AAPM&R was contacted by the U.S. Government Accountability Office (GAO) earlier this year with the opportunity to provide expert input for a study on the quality-of-care currently available for patients with limb loss and limb difference, as well as ways that our national healthcare system can be improved for this patient population.

Marlis Gonzalez-Fernandez, MD, FAAPMR and Prateek Grover, MD, FAAPMR answered the call and met with senior staff from the GAO’s Health Care Team to provide PM&R’s perspective on the level of care available to patients dealing with limb loss and limb difference, and how the quality-of-care for this population can be elevated by more fully incorporating PM&R into health systems and increasing access to physiatrists throughout the care continuum.

The main themes covered by Drs. Gonzalez-Fernandez and Grover for the GAO were the challenges faced by this patient population, for access to both services and devices, and the need for gathering more substantive evidence on the current level and availability of care for this patient population. Finally, they emphasized the point that the quality-of-care available to these patients can be improved by PM&R leading the field of limb loss and limb difference rehabilitation. AAPM&R also provided recommendations for undertaking additional research into coordinated healthcare systems, interprofessional education and fellowships, and creating model systems of limb loss rehabilitation.

This study was requested by Senators Tammy Duckworth (D-IL) and Marsha Blackburn (R-TN) and Representative Brett Guthrie (R-KY-02), the current chair of the House Energy and Commerce Subcommittee on Health and the now-retired Representative G.K. Butterfield (D-NC-01). These are all senior members of Congress who have demonstrated an interest in the quality-of-care and level of resources available to patients with limb loss and limb difference. The hope is that the report produced by GAO (expected in late 2023/early 2024) will serve to inform these federal policymakers as they craft federal legislation to improve the quality-of-care available to this patient population.

Dr. Gonzalez-Fernandez currently serves as the Associate Professor of PM&R and Orthopaedic Surgery, and the Vice Chair for Clinical Affairs in the Department of PM&R, at the John Hopkins University School of Medicine. Dr. Grover currently serves as an Associate Professor of Physical Medicine and Rehabilitation at Penn State Center of Medicine, as well as the PM&R Vice Chair of Quality & Safety and Director of Resident Research at Penn State Health.

Dr. Grover also serves as an at-large member of AAPM&R’s Quality, Practice, Policy & Research (QPPR) Committee, a Strategic Coordinating Committee for the Academy. QPPR is responsible for developing and managing an integrated and strategic plan and resource allocation to advance the practice, policy and research priorities of the Academy. As such, engaging with the GAO on this study was a perfect fit with Dr. Grover’s volunteer work for the Academy, as well as his professional expertise in providing care to patients with limb loss and limb difference.