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Ordering Health Care Services
Re: Orthotics and Prosthetics |
Q: I recently wrote an order for an orthotic devise for one of my patients. The orthotist called and said he was not able to fit the orthotic because the order must come from a physician, chiropractor or podiatrist. Is this true?
A: Yes. According to §605.002 (14) and (18), Texas Occupations Code, the definitions of both “orthotics” and “prosthetics” include the phrase, “under an order from a licensed physician, chiropractor, or podiatrist.” Just as you are subject to discipline by the Board of Nursing if you do not function according to the Nurse Practice Acts, orthotists and prosthetists must practice in accordance with their practice act. Unfortunately, since those definitions are in law, only the Texas Legislature can change these definitions. Until CNAP can get state law changed, a physician must sign orders to prosthetists and orthotists.
There are some possible alternatives, however. Pharmacists are legally allowed to select and fit orthotics. Therefore, if there are pharmacists in your community that provide this service, they can accept your order if you have prescriptive authority. In addition, podiatrists also fit orthotics. Depending upon your patient’s needs, you might even consider referrals to an occupational or physical therapist. Both fit some orthotic devices as part of their scopes of practice and may accept referrals from APNs. |
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© 2006 Coalition for Nurses in Advance Practice
P.O. Box 5047; Austin • Texas 78763-5047 • 512-469-7882
www.cnaptexas.org
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