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ISSN: 2561-987X 

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Ethics (COPE).   

 

 

VOLUME 5, ISSUE 1 

 2022 

 

LETTER TO THE EDITOR 

Laakso L. Letter to the editor regarding: Evolving business models in orthotics. Canadian Prosthetics & Orthotics Journal. 2022; Volume 5, Issue 1, No.3. 

https://doi.org/10.33137/cpoj.v5i1.37717 

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1 

Laakso L. Letter to the editor regarding: Evolving business models in orthotics. Canadian Prosthetics & Orthotics Journal. 2022; Volume 5, Issue 1, No.3. 
https://doi.org/10.33137/cpoj.v5i1.37717 

 

 

 
LETTER TO THE EDITOR 

 

LETTER TO THE EDITOR REGARDING: EVOLVING BUSINESS MODELS IN ORTHOTICS 

Laakso L.1,2 * 

 

1 Orthotics Prosthetics Canada (OPC), Toronto, Canada. 

2 Custom Orthotic Design Group Ltd., Mississauga, Canada.  
  
 

 

Dear Canadian Prosthetics & Orthotics Journal Editorial 

Board, 

I am the President of Orthotics Prosthetics Canada (OPC), 

the credentialing body for orthotic and prosthetic 

professionals in Canada. OPC exists for the fundamental 

purpose of assisting patients in maintaining functional and 

productive lives by setting standards of education, 

credentialing and practice for the healthcare professionals 

who provide orthotic and prosthetic care. The goals of OPC 

are like that of the Canadian Prosthetics and Orthotics 

Journal (CPOJ): your, “passion for promoting and 

disseminating knowledge” is consistent with our role of, 

“advancing the profession of orthotics and prosthetics 

through quality standards of practice, professional 

credentialing, education and awareness”. 

The purpose of this letter is to initiate a constructive 

dialogue, clarify some of the information provided in the 

CPOJ recent article,1 “Evolving business models in 

orthotics” and to highlight our concerns with respect to 

important context about the orthotic and prosthetic 

profession in Canada that we feel was missing from the 

publication.  

The article1 states, “Certification is limited to public 

education”. I will note that the pathway to becoming 

credentialed in Canada includes an undergraduate degree 

in engineering, kinesiology, or related program prior to a 

two-year certificate program at an OPC accredited orthotic 

and prosthetic school. After completion of the formal 

education program, candidates (referred to as Residents) 

must complete a 3,450-hour residency and successfully 

complete the OPC certification examinations. The policies, 

procedures, school curricula, educational objectives, and 

the examination themselves are based on a validated 

practice analysis and evidence-based examination 

methodologies. Based on these facts, we hope it is clear 

that the process to become certified in Canada is much 

more comprehensive than “public education”. 

The pathway to becoming a Certified Orthotist or Certified 

Prosthetist in Canada is accredited by the International 

Society of Prosthetics and Orthotics (ISPO) which is the 

standard of reference for the World Health Organization 

(WHO) for prosthetic orthotic occupations. Although the 

profession is not licensed provincially, due to several factors 

that include but are not limited to cost, it is regulated by OPC 

and therefore recognized by many of the provincial health 

ministries, including Alberta, the province under scrutiny. 

Regulation is identified as a core pillar within the scope of 

OPC, whose mandate is, “to protect the public and advance 

the profession of orthotics and prosthetics through quality 

standards of practice, professional credentialing, education 

and awareness”. Further, professional credentialing makes 

up another core pillar of OPC, which is validated through the 

external parties of the ISPO, the WHO, several provincial 

ministries of health and federal healthcare programs. 

Certification of the profession in Canada is recognized 

globally and is one of six entities that employ nine core 

practitioner standards including minimum education 

standards, entry level competency standards, scope of 

practice, code of ethics, course accreditation, continuing 

profession education, language standards, recency of 

practice and return to practice standards within the orthotics 

and prosthetics profession worldwide.2 The WHO has 

stated, in the document, Prosthetics for Orthotics Standards 

& Implementation Guide,3 Standard 25, “Prosthetics and 

orthotics services should be provided by competent, 

adequately trained professionals.” OPC Certified members 

are recognized and credentialled by ISPO and therefore 

recognized by the WHO as the trained orthotic and 

prosthetic professionals in Canada. The Standards within 

the guide are part of the requirements for Canada to fulfill in 

order to meet our obligations under the Convention on the 

Rights of Persons with Disabilities (CRPD). 

 
OPEN  ACCESS Volume 5, Issue 1, Article No.3. 2022 

 

 

Journal Homepage: https://jps.library.utoronto.ca/index.php/cpoj/index 

 

 

* CORRESPONDING AUTHOR 
 

Linda Laakso, MSc CO(c) FCBC, OPC President 

Orthotics Prosthetics Canada (OPC), Toronto, Canada.  

Custom Orthotic Design Group Ltd., Mississauga, Canada. 
Email: lindalaakso@customorthotic.ca 

ORCID ID: https://orcid.org/0000-0002-1636-3717 
OPC website: https://opcanada.ca/ 

https://doi.org/10.33137/cpoj.v5i1.37717
https://opcanada.ca/
https://jps.library.utoronto.ca/index.php/cpoj/index
mailto:lindalaakso@customorthotic.ca
https://orcid.org/0000-0002-1636-3717
https://opcanada.ca/


 

2 

Laakso L. Letter to the editor regarding: Evolving business models in orthotics. Canadian Prosthetics & Orthotics Journal. 2022; Volume 5, Issue 1, No.3. 
https://doi.org/10.33137/cpoj.v5i1.37717 

ISSN: 2561-987X LETTER TO THE EDITOR 

Laakso L., 2022 CPOJ 

 
To clarify the comments regarding number of practitioners 

we have in Canada, I would like to share the following 

information: 

1. OPC has identified and acknowledged a potential 

shortage in the number of practitioners in the 

future and is addressing the issue through our 

National Education Standards Project. We are 

working to establish more education opportunities 

based on demographic data. In fact, two additional 

students are enrolled within the current programs 

in the 2021-2022 school year cohort. If Alberta, or 

any other jurisdiction has recognized a shortage of 

practitioners, OPC would welcome the opportunity 

to assist in the creation and facilitate the 

development of an accredited orthotics and 

prosthetics program at one of the universities in 

Alberta or local province. 

2. Since 2010, we have seen 18% growth in the 

number of practitioners in Canada and we strive to 

continue to work towards the goal set by the WHO 

of 15-20 prosthetists/orthotists per million people.4  

A final Call to Action from the article is to recognize people 

who are trained in orthotics and prosthetics from outside of 

Canada. To be clear, the role of OPC is to protect the public 

in Canada and recognizes that the standards of practices 

from different countries are not the same as it is in Canada. 

OPC provides a pathway for foreign trained applicants, 

including those who have been recognized by ISPO. It is 

important to note however, that ISPO sets standards for 

education that are global and do not reflect the specific 

scope of practices of various countries or jurisdictions. ISPO 

education standards are setting specific and are vetted by 

experts in each of those settings for schools to become 

accredited. In that respect, although ISPO sets a minimum 

standard for education, it is not always equal to the 

minimum standard of practice in orthotics and prosthetics in 

Canada. Therefore, there may be variance in training 

pathways and competencies of graduates that require 

assessment specific to the context in Canada.  

Orthotics and Prosthetics Canada has in place an objective 

and transparent assessment for graduates from foreign 

trained pathways and programs. By having all practitioners 

achieve a minimum standard for entry to practice as 

developed based on a practice analysis within Canada, we 

are creating a consistent standard that reflects the needs 

and expectations of patients and healthcare professionals 

within our country. Many health care professions including 

the Medical Council of Canada and the Canadian 

Physiotherapy Association have similar practices with 

respect to people who are educated and/or trained outside 

of our borders. 

I hope that this has provided some clarity with respect to the 

stakeholder perspective article1 that you have published. If 

you, or any of your readers require more information or 

clarification, please do not hesitate to contact us. 

ACKNOWLEDGEMENTS 

 

I would like to thank the following persons for helping with the 

preparation of this letter: Helen Cochrane, MSc, CPO (c); Seamus 

Gearin, CAE, OPC Executive Director; Scott Hedlund, CP(c), OPC 

President Elect; And Loren Schubert, MSc, CP(c), OPC Treasurer. 
 

DECLARATION OF CONFLICTING 

INTERESTS 

I have the following conflicts of interest to declare: I am President, 

Orthotics Prosthetics Canada (OPC), the Past President, 

International Society of Prosthetics and Orthotics Canada (ISPO 

Canada) and I am an Owner, Practitioner of the Custom Orthotic 

Design Group Ltd. in Mississauga, Canada. 
 

REFERENCES 

1.Schneider N. Evolving business models in orthotics. Canadian 

prosthetics & orthotics journal. 2021; Volume 4, Issue 2, No.3. 

https://doi.org/10.33137/cpoj.v4i2.35876 

2. Clarke L, Puli L, Ridgewell E, Dillon MP, Anderson S. Regulation 

of the global orthotist/prosthetist workforce, and what we might 

learn from allied health professions with international-level 

regulatory support: a narrative review. Hum. Resour. Health. 2021 

Dec;19(1):1-4. DOI: 10.1186/s12960-021-00625-9 

3.Standards for prosthetics and orthotics, part 1: standards 

[Internet]. World Health Organization. [cited 2021 October 22]. 

Available from: 

https://apps.who.int/iris/bitstream/handle/10665/259209/97892415

12480-part1-eng.pdf?sequence=1&isAllowed=y 

4.Standards for prosthetics and orthotics, part 2: implementation 

manual [Internet]. World Health Organization. [cited 2021 October 

22]. Available from: 

https://apps.who.int/iris/bitstream/handle/10665/259209/97892415

12480-part2-eng.pdf?sequence=2&isAllowed=y 

 

 

https://doi.org/10.33137/cpoj.v5i1.37717
https://opcanada.ca/
https://ispo372224799.wordpress.com/
https://www.customorthotic.ca/
https://www.customorthotic.ca/
https://doi.org/10.33137/cpoj.v4i2.35876
https://apps.who.int/iris/bitstream/handle/10665/259209/9789241512480-part1-eng.pdf?sequence=1&isAllowed=y
https://apps.who.int/iris/bitstream/handle/10665/259209/9789241512480-part1-eng.pdf?sequence=1&isAllowed=y
https://apps.who.int/iris/bitstream/handle/10665/259209/9789241512480-part2-eng.pdf?sequence=2&isAllowed=y
https://apps.who.int/iris/bitstream/handle/10665/259209/9789241512480-part2-eng.pdf?sequence=2&isAllowed=y

