Cooperation on the user – doctor, municipality and orthopedist
From referral to finished aid: who does what and what rules apply
An orthotist rarely works alone on a task. Behind every individually manufactured aid typically lies an interaction between a referring doctor or hospital a municipality that must approve and pay and the orthotist themselves who manufactures and documents the solution. The better that collaboration works the faster and more precisely the user gets the right aid.
§The referral starts the process
The process typically starts with a referral from a doctor, hospital or orthopedic department describing the diagnosis and need for an aid. The referral gives the orthotist a professional starting point, but it is still the orthotist's task to examine the user, take measurements and assess which specific solution fits best.
§Municipality approval
Personal aids such as prosthetics, orthotics and orthopedic footwear are granted in Denmark by the municipality according to section 112 of the Law on Social Services, while certain consumer goods fall under section 113. It is a condition that the user has a permanently reduced functional ability and that there is a concrete need for compensation. The municipality assesses the application based on its own quality standards, and the orthopedist must therefore provide documentation that enables the case worker to correctly assess the need.
§The rules on medical devices
Many of the aids an orthopedist produces are individually adapted to the individual user and are therefore considered so-called 'custom-made' medical devices under the EU regulation on medical devices (MDR, regulation 2017/745). The Danish Medicines Agency supervises the area in Denmark and publishes guidelines for both healthcare professionals, equipment depots and companies that produce custom-made equipment. For the orthopedist, this means, among other things, requirements to be able to document how the equipment was manufactured and what materials were used.
- 01Reference with diagnosis and purpose
- 02Measure shape or 3D scan of the relevant body part
- 03Selected materials and manufacturing method
- 04Date and instructions for user delivery
- 05Agreed follow-up and any adjustment
| Actor | Role |
|---|---|
| Læge eller hospital | Makes diagnosis and refers to aid |
| Municipality | Assess and grant according to the Services Act |
| Orthotist/company | Produces, adapts and documents according to medical device requirements |
| User | Tests the device and provides feedback along the way |
§When collaboration succeeds
When referral, approval, and making work together, the user typically experiences a shorter and more cohesive process: fewer misunderstandings about what's actually needed, and less risk that an aid needs redoing because the preconditions weren't clarified from the start. This makes the administrative part of the trade as important as the craft itself.
“An aid is only as good as the cooperation behind it.”
— Collaborative professional point