill…proven experience. Professionals are measured by specific standards that help define their preparation, capabilities and competence for the patients they serve and the health care providers and facilitators with whom they interact.
This is every bit as true for orthotics and prosthetics as for other health care professions. In 1993, the American Medical Association recognized orthotics and prosthetics as an allied health profession, culminating a steady evolution of the twin disciplines from medical-related craft to true patient care specialty. Like their counterparts in other allied health professions, O&P practitioners are evaluated against exacting standards of education, clinical experience, professional knowledge and demonstrated competence.
Today nine accredited programs across the U.S. offer formal O&P education curricula to prepare the prosthetists and orthotists of tomorrow with credentials ranging from bachelor’s degrees to post-baccalaureate certificates, to master’s degrees. The instruction in these programs places particular emphasis on anatomy and physiology, patient management skills, clinical practices and professionalism, fabrication and fitting techniques.
Upon graduation from an O&P education program, many students seek to further their preparation with a yearlong residency at an accredited site to gain clinical training and experience. The National Commission on Orthotic and Prosthetic Education (NCOPE) serves as the accrediting body for residency programs and participates with the Commission on Accreditation of Allied Health Education Programs (CAAHEP) in accrediting O&P education programs.
Board certification of practitioners establishes and promotes the highest standards of organizational and clinical performance in O&P service delivery. Since 1948 the American Board for Certification in Orthotics and Prosthetics (Pedorthics was added in 2007) has served as the comprehensive credentialing organization for establishing individual and organizational performance standards for delivery of orthotic, prosthetic and pedorthic care. At present, ABC offers 14 different certifications encompassing orthotists, prosthetists, pedorthists, orthotic fitters, mastectomy fitters, assistants and technicians.
ABC certification is well-recognized and highly respected in our field. To earn it, orthotists and prosthetists must meet well-defined educational and experience requirements and pass a rigorous written examination, written simulation, and two-day clinical exam.
Once certified, practitioners must work diligently to update and enhance their knowledge and skill to maintain their credentials in orthotics and prosthetics. Certification is renewable every five years once candidates demonstrate they have reached required continuing education thresholds established to ensure practitioners stay on top of advances in technology and current patient management standards.
ABC’s facility accreditation program evaluates O&P practices against exacting standards relating to governance, administration, staff qualifications, patient care, quality assessment, facility management and safety. ABC is recognized as an approved accrediting organization for suppliers of orthotic and prosthetic services and durable medical equipment by the Centers for Medicare and Medicaid Services. Full facility accreditation is good for three years.
An alternative pathway for individual certification and facility accreditation is offered by the Board of Certification/Accreditation, International (BOC), which was established as a second credentialing body in 1984.
Despite the existence of national O&P certification and accreditation programs, various underqualified providers continue to deliver substandard orthotic and prosthetic care with resulting negative consequences for unsuspecting patients. To combat this practice, 14 states now require licensure for orthotists and prosthetists, and others have legislation under consideration.
As a profession we believe licensure requirements are in the best interests of our field, that prosthetic and orthotic care should be delivered by practitioners who have fulfilled requirements for certification and that state licensure laws should embody similar requirements. Current licensure states include Texas.