Almanac OP The American Orthotic & Prosthetic Association
DECEMBER 2010
&
WWW.AOPANET.ORG
THE MAGAZINE FOR THE ORTHOTICS & PROSTHETICS INDUSTRY
FINDING THE
PERFECT FIT Patient education is the first step in post-mastectomy care
Exclusive: Q&A with VA ASST. SEC. TAMMY DUCKWORTH and David Rotter, CPO Tips for Holiday GIFT-GIVING
Power and Precision
Get outstanding responsiveness with the DynamicArm. Give your patients the greatest power, efficiency, and speed available in an electric elbow. Your patients will love the DynamicArm’s unmatched power, lifting up to 13 pounds and featuring a 50-pound static load capacity. It’s also incredibly responsive with precise, easy control – amazingly, it takes just half a second to go from extension to full flexion. The DynamicArm’s smooth, noiseless free swing brings it closer than ever before to the natural movements of the human arm. Deliver the Power! Call your Sales Representative at 800.328.4058 to find out more. www.ottobockus.com
alphaÂŽ select liner Controlled pistoning with unlimited flexion
Harry August
dog lover | photographer | fitness enthusiast | cross-country traveler | amputee
staying fit and active is important to amputees such as Harry who make the most of every day. Whether he’s working out, walking his dog, or driving out west, Harry requires a liner that delivers comfort and flexibility while controlling pistoning. the alpha select liner features a hybrid gel that delivers enhanced longevity for a variety of limb shapes without sacrificing the comfort to which gel users have become accustomed. its progressive gel style provides extra thickness and comfort distally, yet is thin both proximally and behind the knee. the flexible panel promotes a broad range of motion by minimizing tension on the knee. the liner’s one-way stretch fabric allows for easy donning yet effectively restricts pistoning without requiring a potentially irritating distal matrix.
R eal solutions foR R eal people
Fo r m o r e i n Fo r mati o n call 8 00.8 4 8.4 93 0 o r 74 0.8 6 9.3377 o r vi s it o u r W e b s ite WWW.oWWc o.c o m
O&P Almanac CONTENTS
DECEMBER 2010, VOLUME 59, NO. 12
COVER STORY
COLUMNS
12
Reimbursement Page Official guidelines on patient and referral source gift-giving
30
Ask the Expert Answers to questions about the Medicare Therapeutic Shoe Policy
32
Facility Spotlight Comprehensive Prosthetics & Orthotics Inc.
16 Finding the Perfect Fit
By Kim Fernandez Finding the proper bra or form after mastectomy surgery can be a confusing and emotional experience for women. Expert fitters offer their secrets for helping patients find a good fit, plus give suggestions for selecting the ideal undergarments to keep in stock.
DEPARTMENTS
4
AOPA Contact Page How to reach staff
8
In the News Updates and company announcements
36
FEATURES
24 Active Veteran Care
Amputee and VA Assistant Secretary Tammy Duckworth and her prosthetist, David Rotter, CPO, discuss their relationship and approach to Duckworth’s care, the greatest challenges facing veterans today, and more.
AOPA Headlines News about AOPA initiatives, meetings, member benefits, and more
46 Marketplace
Products and services for O&P
54 Jobs
Opportunities for O&P professionals
60 Calendar
Upcoming meetings and events
64
Ad Index
O&P Almanac (ISSN: 1061-4621) is published monthly by the American Orthotic & Prosthetic Association, 330 John Carlyle St., Ste. 200, Alexandria, VA 22314; 571/431-0876; fax 571/4310899; e-mail: almanac@AOPAnet.org. Yearly subscription rates: $59 domestic; $99 foreign. All foreign subscriptions must be prepaid in U.S. currency, and payment should come from a U.S. affiliate bank. A $35 processing fee must be added for non-affiliate bank checks. O&P Almanac does not issue refunds. Periodical postage paid at Alexandria, VA, and additional mailing offices. Postmaster: Send address changes to: O&P Almanac, 330 John Carlyle St., Ste. 200, Alexandria, VA 22314. For advertising information, contact Dean Mather, M.J. Mrvica Associates Inc. at 856/768-9360, e-mail: dmather@mrvica.com. DECEMBER 2010 O&P ALMANAC
3
OP Almanac
AOPA CONTACT INFORMATION
&
AMERICAN ORTHOTIC & PROSTHETIC ASSOCIATION (AOPA) 330 John Carlyle St., Ste. 200, Alexandria, VA 22314 AOPA Main Number: 571/431-0876 AOPA Fax: 571/431-0899 www.AOPAnet.org
EXECUTIVE OFFICES
MEMBERSHIP AND MEETINGS
Thomas F. Fise, JD, executive director, 571/431-0802, tfise@AOPAnet.org
Tina Moran, CMP, senior director of membership operations and meetings, 571/431-0808, tmoran@AOPAnet.org
Don DeBolt, chief operating officer, 571/431-0814, ddebolt@AOPAnet.org O&P ALMANAC Thomas F. Fise, JD, publisher, 571/431-0802, tfise@AOPAnet.org Josephine Rossi, editor, 703/914-9200 ext. 26, jrossi@strattonpublishing.com Catherine Marinoff, art director, 786/293-1577, catherine@marinoffdesign.com
Tom Wessel, director of business development, 651/724-8753, twessel@AOPAnet.org Kelly O’Neill, manager of membership and meetings, 571/431-0852, koneill@AOPAnet.org Steven Rybicki, communications manager, 571/431-0835, srybicki@AOPAnet.org Michael Chapman, coordinator, membership operations and meetings, 571/431-0843, mchapman@AOPAnet.org
Dean Mather, advertising sales representative, 856/768-9360, dmather@mrvica.com
Ann Davis, office, meetings administrator, and associate editor, AOPA in Advance, 571/431-0876, adavis@AOPAnet.org
Steven Rybicki, production manager, 571/431-0835, srybicki@AOPAnet.org
AOPA Bookstore: 571/431-0865
Ann Davis, staff writer, 571/431-0876, adavis@AOPAnet.org Teresa Tobat, editorial/production assistant, 703/914-9200 ext. 33, ttobat@strattonpublishing.com
Kathy Dodson, senior director of government affairs, 571/431-0810, kdodson@AOPAnet.org Devon Bernard, manager of reimbursement services, 571/431-0854, dbernard@AOPAnet.org
Reimbursement/Coding: 571/431-0833, www.LCodeSearch.com a
AMERICAN ORTHOTIC & PROSTHETIC ASSOCIATION SERVING THE O&P FIELD FOR OVER 90 YEARS
Renew the Easy Way With AOPA ONLINE PAY Login to pay your dues and update your membership directory information at:
www.aopanetonline.org/profile
Renew Online Today! O&P ALMANAC DECEMBER 2010
EDITORIAL MANAGEMENT Stratton Publishing & Marketing Inc. ADVERTISING SALES M.J. Mrvica Associates Inc. DESIGN & PRODUCTION Marinoff Design LLC PRINTING United Litho Inc.
BOARD OF DIRECTORS OFFICERS President Thomas V. DiBello, CO, FAAOP, Dynamic O&P, LLC, Houston, TX President-Elect Bert Harman, Otto Bock Health Care, Minneapolis, MN Vice President Tom Kirk, PhD, Hanger Orthopedic Group, Austin, TX Treasurer James Weber, MBA, Prosthetic & Orthotic Care, Inc., St. Louis, MO Immediate Past President James A. Kaiser, CP, Scheck & Siress, Chicago, IL Executive Director/Secretary Thomas F. Fise, JD, AOPA, Alexandria, VA
GOVERNMENT AFFAIRS
Joe McTernan, director of reimbursement services, 571/431-0811, jmcternan@AOPAnet.org
4
PUBLISHER Thomas F. Fise, JD
DIRECTORS Kel M. Bergmann, CPO, SCOPe Orthotics and Prosthetics Inc., San Diego, CA Rick Fleetwood, MPA, Snell Prosthetic & Orthotic Laboratory, Little Rock, AR Michael Hamontree, OrPro Inc, Irvine, CA Russell J. Hornfisher, Becker Orthopedic Appliance Co., Troy, MI Alfred E. Kritter, Jr., CPO, FAAOP, Hanger Prosthetics & Orthotics Inc., Savannah, GA Eileen Levis, Pennsylvania Orthotic and Prosthetic Society, Allentown, PA Anita Liberman-Lampear, MA, University of Michigan Orthotics and Prosthetics Center, Ann Arbor, MI
NEW! UPDATE MEMBERSHIP DIRECTORY INFORMATION ONLINE
Mahesh Mansukhani, MBA Ossur Americas, Aliso Viejo, CA Frank Vero, CPO, Mid-Florida Prosthetics & Orthotics, Ocala, FL Copyright 2010 American Orthotic and Prosthetic Association. All rights reserved. This publication may not be copied in part or in whole without written permission from the publisher. The opinions expressed by authors do not necessarily reflect the official views of AOPA, nor does the association necessarily endorse products shown in the Almanac. The Almanac is not responsible for returning any unsolicited materials. All letters, press releases, announcements, and articles submitted to the Almanac may be edited for space and content. The magazine is meant to provide accurate, authoritative information about the subject matter covered. It is provided and disseminated with the understanding that the publisher is not engaged in rendering legal or other professional services. If legal advice and/or expert assistance is required, a competent professional should be consulted.
and even more comfort for your patients.
CALL 1-800-992-3580 OR VISIT www.drcomfort.com ®
TM
Through December 31sT
$75 oFF* regular price
WhiTe sTealTh see resTricTions beloW
Stealth X2 (frOnt)
Stealth X2 apprOved L0637
*discount applies to regular price white stealth. offer excludes stealth rehab, stealth cb, & stealth xtreme.
A d d i t i o n A l P d A C A P P r o v e d S t e A lt h P r o d u C t S Stealth rehab l0627
Stealth prO l0631
Ph: 888-982-8181 • Fx: 877-288-4197 • sales@optecusa.com
call ToDay To geT a
Glide to warp speed recovery!!!
copy oF our
neW
caTalog!
Stealth lSO (back)
Stealth lSO apprOved L0637 • Available in two strap and four strap designs • Back Panel automatically contours to your patient’s lordosis • Durable closure system does not tangle or need to be reset • Closure system offers mechanical advantages that allow for precise compression and increased spinal support • Ergonomic Front & Back panels contour to patient’s size and shape
R e a d y W h e n Yo u A r e . . .
9 7 5 P r o g r e s s C i r c l e • L a w r e n c e v i l l e , G A 3 0 0 4 3 • w w w. o p t e c u s a . c o m
n
In the News Grant Aims to Combat Heterotopic Ossification
CDC Releases Latest Birth Defects Data Birth defects occur in about 3 percent of all live births, and more than 2,100 babies born in the United States have differences in arms, legs, or both, according to a study from The Centers for Disease Control and Prevention and National Birth Defects Prevention Network released in September. Using data tabulated from 14 birth defects tracking programs, this study examined the prevalence of birth defects in the United States from 2004 to 2006. Key findings include: • Each year, approximately 2,155 live births involve a reduction or difference of upper or lower limbs. • Reductions or differences in upper limbs were more prevalent, occurring in one of every 2,869 live births, or 3.49 per 10,000 live births. • Reductions or differences in lower limbs occurred in one of every 5,949 live births, or 1.68 per 10,000 live births.
8
O&P ALMANAC DECEMBER 2010
Researchers at Carnegie Mellon University’s (CMU) Bone Tissue Engineering Center have received a $2.9 million Department of Defense grant to develop a therapy to prevent heterotopic ossification—a painful condition common among wounded soldiers in which bone nodules form in soft tissues or at the site of amputation. Through the new grant, Jeffrey O. Hollinger, director of the center, and Krzysztof Matyjaszewski, a professor at CMU’s Mellon College of Science, will develop new tools to help prevent the growth of these painful bone formations, which can make it difficult for amputees to wear limb prostheses. “We are developing novel nanostructured polymers that will place selective biological cues at the stump site to block the bone formation cascade in the soldier’s traumatized muscle,” says Hollinger, who also is director of the Craniofacial Program, one of five programs funded under the
TRANSITIONS
Rutgers-led consortium in the Armed Forces Institute of Regenerative Medicine. Hollinger’s program is researching therapies to help heal combat injuries to the face and jaw. Matyjaszewski, who has developed a method that allows for nanoscale control over the polymers formation, says the ability to control and block mineralization and bone formation opens up many compelling opportunities for new research. Increased use of improvised explosive devices has caused the number of soldier amputations to grow by more than 60 percent since 2009, according to U.S. Army reports. Heterotopic ossification also can occur in a number of situations other than amputation, most commonly after joint replacement surgery.
PEOPLE IN THE NEWS
Dan Blasini, RN, BSN, BC-CM, Hanger Orthopedic Group clinical care manager, was selected as a finalist for the first annual Dorland Health People Awards in the Life Care Planner category. The award recognizes health-care professionals who share their knowledge and skills to address challenges and meet the needs of their team, patients, and patients’ families. Tom Nomura, CPO, has joined SCOPe Orthotics & Prosthetics Inc’s Orange County office. He has 16 years of O&P experience and is certified in the C-Leg, Harmony Systems, and WalkAide.
James Redhed, CPO, was hired by Cascade Prosthetics & Orthotics in Washington State. Morgan Stanfield has been appointed director of marketing and communications for Orthocare Innovations. Saravanan Sundarakrishnan of Comprehensive Prosthetics & Orthotics has earned CPO certification from the American Board for Certification in Prosthetics, Orthotics and Pedorthics Inc.
n
In the News TRANSITIONS
Lamprey Offer Insights Into Movement Dynamics By creating a computational model of how the bodies of swimming lamprey bend and move, researchers at the University of Maryland and Tulane University hope to develop a prosthesis that better works with the human body’s natural motions. According to the research study, recently published in the online edition of the Proceedings of the National Academy of Sciences, the researchers’ model is the first to examine the interaction of both internal and external forces on locomotion.When the fish move, their muscles contract to propel them through the water as the water moves against them. Their movements are determined by both the internal muscle strength and external force of the water. By matching the body’s complex natural movements to the mechanical properties of prosthetic devices researchers can create the next generation of prosthetics. The lamprey’s nervous system, for example, will help to design prosthetics for patients with spinal cord injuries. a 10
O&P ALMANAC DECEMBER 2010
BUSINESSES IN THE NEWS
The American Board for Certification in Orthotics, Prosthetics and Pedorthics Inc. (ABC) has reinstated its Certified Orthotic/Prosthetic Assistant certification program. “ABC believes that this individual plays an important role as care extender in current and future business models for the delivery of O&P care and with the encouragement of the profession, we are confident that now is the appropriate time to reinstate this certification program,” says D. Deane Doty, Jr., CPO, ABC president. The Eastern Michigan University Orthotics and Prosthetics program welcomes the Class of 2012. This is the eighth class and one of the most diverse groups to enter EMU, with many of the students moving to Michigan to join the program. Great Steps Orthotic & Prosthetic Solutions in Sartell, Minnesota, celebrated its 10th anniversary by having a community gathering to watch retired Sgt. 1st Class and double amputee, Dana Bowman, sky dive and parachute to the Great Steps O&P Solutions’ facility. Bowman spoke about how he lost his legs while colliding in the air with his Golden Knights Parachuting teammate who died as a result of the accident as well as his recovery and re-enlistment in the Army nine months later.
in Northern Virginia, opened an outpatient facility in Clinton, Maryland. OandPDirect.com, an e-commerce Web site for orthotic and prosthetic facilities, was unveiled at the 2010 AOPA National Assembly with the help of a NASCAR racing simulator. OandPDirect.com held a virtual race and winner Jeff Forbes, LPTA, BOCP, from the University of Mississippi received the OandPDirect.com Cup and an Apple iPad. OPAF and The First Clinics were joined on the tennis court by Wimbledon champion Dennis Ralston. A life-long player and coach, Ralston, an amputee himself, is partnering with OPAF and First Volley to advance adaptive tennis. The Pedorthic Foundation has created the largest single charitable organization in the pedorthic community, “Feet for Life.” The foundation has been given an initial donation of 10,000 pairs of shoes, which will go to diabetics with limited income and resources. The shoes will be distributed through credentialed pedorthists who sign up to participate in the initiative. The Foundation also started the Richard B. Schwartz Award to recognize and honor an individual or company for advancing the pedorthics profession.
Hanger Orthopedic Group Inc. announced a definitive merger agreement for acquisition of Reno, Nevada-based Accelerated Care Plus, a provider of integrated clinical programs for sub-acute and long-term care rehabilitation providers.
Pongratz Orthotics and Prosthetics has been appointed the sole provider for in-and-outpatient services at Maricopa Medical Center’s Arizona Burn Center in Phoenix.
Infinite Technologies, O&P provider for INOVA Health Systems
Rx Textiles Inc. has acquired SPT Technology Inc.
SPINAL SOLUTIONS BY ÖSSUR from Occiput to Sacrum
SPINAL SOLUTIONS
ceRvIcAL SOLUTIONS
TRAcTION SOLUTIONS
Miami Lumbar ® TLSO(shown) Miami Lumbar ® LSO Miami Lumbar ® Slim Miami Lumbar ® Sacro-Illiac
Miami J® Advanced Cervical Collar(shown) Miami J® Cervical Collar Miami Jr® Pediatric Cervical Collar Occian® Back ICU Collar Papoose® Infant Spinal Immobilizer
ReSolve® Halo System(shown) Open Back Ring Closed Back Ring Lil’ Angel® Pediatric Halo System
Learn more about Össur spinal solutions today! usa 800 233 6263 canada 800 663 5982 www.ossur.com
© 2010 Össur
n
Reimbursement Page By Joseph McTernan, AOPA government affairs department
Giving Gifts? Better Take Care Federal statutes and AOPA Code say what’s permissible
I
n the words of a famous holiday song, “It’s the most wonderful time of the year.” As the holiday season rapidly approaches, the spirit of giving blossoms, and for a short few weeks, people try to forget the stresses of daily life and focus on sharing good fortune and holiday cheer. Health-care providers often show their appreciation to their patients and the physicians who referred them by offering holiday gifts to thank both patients and referral sources for their continued loyalty and to convey appreciation for their business. Giving gifts during the holidays may be well intended, but it can often create unexpected problems involving anti-kickback statutes. While limited gift giving is generally acceptable, O&P practitioners should take care to make sure that gifts given with the purest of intentions are not misconstrued as inducements offered in exchange for future business.
As the holiday season rapidly approaches, the spirit of giving blossoms, and for a short few weeks, people try to forget the stresses of daily life and focus on sharing good fortune and holiday cheer. 12
O&P ALMANAC DECEMBER 2010
This month’s Reimbursement Page will discuss what is allowed, what is not allowed, and the difference between restrictions on gifts for patients and gifts for referral sources.
Gifts to Medicare Patients The value of the patient/practitioner relationship is truly immeasurable. Very few situations arise that cannot be resolved if there is mutual trust between the O&P practitioner and the patient. It is natural, then, for O&P and other providers to want to express their gratitude toward their patients, especially around the holidays. While giving gifts to Medicare beneficiaries is allowed, the Social Security Act contains several provisions that prohibit the use of gifts as an inducement to encourage patients to choose you over other providers in your area. In August 2002, the Office of Inspector General (OIG) for the Department of Health and Human Services published a special fraud alert that set guidelines on acceptable gifts
that providers could offer to Medicare beneficiaries. First and foremost, gifts of cash or cash equivalents of any kind are prohibited. Cash equivalents include such things as the routine waiver of coinsurance and deductibles, gift certificates, and gift cards. An important exception to this rule is the waiver of coinsurance and deductibles in cases where the patient is financially unable to pay. If this scenario exists, providers may make a case-by-case decision to waive the patient’s coinsurance and/or deductible. This decision should be documented in your records. While you are not required to take extreme measures to document the patient’s overall financial situation with tax returns, pay stubs, and the like, you should document that you have reason to believe the patient cannot afford the deductible or coinsurance and that you have made an individual decision to waive this patient’s financial responsibility.
Solutions that work for your business. A d d R E S S I N G C O M P L E X I T I E S O F N E U R O PAT H I C A N d / O R d Y S VA S C U L A R L I M B S Hands-on training for medical professionals directly involved with patients in multi-disciplinary clinical settings.
Hands on FEET Workshop
COURSE OBJECTIVES: • Identify patients at risk for foot ulceration due to lack of sensation • Identify causes and clinical signs of degeneration and pressure sites • describe how to use objective evaluation and documentation to assess, treat and follow-up • Incorporate thermography into evaluation and treatment protocols ABC has authorized 9.75 hrs for this course. Available dates & locations are specified online at http://www.spsco. com/services/educational.asp or by calling Kim Martin at 800.767.7776 x 173.
Experience Our Commitment
T: 800.767.7776 x 3 F: 800.869.7776 www.spsco.com estore.spsco.com
n
Reimbursement Page
Nonmonetary gifts to Medicare beneficiaries are acceptable within certain guidelines, but they must be of nominal value. The OIG report stated that the value of gifts to beneficiaries should not exceed $10 per gift or a total of $50 per calendar year. In other words, you can offer a Medicare beneficiary a maximum of five gifts valued at $10 each in any calendar year. The OIG report specifically states that no terms may be associated with these gifts. For example, you cannot require that the patient come in for an evaluation in order to receive the gift. The low value limit on gifts to beneficiaries allows you to show your appreciation for past business while steering clear of any potential fraud and abuse allegations regarding the value of the gift.
In addition to the value limit on nonmonetary gifts, several other restrictions govern the provision of gifts to referral sources. First, the value of the gift may not be tied to the volume of referrals received from a physician’s office. For example, you cannot provide a gift of higher value to your regular referral sources than you do to those that only refer patients periodically. While you do not have to offer the same gift to all of the practitioners who refer patients to you, you cannot base your decision of what to give on the number of referrals you receive. Second, gifts may not be solicited by referral sources. If the physician requests a specific gift and you provide it, the OIG considers your action an inducement in the hope of receiving future referrals and classifies the gift as a violation of federal antikickback statutes.
Code is the section on Frequently Asked Questions, which addresses some of the valuable questions AOPA members have submitted after reviewing the code. For example, one of the issues addressed involves
The voluntary AOPA Code of Interaction with Heathcare Professionals is a valuable resource in determining how to offer gifts of minimal value to referral sources without running afoul of federal anti-kickback statutes.
General Advice
Gifts to Referral Sources While giving gifts to Medicare beneficiaries should be approached with caution, gifts to those who referred the patients to you are viewed with even more scrutiny. Limits on gifts to referral sources are addressed by federal anti-kickback provisions. As is the case with gifts to beneficiaries, monetary gifts of any value also are prohibited. Nonmonetary gifts are allowed under very limited circumstances. When originally published in 2004, the limit on nonmonetary gifts to referral sources was $300 aggregate per calendar year. This limit is raised annually according to the increase in the Consumer Price Index. The aggregate limit for 2010 is $355. It is important to note that this is a limit, not an entitlement.
14
O&P ALMANAC DECEMBER 2010
In addition to federal anti-kickback provisions, AOPA has published its own document regarding gifts for referral sources. The American Orthotic and Prosthetic Association Code of Interaction with Healthcare Professionals addresses the practice of providing gifts to health-care professionals who have the ability to refer patients to your organization. The full document, including a Frequently Asked Questions section, may be found online at www.aopanet.org/ AOPA_Code_of_Interactions_with_ Healthcare_Professionals.pdf. This voluntary AOPA Code is a valuable resource in determining how to offer gifts of minimal value to referral sources without running afoul of federal anti-kickback statutes. Based on guidance originally published by the Pharmaceutical Research and Manufacturers of America, it is written with the specific needs of O&P facilities in mind and should be reviewed carefully before offering any gifts or benefits to existing or potential referral sources. One of the highlights of the AOPA
providing pens, notebooks, and other marketing materials as “giveaways” to referral sources. This is not recommended due to the fact that these materials are not primarily intended for educational purposes. Another question inquires about meals. As long as the meals are provided as part of an educational program and are modest in nature, they are typically deemed to be appropriate. Funding a golf or ski trip or a gourmet dinner for physicians (with or without spouses) is not. The full section can be reviewed by accessing the aforementioned URL. While holiday gift giving is an honored tradition around the world, when it comes to the world of the O&P business, it is important to play by the well-established rules. Failure to do so can lead to a very unhappy new year. a Joe McTernan is AOPA’s director of reimbursement services. Reach him at jmcternan@AOPAnet.org.
Finding the
Fit
New products and careful fittings make all the difference for post-mastectomy patients
16
O&P ALMANAC DECEMBER 2010
BY KIM FERNANDEZ
F
itting mastectomy patients with post-surgery bras and forms can present challenges, say those who do it every day. Some of the difficulties are physical, such as fitting different body shapes, finding a prosthetic form that matches a woman’s lifestyle, or compensating for reconstructive surgery that didn’t quite turn out as well as hoped. But when a solution is found, and a woman stands up and looks in the mirror and sees herself in a wellfitted undergarment that looks and feels good, fitters say her entire world can change. Cyla Weiner, founder and owner of Sylene of Washington in Chevy Chase, Maryland, says she frequently sees women react emotionally when a product compensates for post-mastectomy body changes or not-quite-perfect reconstructive surgeries. “We have a product called a Balance Shaper that’s made of silicone and is very thin,” she says. It’s designed to help achieve symmetry after implant reconstruction—sometimes years down the road after weight gain or loss—when the reconstructed breast isn’t matching the natural breast. “Women don’t realize this sort of thing is available to them,” says Weiner. “It really fills them out and makes a world of difference, and there’s a lot of emotion when that happens. They see it is easy, and they’re ecstatic. They hug us in the dressing room.”
The Right Size Emotions run high when choosing post-surgery bras, camisoles, other garments, and breast forms. While finding the perfect piece can bring a patient to elation, visiting a shop only to find nothing in the right size or style can create heartbreak, too. Constance Niclas, CMF, CFm, says she’s seen both extremes over and over in her years fitting women at Hackensack University Medical Center. Many of the upsetting days come when shops are ill-prepared to fit women who don’t meet the idea of “average” proportions, she says. “A fuller [figure] market is definitely out there,” says Niclas, adding that many of those women think they need a smaller size bra than they actually do. “If you have a woman who has spill coming out of the top of the brassiere, we know that’s wrong,” she says. “We need for that tissue to be inside the cups. European manufacturers go up to a size F or G, but we don’t see much of that with American companies.”
DECEMBER 2010 O&P ALMANAC
17
While she was fitting, Niclas spent a lot of time convincing women to try the next size up, and that’s not easy when they’re emotionally fragile. The stigma attached to larger sizes affects mastectomy bras as well as ordinary clothing. “It’s confusing for a lot of women,” she says. “They never had a good bra fitting to begin with, and they don’t understand that it’s OK to go into a D or E cup. They’re embarrassed [about their size] and they don’t want to talk about it.” Andrea Barbera, care manager for Anita USA, in Ft. Lauderdale, Florida, says that’s a real problem. “More than 80 percent of women don’t wear a properly fitted bra,” she says. “They don’t know what size they need. Once you’re in a surgical situation, post-mastectomy, if you’ve never been properly fitted by a professional fitter, you’ll go in and buy the same wrong size you’ve been wearing for a long time. Only now, you’re trying to support a prosthetic device to replace the tissue that’s not there anymore.” That can lead to difficulties. The wrong size bra won’t cushion the form up against the body, but instead allows it to hang from the bra straps, causing discomfort. “Patients come in and say the breast forms are so heavy,” says Maria Cortinas, owner of the Lady Like Mastectomy Boutique in San Antonio, Texas. “A lot of times, their bra is already old and they need a new one. The straps are pulled all the way down, so instead of having the prosthesis sitting on their body with the bra supporting it, it’s basically hanging. That puts a lot of weight on the shoulder. So a lot of that has to do with the bra fit and the bra itself.” Most women also don’t know how much their natural breast weighs, making finding a comfortable form even more difficult. “A size D cup weighs around 15 pounds,” says Niclas, adding that women are often shocked when they pick up a comparable size
18
O&P ALMANAC DECEMBER 2010
breast form and feel its weight in their hands. Getting them to try the form on in a properly fitted bra helps them realize it’s not heavier than it should be. “You wouldn’t walk around with a breast in your hand,” says Barbera. “Why would you put a breast form in your hand to decide what works?” She spends time encouraging women to try the forms on with a new bra, perhaps in a different size than they’ve had in the past, so they understand why it weighs what it does.
the breast form. Keep in mind that a natural breast is supported by your muscles and rib cage and natural tissue. The form is only supported by the bra.” “You have to take the measurements,” says Cortinas. “We see a lot of women, older women especially, who should wear a 36 but want to be in a 38 or a 40. They just want to be comfortable. They’ve never had a proper bra fitting, and when we try to put them into their true fit, it’s not
“It’s less about form adjustment than it is about wearing a bra that fits and is properly adjusted.” –Andrea Barbera
“Often, in trying to accommodate lighter and lighter forms, there is no symmetry to the body,” she says. “You cannot balance. The shoulders, spine, and whole upper area are totally off.” “It’s less about form adjustment than it is about wearing a bra that fits and is properly adjusted,” she says. “To be honest, bras should be worn a little more snugly than some women like. I tell them that when your bra starts to feel like your favorite pair of slippers, it’s not working anymore. You have to have it properly adjusted so it supports the form—when it pulls away from the body is when you become aware of the weight of
comfortable. They’re not used to it.” That said, there are situations when a lighter form would be better, including when a patient is older or has other issues that affect her ability to balance or support the prosthesis. “I personally think the swimming form is paramount,” says Niclas, explaining that these forms are lighter than standard ones. “What about the woman who’s having issues with scoliosis or osteoporosis? She can’t wear a standard form. She should be wearing a lighter form, and that should be documented on her medical record for when she goes in to submit for Medicare or insurance.”
The Right Schedule Many women need to understand that changes in their bodies often mean a new bra fitting is necessary. “You lost 20 pounds. What changed? Your breast size,” Niclas says. “You’ve had an illness and stayed home and gained 20 pounds, and what’s not fitting right? Your bra. It can even mean you have one breast that’s high and one that’s low.” “I think sometimes women change their shoes and their lipstick more often than they change their bras,” says Barbera. “The standard is that you should be refitted once a year. I believe you should be fitted twice a year. Your weight goes up and down and can fluctuate from one place to another on the body. In an average size or a petite figure, a couple of pounds can make a big difference.” Most fitters recommend that mastectomy patients purchase new bras every three to six months. Insurance companies don’t always agree, however, and the numbers and styles that companies cover vary widely. Cortinas says that while having women come in for frequent fittings is a great thing for them, it can actually lead to further confusion. “You’re not going to be the same size in every bra, even when they’re from the same maker,” she says. “Bra cups come in so many different cuts.” But women are frequently resistant to going up a size. And when a woman is emotional after losing a breast, that can be a hard road to navigate. “We try to explain that if the bra’s not properly fitted, the form isn’t going to be right up against her,” she says. “If they insist on a size, we’ll try to give them the best bra we can that gives them some support.”
20
O&P ALMANAC DECEMBER 2010
‘I think you need to put this one on,’ and then have her close her eyes and feel herself so she’d know it fit.” There can also be resistance to the price of a bra, particularly when “There’s a lot of emotion,” says insurance doesn’t cover buying more Weiner. “You don’t know what they’re than one or two at a time. dealing with. There are so many fears, “When you buy a better-quality and there’s a lot of frustration.” Niclas says she used to take women brassier, they’re usually between $40 and into the dressing room with a bra to try $60,” says Niclas. “You’re going to find that the better makers of brassieres stay without letting on to the size. in about that price range. We explain “I’d never say, ‘Oh my, you’re that those bras are actually going to last wearing a size 40B and that’s wrong,’” longer. I think once they get it and they she says. “I’d just bring it in the right understand that this is for them, it’s size and tell the woman that I thought easier. If you’re not feeling good in what this one would make her feel better. If you’re wearing, then you shouldn’t be they have a bra in the wrong size, it’s going to bother them all day. So I’d say, wearing it.”
They may all look alike… … but there is only one
That said, having a few lessexpensive bras in stock can help. “We carry a standard bra that’s $35.99,” says Cortinas. “They can usually afford that one if they need to pay out of pocket.” And, Niclas adds, many mastectomy shops are willing and able to help women out when the money isn’t there. “The largest brassiere I ever fit was a size 52I,” she says. “I used to have a woman from the industry who gave me brassieres because I had a lot of [patients who could not afford them]. So I had this bra and a woman came in and she needed it, and I was able to give it to her. In my wildest dreams, I never thought I would be able to fit her. And let me tell you, she was one happy lady walking out of there.”
The Right Selection Among the biggest challenges mastectomy fitters face is finding undergarments that not only support prostheses, but are attractive as well. “I sat in on ABC scoring,” says Barbera, referring to the new standards that will be unveiled in October by the American Board for Certification in Orthotics, Prosthetics & Pedorthics. “One of the things we required is that O&P stores have to keep an inventory. Unlike a cervical collar that you can order and have somebody wait for,
22
O&P ALMANAC DECEMBER 2010
when a woman comes in after this surgery and she’s waited the correct amount of time for her first fitting, she wants to walk out with a breast form and one or two bras to take home.” “The O&P places aren’t going to carry the same merchandise as a mastectomy boutique,” says Barbera. “We know that. But they do have to be able to accommodate full-figure and average women, and they have to carry two or three different bras. The mastectomy stores have a better selection, but the prosthetic stores are definitely paying more attention than they have in the past.” At the bare minimum, a shop should carry a good sports bra, a good hydroform, a bathing suit to show how the form works with it, a large size prosthetic, a basic cotton bra, a front opening bra, and a post-surgery camisole, says Niclas, as well as some partial forms for women who need them after reconstruction surgery leaves their breasts asymmetrical or a lumpectomy leaves a breast misshapen. Shop owners need to pay attention to trends as well. “You want the breasts to not be moving, but you don’t want them compressed, either,” she explains. “We are definitely not wearing what our grandmothers used to wear. And larger breasts are making
the challenges even greater, especially when you’re trying to offer the support and make it beautiful.” Appointments can get touchy when dealing with mastectomy patients, and while fitters say most people are ready for that, they’re often unaware that women who’ve had reconstructive surgery are also emotionally fragile. “Most times, that surgery is not perfect,” says Weiner. “And once you’re diagnosed and you’re dealing with the issue of breast cancer, you want to deal with it, do what you need to do, and then you want to go on with your life. Issues arise very frequently— women get infections, their implants need to come out, all kinds of things happen. They’re psychologically and emotionally not ready to deal with fixing it up. They had their hearts set on being reconstructed and being done.” The emotion accompanying breast surgery is why many shops will still alter regular bras, sewing pockets into the bras women wore pre-surgery, to make the transition easier. Professionals should be prepared for that possibility, Niclas warns. “It’s going to be a process, and you’d better have a tissue box ready,” she says. “The patient is full of emotion, and rightfully so. Half an hour is not an unusual amount of time to spend figuring out what will be the right bra for her, and it’s not a bad idea to have patients bring in the bra they were wearing previously. Not every woman wants to wear a prosthetic bra.” “It’s change,” says Barbera. “You get used to something and it becomes a security blanket. There are so many different things out today, and we explain that we really want to find the right fit for a woman, to show them and see how they feel. Very often, it’s the first fitting that endows the trust. That’s when it becomes easier. If women feel good, they’re going to want to come back.” Kim Fernandez is a contributing writer to O&P Almanac. Reach her at kim@ kimfernandez.com.
An interview with VA Assistant Secretary Tammy Duckworth and her prosthetist, David Rotter, CPO
ACTIVE
Photo: Cherie Cullen, Department of Defense
Veteran Care 24
O&P ALMANAC DECEMBER 2010
T
departmental communications and oversees programs relating to intergovernmental relations, homeless veterans, consumer affairs, and the department’s six national rehabilitative special event programs. In 2007, Duckworth began working with Rotter, CPO, an Illinois licensed prosthetist, orthotist, and pedorthist, who has more than 16 years of experience specializing in upperextremity prosthetics and complicated fittings, including multiple amputation levels and hip disarticulation patients. A frequent educational lecturer, Rotter is clinical director of prosthetics for Scheck & Siress of Chicago and laboratory manager for the company’s office at the University of Illinois Medical Center. He has extensive experience in both pediatric and adult management and works with many amputee athletes and active veterans. O&P Almanac talked to both Duckworth and Rotter about the O&P industry and how their relationship has helped Duckworth maintain a busy professional life as well as resume personal activities such as completing the Chicago Marathon and flying as a civilian pilot.
he most effective patient-prosthetist relationships are the ones that balance personalized attention with open, honest communication.The partnership between L. Tammy Duckworth, Department of Veterans Affairs (VA) assistant secretary for public and intergovernmental affairs, and her prosthetist, David Rotter, CPO, is one such example. A major in the Illinois Army National Guard, Duckworth served in Iraq as an assistant operations officer and also flew combat missions as a Black Hawk helicopter pilot. In 2004, the helicopter she was co-piloting was struck by a rocketpropelled grenade. As a result of the attack, she lost both of her legs and partial use of one arm. Since her recovery at Walter Reed Army Medical Center, Duckworth has dedicated her life to public service, advocating on behalf of disability rights and veterans. In 2006, she was the Democratic candidate for Illinois’ 6th congressional district, and she served as the director of Illinois Department of Veterans Affairs from 2006-2008. As the current VA assistant secretary for public and intergovernmental affairs, she directs
H
QUESTION: Tammy, how have O&P professionals helped you navigate since your injury? DUCKWORTH: It started with the first peer visitors, showing me what was possible. I woke up only knowing the things I wouldn’t be able to do again. Once I saw other amputees walking, running, and even flying again, I knew I could do that too. I had some complications early on, and we weren’t sure if I would have to become a hip disarticulation patient. Dennis Clark out of Waterloo, Iowa, was helping run Walter Reed’s prosthetics shop. He was the first person to bring me hope late one night. He came into my room at a time when I despaired, and he told me that he would work with me as much as I needed. He said that we might not solve the problem on the first try, but if I were willing to let him fail, he’d keep trying. I think that has been the central theme to my relationship with my prosthetists: We always try new things, whether it’s a new liner,
H
H
H
H
socket or state-of-the-art joint. I see our relationship as a collaborative one of experimentation, always trying to improve, and in the end, producing a better limb for me to use in living my life. QUESTION: How long have you been working together, and what makes your relationship work? ROTTER: We have been working together for three years. Tammy and I have the same mind set—not to be content with the status quo. She allows me to be a creative thinker and come up with different solutions to make her prosthesis better. When we started working together, I took a systematic approach to try and improve on every aspect of her prostheses. The result was a custom suspension system, a mechanism to help her sit comfortably and a socket design that takes advantage of her remaining anatomy while promoting stability. Our approach has been to take nothing for granted and try to continually improve on what she currently uses.
I am not content to reach a point when we say we are done–there is always room for improvement. DUCKWORTH: David is exactly what I was looking for when I left Walter Reed—someone who was willing to try new things with me. He came up with a way to create a modified hip joint using a backwards knee. When we first met, I told him that I wanted to be one of the first amputees that the industry turns to when testing new devices. Our relationship has built on that with neither of us satisfied with a leg that is just “good enough.” QUESTION: David, how do you keep Tammy’s prostheses working so that she can maintain her demanding lifestyle? ROTTER: First and foremost, comfort is paramount. The technology in Tammy’s prosthetic components can be advanced and exciting, but if the devices are not comfortable to wear the benefits can’t be realized. Like many of the returning veterans that have suffered blast injuries, Tammy has
DECEMBER 2010 O&P ALMANAC
25
H
H
H
H
“I think the biggest challenge for amputees coming out of the military medical system is the high expectations they have for care. We expect our providers to be fast and able to handle the most high-tech devices.” —TAMMY DUCKWORTH
struggled with heterotopic ossification in her residual limbs. This has been advantageous on her AK side because without that extra bone she would be close to a hip disarticulation. The challenge has been to harness the extra bone length while avoiding the prominent jagged portions that can be very painful. It has been important to identify goals and work sequentially to meet them. Tammy can find herself in cars, airplanes, at a desk, or a podium. The prostheses must be tailored to accommodate all facets of her busy life. She needs to sit comfortably as much as walk comfortably. QUESTION: What do you think has been the greatest research advancement in the O&P field?
ROTTER: The industry continues to benefit from advancements in material H H H H H technology. Lighter and stronger plastics, an array of gel materials, and a plethora of components have dramatically increased the options available to prosthetists in the construction of prostheses. We are now in an era where microprocessor technology is becoming increasingly accessible to more amputees. The appropriate use of this technology has the ability to dramatically improve function, and as a result, improve people’s lives. History has shown To live the American Dream that times of war arms and legs are not a luxury. have prompted us Please let Congress know that you want them as a society to invest to support: H.R. 2479, which will assure quality of treatment and replacement limbs in advancements amputees receive, and also the parity bill that lets amputees get the limbs they need in prosthetics. As a without unfair limitations imposed by their insurance companies. result of the Iraq and For more information go to Afghanistan conflicts, aopanet.org or Amputee-Coalition.org or armsandlegsarenotaluxury.com. we have seen an Thank you. unprecedented level of commitment on the part of our government to push for improvements in current prosthetic technology. 26
O&P ALMANAC DECEMBER 2010
Photo: David Rotter, CPO
H
Rotter and Duckworth
The confluence of aggressive research and development funding, and the age of microprocessors present a tremendous opportunity for dramatic improvements in existing options. DUCKWORTH: I think my generation of Iraq and Afghanistan War amputees have been a catalyst in the research in O&P. The C-Leg was already on the market, but with so many highfunctioning and very athletic, young amputees entering the Department of Defense’s system—and its large budget—the industry was able to respond with new microprocessorcontrolled devices that otherwise may have been in development much longer. I love the Proprio ankle and am prodding for the newer, lighter version. I have a Power Knee and am part of the group that pushed for the Power Knee 2. I think the new computercontrolled and power limbs are the future of this field. QUESTION: Tammy, prior to your bid for the Illinois 6th congressional district seat in 2006, you never held a public office. What was the impetus for running?
IDENTIFY | INNOVATE | INDIVIDUALIZE CPIdeal is our pursuit of the ideal form, fit and function for each individual. We begin by identifying the critical needs of our customers, then create innovative designs to provide an ideal performance. Finally, each foot is custom built and shipped the same day to provide individualized solutions from thousands of possibilities.
The Soleus® – with an innovative multiple spring design – produces natural movement, smooth transition and superior range of motion.
You can trust College Park to create your patient’s CPIdeal.
individualized solutions. thousands of possibilities.
800.728.7950
I
www.college-park.com
the military medical system is the high expectations they have for care. We expect our providers to be fast and able to handle the most high-tech devices. Unfortunately, not every O&P facility is up to this task. It will be important for us to find the right prosthetist and to keep our expectations high. QUESTION: What can the O&P field do to make more people aware of the life-restoring services provided by prosthetists and orthotists? Photos: David Rotter, CPO
DUCKWORTH: I decided to run for office after becoming an advocate for other war wounded at Walter Reed. I was the highest-ranking amputee there for a while, and it fell on me to represent my lower-ranking comrades. I began working with Sen. Richard Durbin (D-Illinois) and his staff to help my buddies, and one day he called and encouraged me to run for office myself. It took a few weeks, but I eventually said yes. QUESTION: Tammy, what was your greatest achievement as the director of Illinois Department of Veterans Affairs? DUCKWORTH: I think the greatest achievement was the promotion of private-public partnerships. We started more than $70 million worth of new programs, and most of them involved the participation of non-governmental entities such as the Rehabilitation Institute of Chicago, The John Marshall Law School, and the various veterans’ organizations to be successful. Government can’t do it all, and these partnerships are a way to leverage funding and expertise. QUESTION: What is the biggest challenge facing disabled veterans today? ROTTER: Veterans need to be their own best advocates for receiving the care they need. There are many more prosthetic options now available for amputees, including activity- and task-specific prostheses. Tremendous resources have been made available to veterans treated at Walter Reed. Veterans returning to their communities need to be proactive in seeking out resources on a local level to maintain the level of care they have already been provided. DUCKWORTH: I think the biggest challenge for amputees coming out of
28
O&P ALMANAC DECEMBER 2010
ROTTER: The media continues to play a large part in demonstrating to the public the capabilities of a new generation of prosthetic and orthotic technology. The Internet has revolutionized the options available to patients. The consumers of orthotic and prosthetic services of today are better informed than ever on the options available to them. The O&P industry is small with limited resources. Whether it is Oscar Pistorius vying to compete against able-bodied athletes or the “Luke Arm” demonstrated on 60 Minutes, the media has been the best source of disseminating information to the public at large about P&O.
DUCKWORTH: I think the field should harness social media. In addition to traditional media, O&P should be posting more stories, blogs, videos of folks doing amazing things with their prostheses. There are many ways to highlight what you do, and I think that it’s time for shameless self-promotion. The more people who see what you can do, the better the chances that someone who didn’t think he could ever live a normal life again will learn that there are many options and reach out for help. QUESTION: Tammy, did you encounter any challenges in how your treatment claims were handled by the insurers? DUCKWORTH: I have always used either the VA or DoD systems, so I have not had to deal with private insurers. I did have difficulty at first with the VA because the O&P shop at my VA hospital was not up to my standard. It took a year, but I eventually received permission to use Scheck & Siress, paid for by the VA. a
n
Ask the Expert By Joseph McTernan, AOPA government affairs department
Medicare Changes Its Therapeutic Shoe Policy Here’s what the policy says about certification, reimbursement, and more
Recent changes to the Medicare Therapeutic Shoe Policy have led to many questions about what documentation must exist in order to be reimbursed. This month’s Ask the Expert column covers some of the more common questions the AOPA staff is answering about this policy.
Q.
Can the supplier of the shoes complete the certifying statement as long as it is signed and dated by the certifying physician?
A.
No. The Medicare Local Coverage Determination (LCD) for Therapeutic Shoes requires that the certifying statement must be “completed, signed, and dated by the certifying physician.” Unlike prescriptions, the LCD does not allow for completion of the certifying statement by someone other than the certifying physician.
Q.
Is the certifying statement considered enough documentation to support the medical need for diabetic shoes?
A.
Unfortunately, no. The Medicare Therapeutic Shoe Policy Article specifically notes that the certification statement alone does not meet the documentation requirements for coverage. The article clearly outlines what must be present in the certifying physician’s medical records to support your claim. The certifying physician must personally document that an in-person evaluation of the patient occurred
30
O&P ALMANAC DECEMBER 2010
within six months of delivery of the shoes. The documentation of this visit must include confirmation of at least one of the secondary conditions required in the policy for Medicare coverage of therapeutic shoes. Alternatively, the certifying physician may “obtain, initial/sign, date, and indicate agreement with the records of another MD, DO, physician assistant, nurse practitioner, or clinical nurse specialist that documents the occurrence of an in-person evaluation of the patient within six months of delivery of the shoes that documents one or more of the secondary criteria.”
Q. A.
Is it acceptable to mail shoes and inserts to Medicare patients?
No. Effective July 1, 2010, for therapeutic shoes and inserts to be covered, the supplier must separately document one in-person visit in which the patient was evaluated and a second in-person visit to confirm the proper fit and function of the shoes and inserts. While both of these visits may occur on the same day, assuming the supplier has appropriate stock to meet the needs of the patient, both evaluations must be separately documented in the supplier’s records.
Q. A.
What new policy requirements are effective Jan. 1, 2011?
Effective on or after Jan. 1, 2011, the certifying physician must have an in-person visit with the patient during which diabetes management is addressed within six months before delivery of the shoes and/or inserts. The certifying physician also must sign the certification statement on or after the date of the in-person visit and within three months of delivery of the shoes/inserts. In addition to these requirements, there also must be documentation of an in-person visit with the prescribing physician within six months of delivery of the shoes and/or inserts.
Q.
Can the provider of the shoes be held liable for documentation that does or does not exist in another provider’s records?
A.
The LCD and Policy Article specifically state that including the KX modifier on the supplier’s claim indicates that all coverage criteria have been met. While you cannot control another provider’s documentation practices, Medicare considers it your responsibility to ensure that all of the coverage criteria have been met before you submit your claim for reimbursement. If all of the criteria have not been met, policy indicates that the shoes will be denied as not covered.
Q.
Can all three sets of inserts for a calendar year be dispensed at the same time as the shoes?
A.
Yes, as long as the patient has been instructed to rotate use of the inserts so they wear evenly. No item is covered by Medicare unless it
is deemed to be medically necessary. If the patient is instructed to use one set of inserts until they are worn out and then use a second pair, the medical need for the second pair is not established until they are used. If the patient is instructed to rotate the inserts, then they are deemed to be medically necessary when the shoes are dispensed.
Q. A.
If I did not provide the shoes, may I provide inserts?
Yes, but in limited circumstances. For Medicare to cover inserts provided independently of therapeutic shoes, the provider of the inserts must obtain a written statement from the provider of the shoes indicating that the patient has appropriate footwear into which the insert may be placed.
A.
The Medicare benefit for therapeutic shoes and inserts is limited to one pair of shoes and up to three sets of inserts per calendar year. This is a benefit limit, not an entitlement. If a patient receives a pair of shoes and inserts late in the calendar year, there may be no medical need to replace them early in the next calendar year. Like all Medicare benefits, therapeutic shoes are subject to medical necessity criteria. If the previously supplied shoes and inserts remain medically appropriate, new shoes and inserts may be considered not medically necessary. I hope this month’s Ask the Expert column has answered some of your more pressing questions about therapeutic shoes and Medicare coverage. Additional questions are always welcome, and the AOPA reimbursement staff looks forward to continuing to provide answers. a
Q.
Joe McTernan is AOPA’s director of reimbursement services. Reach him at jmcternan@AOPAnet.org.
If patients receive therapeutic shoes and inserts in November, are they automatically able to get new shoes and inserts in January?
O&P Almanac COMING NEXT ISSUE Haiti: One Year Later Gait Analysis: Techniques & Outcomes Watch your mail for the first 2011 issue! For more information about the O&P Almanac and other AOPA publications, visit us online at www.AOPAnet.org.
FINALLY!! O&P Board Study Resources We can help you PASS your BOARDS The ONLY Comprehensive Study Guides Specifically for Orthotics and Prosthetics (Many of our products are available in DVD Format also!)
JUST ADDED: The MASTECTOMY FITTER’s Review and Study Guide
We also have Board Study Value Packages in Orthotics and Prosthetics
Our BEST SELLING products to save you money!
www.oandpstudyguide.com DECEMBER 2010 O&P ALMANAC
31
n
Facility Spotlight By Deborah Conn
With the help of integrated technologies, Comprehensive P&O’s patient-focused practice thrives
Doing Well
By Doing Good
Amit Bhanti, CPO, and Donald Goertzen, CP, LPO
FACILITY:
Comprehensive Prosthetics & Orthotics Inc.
LOCATION:
Headquarters in Peoria, Illinois, 5 offices in central Illinois
OWNER:
Amit Bhanti, CPO, and Donald Goertzen, CP, LPO
HISTORY:
5 years in business
32
O&P ALMANAC DECEMBER 2010
P
atients come first at Comprehensive P&O. The Peoria, Illinois-based facility was founded on the principle that all patients receive the care they need, regardless of their insurance or financial status. “It is a weird thing to say in today’s world,” says Amit Bhanti, CPO, and co-owner, “but we truly believe in this whole ideology.” Comprehensive P&O first opened its doors in December 2005. Donald Goertzen, CP, LPO, and Charu Bhanti, BPO, founded the business. Amit, Charu’s husband, joined the company’s leadership team in February 2008 as clinical director and CEO. Comprehensive P&O has six physical offices in Illinois and serves another eight locations on a weekly
basis or as needed through local hospital rehabilitation departments. The staff includes nine practitioners, two residents, three technicians, and six administrative employees, including two who work full time in the billing department. The ratio of orthotic to prosthetic patients is about even, and practitioners normally have a varied caseload. “We do some highly specialized work,” says Bhanti, “and [our facility] is a center of excellence for scoliosis and prosthetics. We have recently started a new way of looking at adult spinal deformity, and our clinic uses a team approach, with a spine surgeon, orthotist, advance practice nurse, and physical therapist, to treat adult spine deformities.”
CORE-SPUN SUPPORT SOCKS
“FINALLY, COMPRESSION I CAN WEAR!” Core-Spun Support Socks for men and women look and feel like a soft, comfortable everyday sock with the added benefit of true gradient compression. The ultra stretchy yarns make the socks easier to put on and the added thickness makes the socks more comfortable for all-day wear.
A SUPPORT SOCK THAT IS ESIER TO PUT ON THAN TRADITIONAL COMPRESSION GARMENTS With reasons ranging from limited mobility or dexterity to complaints about overall general comfort, many individuals struggle with donning or wanting to wear their compression garments every day.
Core-Spun by THERAFIRM® Support Socks
Core-Spun by Therafirm® gradient compression socks, a patent pending innovation by Therafirm®, are made with the unique technology of core-spun yarns. These yarns are made using a process of twisting fibers around an inner fiber creating one yarn that enhances stretch, as well as strength and durability. Couple this technology with true gradient compression and the result is an ultra stretchy compression garment that is easier to put on and exceptionally comfortable.
WHAT PROVIDERS AND PATIENTS ARE SAYING ABOUT CORE-SPUN BY THERAFIRM I know that compression garments can be difficult for my patients to don themselves. Many openly admit they have not worn the garments when I visit with them at follow-up appointments. I am so pleased to have seen an increase in patient compliance since I started recommending Core-Spun by Therafirm. My mother has had to wear support hose since 1979, and she has always hated them because they were ugly, uncomfortable, hard to get on. Her provider started carrying your Core-Spun socks a couple of months ago and I got her a pair to try out. She liked them so much that I got her two more pair the next week. They are great!! They are comfortable, easy for her to put on -- and they work! Thank you for making such a great product! I wanted to tell you about my experience with Core-spun compression socks. It used to feel like you were putting a 100 pound leg in a 20 pound sock with other compression socks. They were impossible to get on and to pull them up. Core-spun are much different, they stretch more, so they are much easier to get on. I'm so glad that someone told me about them. They are the BEST thing that happened to compression socks!
For more information contact Knit-Rite at 800-821-3094 or e-mail customerservice@knitrite.com. Also distributed by:
CONNECT WITH US ON THE WEB!
Education and Fabrication The company recently moved its headquarters into a new, 15,000-squarefoot, state-of-the-art facility in Peoria. The building includes an education center, a classroom that accommodates 35 people, a library, and a special waiting room for out-of-state patients, which is equipped with televisions and computers to make their longer waits more enjoyable. The facility also holds a 5,000-square-foot central fabrication laboratory, and each branch office has its own lab to carry out basic functions. Nevertheless, Bhanti says, practitioners still outsource about half their fabrication needs. “It depends on how busy we are,” he says. “We don’t want our patients to have to wait any longer than necessary to receive services.” That focus on patients is at the core of their business, say Bhanti and Goertzen. For patients who do not have the insurance coverage or ability to
34
O&P ALMANAC DECEMBER 2010
self-pay, the company makes every attempt to work out payment plans or find alternate fund sources. In fact, the practice has its own social service department that helps patients figure out how to secure financial assistance. But if a patient simply can’t pay, Comprehensive P&O provides free care. Bhanti is quick to point out that the business is thriving. “We do a great job of taking care of patients,” he says, “and whether they’re paying or not, they bring in more business. We have a deep commitment to corporate social responsibility, and we believe that if we do well by our patients and our employees, the profits will follow.”
Communication and Independence Bhanti describes the company’s corporate structure as a “hub and pillar” model, instead of the more common “hub and spoke” arrangement. He likens it to building new cell phone towers (or pillars) to boost a weakening signal as it gets farther from the source.
“Even though we have corporate ownership run from the hub, we have local hearts running local offices, while still adhering to our unique corporate culture” he says. Communication and independence are priorities at Comprehensive P&O. Employees have a high degree of autonomy, and free exchange of information and ideas is encouraged. The largely paperless offices rely heavily on an integrated computer and communication network that encompasses everything from smartphones to interconnected patient rooms. A single phone system covers every office and cell phone, and a secure system lets staff members send instant messages to one another and access patient and financial data no matter where they are. “These systems mean we can share our resources much better and respond quickly to patients’ and referral sources’ needs,” says Bhanti. Bhanti and Goertzen hope to bring their unique business philosophy and high standards of care to an increasing number of patients. “Our modular structure is scalable, so we can easily adapt our systems to include more offices,” says Bhanti. Even though he and Goertzen have just moved the company into a new facility, their eyes continue to look ahead. a Deborah Conn is a contributing writer for O&P Almanac. Reach her at debconn@ cox.net.
For over 50 years, PEL has offered practitioners a reasonable
PRICE on the most popular products available from the O&P industry’s most respected manufacturers. Phone, fax or email a friendly PEL CSR, like Larry, for information on the newest, most innovative products available – at a competitive price.
Larry Moore, Customer Service Representative • Veteran’s Administration Specialist • International Auditor with UPS • Majored in Business Management at CSU • Enjoys playing and watching sports • Devoted family man – wife, new baby son and two dogs
Allard USA Combo Custom KAFO
Becker Orthopedic Model 1018 Modular Ratchet Lock Knee Joint • Designed to promote full knee extension by providing knee stability to the patient through an incremental range of knee flexion • Features a long, angled, locking lever that is easily operated by the patient • Lever may also be shortened, or configured into a standard bail • Fully interchangeable with Becker’s 1017, 9005 and 9006 models
NEW! Ohio Willow Wood Alpha® Select Liners Alpha Select combines several key liner characteristics into one product: • Refined, progressive gel style provides 9 mm gel distally for extra comfort, 6 mm gel over the tibial crest, then thins to 2.5 mm gel behind the knee and proximally • New hybrid gel has a higher durometer that combines durability with comfort • A one-way stretch fabric delivers controlled pistoning without requiring a potential irritating distal matrix • Knee panel allows for easy flexion without pulling at the knee
• Removable knee brace attachment for ToeOFF® or BlueRocker™ • Creates an innovative orthotic solution for management of footdrop combined with genu-recurvatum • Low-profile and lightweight • Uprights easily shaped and adjusted to optimum height for patient • Modular components to accommodate variances in thigh and calf circumference. • Easy to don and doff Build a state-of-the-art custom KAFO within your own facility today!
®
Experience the Power of One.
Over 50 years of one stop shopping for all your O&P needs.
Phone: 800-321-1264 Fax: 800-222-6176 E-mail: customerservice@pelsupply.com Web: www.pelsupply.com
n
AOPA Headlines AOPA WORKING FOR YOU
YOU Make It All Happen We heard you in 2007—now don’t miss the new AOPA member survey
D
uring the past three years, AOPA members have seen dramatic changes in the way your organization seeks to serve members. These new ways of doing business reflect the results of the December 2007 Member Survey, which generated a 29 percent response rate—an extraordinarily high response compared with survey-world norms. The size of the response sent strong signals that AOPA members really care and continue to have high expectations for their 93-year-old organization. Another sign of that caring is the consistent 94 to 97 percent renewal rate AOPA has enjoyed over the years. Even in 2009, an economically challenging year, 94.6 percent of AOPA members expressed their loyalty by renewing. That 2007 survey elicited facts and opinions that shaped the 11 strategic initiatives around which we reallocated precious resources to implement what you told us you wanted and needed. That meant some tough decisions, as the staff slimmed down from 24 to 10. Only by increasing efficiencies LINCOLN AIRPORT AD of what previously had been in-house and outsourcing several activities was it possible to increase AOPA’s legislative advocacy investment five-fold.
We Make Great Americans Great Again
Telling the Story
For the first time, O&P has had a bold presence in national media as the now properly funded public relations program responded to your priority for putting O&P on the map and distinguishing O&P from Durable Medical Equipment (DME). Ad placements in Time, Business Week, U.S. News & World Report, Forbes, and several regional editions of national magazines told the story in a compelling way. To further the legislative agenda, AOPA placed posters of the print ads at high-traffic transit stops in the nation’s capitol used by legislative and other public-policy decision makers. Amputees and people with impaired limbs need two things included in health care reform. Tell Congress to support H.R. 2575 (parity) and H.R. 2479 (Medicare O&P Improvement). Because arms and legs are not a luxury.
AOPAnet.org
Amputee-Coalition.org
armsandlegsarenotaluxury.com
Finding What Works In addition to your clear direction to ramp up legislative advocacy and public relations, the other big agenda item in that group of 11 initiatives was comparative effectiveness research. For the first time, AOPA was able to fund six pilot 36
O&P ALMANAC DECEMBER 2010
AOPA Congratulates New and Retiring Board Members December 1 marks the changing of the guard at AOPA. The election of new officers and board members at the Annual Business Meeting in Orlando on October 1 set the stage for this annual changeover.
Thomas V. DiBello, CO, FAAOP, left, and James A. Kaiser, CP, at the 2010 AOPA National Assembly.
Thomas V. DiBello, CO, FAAOP, automatically moves into the president’s chair succeeding James A. Kaiser, CP, who serves one more year on the board as immediate past president. Brian Gustin, CP, occupied that role for the past year and leaves the board after more than a decade of service. Bert Harman moves to the president-elect position after serving one year in the position of vice-president, to which Tom Kirk, PhD, was newly elected. Kel Bergmann, CPO, was re-elected to a three-year term representing members with 11 to 199 facilities; Eileen Levis was newly elected to a three– year-term representing those with one to three facilities; and Mike Hamontree returns to an at-large seat after serving as president in 2005. James Weber, MBA, was elected to a new two-year term as treasurer, and Lisa Schoonmaker, CPO, FAAOP, and John Reynolds, CPO, completed their terms on the board. Continuing their service on the Board of Directors are Rick Fleetwood, MPA; Russell Hornfisher; Alfred E. Kritter, Jr., CPO, FAAOP; Anita Liberman-Lampear; Mahesh Mansukhani, MBA; and Frank Vero, CPO. A huge debt of gratitude is owed to these members of the O&P profession that give so much of their time and energy to ensure a better community for all.
Apis Footwear Company 1-888-937-2747
PDAC Code A5500 + A5512 (3 Pairs)
Feather-Lite Premiere Collection
$52.50/Package
The Right Choice for The Right Reasons!
n
AOPA Headlines AOPA WORKING FOR YOU
research projects to provide a framework for seeking expanded funding from government and private foundations on the basis of hard evidence on how much difference proper O&P services can make in the lives of patients and the pocketbooks of payers. AOPA also was a founding member of the newly created research/education organization—the Center for O&P Learning and Outcomes-Evidence Based Practice (COPL). Two larger research projects jointly funded by several manufacturer members and AOPA are designed to deliver additional information on how various devices and treatment programs not only benefit patients, but also channel payer monies more effectively into the best outcomes. AOPA also retained experts at the Jefferson School of Population Health in Philadelphia to conduct a literature search and create the framework for a longitudinal patient registry study that can be used to capture results on patient outcomes over a longer period of time. Discussions have been held with university researchers and personnel from the Departments of Defense and Veterans Affairs on the prospects of creating a longitudinal database that might include data from military personnel and veterans treated by O&P facilities, VA hospitals, and private practitioners. A pilot effort gathered patient registry data from nine
[ 38
SAVE THE DATE SEPTEMBER 19-22, 2011
O&P ALMANAC DECEMBER 2010
]
AOPA members and 45 patients. This microcosm of the database confirms substantial improvements in functioning and overall health with proper treatment. A separate survey was used for patients and a corresponding survey for the providing practitioner.
Benchmarking Progress It’s been quite a ride and it all has been propelled by what you told us in that 2007 membership survey. Now it’s time to benchmark our progress and see what lies ahead. You have received, or soon will receive, the 2010 version of that earlier survey. Many of the questions will be similar to those we asked three years ago to accomplish the necessary benchmarking. But a few will be different, such as seeking information on which payers in your state are most realistic in their reimbursements for six high-volume L codes. That information will help direct AOPA’s strategy to make sure the development of implementing regulations for the new health care law does not hamper O&P’s ability to deliver quality patient care. Please take a few moments from your busy life to complete the survey and make sure AOPA has your feedback to accomplish your priorities. Patient-care facilities may complete the survey at www.AOPAMemberSurvey.com. a
For more information, visit our Web site at www.AOPAnet.org.
Masterflex
Using NEW Transfer Paper “Jungle” 110P26/10
Color Blue
Neon Pink Transparent Neon Green
Item #: 111P2_ _/thickness Sheet Size: 40x40” Colors* Available: 5906 Breckenridge Pkwy Suite G Tampa, FL, 33610 Ph: 800-378-2480 Black Fax: 813-246-5998 111P264 www.eurointl.com
Silver 111P276
Light Red 111P269
Neon Pink 111P272
Blue 111P265
Midnight Blue 111P267
Red 111P268
Green 111P271
Neon Yellow 111P273
Neon Green 111P274
Gold 111P275
White 111P263
Applications: Inner shoe material, Waterproof splint, MetacarpusMaroon 111P270
Sky Blue 111P266
forearm splint, Arm prosthesis, Foot prosthesis, Peroneal/Ankle/Foot caps, Trial Shoe, Trial Prosthesis for thigh amputations, Inner Boot, Hip Disarticulations, etc.
Available in 2 & 4mm Masterflex Color Transparent Also Available in 1.5, 2, 3, 4, and 5mm *Actual colors may differ slightly based on print settings/printer type.
111P262/thickness
n
AOPA Headlines
Tom Wessel Joins the AOPA Team AOPA is pleased to announce the addition of Tom Wessel who will serve as director of business development. In this new role, Wessel will develop and implement AOPA’s marketing and sales strategies to ensure growth of the organization’s products and services. He also will work closely with AOPA members and staff to expand and enhance the membership experience. Wessel has more than 25 years of health-care experience and leadership in sales and marketing. As former vice president of sales and marketing for respiratory product company, RespirTech, he led a complete sales transition plan. Prior to RespirTech, Wessel served as director of payer relations and contracting, and director of sales and marketing for mobility solutions at Otto Bock HealthCare. He also spent 17 years at 3M Company where he held mid-level positions within the company’s medical-surgical division.
Wessel has a master’s degree in marketing from North Central College and a bachelor’s degree from Lake Forest College. He finished a mini MBA in medical technology management from University of St. Thomas and has completed programs through the University of Indiana’s Kelley School of Business and the University of Pennsylvania’s Wharton School.
AOPA Advertising Posters FREE For Members Change Standing for in Washington me So for r is Easie rs. Than for Othe maneuver gh having to e seeking It’s hard enou ress when you’r e around Cong But when you’r er. your cause. support for it’s even hard it on one leg, do to g tryin and ican Orthotic Amer the g Congress That’s why ciation is urgin g givin , 2575 Prosthetic Asso H.R. S. 3223 and hetic fits for prost to pass bills arable bene ve amputees comp those they would recei . to ment arms and legs surgical treat r medical or for any othe are using ance companies s, which Currently, insur limit and lifetime tees arbitrary caps gh to reimburse ampu enou hetic may not be entary prost most rudim certainly not for even the es. And it’s devic tic and ortho an s thatlity. y’s prost erichetic r toda ry Am to cove mobi ghiev eve e tee’s enou bel improve an ampu to If you can greatlyt to be able 3223 ing to pass ethS. ress has the righ Cong som do e urge will Pleas wave,, the bills thatte and walkand r sta H.R. 2575 the medically tell youget itleand amputees to t (ins ert lead full, about enab por they need to es sup devic to ssary tor nece legisla . ure to ass productiv bere)lives bill num rity and) legs arms s (pa nesica, in Amer use fair nce Beca information insura luxur . y. For more sites: are not putaees nd rg, the following for am arou uver ion.o go to any of g to mane oalit tee-c havin ampu gh rg, seeking enou net.o when you’re luxur y.com. AOPA It’s hard e nota you are legislatur andlegsare when But the state e. or arms your caus harder.
support for on one leg, it’s even it trying to do Orthotic and the American urging _________ That’s why n is Associatio amputees Prosthetic lature to give d parity) for state legis (calle tic le benefits comparab legs, and ortho arms and hetic prost chronic limb ve those with would recei bracing for . to those they treatment impairment, or surgical r medical for any othe are using companies ance h may insur limits, whic Currently, and lifetime tees for even arbitrary caps to reimburse ampu orthotic gh hetic and not be enou entary prost enough to cover not the most rudim it’s certainty an MS devices. And tics that can improve s to today’s ortho ce or the prosthetic patient’s balan tee’s mobility. ampu restore an to support legislature hetic Tell your state orthotic and prost the and those _________, s amputees to get the that allow irments parity bill al limb impa need to with substanti ssary devices they nece cally . medi uctive lives a live full, prod legs are not and America, arms on go to any of the Because in mati infor more luxury. For net.org, sites: AOPA or following oalition.org, y.com. amputee-c notaluxur gsare armsandle t,” tic Adult Benefi and and Ortho Care Policy * “Prosthetic of Health Department ts. Colorado and Benefi Medical Policy Financing
40
O&P ALMANAC DECEMBER 2010
Looking for an inexpensive way to promote O&P causes and enhance your patient-care office’s decor? Then look no further than www.AOPAnet.org. AOPA members now can order free replicas of the advertising posters unveiled at the 2010 National Assembly. The posters, which appeared in a variety of print publications throughout October and November, are available from the AOPA Bookstore for use in patient-care facilities. To see the available ads, go to AOPA’s Web site (www.AOPAnet.org) and select the Press Room pull down menu to access all six print ads. For poster-sized copies of the ads, download an order form at www.AOPAnet.org/2010_PR_Posters_ Order_Form.pdf and specify your choices and quantities. Ad posters are complimentary for members as long as supplies last. a
IN MEMORIAM
Gerald L. Martin, RTP, FAAOP Gerald “Jerry” L. Martin, RTP, FAAOP, died October 23. After serving the O&P community for several years as a registered prosthetic technician, he graduated from Florida International University with a bachelor’s degree in 1995. Martin then completed his prosthetics residency at The Cleveland Clinic. His affinity for the tropics brought him back to Florida, and he established his practice in Tamarac, Florida, near Ft. Lauderdale. Later, Martin achieved a fellowship in the American Academy of Orthotists and Prosthetists. And as a patient advocate, he lobbied with state representatives to gain support and passage of the licensure law. Before he died, Martin planned to expand his practice to the New Port Richey area, about an hour from Tampa.
IDENTIFY | INNOVATE | INDIVIDUALIZE CPIdeal is our pursuit of the ideal form, fit and function for each individual. We begin by identifying the critical needs of our customers, then create innovative designs to provide an ideal performance. Finally, each foot is custom built and shipped the same day to provide individualized solutions from thousands of possibilities.
The Tribute® – is a custom gait matched, multiaxial design with a full-length toe lever. Ideal for low to moderate impact individuals that require stable footing on varied terrain.
You can trust College Park to create your patient’s CPIdeal.
individualized solutions. thousands of possibilities.
800.728.7950
I
www.college-park.com
n
AOPA Headlines AOPAversity Audio Conference: 2011 New Codes and Medical Policies With 2011 just a month away, now is the ideal time to begin familiarizing yourself with changes in coding and policies. Be prepared for 2011 by joining us Wednesday, December 8, at 1 p.m. EST for our last AOPAversity audio conference of the year, “2011 New Codes and Medical Policies.” By dialing in this month you can: • learn about new HCPCS codes effective Jan. 1, 2011 • discuss verbiage changes to existing codes and how they may affect your business • find out which codes will no longer be used as of Jan. 1, 2011 • discover other changes to the HCPCS system • find out AOPA’s interpretation of why the changes took place. The cost of participating is always just $99 per line for AOPA members ($199 for nonmembers) and any number of employees may listen on a given line. Listeners can earn 1.5 continuing education credits by returning the provided quiz within 30 days and scoring at least an 80 percent. Register at www.AOPAnet.org. Contact Ann Davis at adavis@AOPAnet.org or 571/431-0876 with questions.
AOPA PRESENTS
Expert Coding Advice 24/7 at www.LCodeSearch.com
> > >
The O&P coding expertise you’ve come to rely on is now available whenver you need it. Match products to L codes and manufacturers— anywhere you connect to the Internet. This exclusive service is available only for AOPA members.
Log onto LCodeSearch.com and get started today.
Not an AOPA member?
GET CONNECTED Contact Michael Chapman at (571) 431-0876, ext. 293 or mchapman@AOPAnet.org. Manufacturers: Get your products in front of AOPA members! Contact Joe McTernan at jmcternan@AOPAnet.org or (571) 431-0876, ext. 211.
Visit AOPA at www.AOPAnet.org
42
O&P ALMANAC DECEMBER 2010
www.AOPAnet.org
EZ Flex Liner
Practical Magic Hardly just a pretty face,the EZ Flex Liner delivers unequaled function without sacrificing anything. Unified Flexible Front
The unique fabric on the anterior surface provides unlimited stretch over the patella for greater elasticity while reducing pressure on the knee and the amount of energy required to flex the knee
80% Less Vertical Stretch Posteriorly
As compared to other Alps gel liners, virtually eliminating pistoning while minimizing bunching behind the knee during flexion
Medial view of the knee in flexion demonstrates the greater elasticity of the anterior fabric to extend over the front of the knee. Paring it with the limited vertical stretch posterior fabric reduces the overall effort expended by the amputee to bend the knee and increases comfort.
Alps New EZ Flex Liner (anterior view shown above) is available in 3mm or 6mm Uniform thicknesses. Eight sizes fit circumferences of 16 cm to 44 cm.
NOW IN STOCK: Š 2009 ALPS. All Rights Reserved.
Antioxidants & EZ Gel Protect Skin--
Antioxidants in EZ Gel help protect the skin from damage caused by free radicals. ALPS EZGel is perfect for those with poor skin characteristics or sensitive tissues.
Budget Friendly-No other liner on the market provides this quality, durability and functionality at this price... absolutely no other!
800.574.5426 www.easyliner.com info@easyliner.com
Ready When yo
u
aRe ... tm
lumbar
Thoraco-lumbar Thoracic ScolioSiS
If only I could have:
R e a d y W h e n Yo u A r e . . .
- tech support round-the-clock. - quality products at a fair price. - the brace when my patient needs it. - my orders taken anytime. - a brace the way I want it.
24 • 7 • 365
call ToDay To geT a coPy of our
New
caTalog!
TlSo (back)
TlSo TlSo
w/
w/
Dlk
PPX
Only OPTEC fits that mold!!! For nearly 15 years, OPTEC has been a leader in custom spinal orthotic manufacturing.
PDAC Approved LSO & TLSO Ph : 8 8 8 -98 2 -81 8 1 • F x : 877- 288- 4197 • sales@opt ecusa.com 9 7 5 Pro gres s C ircle • L a wrenceville, GA 30043 • www.opt ecusa.c o m
n
Marketplace
ORTHOTIC MANAGEMENT OF GENU RECURVATUM COMBINED WITH FOOTDROP Allard USA introduces COMBO, a thigh cuff/ knee brace attachment for ToeOFF or BlueRocker that offers a lightweight, low-profile, functional orthotic solution for the management of genu recurvatum or chronic knee instability, accompanied with footdrop. Combine COMBO with ToeOFF or BlueRocker to fabricate a KAFO, customized to meet your patient’s needs. Uprights with dual-axis joints are easily shaped and adjusted to optimum height for the patient. Adjustable knee control popliteal interface for genu-recuvatum control. Modular components allow you to accommodate variances in thigh and calf circumferences. For more information, call 888/6786548, e-mail info@allardusa.com, or visit www.allardusa.com.
MT. EMEY CUSTOM ORTHOTICS: FREE SHIPPING Apis is dedicated to providing great services and products to our valued partners.
less time. Whether you need to order the orthotics only or with the great selection of therapeutic or diabetic shoes, we offer great package deals, call us to find out and you will not be disappointed. Our friendly CSRs are expecting your call at 888/937-2747.
THE TRIBUTE® FOOT FROM COLLEGE PARK The Tribute® delivers dependable performance in an economical package. The true multi-axial design and precision Gait Match provides the user better control and stability. The fulllength toe lever and a low frequency response are ideal for people who require firm footing on varied terrain. The Tribute® is an ideal solution for initial fittings and low to moderate impact users. Key Features include: • True multi-axial function with transverse rotation for natural feeling performance. • Adjustable Stride Control™ offers fine adjustment to match any individual’s gait. • Full-length toe lever with low frequency dynamic response. • Scaled design allows for more natural proportions for improved cosmetic appearance. • Same-day, custom built to order. For more information, call 800/7287950 or visit www.college-park.com.
EURO FABRIC COVER Mt. Emey custom orthoses program is a leading program to help healthcare professionals with their pedorthics needs. Currently Apis offers limited time free shipping for all custom orthotics orders and $75 for three pairs. Your patient will be compliant in
46
O&P ALMANAC DECEMBER 2010
Euro International is pleased to announce their new Euro Fabric Cover designs to our product line. This
young, fresh, sleek, and trendy insole cover material is made with 50 percent Polyester and 50 percent Trevira BIOactive (Polyamide) with rear PU film. A completely problemfree bonding without penetration of the adhesive into the tissue leaves the elasticity of the material untouched. The Trevira BIOactive fiber with integrated silver-ions allows for excellent wearing comfort: • Permanent antimicrobial for highest hygiene standards • Acts directly on the fiber surface • Hypoallergenic • Good breathability • Non-fading • No damage due to frequent wear • Prevents odors. For more information, call 800/3782480 or visit www.Eurointl.com.
OTS BT-4 INFRARED OVEN • Eight 1,000 watt emitters; four on top and four on bottom. • Programmable digital temperature controller. • Dual electric fans for air circulation. • 4 interior lights and large viewing window. • Access point for vacuum line. • Tray with fitted Teflon® cover for sheet plastic. • 18’’ clearance for bubble forming **Purchase any PDQ oven between now and December 31, 2010, to receive up to $400 toward freight charges** Applies to sales in the United States only. Terms and conditions apply. Speak with an OTS representative for more information. OTS Corp. 800/2214769 or www.ots-corp.com.
INTRODUCING KISS REPLACEMENT KITS! These kits are designed to replace key components, without the need to purchase a distal base! CMP32/A: Includes a velcrosewn placard, proximal nut and screw, proximal strap, and distal strap. CMP31/A: Includes an adhesive-ready placard, proximal nut and screw, proximal strap, and distal strap. For more information, contact KISS Technologies LLC at 410/663-KISS or visit www.kiss-suspension.com.
NEW FROM MOTION CONTROL: NEW TRIAD PREAMP
• • • • •
Three mounting options Water resistant case High interference rejection Gain adjustments on preamp Compatible for use with: »» Utah Arm 3 & 3+ (kit: p/n 4050214) »» Utah Hybrid Arm (kit: p/n 4050214) »» ProControl Systems (kit: p/n 4050216) »» Otto Bock electrode cables. For more information, call 888/6962767, e-mail info@UtahArm.com, or visit www.UtahArm.com.
NEW FROM MOTION CONTROL: MC WRIST ROTATOR
• New lamination collar—available in three sizes • In-hand version also available— built into MC Hand or ETD. For more information, call 888/6962767, e-mail info@UtahArm.com, or visit www.UtahArm.com.
• New MC Wrist Rotator (p/n 3010748) • Two new versions—both mount in forearm • Standard: use with ProControl2; U3; Utah Hybrid • ProWrist: use with microprocessorcontrolled TDs • 2x speed and torque of previous versions
Provel offers cost effective, fast, easy to use, and reliable O&P automation. The D2 digitizer, C7 carver, and T7 thermoformer are appropriate for small clinics as well as large central fab's. AOP file compatible and backed by a two year warranty. The D2 digitizer allows automated shape capture of prosthetic casts with unmatched accuracy. The C7 carver is not only fast and precise, its self contained dust collection system is extremely quiet. The T7 thermoformer consistently produces high quality thermoplastic sockets from industry standard preforms.
For more information visit www.provel.us or call 509.857.2009. DECEMBER 2010 O&P ALMANAC
47
n
Marketplace
TORSION RECEIVER: A NEW TURN FOR FUSION & DURALITE FEET
MEDICAL WHITE STEALTHS $75 OFF—SEPTEMBER 1 – DECEMBER 31, 2010
A new proximal adapter option is now available for the Fusion™ and DuraLite™ Feet. The new Torsion Receiver mounts on top of the Fusion or DuraLite shank and requires no drilling. The proximal end is a pyramid receiver. A sense of natural movement is attributed to the 24 degrees internal rotation and 24 degrees external rotation. It is this rotation that let’s wearers turn or rotate, in or out, just as they do on their sound side. Additionally, clinicians may adjust the stiffness of the Torsion Receiver to one of six levels. For information, contact Ohio Willow Wood at 800/848-4930 or www. owwco.com.
When it comes to support and comfort, OPTEC’s Stealth is King!!! Easy to put on. Easy to take off. The Stealth brand is our most popular anterior opening brace. The closure system glides like butter and provides smooth compression, which can be regulated by your patients. Your patient will actively participate in their rehabilitation by adjusting compression and support to the desired level, thus enhancing comfort and patient
DYCOR
RENEWING INDEPENDENT LIFESTYLES K1A "K Series" Feet
Engineered
for
Assisted
Transfer
Excellence.
Average weight of "K Series" feet is 7 oz. (including foot shell & titanium pyramid), Patent & Patent Pending. Visit www.dycormfg.com for additional information and Keel deflection (weight) chart. 800-794-6099 48
O&P ALMANAC DECEMBER 2010
compliance. Take advantage of the $75 off OPTEC’s Stealth White braces and see for yourself why they are our most popular brand of brace. This offers Includes OPTEC’s Stealth LSO and LSO LP (L0637), Stealth X2 and X4 (L0637), Stealth Pro 2 and Pro 4 (L0631). Call us today at 888/982-8181 or find out more about these and other products online at www.optecusa.com.
NEW CATALOG WITH PDAC APPROVED CODES Call us today at 888/982-8181 to request our new 2010-2011 catalog! OPTEC USA consistently offers cutting edge products of the highest quality. Beyond offering innovative orthoses at a fair price, OPTEC USA works to help your practice be successful by submitting our braces to the PDAC (Pricing, Data Analysis, and Coding) for review and determination. PDAC recently reviewed OPTEC USA’s products with the following determinations: VertaMax – L0627, Stealth TLSO with DLK – L0462, Stealth TLSO with ATE – L0464, Oasis LSO and Oasis LSO LP - L0637. Find out more about these and other products online at www.optecusa.com or call us today at 888/982-8181!
mobility WITH ENTEGRITY
ENTEGRASV from Hosmer • • • • • • • • 1.800.251.6398
Independently adjustable hydraulic knee Rugged thru-bolt design Lightweight aluminum alloy frame Maintenance-free Oilite® sleeve bearings 135° range of motion Integrated kneeling pad ISO tested and rated for 220 lb (100 kg) • +46 8 505 332 00
• 1.800.827.0070 AD293-031210
n
Marketplace
OPTEC’S CUSTOM BRACES— READY WHEN YOU ARE – 24/7/365
For nearly 15 years, OPTEC USA has been a leader in custom spinal orthotic manufacturing. We provide the high-quality products and services you need from your central fabricator. With around-the-clock technical support, quality products at a fair price, and availability to take orders anytime, you will find that OPTEC USA fits your needs. Further, you will get your custom brace when your patient needs it and just the way you want it. Try OPTEC USA for your next custom orthosis! Find out more about these and other products online at www.optecusa.com or call us today at 888/982-8181!
OPTEC USA—EZ STEP ™ LEATHER ANKLE GAUNTLET OPTEC’S EZ Step Leather Ankle Gauntlet continues the pattern of innovation and excellence catered to your needs. The EZ Step’s custom fabrication combines incomparable comfort with unparalleled control, helping to make each step easier than the last. Key features include: • Unsurpassed craftsmanship and professionalism • Premium leather outer shell with soft, comfortable, padded leather lining • Thin, durable, polymer ankle and foot stabilizer • Less bulky and rigid than traditional gauntlets • Multiple closure systems for easy donning and doffing.
50
O&P ALMANAC DECEMBER 2010
For more information on OPTEC’s EZ-Step ™ Leather Ankle Gauntlet or our other products, please call customer service at 888/982-8181 or visit us at www.optecusa.com.
THE NEW PROPRIO FOOT® WITH EVO™ BY ÖSSUR: STABLE, SMOOTH, AND COMFORTABLE The newly redesigned PROPRIO FOOT with EVO utilizes intelligent ankle flexion to help users walk confidently and naturally without watching the ground, alleviating having to think about every step for fear of tripping and falling. It also features the exclusive EVO (Energy Vector Optimization) technology for improved dynamic response, enhanced comfort, and excellent stability throughout the gait cycle. The lifelike ankle movement enables this foot to adjust for normal sitting and standing, and automatic alignment for adapting to various types of footwear. Suggested Medicare assigned billing code is L-5973. For more information call Össur at 800/233-6263 or visit www.ossur.com.
TAKE A STEP IN THE RIGHT DIRECTION! E-MAG ACTIVE STANCE CONTROL KAFO Easy to fit for practitioners and even easier for patients to use, this integrated, low-profile joint provides the best in electronic stance control and helps your patients get into a more active lifestyle. The E-MAG Active calibrates itself to capture the user’s unique gait pattern with the help of the simple onboard programming. This unique feature adds a whole new dimension of functionality for people who previously have had limited bracing options, such as a locked knee brace or manual device. Help your patients get back into the swing of things with the E-MAG Active! Visit www.ottobockus.com.
NEW PROSEAL SYSTEM FOR TF SUCTION SOCKETS The new ProSeal System creates a proximal seal between the socket and liner, suitable for suction sockets for transfemoral amputees. The system consists of the 452A1 ProSeal Ring, an uncovered Liner, and the 21Y14 PushValve auto-expulsion valve. The ProSeal Ring maximizes the surface area and enhances the vacuum effect on the entire residual limb—not just the distal end. Users benefit from increased suspension in the socket plus easy donning and doffing. To learn more, contact your sales representative at 800/328-4058 or visit www.ottobockus.com.
DEMAND THE BEST Your patients do! Why shouldn’t you?
ABC facility accreditation is the BEST. We offer the: :: Best value :: Highest standards :: Longest track record for excellence in the orthotic, prosthetic and pedorthic professions
We Can Help The American Board for Certification in Orthotics, Prosthetics and Pedorthics Inc. 330 John Carlyle St., Ste. 210 Alexandria, VA 22314 703-836-7114
ABC facility accreditation isn’t just about meeting the minimum standards—it’s about you and the quality of care you provide. Accreditation from ABC tells your patients that the highest standards in the profession have been met. Contact us today at 703-836-7114 and join the best in the profession. Download the accreditation guidelines and an application at www.abcop.org.
www.abcop.org
BEST :: DEMAND THE BEST :: DEMAND THE BEST :: DEMAND THE BEST :: DEMAND THE BEST :: DEMAND THE BEST DEMAND THE BEST
n
Marketplace
NEW CUT-4-CUSTOM TLSO/LSO FROM PEL SUPPLY A simple solution for same-day fabrication in your facility, the new Cut-4-Custom from Allard USA can be fabricated in your facility in less than an hour! You really have to try this new custom LSO/ TLSO to see how quick and easy it is to customize. Look at these features: • Becomes soft—ready to mold to patient contours in less than 10 minutes • Solidified and finished LSO or TLSO in about 20 minutes • Front and back sections pre-cut with straps pre-attached • Four heights accommodate prescriptions and patients anatomy • Interchangeable backs and fronts sold separately • Lightweight, aerated for breathability • X-ray translucent and OK for shower
For more information on the new C-4-C, and other quality products from Allard USA, call your friendly PEL Customer Service Rep at 800/321-1264, fax 800/222-6176, e-mail customerservice @pelsupply.com, or order online at www. pelsupply.com.
MODULAR RATCHET LOCK KNEE JOINT FROM PEL SUPPLY The new Model 1018 knee joint, from Becker Orthopedic, is designed to promote full knee extension by providing knee stability to the patient through an incremental range of knee flexion. The joint features a long, angled, locking lever that is easily operated by the patient. The lever also may be shortened, or configured into a standard bail. Model 1018 also is fully interchangeable with Becker’s 1017,
For Sale
Used O&P Carving Equipment
Seattle Systems SM 2000 CV
PDI Pros Series 110-60
Very fast even at high resolution
A little easier to use and clean
Both systems are well suited for BKs, AKs, Spinals and Knees. * Also: Provel D1 digitizers, Seattle thermoformer * Trial runs, spare parts and support available.
Chapman Associates (414) 570-9700 dchapman1@wi.rr.com 52
O&P ALMANAC DECEMBER 2010
9005 and 9006 models. The interchangeabilty of this new series of knee joints allows the practitioner to quickly and easily change the knee joint function of the orthosis from locked (1017), to ratchet lock (1018), to stance control (9005/9006) at any time during the rehabilitation process. For more information, on any of Becker’s high-quality, innovative orthotic components, please call your friendly PEL Supply Customer Service Rep at 800/321-1264, fax 800/2226176, email customerservice@pelsupply. com, or order online at www.pelsupply. com.
DNS ON SHELVES AT SPS SPS has the amazing Dorsal Night Splint (DNS) ready to ship to you. Manufactured by Active Innovations’ (previously Active Ankle), DNS has been designed to hold the foot in a neutral position during sleep. This position helps alleviate morning pain and discomfort associated with plantar fasciitis. It is also applicable for virtually any condition where stabilization of the ankle in a neutral position is desired. Overall benefits include: • Unique small anterior dorsal clamshell design holds foot in neutral position to prevent contracture, supports the arch and allows for proper healing • Anti-Slip Pad on bottom facilitates easy, safe night-time ambulation • Thick lightweight padding improves comfort while sleeping • New triple-stitched, stretch-resistant strap • Prevents passive plantar flexion. For additional product information call SPS Customer Service at 800/7677776, ext. 3.
TM
n
Jobs
INCREASE EXPOSURE AND SAVE!
Place your classified ad in the O&P Almanac and online on the O&P Job Board at jobs.AOPAnet.org and save 5 percent on your order. BONUS! Online listings highlighted in yellow in the O&P Almanac.
- Northeast - Mid-Atlantic - Southeast - North Central - Inter-Mountain - Pacific Use our map to find which region you fit into!
CLASSIFIED RATES Classified advertising rates are calculated by counting complete words. (Telephone and fax numbers, e-mail and Web addresses are counted as single words.) AOPA member companies receive the member rate. Member Non-member Words Rate Rate 50 or fewer words $140 $280 51-75 words $190 $380 76-120 words $260 $520 121 words or more $2.25 per word $5.00 per word Specials: 1/4 page, color 1/2 page, color
$482 $678 $634 $830
Advertisements and payments need to be received approximately one month prior to publication date in order to be printed in the magazine. Ads can be posted and updated at any point on the O&P Job Board online at jobs.AOPAnet.org. No orders or cancellations are taken by phone. Ads may be faxed to 571/431-0899 or e-mailed to srybicki@ AOPAnet.org., along with a VISA or MasterCard number, the name on the card and the expiration date. Typed advertisements and checks in U.S. currency made out to AOPA can be mailed to P.O. Box 34711, Alexandria, VA 22334-0711. Note: AOPA reserves the right to edit Job listings for space and style considerations. Responses to O&P box numbers are forwarded free of charge. Company logos are placed free of charge. JOB BOARD RATES Visit the only online job Member Non-member board in the industry at Rate Rate jobs.AOPAnet.org! $80 $140 Save 5 percent on O&P Almanac classified rates by placing your ad in both the O&P Almanac and on the O&P Job Board, online at jobs.AOPAnet.org.
54
O&P ALMANAC DECEMBER 2010
Northeast
CPO, CO, Board-Eligible Orthotist or Prosthetist, BOCO or BOCPO, C.Ped Maine • Are you looking for something more? • Do you want to be more than a number? • Do you want a great life and a great job? • We are a terrific practice looking for some nice people. Is this you? We are a well-established, patient-oriented, ABC-accredited facility seeking to strengthen our staff. Competitive salary offered, with bonuses commensurate with productivity, and renumeration for required educational credits. Offices located in picturesque Maine, just a short distance from our coast and mountain regions. Learn more about joining our team of dedicated specialists by contacting:
O&P Ad 25356 O&P Almanac 330 John Carlyle St., Ste. 200 Alexandria, VA 22314 Fax: 571/431-0899
Certified Prosthetist/Orthotist New York/New Jersey Area “Be in business for yourself, but not by yourself.” Terrific opportunity for a professional patient-focused practitioner. If you have more than five years clinical experience, are self motivated with an enterprising spirit, call for details on this exciting program to put you into your own fully equipped O&P clinical center. Finally get paid what you are worth! Your success is our success. Be the professional CPO you have always wanted to be while getting support services from a company with more than 50 years of successful and respectable experience. This is the most positive business arrangement for the true professional patient-centered CPO. Call:
JLJ&J Business Development Phone: 862/266-4932
New York Orthotics & Prosthetics Part-time Orthotist New York City Area Immediate opening for CO in the NYC area. Job requires two days at clinic working with orthopedic and rehabilitation doctors. Submit your resume to:
E-mail: nyorthotic@verizon.net Fax: 212/504-3066
Central Fabrication Manager
Inter-Mountain
Certified Prosthetist/Orthotist West Monroe, Louisiana We are searching for an individual who desires the security of working for the oldest patient-care company in the world! If you have excellent clinical, organizational, and communication skills, we would love to speak with you. Management experience a plus! This position is accompanied by top compensation and benefits, relocation assistance, paid certification dues, state-of-the-art education, and much more! If interested, please contact, in confidence:
Sharon King Hanger Prosthetics & Orthotics, Inc. Phone: 512/777-3814 Fax: 512/777-3772 E-mail: Sking@hanger.com www.hanger.com/careers
Tempe, Arizona We are searching for the individual that wants to move to the next level! Someone who will be responsible for all activities within the fabrication center to ensure quality products are produced and delivered timely and within budget; monitors adherance to all safety, administrative, and financial policies and procedures; and will recruit and develop members of the fabrication team to support the continual improvement of skill levels and production processes. BA/BS in engineering, business or related field or equivalent combination of education/experience. Five or more years experience as a production manager in an O&P facility, central fabrication center, or health-care related facility. We offer a very competitive benefit and salary package. Signing bonus for the right person! If interested, please contact, in confidence:
Sharon King Hanger Prosthetics & Orthotics, Inc. Phone: 512/777-3814, Fax: 512/777-3772 E-mail: Sking@hanger.com www.hanger.com/careers AVAILABLE POSITIONS Orthotist
Why do I work for Hanger?
“
Hanger offers amazing resources for growing my skills. I have access to a vast network of more than 1,000 fellow practitioners across the country that I can call on—and I can learn far more from their real-life experience than I ever could from a textbook.
Philadelphia Area, PA York, PA Houston, TX Milwaukee, WI Wheeling WV
Orthotist/Prosthetist Cincinnati, OH
Prosthetist
Plus, I can take advantage of continuing education opportunities and extensive technological resources by being part of the largest prosthetic and orthotic company in the nation. I plan to have a long career with Hanger.
”
Charlye Tran, CPO, Practice Manager
Contact, in confidence: Sharon King, Director, Recruitment Tel: 512-777-3814 FAX: 512-777-3772 sking@hanger.com Hanger Orthopedic Group, Inc. 10910 Domain Drive, Suite 300 Austin, TX 78758
For more information visit www.hanger.com/careers Hanger Orthopedic Group, Inc. is committed to providing equal employment to all qualified individuals. All conditions of employment are administered without discrimination due to race, color, religion, national origin, sex, age, disability, veteran status, citizenship, or any
Evansville, IN Michigan City, IN Paducah, KY Methuen, MA Duluth, MN Springfield, MO
Meridian, MS Albany, NY Cleveland, OH Westlake, OH Enid, OK
Waterbury, CT Port St. Lucie / Melbourne, FL Hattiesburg, MS Jackson, MS
Prosthetist/Orthotist
Salinas, CA Miami, FL Pensacola, FL Atlanta, GA Louisville, KY West Monroe, LA Baltimore, MD Lansing, MI Farmingdale, NJ
Stratford, CT Waterville, ME Springfield, MO
Albany, NY Akron, OH San Antonio, TX Pittsburgh, PA Bremerton, WA Lakewood, WA Olympia, WA Port Angeles, WA
Certified Pedorthist
Tacoma, WA Wheeling, WV
other basis prohibited by federal, state or local law. Residency Program or Certificate Primary Education Program Info, contact: Robert S. Lin, CPO/Dir. of Academic Programs. Hanger P&O/ Newington O&P Systems, Ph. 860.667.5304; Fax 860.667.1719 DECEMBER 2010 O&P ALMANAC
55
n
Jobs Southeast
CPO Georgia An experienced CPO is needed for a well-established, ABC-accredited facility in Georgia. The individual must be licensed (or eligible) by the state of Georgia. This position is for three of our central-Georgia locations, and has opportunities for advancement. Benefits include full health insurance (including dental), life insurance, and a company-sponsored retirement plan. Send resume to:
C. H. Martin Company, est. 1912 Fax: 404/525-9819 www.chmartinco.com
Certified Prosthetist/Orthotist (licensed Certified Orthotist and/or Prosthetist Jackson, Mississippi The Crossroads of the South. College town…always something to do! Parks, museums, cultural events, historic sites, sports, and major downtown project improvements. This patient-care facility is a top-producing facility and a two-time winner of Hanger’s Excellence Award! If you want more than a job and are ready to make a move, we would love to discuss your goals. We offer a very competitive salary and benefit package accompanied by relocation assistance and sign-on bonus potential…plus much more! If interested, please contact, in confidence:
Sharon King Hanger Prosthetics & Orthotics, Inc. Phone: 512/777-3814 Fax: 512/777-3772 E-mail: Sking@hanger.com www.hanger.com/careers
Bulow BioTech Prosthetics, www.bulowbiotech.com is seeking energetic, caring, and talented certified prosthetists to open clinics in several states. The certified prosthetist will be free to focus on patient care and given all the tools needed for success. We are unique in that we specialize in prosthetic patient care services only, allowing us to provide customized, one-on-one care for each of our patients. This is an amazing opportunity for very select individuals who want to take their career to the next level. A minimum of 4 years‘ experience as a certified prosthetist and a passion for prosthetic patient care excellence is required. Position includes excellent benefits and salary with monthly profit participation. Qualified and interested individuals please e-mail resume to: chris.casey@bulowbiotech.com
Certified Prosthetist/Orthotist (licensed or eligible) Atlanta, Georgia More than just home of the Big Chicken, Marietta is close enough to enjoy the city of Atlanta but far enough away to give you the best of both cities! The area has it all: professional sports; Centennial Olympic Park; Atlanta Symphony Orchestra, opera, ballet; the Fox Theatre; the Tabernacle; the High Museum of Art; the world’s largest indoor aquarium; the World of Coca Cola, and much more! We have an opening for a well-rounded prosthetist/ orthotist who possesses great organizational and communication skills, along with excellent patient-care experience. We offer a very attractive salary and benefit package, which includes relocation assistance and a sign-on bonus potential. Ready to make a change? Join the Hanger Team! If interested, please contact, in confidence:
AMERICAN ORTHOTIC & PROSTHETIC ASSOCIATION SERVING THE O&P FIELD FOR OVER 90 YEARS
Renew the Easy Way With AOPA ONLINE PAY Login to pay your dues and update your membership directory information at:
www.aopanetonline.org/profile
Renew Online Today! 56
O&P ALMANAC DECEMBER 2010
NEW! UPDATE MEMBERSHIP DIRECTORY INFORMATION ONLINE
Sharon King Hanger Prosthetics & Orthotics, Inc. Phone: 512/777-3814 Fax: 512/777-3772 E-mail: Sking@hanger.com www.hanger.com/careers
PROSTHETIC SOFT-SOCK®
KNIT-RITE SOFT-SOCK® WITH 3-D TOE SHAPE THE ORIGINAL SOFT SOCK® - WITH A NEW, PATENTED HEMISPHERICALLY KNIT THREE-DIMENSIONAL DISTAL SHAPE. The new distal end shape provides improved fitting qualities and comfort over the traditional flat knit envelope shape of prosthetic socks.
Soft Socks are available in X-Static® - the Silver Fiber® or original CoolMax®, both moisture wicking fibers that move moisture away from skin and inhibit odor in the sock. Soft Socks feel soft and cuddly worn next to the skin, and Lycra provides stretch and excellent fitting qualities.
Patented Hemispherically knit three-dimensional distal shape.
®
ONLY BY DUPONT
ALSO AVAILABLE
Soft-Sock w/ X-Static
Shorty Soft-Sock
Proximal Soft-Sock
Patent No. 7,363,778
For more information contact Knit-Rite at 800-821-3094 or e-mail customerservice@knitrite.com. Also distributed by:
CONNECT WITH US ON THE WEB!
n
Jobs Pacific
Certified Orthotist/Prosthetist Honolulu Established and independently owned O&P company has an immediate opening for a well-rounded orthotist, preferably someone who can do both orthotics and prosthetics. Applicant should possess certification from an accredited program, more than five years in the field, and who possess great organizational and communication skills, along with excellent patient-care experience. Salary commensurate with experience. Fax resume to:
Fax: 808/791-1025
Orthotic and Prosthetic Technician California We are a rapidly expanding practice in Chico, California, that has an immediate opening for a self-motivated technician. Must be able to learn new fabrication techniques quickly and keep pace with a very busy work load in both orthotics and prosthetics. More than three years’ experience is a big plus. We are seeking a person who can speak Spanish and English but this is not a requirement. If you are looking for a great work environment, fair wages, and good benefits, please send your resume to:
Fax: 530/894-6915 E-mail: mike@elitebiomechanicaldesign.com
Certified Orthotist/Board Eligible Orthotist Richmond, California Howard Orthopedics Inc. is seeking a self-motivated certified orthotist and board eligible orthotist for its growing practice. Candidates must have excellent communication and organizational skills and be patient oriented. We offer a competitive salary, health benefits, 401(k), and profit sharing. Please send resumes to:
Certified Orthotist/Certified Prosthetist Orthotist California Do you want to work for an established, growing company in an environment that values clinical excellence, and work/life balance? Do you want to live in one of the most desired and diverse areas in the country, beautiful Southern California? SCOPe has a career opportunity for you. We are a leading orthotics and prosthetics company looking for an energetic and motivated CO and/or CPO to provide comprehensive assessment, treatment, and follow-up for our patients. SCOPe offers competitive salaries as well as an excellent benefits package for full-time employees. Salary is commensurate with experience. All communications will be held in the strictest confidence. Interested parties can send resumes via email to:
Fax: 858/292-5496 E-mail: jobs@scop.net www.scop.net
Certified Prosthetist/Orthotist or Certified Prosthetist Southern California Exceptional opportunity for a CPO/CP in California’s beautiful Santa Clarita Valley. Are you looking to grow your career and take on more responsibility? We are a well established multi-facility company with an immediate opening for an experienced practitioner (CPO or CP with orthotics experience) to manage our Santa Clarita office. This certified practitioner must be highly motivated, patient-oriented, and possess sound clinical, organizational, and interpersonal skills. A minimum of five years clinical experience is preferred. We offer a highly competitive salary and outstanding benefits package. If you are ready to take the next step in your career and relocate to one of the safest and most desirable places to live in the nation, please send your resume with cover letter to:
E-mail: alexa@howardorthopedics.com Valley Institute of Prosthetics and Orthotics Siri Khalsa, Administrator E-mail: skhalsa@vipoinc.com www.vipoinc.com 58
O&P ALMANAC DECEMBER 2010
n
Jobs North Central
Director, Professional and Clinical Services Minneapolis, Minnesota Join Otto Bock HealthCare, the global leader in maintaining and restoring human independence. We are looking for a CPO/CP/CO with a minimum 10 years’ industry clinical experience to provide leadership to our professional and clinical services team. This highly qualified, proven leader will be responsible for managing the development and provision of world-class clinical and technical education of our products and services for customers, patients, and employees in the areas of O&P and mobility solutions. The ideal candidate will be viewed as a “key opinion leader” and a senior clinician representing Otto Bock to the industry. This position is located in Minneapolis, Minnesota. If you’re ready to make a difference, submit your resume to:
E-mail: jane.stoner@ottobock.com
Certified Orthotist Green Bay and Appleton, Wisconsin Monroe BioTechnology is seeking a talented Certified Orthotist. This individual must possess a bachelor’s degree, have completed an NCOPE residency and have an additional three years of clinical experience. We are a two-office privately owned facility in Green Bay and Appleton, Wisconsin, offering prosthetics, orthotics, and high-definition silicone restoration. We have our own in-house lab and make full use of the BioSculptor CAD system. A successful candidate would be passionate about clinical orthotics, have excellent communication skills, be computer literate, and dedicated to using all their clinical skill and talent toward the pursuit of excellence in all areas of orthotics. If you desire to work as a respected clinician with other skilled, respected clinicians, please send your resume to Stephanie Sheedy at:
CPO and Pediatric CO Indiana Excellent career opportunities in a professional environment. Prevail Prosthetics & Orthotics is looking for career-oriented professionals for our growing business located in central and northern Indiana. We are looking for orthotic practitioners for rehabilitation, pediatric and orthopedic/orthotic management, as well as CP and CPO for active and geriatric populations. We offer quality working environments with excellent salary and benefits. Forward resume to:
E-mail: Stephanie@monroebiotech.com www.monroebiotech.com
Mid-Atlantic
Billing Specialist Kentucky Growing O&P company in Western Kentucky region looking to hire billing specialist to work in-house. Please e-mail resume to:
E-mail: llawrence.fsp@insightbb.com
Rita Hanke, Business Manager Prevail Prosthetics & Orthotics 7735 West Jefferson Blvd. Ft. Wayne, IN 46804 E-mail: rhanke@prevailpandp.com
Certified Orthotist/Prosthetist Kentucky O&P company in Western Kentucky region looking to hire ABC/BOC Certified Orthotist/Prosthetist. Please e-mail resume to:
E-mail: llawrence.fsp@insightbb.com
DECEMBER 2010 O&P ALMANAC
59
n
Calendar
2010 ■■
PROMOTE EVENTS IN THE O&P ALMANAC
CALENDAR RATES Telephone and fax numbers, e-mail addresses and Web sites are counted as single words. Refer to www.AOPAnet.org for content deadlines. Member Non-member Words Rate Rate 25 or less $40 $50 26-50 $50 $60 51+ $2.25 $3.00 per word per word Color Ad Special: 1/4 page Ad $482 1/2 page Ad $634
$678 $830
BONUS! Listings will be placed free of charge on the Attend O&P Events section of www.AOPAnet.org. Send announcement and payment to: O&P Almanac, Calendar, P.O. Box 34711, Alexandria, VA 22334-0711, fax 571/431-0899, or e-mail srybicki@AOPAnet.org along with VISA or MasterCard number, the name on the card, and expiration date. Make checks payable in U.S. currency to AOPA. Note: AOPA reserves the right to edit Calendar listings for space and style considerations. For information on continuing education credits, contact the sponsor. Questions? E-mail srybicki@AOPAnet.org.
AOPA-sponsored activities appear in red.
60
O&P ALMANAC DECEMBER 2010
■■ DECEMBER 8 Ultraflex: Pediatric UltraSafeGait™ Continuing Education Course, via WebEx, 5:00 – 6:00 pm ET. Covers assessment of pediatric pathological gait and influencing shank kinematics with the new Adjustable Dynamic Response™ (ADR™) technology. Presenter: Keith Smith, CO, LO, FAAOP. Register by calling 800/220-6670 or at www. ultraflexsystems.com. ■■ DECEMBER 9 Ohio Willow Wood: LimbLogic® VS for Technicians via WebEx, 1:30 pm ET. Learn essentials of elevated vacuum socket fabrication using available socket adaptors with LimbLogic VS. Learn how to deal with airtight issues, unit operation, and diagnostics that will keep the system optimal for patient use. Credits: 2.5 ABC/2.0 BOC. www.owwco.com/webinar.php. ■■ DECEMBER 9 OPGA: Bioness Training Course. Pinellas Park, FL. One-day course covers NESS L300 system evaluation, hands-on training and functional electrical stimulation concepts. Instructed by John Michael, MEd, CPO/L. The NESS L300 is a user-friendly neuroprosthetic designed to improve gait for individuals experiencing foot drop. 6.75 MCEs from ABC. Call 800/214-6742 or register at www.opga.com. ■■ DECEMBER 16 Ultraflex: Adult UltraSafeStep™ Continuing Education Course, via WebEx, Noon – 1:00 pm ET. Focuses on normalizing adult pathological gait with
the utilization of Adjustable Dynamic Response™ (ADR™) knee and ankle technology. Register by calling 800/220-6670 or at www. ultraflexsystems.com. ■■ DECEMBER 21 Ultraflex: Complex Orthopedic Rehabilitation Continuing Education Course, via WebEx, Noon – 1:00 pm ET. Focuses on Ultraflex combination dynamic and static stretching orthosis for addressing complex orthopedic rehabilitation goals and restoring range and function. Register by calling 800/220-6670 or at www. ultraflexsystems.com.
2011 ■■ JANUARY 5 Ultraflex: Pediatric Spasticity Continuing Education Course, via WebEx, 8:00 – 9:00 am ET. Covers clinical assessment of the pediatric neuromuscular patient with spasticity and using R1 and R2 for determining orthotic design for maintaining and improving muscle length. Presenter: Keith Smith, CO, LO, FAAOP. Register by calling 800/220-6670 or at www.ultraflexsystems.com.
JANUARY 12 Ultraflex: Pediatric UltraSafeGait™ Continuing Education Course, via WebEx, 5:00 – 6:00 pm ET. Covers assessment of pediatric pathological gait and influencing shank kinematics with the new Adjustable Dynamic Response™ (ADR™) technology. Presenter: Keith Smith, CO, LO, FAAOP. Register by calling 800/220-6670 or at www. ultraflexsystems.com. ■■
■■ JANUARY 18 Ohio Willow Wood: Discover LimbLogic® VS via WebEx, 1:30 pm ET. Critical components and operation discussed. Covers interpreting feedback from fob and basic fabrication processes for system. Credits: 2.5 ABC/ 2.0 BOC. To register online, visit www.owwco.com/webinar.php. ■■ JANUARY 19 Ohio Willow Wood: LimbLogic® VS for Technicians via WebEx, 1:30 pm ET. Learn essentials of elevated vacuum socket fabrication using available socket adaptors with LimbLogic VS. Learn how to deal with airtight issues, unit operation, and diagnostics that will keep the system optimal for patient use. Credits: 2.5 ABC/2.0 BOC. www.owwco.com/webinar.php. ■■ JANUARY 20 Ohio Willow Wood: LimbLogic VS® Applications Practitioner Course. Mt. Sterling, OH. Course covers various clinical aspects of LimbLogic VS applications: static and dynamic socket fitting, vacuum pump configurations, fob operation, system evaluation, liner options, alignment, and troubleshooting. Credits: 7.25 ABC/7.0 BOC. Registration deadline: 12/30/2010. Contact: 877/665-5443. ■■ JANUARY 20 Ultraflex: Adult UltraSafeStep™ Continuing Education Course, via WebEx, Noon – 1:00 pm ET. Focuses on normalizing adult pathological gait with the utilization of Adjustable Dynamic Response™ (ADR™) knee and ankle technology. Register by calling 800/220-6670 or at www. ultraflexsystems.com.
n
Calendar
■■ JANUARY 21–22 Ohio Willow Wood: LimbLogic® VS Applications Technicians Course. Mt. Sterling, OH. Learn all aspects of fabricating LimbLogic VS for various applications: socket materials, controller configurations and care, fob operation, troubleshooting. Fabricate sockets following recommended techniques for airtight socket designs. Credits: 12.25 ABC/12.0 BOC. Registration deadline: 12/30/2010. Contact: 877/6655443.
JANUARY 25 Ultraflex: Complex Orthopedic Rehabilitation Continuing Education Course, via WebEx, Noon – 1:00 pm ET. Focuses on Ultraflex combination dynamic and static stretching orthosis for addressing complex orthopedic rehabilitation goals and restoring range and function. Register by calling 800/220-6670 or at www. ultraflexsystems.com. ■■
■■ FEBRUARY 17–19 PrimeFare West Regional Scientific Symposium 2011. Salt Lake City. Salt Palace Convention Center. Contact Jane Edwards at 888/388-5243. ■■
FEBRUARY 28–MARCH 4
Spring 2011 SuperCourse at Motion Control, Inc. Salt Lake City. In-depth training of Utah Arm/U3+/ Hybrid Arm; ProControl2; Hands-on experience with user interface software so bring your laptop. CEUs: 34 (estimated) awarded by ABC; First Look at NEW Li-Ion Battery for U3/ U3+/Hybrid, NEW Electric Wrist Rotator, NEW TRIAD Preamps; Plus an overview of the NEW and EXCITING Motionfoot® from Motion Control. The Spring 2011 62
O&P ALMANAC DECEMBER 2010
SuperCourse is a 5-day event. The fee is $1,350. For more information or to register, call 888/696-2767, e-mail info@ UtahArm.com, or visit www. UtahArm.com.
■■ APRIL 27–29 New York State Chapter of AAOP Educational Program. Albany, NY. Albany Marriott Hotel. Contact Joann Marx, CPO at Marx4nysaaop@aol.com.
■■ MARCH 9 Ohio Willow Wood: LimbLogic® VS for Technicians via WebEx, 1:30 pm ET. Learn essentials of elevated vacuum socket fabrication using available socket adaptors with LimbLogic VS. Learn how to deal with airtight issues, unit operation, and diagnostics that will keep the system optimal for patient use. Credits: 2.5 ABC/2.0 BOC. www.owwco.com/webinar.php.
■■ MAY 11-14 PA Academy of Orthotic & Prosthetics Spring Conference. Pittsburgh. Sheraton Station Square. Contact: Beth Cornelius or Joseph Carter at 814/455-5383.
■■ MARCH 16–19 37th Academy Annual Meeting & Scientific Symposium. Orlando. Caribe Royale Orlando. Contact Diane Ragusa at 202/380-3663, ext. 208 or dragusa@oandp.org. ■■ MARCH 28–APRIL 2 Association of Children’s Prosthetic-Orthotic Clinics 2011 Annual Meeting. Park City, UT. The Canyons. For more information, call 847/698-1637, e-mail acpoc@ aaos.org, or visit www.acpoc.org. ■■ APRIL 15 Ohio Orthotics and Prosthetics Association Annual Spring Meeting. Columbus, OH. Hilton Columbus. Contact Dianne Farabi at 614/659-0197 or dfarabi@columbus.rr.com.
APRIL 15–16 Ohio Chapter, American Academy of Orthotists and Prosthetists (AAOP) Annual Spring Technical Meeting. Columbus, OH. Hilton Columbus. Exhibits included. Contact Richard W. Butchko 614/659-0197 or butchko1@ columbus.rr.com. See Web site at www.ohiochapteraaop.com.
■■ MAY 12–14 Western and Midwestern Orthotic Prosthetic Association/California Orthotic and Prosthetic Association Annual Meeting. Reno, NV. (New) Peppermill Hotel. For more information, contact Steve Colwell at 206/440-1811 or Sharon Gomez at 530/521-4541 or visit www.wamopa.com.
2012 ■■ MARCH 21–24 38th Academy Annual Meeting & Scientific Symposium. Atlanta. Hilton Atlanta. Contact Diane Ragusa at 202/380-3663, ext. 208 or dragusa@oandp.org.
2013 ■■ FEBRUARY 20–23 39th Academy Annual Meeting & Scientific Symposium. Orlando. Caribe Royale Orlando. Contact Diane Ragusa at 202/380-3663, ext. 208 or dragusa@oandp.org.
■■ JUNE 3–4 PrimeFare East Regional Scientific Symposium 2011. Nashville. Nashville Convention Center. Contact Jane Edwards at 888/388-5243. ■■ SEPTEMBER 19–22 AOPA National Assembly. Las Vegas. Mirage Hotel. Exhibitors and sponsorship opportunities, contact Kelly O’Neill, 571/431-0852, or koneill@ AOPAnet.org.
■■
Renew the Easy Way With
AOPA ONLINE PAY www.aopanetonline.org/profile
AMERICAN ORTHOTIC & PROSTHETIC ASSOCIATION
Business OpTimizATiOn AnAlysis TOOl (BOAT) AOPA’s largest and most successful members use the BOAT and you should also.
The BOAT will help you:
This AmAzing Profit Booster is FREE for AoPA MeMbers. You will have access to your own secure and confidential account on the BOAT which will contain your company’s reported data and is specifically tailored to help O&P business owners manage their business for
•
Create budgets
•
Track your finances
•
Participate in the annual Operating Performance and Compensation survey (OPC)—which provides you with a personal benchmark comparison study
•
OPC data you submit will automatically populate your BOAT site providing valuable historical information
•
Provide access to the new AOPA Patient Satisfaction Survey (required by certifying bodies)
•
Examine the financial fitness of your business
•
Help you identify and understand your competition, market conditions and referral sources
•
Much more!
3
Enroll Today!
greATer prOfiT And quAliTy pATienT cAre.
If you do not already have a BOAT account, contact AOPA’s BOAT partner, Michael Becher, Industry Insights, (614)389-2100 x 114 or mbecher@industryinsights.com, to enroll today.
n
Ad Index
Company
Page
Phone
Web site or E-mail
Allard USA Inc.
21, 61
888/678-6548
www.allardusa.com
ALPS
43
800/574-5426
www.easyliner.com
Orthotics, Prosthetics & Pedorthics
51
703/836-7114
www.abcop.org
Apis Footwear
37
888/937-2747
www.bigwideshoes.com
College Park Industries Inc.
27, 41
800/728-7950
www.college-park.com
Daw Industries
1, 53
800/252-2828
www.daw-usa.com
Dr. Comfort
5, C3
800/556-5572
www.drcomfortdpm.com
Euro International
9, 39
800/378-2480
www.eurointl.com
Fillauer Companies Inc.
49
800/251-6398
www.fillauercompanies.com
KISS Technologies LLC
29
410/663-5477
www.kiss-suspension.com
KNIT-RITE
33, 57
800/821-3094
www.knitrite.com
Motion Control
23
888/696-2767
www.utaharm.com
Oandpstudyguide.com
31
410/266-1671
www.oandpstudyguide.com
Ohio Willow Wood
2
800/848-4930
www.owwco.com
OPTEC
6, 7; 44, 45 888/982-8181
www.optecusa.com
Össur® Americas Inc.
11, C4
800/233-6263
www.ossur.com
Otto Bock HealthCare
C2
800/328-4058
www.ottobockus.com
PEL Supply Company
35
800/321-1264
www.pelsupply.com
Spinal Technology Inc.
15
800/253-7868
www.spinaltech.com
SPS
13
800/767-7776, Ext. 3
www.spsco.com
Texas Assistive Devices LLC
19
800/532-6840
www.n-abler.org
American Board for Certification in
OP Almanac Online &
Reading the O&P Almanac has never been easier! • • • •
Access advertiser Web sites by simply clicking on the hotlinks Access content with the click of a mouse or the touch of a smart phone Easily e-mail your favorite articles to colleagues Save articles as PDFs!
Go to www.AOPAnet.org, click on ‘O&P Almanac Online’ today! For more information, contact Steven Rybicki at 571/431-0835 or srybicki@AOPAnet.org. For advertising information, contact Dean Mather at 856/768-9360 or dmather@mrvica.com.
64
O&P ALMANAC DECEMBER 2010
AVAILABLE
NOW!
and even more comfort for your patients.
CALL 1-800-992-3580 OR VISIT www.drcomfort.com ®
THE NEW FLEX-FooT BALANCE.™ THE LIGHTEST MULTI-AXIAL K2 FooT. ®
with cover
without cover
Introducing Flex-Foot Balance, the ideal balance of light weight and stability for household/K2 ambulators. In addition to being the lightest foot in its class, Flex-Foot Balance offers a host of premium features, like an integrated multi-axial ankle, a full-length toe lever, and a removable sandal toe foot cover. All of which make Flex-Foot Balance comfortable and smooth for unilateral users, yet stable and reliable for bilateral users.
“I find the Flex-Foot Balance comfortable and smooth for unilateral users, yet it is stable and creates confidence in bilateral users.” — Keith R. Sardo, CPO
CALL (800) 233-6263 or VISIT oSSUr.CoM To LEArN MorE.
©2010 Ossur. All rights reserved. Össur, Flex-Foot and Talux are registered trademarks of Össur.