I was recently asked to participate in a panel discussion (along with two other lab owners) on the role of 3D printing in orthosis manufacturing and how the future of podiatry may look. It was interesting to see that as lab owners we had some concerns about where the profession was heading. Working in a lab puts us in a fortunate position – we get to work with a vast range of podiatrists in both private and public settings from different backgrounds in different countries. This means we get a good feel of the profession as a whole.
Whilst the theme of the panel discussion was intended to be around comparing traditionally made orthotics to 3D printing, the most common topic among the panel, was actually that the cast/scan is one of the key pillars of orthosis production. That in itself was interesting given that 3D printing is probably more of a ‘sexy’ topic compared to casting/scanning techniques. I have spoken at length over the years and have two previous blogs on casting tips to improve your orthotic outcomes and tips on getting great orthotics from a scan. At QOL, we feel that whether you cast or scan is a decision for each individual practice or practitioner to make. The more important point here is how you cast or scan and being aware of the likely outcomes of your cast or scan.
This interaction of casting or scanning your patient along with the accompanying gait/biomechanical assessment is a key moment for patient education.
On the surface, that may seem like a dramatic statement. But if we dig a little deeper, it becomes clear why this is a critical moment in the management of your patient. As more and more retail stores open up and offer “orthotics” to unsuspecting people (often multiple pairs along with accompanying shoes), the general public now has more choice than ever.
As scanning has evolved, you can now use your iPhone to take a scan of the patient’s foot. The technology itself is impressive, but what message does that send to patients? Picture this – a patient walks into a podiatrist’s clinic, is told they need orthotics, the podiatrist then pulls out their iPhone to scan the foot (which can be done in under a minute) whilst the patients just tries to hold the foot still. If we put ourselves in the patient’s position, they may start think they’ve seen something similar at the local retail store. How are they to know the end product is anything different? And what about any other profession that prescribes orthotics for their patients? Is the message they’re getting is that all it takes is an iPhone and you can get orthotics just like the ones from the podiatrist?
For many people who maybe don’t know the value of the podiatry profession, let alone the value in truly custom orthotics from a podiatrist, how are they to see the difference in orthotics from a retail store (or anyone else who wants to prescribe orthotics) vs orthotics from a podiatrist?
The (unfortunate) reality is that we as the podiatry profession are never going to able to stop retail stores or other professions selling orthotics. In my opinion, if you’re putting time and energy into trying to stop these things, you’re focusing on the wrong thing. Rather, use your time and energy to educate your patients. When you’re casting or scanning your patient, use that time to explain to them why you’re holding the foot in a certain manner. Explain to them the outcomes this clinical skill which has been learned and perfected by you over many years will help to produce a more comfortable and better performing orthotic. Explain to your patient how this is different to other ways of producing orthotics (think library devices and prefabricated orthotics). Explain to them the findings of their gait/biomechanical assessment and how that is influencing your orthotic prescription.
I can guarantee that once that patient understands that this part of the process is highly trained clinical skill, they’ll never entertain getting their orthotics from anyone but a podiatrist. We need to ensure this part of the profession is differentiated to what others may offer. By maintaining a high standard of orthotic production and educating this to your patients is one critical way the podiatry profession will ensure we grow and thrive.