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Practice Analysis of Certified Practitioners in the Disciplines of Orthotics and Prosthetics

September 2022

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Results Related to Professional Background, Demographic Information and Work Setting

This section provides background information regarding the sample of ABC Certified Practitioners. The survey included a questionnaire regarding professional history, work environment, educational background, and demographic information.

Professional Background
The profile of survey respondents is below. The results in the tables below reflect the sample size of 975 used for the analyses: 540 orthotics-track responses, and 435 prosthetics-track responses. In each table, orthotics-track and prosthetics-track respondent results are presented separately as well as aggregated.

As seen in Table 1, overall, a majority of respondents (61%) hold the CPO credential, while the remaining respondents (39%) hold single-discipline credentials.
Table 1
ABC Practitioner Credential Held

Orthotics Prosthetics
CO42%0%
CP0%35%
CPO58%62%
Total100%100%

Both orthotics-track respondents and prosthetics-track respondents were asked how many years of experience they have in orthotic and prosthetic practice (Table 2). Respondents overall reported a wide variety of years of experience in the disciplines. The largest share of orthotics-track respondents reported having 1–5 years of experience in orthotics (27%), followed by 11–20 (22%). Only 16% of the orthotic respondents in the 2015 study were in the 1-5 years of experience group. The largest share of prosthetics-track respondents, on the other hand, reported having 21–30 years of experience in prosthetics (23%), followed by 11–20 (20%).

Table 2
Years of Experience in Orthotic or Prosthetic Practice
 Orthotics Prosthetics 
1-527%18%
6-1014%15%
11-2022%20%
21-3015%23%
31 or more15%19%
Did not answer8%5%
Total100%100%

There was a significant increase in the percentage of orthotists and prosthetists who reported obtaining a master’s degree to initially qualify for their credential. Thirty-six percent of orthotists and 26% of prosthetists reported having a master’s degree in O/P (Table 3) compared to 6% and 4% in the 2015 study.

Table 3

Initial Qualifying Education/Degree/Certificate/Diploma for ABC Certification
 Orthotics Prosthetics 
HS/GED1%1%
HS/GED and O/P short-term courses2%1%
HS/GED and O/P certificate2%2%
AA/AS2%3%
AA/AS in O/P2%3%
BS in O/P10%14%
BA/BS and O/P certificate3340%
Master’s Degree in O/P36%26%
Other4%6%
Did not answer8%6%
Total100%100%

Respondents were also asked to report the highest education they have completed in any discipline. Table 4 shows that the largest share have earned a master’s degree in O&P (31%). 

Table 4

Highest Level of Education Attained in Any Discipline
 Orthotics Prosthetics 
HS/GED0%0%
HS/GED and O/P short-term courses1%1%
HS/GED and O/P certificate2%2%
AA/AS2%2%
AA/AS in O/P2%2%
BA/BS (non O/P)9%12%
BS in O/P5%8%
BA/BS and O/P certificate26%28%
Master’s Degree in O/P36%26%
Master’s Degree (non O/P)7%10%
Doctorate2%2%
Other1%3%
Did not answer8%6%
Total100%100%

As can be seen in Table 5, a majority of respondents (82% overall) work on a full-time basis in the O&P profession.

Table 5
Employment Status in the O&P Profession

Orthotics Prosthetics 
Full-time82%82%
Part-time7%8%
Not currently working in the O&P profession3%4%
Did not answer8%6%
Total100%100%
 
Demographic Information

Respondents were asked to share personal demographic data, including age, racial/ethnic background, gender identity and sexual orientation. The results of which are presented below in Tables 6-9. The most significant change from the 2015 report was in the orthotics discipline. In 2015 only 20% of the respondents reported their age in the 25-34 category, which was the fourth largest group. This increased to 34% and became the largest group of respondents.

Table 6

Age of Respondents

Orthotics Prosthetics 
Under 250%0%
25-3434%22%
35-4420%21%
45-5416%22%
55-6417%21%
65 or over5%8%
Did not answer8%7%
Total100%100%

The question about race and ethnicity allowed participants to select more than one option. Table 7 includes respondents who selected more than one racial/ethnic background, so the total responses indicated are higher than the total number of respondents. 

Table 7

Racial/Ethnic Background of Respondents
 Orthotics Prosthetics 
American Indian or Alaska Native1%1%
Asian6%3%
Black or African American2%1%
Hispanic or Latino/Latina3%3%
Native Hawaiian or Other Pacific Islander1%0%
White (Non-Hispanic)77%79%
Other (please specify)0%2%
Prefer not to answer5%6%
Did not answer9%7%
Total102%101%

Gender profiles of respondents changed significantly from the 2015 study.  Women made up nearly 50% of orthotic respondents (versus 28%).  Men were 79% of prosthetic respondents in 2015 and are now 62%.

Table 8

Gender Identity

Orthotics Prosthetics 
Man39%62%
Woman48%25%
Non-binary0%0%
Transgender0%0%
An identity not listed (please specify)0%1%
Did not answer13%12%
Total100%100%

Table 9

Sexual Orientation

Orthotics Prosthetics 
Asexual5%6%
Bisexual3%1%
Gay1%0%
Heterosexual/Straight69%73%
Lesbian2%1%
Pansexual0%0%
Queer1%0%
An orientation not listed (please specify)1%2%
Did not answer18%16%
Total100%100%
 
Work and Patient Characteristics

A profile of respondents’ work and patient characteristics is presented below. Results were analyzed separately for orthotics-track and prosthetics-track respondents and are presented in parallel in Tables 10-19.

Respondents were asked to report which of the following best matched their primary work (employment) setting. The largest share reported working in a privately owned multi-facility orthotics and/or prosthetics practice (37.7%). The remaining respondents reported working in a variety of other settings, as can be seen in Table 10. There was a 5% decrease in the number of respondents who reported working in a single-location practice (privately owned) from the 2015 study.


Table 10

Primary Work Setting
 Orthotics Prosthetics 
Part of a multi-facility orthotics and/or prosthetics practice (publicly owned)16%18%
Part of a multi-facility orthotics and/or prosthetics practice (privately owned)38%38%
Single-location orthotics and/or prosthetics practice (privately owned)12%16%
Hospital or rehabilitation center15%9%
University-based clinic or facility3%2%
Academic or educational institution (teaching/research)3%3%
Central fabrication facility1%0%
O&P manufacturer/distributor1%3%
Other5%6%
Did not answer7%6%
Total100%100%

Respondents were asked to identify the personnel at their primary work setting who perform seven activities: perform initial assessment; measure, mold, and/or scan; modify model or image; fabricate; fit and/or deliver; follow-up assessment and/or education; and modify and/or repair. Results are presented in Table 11 for orthotics-track responses and in Table 12 for prosthetics-track responses. The biggest change from the 2015 study was in the Fabricate area. In orthotics the percentage reduced from 55% to 41%, while in prosthetics it reduced from 60% to 45%. This shift is corroborated by the continued shift towards utilizing central fabrication versus in-house fabrication (see Table 14).

Table 11

Personnel at Work Setting Who Perform Each Type of Activity (Orthotics)
 Perform initial assessmentMeasure/
mold/ scan
Modify model/ imageFabricateFit/deliverFollow-up assessment/ educationModify/ repair
Practitioners, including residents87%86%69%41%87%86%84%
Pedorthists17%16%12%8%16%16%16%
Assistants7%10%7%7%11%12%15%
Fitters19%13%5%4%23%20%15%
Technicians1%2%24%49%2%1%30%
Support personnel (Non-credentialed)2%2%2%2%2%2%3%

Table 12

Personnel at Work Setting Who Perform Each Type of Activity (Prosthetics)
 Perform initial assessmentMeasure/
mold/ scan
Modify model/ imageFabricateFit/deliverFollow-up assessment/ educationModify/ repair
Practitioners, including residents88%86%85%45%87%88%87%
Pedorthists21%21%14%9%21%21%20%
Assistants6%9%7%10%10%12%15%
Fitters18%14%4%4%23%19%15%
Technicians1%1%16%55%1%1%35%
Non-clinical staff2%1%2%5%1%3%4%

The increases in the first two categories in Table 13 are likely due to the inclusion of adjustment and documentation to these descriptions in this study.

Table 13

Primary Work Performed
 Orthotics Prosthetics 
Clinical prosthetic patient care, including adjustment and documentation12%39%
Clinical orthotic patient care (custom fabricated), including adjustment and documentation
40%12%
Clinical orthotic patient care (prefabricated), including adjustment and documentation16%8%
Prosthetic fabrication4%10%
Orthotic fabrication
8%3%
Education7%9%
Research2%3%
Administration10%13%
Other (please specify)2%3%
Total100%100%

Both disciplines reported seeing a higher percentage of patients in their own offices in comparison to other settings, versus the 2015 study. In orthotics the change was from 54% to 66%. In prosthetics if went from 63% to 71%.

Table 14

Percentage of Direct Patient Care Time Spent in Each Setting
 Orthotics Prosthetics 
O&P office66%71%
Specialty clinic (e.g., neuromuscular, cerebral palsy, spina bifida)8%3%
Acute care hospital11%8%
Long-term-care facility (e.g., nursing home, assisted living facility)3%6%
Stand alone rehabilitation facility6%4%
Patient’s residence3%6%
Any other facility4%4%
Total100%100%

The orthotic respondents reported that nearly half of the patients they see are pediatric. This is a marked increase from the 2015 study (37%). The prosthetic respondents reported similar percentages to the 2015 study

Table 15

Percentage of Patients in Each Age Range
 OrthoticsProsthetics
Pediatric (0 to 18)48%13%
Adult (19 to 65 years)29%50%
Geriatric (more than 65 years)24%37%
Total100%100%

There were only minor differences between the 2015 study and this report. There was a 6% reduction in the percentage of patients seen in the rehabilitative phase of care and a commensurate increase in chronic patients for orthotics. There were smaller but similar changes for prosthetics.

Table 16

Percentage of Patients in Each Phase of Care
 OrthoticsProsthetics
Acute phase of care25%18%
Rehabilitative phase of care33%45%
Chronic phase of care42%37%
Total100%100%

The orthotic respondents reported that 42% of the patients they see are in the Congenital/ Developmental etiological category. This is an increase from the 30% reported in the 2015 study.  This change may be related to this study’s expansion of Congenital to also include Developmental etiologies.

Table 17

Percentage of Patients in Each Etiological Category
 OrthoticsProsthetics
Disease37%63%
Trauma21%25%
Congenital42%12%
Total100%100%

For the first time, in this study respondents were asked about the percentage of orthoses/prostheses they provide incorporated additive manufacturing. The results are shown in Table 18.

Table 18

Percentage of Orthoses/Prostheses in Each Area Incorporating Additive Manufacturing (3D Printing)
 Orthotics Prosthetics 
Upper extremity orthoses2%2%
Lower extremity orthoses6%5%
Foot orthoses (including diabetic inserts)11%9%
Spinal orthoses6%3%
Cranial orthoses40%4%
Upper extremity prostheses1%6%
Lower extremity prostheses3%5%
Total100%100%

For both orthotics and prosthetics there was an increase in the utilization of central fabrication from the 2015 study. In orthotics on-site fabrication reduced from 57% to 39%. In prosthetics it decreased from 69% to 61%.

Table 19

Percentage of Orthoses/Prostheses Fabricated Onsite or at Central Fabrication Facility
 Orthotics Prosthetics 
Onsite39%61%
Central fabrication61%39%

 



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