Frequently Asked Questions (FAQs) for MEMBERS
REGULATIONS / STANDARDS / GUIDELINES
PRESCRIPTION CUSTOM FOOT ORTHOSES (PCFO)
What has changed compared to the previous PCFO Standard of Practice?
For a full explanation of the changes to the Standard, see the infographic here.
Why were changes made to the PCFO Standard?
The amended Standard provides further clarity surrounding the prescribing and dispensing of PCFO by Members, while best practices ensure that the public of Ontario have access to safe and effective PCFO’s by:
- Providing clearer language and definitions within the Standard;
- Amending the requirements related to prescribing, casting and dispensing to ensure better continuity of care;
- Expanding on the requirements for documentation related to PCFO to make clearer the need, goal(s) and efficacy of a PCFO;
- Standardizing the requirements for follow-up appointment(s) after PCFO are dispensed to ensure optimal functioning of each PCFO;
- Standardizing the requirements for expectations of treatment and patient dissatisfaction to better inform and empower patients as active members of their own health care team; and,
- Improving access to PCFO and ensuring patient safety by defining a limited timeline in which a patient may have a PCFO re-dispensed without the need for a full reassessment.
The amendments were made with a focus on the membership in order to improve the prescribing and dispensing of prescription custom foot orthoses for patients and the public.
Can I mail PCFO to patients, or leave orthotics at the front desk for patients to pick up?
No. Best practice requires that the PCFO is dispensed by a Member. Dispensing includes inspecting the PCFO to ensure it meets the prescription, fitting the PCFO on the patient, and educating the patient on the proper use of the PCFO. These processes can only be done in-person by the prescribing Member (or another Member if the prescribing Member is unable to dispense the PCFO).
Can I delegate the dispensing of PCFO to clinic staff members or assistants?
No. PCFO must be dispensed by a Member. Best practice requires that the PCFO is both prescribed and dispensed by the same Member; however, another designated Member may dispense the PCFO to the patient.
I performed a PCFO assessment on a patient. They are now requesting a copy of their prescription to take elsewhere. Do I need to provide it to them?
Before proceeding with any assessment or treatment, Members need to begin with a conversation with their patient explaining the assessment and treatment plan, and obtaining appropriate consent from the patient. As always, such discussions with the patient should be properly documented in the patient’s records. In the case of orthotic management, patients need to understand from the outset that Members are unable, in accordance with the College’s standards, to merely provide an orthotic prescription. In particular, Members need to explain they have a professional obligation to provide comprehensive care to the patient, and that includes conducting a thorough assessment, dispensing of the orthotics, and providing follow-up management.
In accordance with section 18 of Ontario Regulation 203/94 (and other legislation requirements), Members are required to provide a patient with access to or a copy of the patient’s records as provided for in the regulation. This does not entitle a patient to an original prescription for orthotics to take elsewhere.
According to the PCFO Standard, the orthotic prescription is defined as the set of instructions intended for the orthotic laboratory that very specifically outlines the parameters of design, composition and fabrication of the orthotic. If the orthotic prescription is already part of a patient’s record, then access to or a copy of the prescription must be provided to the patient upon request. However, if the orthotic prescription has not been completed at the time of the patient’s request, it is not part of the record and there is no obligation for the Member to provide a prescription. But again, to avoid any misunderstandings, patients need to be advised about the Member’s obligations from the outset – before any assessment is conducted and a prescription is prepared.
I prescribed orthotics to my patient last year in June. It is now July of the following year and they want another pair. Can I just dispense a pair using the same prescription?
No. A new assessment and prescription is required. In appropriate circumstances, a prescribing Member may re-dispense a PCFO to a patient within one year of the original orthotic prescription without the requirement for a full patient assessment.