My New Leg

The first step to getting a prosthesis is getting a prescription from a physician, so I called her office today. This has always puzzled me because it hardly requires a medical degree to diagnose that I’m missing a foot and to determine that an artificial limb would be an appropriate course of treatment. Personally, I’d rather save their years of medical training and expertise for when I have cancer and not waste their time with a no-brainer like this. But such is our health care system. (The prosthetics field has not always been as scrupulous or self-regulating as it is now, and I suspect the need for a prescription has its historical origins in a need by the VA to regulate prosthetists’ billing practices. I should look into this.)

Maybe I should start at the beginning. The person is I really want to see is Wayne, my prosthetist. Prosthetists are the allied health care professionals who make prostheses (orthotists make orthoses, or braces). They have their own self-regulating certification programs, so certified prosthetists use the initials C.P. after their name, certified orthotists use the initials C.O., people with training in both fields use C.P.O. This is worth mentioning because my health insurance will only pay for a prosthesis made by a certified prosthetist (in their network), which was prescribed by a physician.

Here’s how it works. I need to get a prescription from a physician. Then I need to bring the prescription into Wayne’s shop and give it to Julie, the head admin assistant who handles billing — and pretty much everything except for actually making the leg, really. Julie will use the prescription to seek authorization from my health insurance, and get their assurance that they’ll reimburse Wayne for the cost of making my prosthesis. Essentially, Wayne makes me the prosthesis, bills my health insurance, and they pay for the leg. Given that an appropriate prosthesis for an active amputee such as myself can cost in the ballpark of $7-8,000, this is one of the more important, albeit boring, parts of getting a new leg.

But I am not off to a good start. I am blessed with good health, other than the nearly constant colds my daughters bring home from preschool and daycare, and haven’t ever bothered to see my primary care physician. I’m not ill and I manage my own health responsibly, so why see the doctor? So when I called to schedule an appointment, I was told that I’m considered a new patient and they do not have any opening for new patients. They’ll call me back if they have an opening. In the meantime, my COBRA health insurance runs out on June 1, so the clock is ticking and now I’m sorry I procrastinated and didn’t take care of this earlier.

If you want to learn more, read an account of the history of American prosthetics in the chapter about the increasing management of prosthetics care, Management and Care, in my Ph.D. dissertation about the prosthetics field, Performing Able-Bodiedness: amputees and prosthetics in America.