Following a Different Path
By Steve Hill, CO

I’m a technician, and I’m sure I always will be. I’m a certified orthotist and have done a fair amount of patient care, but I’ll always feel the pull of the bench. 

However, in the past few months I’ve started seeing patients for a local practice, Asheville Orthotic Prosthetic Center in Asheville, N.C. Although I’ve had some patient contact in the past, I’ve never had to actually carry a patient load and do all of the things required of a practitioner. 

That experience has given me a much better perspective on what it takes to be a practitioner as opposed to a technician. If you’ve ever thought about becoming a practitioner, I’ve put together this article to help you consider the pros and cons. You may find that it’s a perfect next step, or you may find that you are better off perfecting your craft and becoming the ultimate technician. 

What’s your type?
It takes two fairly different mentalities to do each job. If you’re an outgoing type and love to meet new people – many of whom are in crisis – then patient care might be for you. 

I’ve found an expected, but still surprising benefit of patient contact is the feeling that I’m doing actual good for someone. As a technician, I always knew that the end result of my labors was, mostly likely, helping people continue on with their lives. But seeing with my own eyes the smile that comes over a patient’s face is a thing apart. 

As a younger man, my patience for patients was thin. I wanted to be around people who were happy and healthy. I was content just to work behind the scenes and let others deal with the complexities and unpredictability of the human condition. 

If you have good hand skills but are more comfortable working with a small group of people, or by yourself, maybe the path of technician suits your temperament more. If that’s the case, do what I did. Focus your energies on becoming the best technician you can be. 

But as I’ve aged, I’ve mellowed. Crying children and irritable seniors – the two largest segments of the orthotic patient population – no longer make me want to run for the hills. With that change in temperament, I find that patient care is not only more rewarding, it’s actually fun at times. 

You, too, may be experiencing a change in temperament. Consider going back to school if you want to deal with people daily and see the results of what you do. 

Drawbacks and benefits
If you do decide to become a clinician, here are four things that will either help you or hurt you along the way. 

Talk with your clinician. In my less familiar role as an orthotist, I found that I relied more on my previous work experience than time I spent in the classroom. 

Don’t get me wrong—I gained valuable information in formal training that I used with every patient. But it’s the problem-solving experience I had already gained by interacting with my clinician that really proved its worth. 

Book learning can reach its limitations quickly because one patient treatment rarely resembles another. Even foot orthotics are more complex than they seem. Subtle changes in material and construction can greatly affect the patient’s outcome. It was only because I had talked with my clinician that I knew why those changes would work. If you don’t know that, it’s probably time to learn. 

Ask your clinician why he does the things he does. Even if you stay a technician, the knowledge will help you improve the work you do. 

Technician’s advantage: bench skills. A fringe benefit of having a technician’s background is the ability to make good adjustments. I’m not going to turn this into a “clinicians can’t fabricate their way out of a paper bag” article, because many of them have excellent hand skills and might be happier in the lab. But you have to admit that time on the bench translates into a good-looking adjustment. 

The patient care facility I’ve been working in has a top-notch lab downstairs. Still, each practitioner is expected to modify his or her own mold. My skill with plaster saved my bacon on several occasions as a practitioner. 

Technician’s disadvantage: paperwork. I knew clinicians had to do a fair amount of paperwork. What I didn’t know was its sheer volume and importance. 

Not only do I have to select the correct L codes, but I have to create a properly worded justification. Not only do I have to write progress notes, but I have to do them a certain way. Prescriptions, diagnoses, work orders, parts orders…without an electronic patient management program a two-practitioner office would kill off a small deciduous forest every year. 

Many technicians struggle to simply read a work order, never mind write the vast amount required of a clinician. If the thought of writing mounds of literature makes you sleepy, patient care may not be for you. 

Know your shoes. One last note—before I was a clinician, I never knew an orthotist spent so much of his working day kneeling in front of people trying to get their shoes to fit. At times, it can leave me frazzled. At least I know that when I retire, I can always make some extra money working at Foot Locker. 

Whether you’re a technician or clinician, follow your dream. If you’re not happy, there are other career paths in O&P you can follow. 

Steve Hill, CO, is secretary of OPTA and CEO of Delphi Ortho, located in Asheville, N.C. and on the Web at www.delphiortho.com.