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Orthopedic assistant profession promotes policy change, recognition
Orthopedics Today, March 2014
Jason S. Mazza, MSc, OA-C, CSA, SA-C, OTC, CCRC
In a previous column, I discussed the rebirth of the orthopedic assistant (
also known as orthopedic physician’s assistants) profession in 2013. Since
then, I have received a number of questions raised by surgeons and practice
administrators about the regulations of practice for orthopedic assistants (
and orthopedic physician’s assistants).
In summary, orthopedic physician’s assistants (OPA-C) are licensed to
practice in Tennessee. The scope of practice and general rules of practice
are defined by the Tennessee Board of Medical Examiners. In New York,
orthopedic physician’s assistants are known as registered specialist
assistants (RSA) and are licensed by the New York State Education Department
. RSAs in orthopedics may perform all activities within their scope of
practice that are assigned by the supervising physician. Supervision has to
be continuous, but the physician does not necessarily need to be onsite at
the time services are rendered.
Jason S. Mazza
Individuals who completed a formal OPA training program that was accredited
by the American Medical Association between 1971 and 1974, may use the title
orthopedic physician’s assistant in California. Similarly, a select group
of OPAs were included under Minnesota’s first set of physician assistant
regulations between 1983 and 1985.
Outside of those states, OPA/OA practice is governed by physician practice
oversight laws and physician delegation statues for most areas of the
country. The tasks that an OPA/OA is able to perform in the clinical setting
vary by state. Further regulations also exist in hospital settings.
Licensure
Since the OPA/OA profession has advanced to a master’s level training, the
need for licensure has again become a focus of the profession. As discussed
in previous articles, physicians have voiced that they want a well-trained
assistant and want to avoid spending months or years teaching orthopedics to
an assistant. The Master of Orthopaedic Assistant Program at the University
of St. Augustine is a perfect fit for this. Graduates of the program have
completed a rigorous didactic science and orthopedic procedures component
followed by 40 weeks of clinical rotations in various orthopedic
subspecialties. These graduates are work-ready. All they need to learn are
basic practice procedures along with the supervising physician’s
preferences and nuances. One could argue that they do not have real-world
experience, but like all other health professionals, that comes with time.
While there is no standardized definition of a physician extender, it is
generally accepted that this type of provider is a health professional who
has received the appropriate training through an accredited institution of
higher learning and serves as a substitute for a physician in certain
aspects of patient care. OPAs/OAs meet this criterion.
Why do OPAs/OAs need licensure if their practices fall under delegation laws
? One reason is that as medicine and technology continue to merge,
orthopedic services will be delivered in more efficient capacities. At one
point, for example, the patient and provider may not be in the same location
. Licensure of the profession would provide some means that the OPA/OA is
qualified and competent to perform the activities that fall within the scope
of practice.
Protection of the public
The purposes of professional licensure are essentially to protect the public
from harm by setting minimal competencies and standards for a specific
profession. The practice of an OA/OPA involves assisting with examinations,
giving injections, immobilizing fractures, applying and removing orthopedic
devices and assisting in the operating room — all of these duties pose
risks to patients. Most lay people are not able to identify the difference
in credentials among allied health professionals and are not able to discern
whether someone is qualified to serve in a particular role. This can leave
patients vulnerable. The possession of licensure offers some basic
protections and shows that a particular professional has met specific
standards. The OPA/OA profession has been in existence for more than 40
years with limited licensure. Obtaining licensure in the remaining states
will only enhance the roll of practicing OPAs/OAs and offer the public
greater protections.
With the advancement of training to a master’s level, we feel that our
profession should be more greatly recognized by surgeons, administrators and
policy makers. Traditionally, many hospitals, health care entities and
organizations have only recognized advanced registered nurse practitioners
and physician assistants for advanced privileges and credentialing. These
are professions with a significant number of members and recognized training
programs. They are able to serve orthopedists and other specialists from
their training as a generalist. The OPA/OA profession is relatively small in
numbers compared to both the PA and ARNP professions. Despite this, OPA/OAs
are specialty trained, which offers potential advantages to orthopedic
surgeons.
There is good agreement that the burden of musculoskeletal care will
continue to trend upward. As the traditional models of medicine have shifted
to a more specialized approach, the need for qualified and well-trained
specialty assistants has become greater. Orthopedic assistants are specialty
-trained allied health professionals who can meet the ever changing needs of
orthopedic surgeons. Many surgeons have embraced the OPA/OA profession.
Further support and recognition is needed to achieve licensure in other
states. This ultimately will benefit practicing orthopedic surgeons from the
vantage point of potential time- and cost-savings.
Our goal is to expand our credentialing classification and foster a new
sense of thinking among the orthopedic community and policy makers. The
educational level and training for today’s OPAs/OAs parallel those of other
physician extenders. A national certifying examination is in place
following graduation. A professional membership and education society,
American Society of Orthopaedic Assistants represents the profession at the
national level and encourages growth and continuing medical education for
its members. As a profession, we have gained recognition from many surgeons,
practice managers and other recognized medical organizations during the
last four decades. Wider acceptance of the profession and state regulation
is our next endeavor.
For more information:
Jason S. Mazza, MSc, OA-C, CSA, SA-C, OTC, CCRC, is immediate past president
and the American Academy of Orthopaedic Surgeons liaison for American
Society of Orthopaedic Assistants (ASOA) – formerly ASOPA.
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发帖数: 666 | 2 这个行业很新，不知道能不能发展起来。 AAPA就对他们很不满。 | m*******1
发帖数: 328 | 3 这个program出来后直接进骨科的希望微乎其微， 必须在一个有residency的program工
作N年后可能有一点希望， 其性价比还不如在美国读个医学院 |
|
