In the orthotics and prosthetics field, 'patient choice' is a hot topic.  In this case, when I refer to 'patient choice', I am referring to a patient being able to select his or her own preferred orthotic and/or prosthetic provider.  If the patient's insurance plan policy only offers in-network benefits, then the patient should be able to select any orthotic and/or prosthetic provider that is contracted with the insurance plan. 

So, why is 'patient choice' important?  The obvious answer is this:  If you are dealing with a life long orthopedic condition, or if you have experienced limb loss, the relationship between you and your orthotic and/or prosthetic practitioner is an intimate one.  I encourage people to go out and interview as many practitioners as possible. 

Do they feel comfortable with the individuals they will be working with?  Is the staff helpful?  If a patient is comfortable with the orthotic and/or prosthetic practitioner, then the patient is better equipped, mentally, to begin the rehabilitation process.

'Patient choice' is also important because it holds orthotists and prosthetists to a higher standard of care and promotes a healthy amount of competition in the field.  The practitioner must 'earn' a patient.  Many people I deal with expect that they can always go to any in-network provider.

Imagine the surprise when an amputee learns that his or her primary care physician has opted for an exclusive contract with a singular orthotic and/or prosthetic provider.  "But my insurance company told me JANE DOE ORTHOTICS AND PROSTHETICS company is a contracted provider.  I've been going to them for years".  This is particularly common with certain health maintenance organization (HMO) plans. 

What is the result?  The process of orthotic and prosthetic rehabilitation is challenging, even when the patient can make this choice.  When 'patient choice' is eliminated entirely, it can add to the patient's stress and negatively affect rehabilitation.  When O & P providers no longer have to 'earn' patients, there may be less incentive to continue to 'raise the bar' for quality. 

Is there sometimes a short-term cost savings when an exclusive contract is involved?  Perhaps.  But the majority of the time, a sub-standard O & P device will cost more money in the long-run.