By Marique Newell

"Membership has its privileges, but it also has its responsibilities."

Walter Racette, CPO, first heard the adage 30 years ago, and these days, as he assumes the top leadership role on AOPA's board of directors, the saying resonates loudly with him.

"I'm convinced we have gone away from our responsibilities...to educate and really get people involved and revved up about the issues," he remarked.

In talking with AOPA's new president, it is clear Racette is committed to leading by example and reclaiming that responsibility.

"I want to talk to members. I want to hear from them. I want their feedback," Racette stated. "I want members to know their opinion is valuable, and their participation is critical.

"When any president takes office, he realizes how critical the time is," he continued. "I'm taking this as the most critical time because I'm here, and I'm going to pour myself into it."

Racette is eager to address the challenges—both for AOPA and the O&P field—that he sees today and in the year ahead, to find solutions for those challenges and to close the communication gaps between AOPA, its members and the O&P profession.

Reimbursement woes

While Racette has many items on his agenda, one challenge is glaringly apparent: helping O&P professionals get reimbursed for their services.

"The bottom line is you have to get reimbursed," he said, "and from AOPA's standpoint, that's one of our biggest concerns."

A top item on Racette's list of challenges that directly relates to reimbursement is how AOPA will handle the impending outcomes of the Program Advisory and Oversight Committee (PAOC) meetings.

"We've spent a lot of time trying to influence those meetings," Racette said. "Once they identify qualified provider and direct access legislation and accredited facility language…implementing the changes from those decisions will certainly be a challenge."

He also sees the advancements in O&P technology as another potential strain on reimbursements.

"We need to find a way to embrace new technology and find a way to get paid for it," he said. "Technology is improving, but reimbursement is going the other way."

Above all, Racette recognizes perhaps the largest hurdle he and the profession face is taking the appropriate legislative action to prevent further erosion of reimbursement rates.

"We need to continue to strengthen cooperative efforts between the associations so we can get on the proactive end of things," Racette stated. "As some of these changes in reimbursement trickle down and qualified provider language is established, we'll have to be on top of getting this information out to people."

Clear communications

Putting information out to the field quickly and effectively is yet another goal Racette wants to focus on during his year as president. He's concerned about the recent decline in volunteer participation and emphasized his desire to build stronger relationships between AOPA's board and AOPA members.

He'd also like AOPA to receive more input from the field on current issues. He'd like to have more people involved in volunteer leadership and committee work. Ultimately, he'd like to ensure AOPA's decisions are clearly in line with its memberships' needs.

Racette will look to fellow board members to help him on these issues.

"We need to have more volunteer people helping staff," Racette stated. "And it's the responsibility of the volunteer leadership to source leaders and get them involved."

Phone calls, e-mails and face-to-face meetings are a few examples of the personal gestures he hopes will occur between the board and AOPA members in the coming year.

"The cooperative effort of what's going on with the association and building on that cooperation and setting a sight of one goal for the profession is not a fast process. It's not simple," he said, "but I'm counting on people to be involved."

Cooperation counts

Racette also wants to see stronger cooperation between AOPA and other O&P organizations.

He feels that outgoing President Michael Hamontree made significant strides in strengthening the communication and cooperation within the field during his presidency. Racette wants to build on that momentum in the coming year.

"We've come out of the dark ages with trying to alienate each other," he said. "We realized that's just not getting us anywhere and is not a responsible professional attitude.

"The bottom line is that we have a profession. I think you're a member of the profession, not just of the association," he continued.

Evidence-based care

Racette sees outcomes- or evidence-based care as one specific area where the Academy and AOPA could easily team up to provide pertinent research to the field.

"This is a project we have known has been out there for a long time," he said. "We've been asked to use medical justification in the past and realized we don't have much evidence to base anything on."

Racette will be doing quite a bit of work with this topic in the near future since he is the point person for the outcomes-based area of a new AOPA project, called "Ensuring the Future of O&P: The Sunriver Initiatives."

Although the Sunriver Initiatives is clearly an AOPA project, Racette still sees potential partnership opportunities with other organizations, especially since the results of the initiatives are important to everyone in the profession.

"This is one of those areas that needs to be and is a collaborative thing, at least between the Academy and AOPA," Racette said. "The Academy has done a lot of work on evidence-based care, and we hope to help in any way we can.

"We haven't done the things other medical professionals do, in terms of putting the facts behind the daily decisions we make," he continued. "It's really an important issue for the profession. And it's my responsibility and the board's to move these things forward."

Sunriver Initiatives

Racette is eager to push along all four topics of the Sunriver Initiatives, which is a long-range strategic planning project looking at the key issues the profession faces today and envisioning where the field will be in the year 2015.

The other topics include focusing on business optimization processes, developing a shared vision in the O&P profession and establishing differentiation in O&P by promoting accreditation and certification.

"The executive committee is having monthly calls to find out where we are, what the next step is, who the players are, and so on," Racette explained. "We're basically reporting to each other and are constantly reviewing and refocusing our goals."

Racette can't stress enough how critical he believes it is to keep up the level of excitement surrounding the initiatives, considering the lack of set deadlines and timetables.

"After you go through a session such as the one we did in drafting these initiatives, you're revved up, and somehow you have to sustain that and constantly push toward refinement and growth," he said.

Business philosophies

It's not surprising that Racette would say something like this, considering he constantly pushes himself, his employees and his colleagues, challenging them all to be better practitioners, better business owners and better managers.

He's worked as the director of orthotics and prosthetics and as an assistant clinical professor in orthopedics at the University of California, San Francisco (UCSF) for close to 8 years, and each day, he tries to practice what he preaches.

"You should set a good example. You should say to yourself, ‘I am the role model here,'" he stated. "You don't ask someone to do something you wouldn't do yourself."

Racette also believes strongly in creating a good, positive office environment—for the benefit of the patients and staff—and teaching employees whatever skills and lessons they need to be successful.

Most of all, though, Racette believes in hard work. "I grew up on a dairy farm in Oregon. No matter what career I was going to go into, I learned at an early age the ethics of hard work, respect and responsibility," he said.

Career in O&P

Racette wasn't exactly sure what career he would go into when he graduated from the University of Oregon in 1970. He was interested in working as an athletic trainer and had interviewed with the physical therapy department at the University of Washington (UW) in Seattle when Barny Simons contacted him about attending UW's O&P program.

"Simons was just getting UW's O&P program underway," Racette explained. "If he hadn't contacted me and gotten me in, I don't know where I'd be."

Racette graduated from UW in 1972, and then spent 3 months on active duty, fulfilling his college Air Force ROTC requirement. While in Riverside, Calif., he met Sam Hamontree, CP, and Roy Snelson, CPO(E), who both owned Orthomedics at the time.

"Roy and Sam had visions and they shared those visions with me and challenged me and afforded me opportunities I wouldn't have had and that weren't out there at the time," he recalled.

Racette worked at Orthomedics from 1973 until 1989, starting as a clinician and making his way up to vice president of professional services before the company was sold to NovaCare. He then worked in England for a few years, returning to the United States in 1993. He worked for another NovaCare-purchased company until 1997, when UCSF came calling.

In his current position at UCSF, Racette balances a busy, diverse schedule, which includes seeing patients, managing clinicians, working with residents and teaching a few courses.

His close contact with residents over the years has played a key role in his interest in O&P education standards. He firmly supports increased education requirements for new practitioners, saying that the changes he's seen over the years have already proven beneficial for the profession.

What's ahead

Ultimately, Racette wants nothing more than to do work that will benefit the O&P field, whether he does that work as AOPA's president, as UCSF's director of O&P or as a practitioner seeing patients.

"You just can't be in this field without getting excited about being someone who gets to help people get on in life, to see people achieve things they didn't think they could achieve, and the gratitude people have for helping them along the way," he remarked. "That's a bond that brings all clinicians together."

He is aware of the tough challenges he faces as AOPA's president but is confident that he's surrounded by a core group of dedicated people who want to achieve the same goals he does.

"If we work together, we'll all do well," Racette said.

"It's not about who gets credit. It's about how much better off our patients and businesses are and how much more of a career path and opportunities we are creating for the next generation."

Spoken like a true leader.

Marique Newell is the associate editor for the O&P Almanac. View previous issues of the Almanac online at www.AOPAnet.org. Have a story idea? Call us at (571) 431-0876.