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Posted 2/7/2025 on socials

Today I woke up not entirely sure how to name what I feel – it’s this ever morphing combination of despair, sadness, hope, pride, tenacity, and gratitude – a flood of contradicting sentiments leaving me with little faith that I have responded appropriately, or will, to the outpouring of supportive texts and emails from colleagues, friends, and family in response to the message linked below. I am heartbroken for our team – both those who were laid off or furloughed yesterday and those who remain with us to continue the Amputee Coalition‘s work serving the limb loss and limb difference community in these uncertain times.

Over the past 2.5 years, I’ve had the privilege and the honor to be part of building something special, a dynamic team making an impact through our work every single day. Together we ushered the organization over a metaphoric threshold into a new era of action and productivity. It’s been fun and fulfilling.

Now, the rules have changed but are not yet redefined; it’s hard to play three moves ahead. So, I divert to my most useful disposition, that of ambition. And I’m as committed as ever to seeing it through, to delivering on the promises I made to so many when I joined this organization.

Supporting Our Community in Uncertain Times – An Important Message from Cass Isidro, President and CEO

Submitted as an assignment for Fall 2023 LAWH-LW-10003

In my leadership role at the Amputee Coalition and as the principal investigator (P.I.) for the National Limb Loss Resource Center (NLLRC) under the Administration for Community Living (ACL), a $21M five-year Cooperative Agreement, it is imperative that I implement, advocate, and perpetuate equity within my work every single day. Recognizing the intersectionality of individuals who have lost limbs or who were born with limb differences, is of utmost importance – and in order to do that successfully, I cannot count on my own perspective, I must listen to people who have lived the experience of losing a limb or have grown up missing a limb. 

Even the lessons learned in this expensive MS program for which I am privileged to be in, will not bestow the full breadth of knowledge that I need to get it right. Not even close. 

When I was recruited to the Amputee Coalition, I was excited to be joining one of the most diverse teams that I had ever worked with, but I was surprised to learn that not a single team member was living with limb loss or limb difference, except for the interim CEO – the former Board Chair. One of the most important steps I’ve taken since joining the organization has been the active recruitment of individuals with lived experience, and not just for entry-level or coordinator positions, but positions with authority, director-level positions. 

With this hiring emphasis, it has also been imperative that our organization approach its inclusion intentionally and thoughtfully, not requiring those employees with lived experience to always wear two hats. That is easier said than done, but it should be enough for Olivia, our public policy manager, to show up every day as the policy expert that she is and not also be expected to speak on behalf of all individuals who are missing both of their arms. She should be able to maintain the autonomy to choose when and how she discloses and/or engages her own experience in the context of her job. It is my responsibility to create a space for her, and all six employees with lived experience that I have hired so far, to fulfill the duties defined in their job descriptions without also having to bear the burden of speaking for the community that our organization serves. At an organizational level, in light of the political attacks on DEI initiatives, our Board of Directors, just last month, decided to emphasize our commitment to the work by changing the organization’s mission statement to include explicit language underscoring the prioritization of a culture that embraces diversity, is actively inclusive, and works to create equity both internally and within the community we serve. At a time when some organizations are archiving their DEI webpages, eliminating or merging DEI positions, and/or dissolving departments, having this language positioned within our mission requires that all work of the organization must incorporate diverse perspectives, be inclusive, and promote equity in order to be mission-aligned. That’s a directive that I am certainly proud to follow.

Written for socials on August 3, 2022

Today is my last day at the American Orthotic and Prosthetic Association (AOPA). For the past six years, this organization has given me the opportunity to live my dream job, and I’ve loved every minute of it. I am deeply grateful for the opportunity to have worked with such amazing teammates and to have shared in moments that upon reflection will forever bring a smile to my face. I am thankful to all of AOPA’s members for the opportunity to serve them in this role; it has been such an honor. I am indebted to the Board members and other leaders in the O&P field who have challenged me, believed in me, and supported me along this journey.

While I am full of excitement and curiosity as I turn the page to the next chapter in my career, I am having the hardest time signing off this evening. There is still so much to do 😊.  

AOPA has always been more than an employer; the work has been more than just a job for me. As a second-generation child of O&P, the organization has been part of my life for a long time. The Annual Assembly often provided the location for our family vacations, and early in my career, serving on committees and attending events like the Policy Forum and Leadership Conference created opportunities to network with people who would end up changing my life. Before going to work at AOPA, I was a proud member and its biggest fan. I still am. 

I am proud of what we’ve built and the work we’ve done during my time at the organization. I know our amazing team will continue to deliver for AOPA members and the O&P field.

This past week, I had the opportunity to represent AOPA at the Council of Medical Specialty Societies Annual Specialty Forum where the theme was Advancing Care through Technology: Role of Telehealth, Big Data and Artificial Intelligence. You might be thinking, “What does this have to do with O&P?” 

Everything. Unfortunately, recent trends in the O&P profession have made it hard to be forward-thinking. As AOPA’s incoming President, Jeff Lutz has said, “We’ve been forced to focus on the urgent instead of the important.” We’ve been forced to remain in a constant state of reaction in order to defend the profession. Resources have been allocated to address an array of issues, including misguided audits, predatory contracting practices, regulatory overreach and diminishing reimbursements, to name a few. All of these issues lead to a lack of access to care for O&P patients. 

I don’t think it benefits our patients or our practices to be beholden to the “hype cycle,” but if Telehealth, Big Data and Artificial Intelligence are shaping the future of healthcare, and O&P care is healthcare, we need to be paying attention and thinking about the ways these innovations will impact our profession. 

Being present at this type of conference, also offers perspective. Over the two days, it became very clear that we are not alone in facing the challenges imposed by an ever-changing healthcare environment. In expressing those challenges, vibrant conversations emerged that explored novel approaches to issues and conceptualized solutions. 

In his keynote, Aneesh Chopra, the first Chief Technology Officer for the United States, described an unsustainable cost environment in healthcare limited by financial drivers that ultimately result in suboptimal care for patients. He believes that data is the answer to this conundrum and that evidence should be rewarded. 

Chopra also emphasized the importance of healthcare providers owning their own value proposition, and said that without an assessment of value, there is no way to have true cost transparency. This stands as one of the biggest issues facing O&P, presently. 

Dermatologists have incorporated provider-to-provider telehealth consultations with primary care physicians to ensure that patients get the care they need and that necessary documentation is recorded in a patient’s medical record to support continuity of care. Could this model be embraced by O&P patient care practices? 

Some specialties are using machine learning, AKA artificial intelligence, to track physiological changes in patients that trigger a warning or prompt an intervention for possible prevention. In some cases, individuals living with limb loss see their prosthetists more often than any of their other healthcare providers; this opens the opportunity to track changes. Could this possibly increase the value proposition for appropriately reimbursed prosthetic patient care?

I am thrilled that AOPA is interested in learning more about these novel approaches to practice as well as others our members are currently exploring. We are excited to have Aneesh Chopra as our keynote for the AOPA 2020 O&P Leadership Conference in January and look forward to the thought-provoking and innovative concepts he’ll bring to the discussion. 

As we focus on moving the profession forward, we also remain committed to fighting the urgent issues and continuing to support our members in addressing the challenges facing O&P practices today. I am proud to be part of a team dedicated to improving access to care for people living with limb loss, limb difference and limb impairment.