Lol, clearly it wasn't what you wanted (though I confess I did not read the linked series of essays, er, posts). I would not, however, discourage everyone from an entire profession, particularly if they've expressed interest. It only requires a masters level education with a short residency and appears to earn an appropriate income for the time invested, so it doesn't seem so bad from an outsider's perspective. Medicine and other doctoral fields are not for everyone (many people would be miserable) - best to do what you love.
OK, maybe I was a little too discouraging a couple posts back, but I would just want people to REALLYYY consider the cons of O&P before going into it. Don't get me wrong, I love the job and I love the patient base, that's not my problem with the profession. I'll try to sum up some of the consensus from that other thread on O&P.
1. The schools are putting out more students than there is a demand for.
2. The quality of education is too variable between the different schools (there are 12 O&P programs).
3. There is a large shortage of residency positions and the whole residency system is ancient. No automated match system. Not even an updated list of residency sites available. Pretty much just up to graduates to cold call. You can't get licensed or certified without a residency though, so this whole process can set you back considerably.
4. You pretty much have to be a clinician/salesman. It's all about quantity over quality because in O&P you can't bill for office visits. Non-custom orthotic devices have very low profit margins. And yes you might get paid 40,000 for a prosthetic leg but first you have to buy the 25,000 in componentry and fit and deliver the device before you can even bill for it. If your claim gets denied you're out a very large chunk of money and what are you gonna do, track down a senile diabetic and repo the thing?
5. The O&P scope is constantly encroached upon. MDs, DOs, DPMs, PAs, NPs, PTs, OTs, chiropractors, naturopaths, and even pharmacists all have some amount of orthotic and/or prosthetic services in their scopes.
6. Orthotist/prosthetist notes count for nothing as far as CMS or anyone else is concerned. If the physician's notes aren't perfect, even if ours are, claims get denied. Heck, amputees are sometimes denied artificial limbs as not medically necessary even if the prosthetist's and physical therapist's notes are on point. This is similar to what happened with the therapeutic shoe bill which is why almost no O&P practice offers diabetic shoes & inserts anymore, except maybe some Hanger locations. We know exactly what the requirements are but our notes don't count. The physician may not know exactly what the requirements are but their notes do count and we're legally not supposed to dictate the physician's notes.
7. O&P may require a master's degree now but there are still many practicing orthotists/prosthetists who were grandfathered in from when there were very few requirements. Some have a GED or high school diploma or associate degree and that's about it. I would say because of that there is a lot of riff-raff in the field. Unprofessionalism, sexism, racism, and lots of other isms all run rampant in O&P.
8. Reimbursements for O&P practices are usually well under medicare allowable. Like I'm talkin' 60%, 70%, 80% of medicare. I don't think at my current employer we have a single contract that is even close to 100% of medicare.
You can verify any of this with that other thread. Surprisingly (or should I say unsurprisingly), there wasn't a single dissenting opinion on that thread. Not a single person stepped up and said "I don't know what the heck these guys are talkin' about, O&P is great". That's because...it's not.
/rant over
