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02/13/2024 Allen Jacobs, DPM
Retail Stores Selling Non-Custom Orthotics (Elliot Udell, DPM)
The Good Feet Store discussion is not about competition for the orthotic business. Realistically, our exhibit halls have long been populated by those selling “pre-fabs" as it were. Many podiatrists dispense such non-custom prefabricated inserts in their offices. Thus the concept of using such inserts is not unique the Good Feet Store chain.
My concerns are the following
1. A patient going to the GFS for “orthotics“ more likely than not is suffering from some foot or ankle, or lower extremity pathology, for which they are seeking relief. They are essentially diagnosed and treated by other than a podiatrist. It would be implicit that some of these patients have pathology that requires treatment beyond a simple, pre-fabricated orthotic.
2. By virtue of obtaining a GFS, “ orthotic “, the patient may have been denied appropriate treatment for their pathology. Therefore there is not only delay in diagnosis, but there is a further delay in the provision of appropriate treatment.
3. The pre-fabricated injection molded devices sold by The GFS chain obviously provides by mechanical therapy, contrary to recognized principles for the utilization of functional orthotics, as employed within our profession. I believe these devices, like other pre-fabricated devices, are analogous to “reader glasses”. That is, some people may require minimal correction to restore function, or at least relieve their pain, and not require a true functional orthotic. Again, many podiatrists dispense pre-fabricated orthotics in their offices with little or any adjustment.
4. The success of the GFS chain of stores demonstrates the success of proper marketing for “the foot business“. In my estimate, it exemplifies yet another failure of the APMA to have placed the podiatric physician first and foremost in the public mind as the “go to“ for foot pathology.
5. With regard to the expressed righteous indignation expressed regarding the cost of the GFS pseudo-orthotics, I would just remind those expressing these concerns “let he who is without blame cast the first stone”.
I certainly hope I will not read in PM News of the Good Feet Store receiving the APMA Seal of Approval. As a matter of fact, the GFS chain has podiatry and orthopedic consultants, are have exhibited at podiatric conferences. Dr. Udell ponders whether we might be undercharging for orthotics. If he held the same supportive publicity and advertising driving patients with foot pain to his office, the answer would be yes indeed.
Allen Jacobs, DPM, St. Louis, MO
Other messages in this thread:
02/14/2024 Dominic Bianco
Retail Stores Selling Non-Custom Orthotics (Elliot Udell, DPM)
Public knowledge and educating the public is really part of the answer. The other part is the patient has to feel confident and comfortable with their choice when seeking medical attention.
Retailers are now selling custom made orthotics utilizing shippable impression kits. These start at $200. Originally, they were only available through podiatrists who were selling to their patients custom orthotics for $200 back in the 1980’s. Now it seems these products are widespread not just in custom orthotics, but for all kinds of podiatry products.
Podiatrists, on average, are seeing 10-20 patients per day. Overseeing their practice and growing it takes a lot of time. How many DPMs have hours of time to work on social media? There are some DPMs who are also contributing to the public’s knowledge of the many aspects of podiatry. But the retail companies, especially ones that are selling accessories for podiatry, have the upper hand.
Selling retail today has gotten very huge and complicated. Offering services from your practice is very similar. Retailers today have to have a better than average knowledge of the internet and its workings including social media, SEO settings, product search key words, sales, marketing e-mails, and product knowledge. Not to mention running a business with employees.
Because companies today are all trying to be #1 on search engines, social media, and online marketplaces, the average search for products puts them up front as if saying “here is the product you’re looking for”. I believe Google and other search engines have complicated systems when it comes to keywords which companies that sell product have already figured out how to use and this gives them a leg-up. We also need to look at other medical professions and how Google understands where you would go to get a covid vaccination, as opposed to selling a covid home vaccination, just as an example.
Everyone in business or practice has to sharpen up in these areas in order to capture their fair market share of podiatric products and services. It’s necessary in order to build their practice in today’s www world.
Dominic Bianco, CEO Bianco Instruments, LLC
02/13/2024 James Koon, DPM
Retail Stores Selling Non-Custom Orthotics (Elliot Udell, DPM)
In response to a recent letter reflecting how much the Good Feet Store charges for inserts, it is my experience that they now charge about $1,500 for three different sets of prefabricated inserts matched to the patient after performing their manner of examination. Each pair is purported to be for a specific reason/activity/purpose.
On occasion, I will have a patient who has been in my practice for years show up one day complaining of continued heel/foot pain after having gone and gotten these inserts with no improvement. I quit asking why they didn't come to me first because what's done is done. Most of the time the story goes that they developed the foot pain for which they got the inserts and went there because they thought they would help. And they must help an awful lot of people because there are franchise stores all over the place. Your orthotics don't help everyone. Neither do their inserts.
My father, a retired family practitioner, told me when I first started out that "all the patient wants is for their pain to go away". Some patients will pay unreasonable amounts of money in that pursuit. You can't blame them. They are in pain.
You do what you can. You help them the best way you know how. Most get better, some don't. You can't blame a patient for trying things outside of your office. You don't own them or hold their hand 24/7.
Good Feet (and others) are allowed to charge what they want. It's called free enterprise. You too can charge what you want. I charge $438 for custom functional orthotics, most of which are white polypropylene devices with intrinsic forefoot posting and extrinsic rearfoot posting made by Henhat out of McCook, Nebraska (formerly Burns Orthotics). I know others charge more, some a lot more. What do you care? That patient is not yours. I learned a long time ago that I am only responsible for what goes on in my office.
My favorite line to the patient is this: "Well, I know that the reading glasses you buy at Walgreens help a lot of people but, (as I take of my own glasses continue with) I need prescription glasses". I also show the patient that I too wear functional orthotics and tell them I've been wearing the same pair every day for over 25 years. They understand.
We are blessed to be in the healing arts and make the difference we do in so many people's lives. I quit worrying about things out of my control a long time ago. No one cares about your worries and the pay scale for complaining is no better than it used to be.
James Koon, DPM, Winter Haven, FL
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