Choosing a Prosthetist or Orthotist

While the average person might not even know what a prosthetist or orthotist is, for those people who rely on their expertise, choosing such a practitioner becomes a very important decision. The success and progress of an individual’s rehabilitation depends largely on the skill, knowledge and experience of your practitioner.

Prosthetists are healthcare professionals who design, produce and fit artificial limbs (prostheses) for people who have lost a limb through congenital deformity, disease, or traumatic injury. Orthotists are healthcare professionals who make and fit braces (orthoses) and splints for people who need added support or adjustment for weakened joints or muscles caused by disease, injury or physical disorders. Both prosthetists and orthotists receive special education and training through undergraduate programs and apprenticeships.

Prosthetists and orthotists can be certified by either the American Board for Certification in Orthotics and Prosthetics, Inc. (ABC), or the Board for Orthotist/Prosthetist Certification (BOC). Both credentialing organizations work to ensure that practitioners are fully competent in the area/s in which they are practicing.

However, because each person’s goals and lifestyles are unique, ultimately the prosthetist or orthotist that an individual chooses must meet his or her needs, in addition to being certified. Therefore, it may be helpful to first determine what expectations, goals, and level of support you have before beginning a search for a practitioner:

• What activities do you believe you must be able to perform after receiving a prosthesis or orthosis?

• What activities do you expect to be able to perform after receiving a prosthesis or orthosis?

• Will you need a physical therapist or an occupational therapist?

• What financial support do you have?

• What support will your family and friends be willing or able to provide?

• Is there a support group in the area that can assist you?

While your physician or therapist may suggest a prosthetist or orthotist, the choice is ultimately yours, as their patient. If your physician or therapist wishes to refer you to a certain prosthetist or orthotist, ask why they are recommending this particular practitioner or company. Certainly there can be more than one excellent provider of prosthetics and orthotics in your area, and you should be able to make an informed decision about which provider is best for you.

When you begin your search, make certain that the prosthetist or orthotist is a certified practitioner with experience in fitting patients who have the same level of amputation or injury as yours. He or she should be professional, reliable and very familiar with the latest treatment techniques. Because you will most likely develop a long relationship with him or her, you should select a practitioner with a comfortable rapport who is willing to meet with you to discuss your goals, lifestyle, and specific concerns.

Before deciding on a prosthetist or orthotist, you may wish to talk to some of his or her other patients who are about the same age and have similar amputation or injury levels as you do. Ask them about their experiences with the company and what their satisfaction level has been with the prosthesis or orthosis that they received.

Remember that you should also be looking at the qualifications of the prosthetics and/or orthotics company where a practitioner is employed. The company must be reputable and the facility itself should be accredited by the American Board for Certification. A facility must meet five distinct categories of criteria to be accredited by the ABC:

1.) organization, governance and administrative management

2.) professional staff qualifications and responsibilities

3.) patient care management

4.) quality assessment and improvement

5.) facility and safety management

When searching for a prosthetic and orthotic provider, ask how long the company has been in business, and what their procedures are for addressing complaints or problems. Consider the company’s proximity to your home since most custom-made devices require several visits for fitting and follow-up visits for adjustments and maintenance. And perhaps most importantly, determine if the facility is on your insurance company’s list of preferred providers?

Once you have selected a practitioner, you need to realize that the two of you share responsibility for producing a prosthetic or orthotic device that fits and functions optimally. Make your personal priorities known to your practitioner at the initial meeting. Do you want to be able to run or be athletic, or do you simply want to be able to walk and take care of daily tasks? Is it important for you to be able to remove the device quickly and easily? Does the prosthesis or orthosis need to be cosmetically attractive? Ask your practitioner to discuss available options with you and guide you towards the best choices. By sharing responsibility with your practitioner for your care, the chance for misunderstandings and disappointments is diminished.

Keep in mind that continuity of care is important. It will take time to reach your goals and to perfect the fit of the prosthesis or orthosis. By establishing a good relationship with your practitioner early on, you will benefit later when adjustments or new devices are required.