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

Other messages in this thread:

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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

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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