Chapter 11 Veterinary Orthotics and Prosthetics 289to appropriately direct fabrication. As of 2017, no
certification specific to V‐OP exists. No veteri
nary practice acts in the United States specifi
cally address the use of these devices. Veterinary
practice acts also do not specify prescription
characteristics or discuss the characteristics of
the doctor–patient–client relationship for the use
of V‐OP devices. Likewise, there are no stand
ards or regulations for V‐OP fabricators.
At the same time, H‐OP as an industry or
profession does not limit the scope of practice
to human patients. As such, H‐OP fabricators
and practitioners can and do provide devices to
non‐human patients with no additional train
ing in quadruped mechanics and pathome
chanics. This is concerning because such
individuals may not have knowledge of veteri
nary patient behavior, anatomy, and pathology.
The H‐OP fabricator might fabricate a number
of veterinary devices or fabricate a one‐off as a
favor to a veterinarian or client, or perhaps as
an interesting project. However, the science and
technology of veterinary biomechanics and V‐
OP have passed the stage of novelty and human
interest. The potential risk to veterinary patients
cannot be understated. These risks range from
delay of appropriate therapy to iatrogenic
injury, which can exceed the original injury in
terms of severity and consequence. Clients risk
the financial burden of a potentially inappro
priate or harmful device.
Training, licensure, and certification
H‐OP training and certification programs have
been established chiefly by the American Board
of Certification (ABC) and the Board of
Certification (BOC) founded in 1948 and 1984,
respectively (www.abcop.org/WhoWeAre/
Pages/History.aspx; http://www.bocusa.org/about‐
boc). These certifying bodies are endorsed by
the American Academy of Orthotists and
Prosthetists (AAOP), which was founded in
1970 (www.oandp.org). The education stand
ards endorsed by the AAOP are embodied
within the Standards and Guidelines for an
Accredited Educational Program for the Orthotic
and Prosthetic Practitioner, developed by the
National Commission on Orthotic and
Prosthetic Education (NCOPE) (http://www.
ncope.org/view/?file=NCOPE_Policy). These
standards were recognized by the American
Medical Association’s Council on Medical
Education in 1993, and by the Commission on
Accreditation of Allied Health Education
Programs (CAAHEP). For experiential require
ments, the AAOP endorses the completion of an
NCOPE‐accredited residency program prior to
certification (http://www.oandp.org/page/
licposition). For those individuals who undergo
formal training, a 12–18‐month residency is
required (http://www.ncope.org/view/?file =
2015_residency_standards; all websites in this
paragraph accessed October 2017).
Surprisingly, ABC and BOC are voluntary
certification programs, and licensure is required
in only 15 states in the United States as of this
writing. According to their website, the ABC
believes that the provision of orthotic and pros
thetic care should be vested in practitioners
who have fulfilled requirements for ABC cer
tification and that state licensure should
embody equivalent requirements (www.abcop.
org/State‐Licensure/Pages/ABC‐State‐
Licensure‐Policy.aspx; accessed October 2017).
The limited requirement for licensure in the
United States implies that not all H‐OP fabrica
tors are adequately trained, certified, and
licensed, and by extension the same can be
said for V‐OP fabricators. Fortunately, these
certifications are considered a minimum among
established H‐OP practices.
For those who are licensed, there are several
levels of training, certification, and codes of eth
ics limiting scope of practice including pedor
thist (i.e., foot orthotic fabricator), orthotist and
prosthetist (O and P) technician, fitter, and
assistant. The ABC, BOC, and AAOP actively
support the establishment of training and certi
fying standards for each of these levels and for
all states. The AAOP endorses state licensure of
orthotists and prosthetists as the preferred
method of establishing patient protection
mechanisms through legislated state standards
(http:www.oandp.org/page/licposition;
accessed October 2017). Until such a time as
veterinary O and P fabrication and practice
requirements are established, it is appropriate
to assume the requirement of ABC certification
in orthotics and prosthetics specifically as a
minimum for fabricators of veterinary devices.