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American Society of Orthopaedic Physician’s Assistants
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By Elizabeth Hofheinz, MEd, MPH
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July 10, 2007
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States Hal Blank, president of ASOPA, “In 1976, a group of orthopaedic physician’s assistants became interested in the commonalities of their workplaces. They wanted to ensure a consistency of high-quality care and have an ongoing mechanism to grow the profession. ASOPA was born. Our organization is dedicated to the education and support of orthopaedic physician’s assistants, with the goal of enhancing patient care.” And with a 25% increase in membership in 2006 alone, ASOPA is hitting its mark. “We have a dynamic annual meeting with stimulating speakers addressing timely topics in orthopedics,” says Blank. “Whatever is taught, be it at our meetings or at seminars, we focus on the practical, i.e., how can one implement such-and-such idea into the structure of a clinical practice? We are partnering with the American Academy of Orthopaedic Surgeons (AAOS) on educational endeavors, including an orthopedic technical program known as the Allied Health Committee Program. The 2008 program will focus on fracture management. AAOS is a great partner as it has yearly programs geared toward educating allied health personnel, including nurses, athletic trainers, and an orthopedic program in the allied health programs dealing specifically with technical advances.” Given the occasional confusion about who does what in the orthopedic OR, it is instructive to delineate the responsibilities of an orthopaedic physician’s assistant. “Typically,” says Hal Blank, “OPAs position the patient for the operation, work with the surgeon on site verification, and drape the patient. We also assist as needed during surgery, including holding retractors and helping to irrigate and close. The type of person who becomes an OPA has a strong interest in fracture management and reconstructing joints. An OPA finds great enjoyment and fulfillment in working with the doctor and patient as a team and seeing someone who was in great pain improve their mobility and ambulate without pain.” Much of this teamwork is of a post-op nature. “We are very involved with wound care and patient rehabilitation protocols, for example foot and ankle reconstruction. In these cases, the first week of post-op care is when we remove the wound dressing, send for X-rays, and start them on rehabilitation. In week two, we remove the stitches and give the physical therapist a prescription to start week-two protocols. There are certain levels of progress the patient should be making at week one, week two, etc. We are there to ensure the patient is working through those levels in a healthy and efficient way. Sometimes we challenge them to go a little faster, whereas other times we encourage them to take a bit more time.” As ASOPA has grown, so has the profession of orthopaedic physician’s assistants. And what have been their particular growing pains? “Physician’s assistants are not taught surgery, so their knowledge is limited in this respect,” says Hal Blank. “On the technical aspects of any given operation, they are trained wherever they start working. OPAs are trained in orthopedic medicine and the fundamentals of primary care, but have no background in the various specialties. Once someone has graduated from their program, they can take the OPA certification exam, given by the National Board of Certification for Orthopaedic Physician’s Assistants (NBCOPA). If they graduate from an athletic training or nursing program, they must have five years of experience under the direction of a board-certified orthopedic surgeon. Then they are eligible to sit for the OPA certification exam, which covers all aspects of orthopedics. It is challenging, however, and there is a high failure rate.” Continues Blank, “The other challenge, familiar to many in medicine, is insurance billing. Most third-party payers reimburse for our services, but Medicare does not. We have been working with CMS [Centers for Medicare & Medicaid Services] for years to change this. I think they are finally realizing exactly what we do, namely, help orthopedic surgeons do their jobs in a more timely fashion. The payers do understand that OR time is money, so we’re hoping for some changes regarding payment.” Those sporting badges at an ASOPA annual conference will find much to satisfy their need for professional knowledge. Says Blank, “Our speakers and educators are carefully selected to reflect the latest issues and movements within our field. ASOPA’s 31st Annual Conference will be held in Indianapolis, Indiana, from July 22 – 25, 2007. This year, Robert Haralson III, M.D., MBA, medical director of AAOS, will be our keynote speaker. We have numerous breakout sessions and hands-on workshops, including suturing, sawbones, surgical navigation, and EKG interpretations, to name a few. There will be a nice cross-pollination of physical therapists, nurses, orthopedic technologists, nurse practitioners, and athletic trainers. And, while we are trying to increase this number, last year we had 32 industry reps in attendance. As more people, reps included, learn what OPAs have to offer, they are drawn to our meetings and discussions.” And while those intrigued by ASOPA will enhance their professional lives, they will most likely not be directly involved with research. They will, however, know that ASOPA has a seat at an important table. States Hal Blank, “Some OPAs do data collection with doctors for their research protocols for IRBs [institutional review boards]. They are essentially gathering, but not formulating, the information. As for helping to guide the profession, as president of ASOPA, I sit on the AAOS patient safety council. When topics arise that are pertinent to OPAs, I am asked to write a response, which is then taken under consideration.” For those wishing to derive the benefits of ASOPA, the organization has two membership categories. “There are affiliate and fellow members,” says Blank. “Both of these categories are eligible to receive our association newsletter, the Update, discounts to attend the ASOPA annual meeting, and discounts to take the examination leading to OPA-C certification and logging CMEs with the NBCOPA for recertification. To be a fellow member, you must be a certified OPA. Fellow members also receive full access to the ASOPA website, including available employment opportunities, a job listing service, and a national membership directory. If you are not an OPA, and would like to be a member of ASOPA, a physical trainer, for example, you would be an affiliate member and receive the same benefits as Fellow members with the exception of voting privileges and the ability to hold office on the executive board.” Asked to forecast the future of ASOPA, Hal Blank says, “Going forward the primary thing for us is to increase the synergy with other allied health organizations. In 2008, we will have a couple of joint events with other orthopedic groups, including an educational program and a meeting. It’s an experiment that will hopefully be fruitful.” If Hal Blank has one final message from the presidential megaphone, it’s this: “We are a supremely valuable resource. We can help orthopedic surgeons increase their efficiency by 35 – 45% just by walking in the door. There is a testimonial site on our webpage where physicians and others comment on how we have added value to their work. Doctors rely on us to have a certain level of familiarity with the equipment, and to make purchasing decisions because we have to work with the equipment. Orthopaedic physician’s assistants try to stay a step ahead of the physician in that we attempt to surmise what he or she is going to need at any one time.” The American Society of Orthopaedic Physician’s Assistants ... supporting, instructing, and educating professionals on the move.
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For many years, orthopaedic physician’s assistants (OPA) have been enhancing the practice of orthopedic medicine. Whether it’s in the OR, assisting with wound care, or helping to establish rehab protocols, for more than 30 years they have been supported by the American Society of Orthopaedic Physician’s Assistants (ASOPA).
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