04/01/2026 James Whelan, DPM
When Did Buying Arch Supports Become a Medical Visit?
A patient recently sat in my clinic and told me he
had already been “evaluated”, not by a physician,
and not in a medical office, but at the Good Feet
Store. He stood on a scanner, was shown a
digital image of his feet, told he had “flat
feet,” and was sold a pair of “custom orthotics”
for over $1,500. They came to me because he was
still in pain.
This story is no longer unusual.
Across the country, retail storefronts, most
prominently the Good Feet Store, are offering foot
scans, labeling conditions, and recommending
treatment, often without physician involvement. To
patients, the experience feels indistinguishable
from a medical evaluation. That perception is not
accidental, but constructed.
The Grievances We Can No Longer Ignore
At the national level, concerns surrounding retail
foot care models have emerged across multiple
channels, though they remain fragmented and
uncoordinated.
A 2019 class-action lawsuit, Sisk v. Dr.’s Own,
alleged false advertising and misleading claims
regarding the ability of retail orthotic products
to treat medical conditions. While the case was
ultimately dismissed, it reflects early legal
scrutiny of medical-adjacent marketing in this
space.
Consumer complaints have also been submitted to
state attorneys general and consumer protection
agencies. However, these efforts have not yet
resulted in coordinated multi-state enforcement or
sustained regulatory action.
More recently, a clearer national signal has
emerged through advertising oversight. In 2025,
the National Advertising Division required the
Good Feet Store to discontinue certain pain-relief
claims after determining they were not adequately
supported. This action is notable and parallels
early regulatory pressure observed in other
healthcare sectors.
At the consumer level, complaint data remains
distributed across individual franchise locations.
Better Business Bureau profiles from multiple
regions demonstrate consistent themes, including
high upfront costs, dissatisfaction with outcomes,
and perceived medical framing of services. While
individually localized, the consistency of these
reports suggests a broader national pattern.
The central issue is not the absence of signals,
but rather it is their lack of coordination. When
concerns are dispersed across isolated complaints,
limited litigation, and incremental advertising
oversight, the result is not resolution but
diffusion of responsibility. In that environment,
the burden of navigating risk shifts from systems
of oversight to the individual patient. That gap
represents the national issue.
This Is Not a Gray Area
When a patient undergoes a scan, is told they have
a condition, and is sold a device to treat that
condition, the question becomes unavoidable: what
is that, if not diagnosis and treatment?
State statutes often define the practice of
medicine to include diagnosing and treating
physical conditions. If these activities meet that
definition, then the issue is not innovation, it
is regulation. And if they do, existing statutes
are already sufficient—what is missing is
enforcement.
The Grievances in Practice
First, there is the issue of misrepresentation of
“custom” orthotics. Patients are frequently sold
devices described as “custom” or “personalized,”
yet these products are often prefabricated or
selected from a limited inventory rather than
truly individualized. In many cases, there is no
casting, molding, or physician-directed
fabrication involved, and the use of the term
“custom” may not align with how custom medical
devices are defined in clinical practice. For
patients, this distinction is not trivial—it
directly influences perceived value, expectations,
and decision-making.
Second, there is medical framing without medical
oversight. The in-store experience commonly
includes digital foot scanning, visual displays
that resemble diagnostic tools, and the use of
terminology such as “flat feet,” “imbalances,” or
“alignment issues,” all of which contribute to a
clinical narrative. Yet despite this presentation,
there is typically no licensed medical
professional performing a diagnosis, nor is there
a comprehensive history, physical examination, or
differential diagnosis conducted. The result is a
medical impression without medical accountability.
Third, the use of medically suggestive titles
further blurs this boundary. Employees are often
referred to as “Arch Support Specialists.” While
not inherently inappropriate, in this context the
title can imply clinical expertise to consumers,
blur the line between retail staff and licensed
providers, and contribute to confusion about who
is actually delivering care.
Fourth, there are concerns surrounding high-cost
sales tied to perceived diagnosis. Patients
frequently report spending $1,200–$2,000 or more
on orthotic packages and feeling that the purchase
was medically necessary based on the evaluation
they received. When a product recommendation is
tied to what appears to be a diagnosis, the
transaction is no longer purely retail. Rather it
becomes medically influenced decision-making.
Patients are also frequently sold a series of
orthotics with varying levels of arch support,
intended to be used in a stepwise “transition,”
often based on methods that are not well-supported
by established clinical evidence or widely
accepted standards of care.
Finally, clinicians are increasingly seeing
downstream effects in patient outcomes and
satisfaction. Patients often present after retail
interventions have failed, sometimes with no
improvement, or even worsening symptoms, and
report difficulty obtaining refunds or meaningful
recourse. While outcomes may vary, this pattern
raises an important question: are patients being
adequately informed about the limitations of what
they are receiving?
We Have Seen This Before
The rise of SmileDirectClub forced dentistry to
confront a similar challenge. Digital scans and
treatment recommendations, performed outside
traditional clinical settings, were ultimately
recognized as falling within the scope of licensed
care. Dentistry did not debate this question
indefinitely—they answered it.
The principle is simple: if you collect data to
guide treatment, you are practicing medicine. The
foot should not be held to a different standard.
Now Comes the Hard Part
What are we going to do about it?
First, the American Podiatric Medical Association
should file a formal complaint and request review
by state licensing boards and the Federation of
Podiatric Medical Boards, clearly defining what
constitutes a medical foot evaluation. State
boards must directly evaluate whether practices
commonly used by the Good Feet Store constitute
the practice of medicine—a formal opinion, not
silence, is required.
Second, this issue must be elevated to consumer
protection authorities. State Attorneys General
should examine the marketing of “custom” devices,
the use of medically suggestive language, and
financial practices tied to perceived diagnoses.
If patients are being misled, even
unintentionally, this becomes a consumer
protection issue.
Third, the profession must support strategic legal
action. Rather than broad or unfocused efforts, we
should pursue targeted cases that clearly test the
boundary of practice, supported by careful
documentation of patient harm and financial
impact, and developed in partnership with consumer
protection attorneys. One well-supported case can
define the landscape more effectively than years
of discussion.
Finally, a unified professional position is
essential. The American Podiatric Medical
Association should clearly define what constitutes
a medical foot evaluation, differentiate custom
medical orthotics from retail products, and
provide consistent guidance for members on patient
education and reporting concerns.
A Defining Moment
This is not about eliminating retail. It is about
defining the boundary between retail and medicine.
Because when that boundary blurs, patients are
left navigating a system that looks like
healthcare, but may not function like it. If we
fail to define the practice of podiatric medicine,
it will not remain undefined. It will be defined
by those without the training, without the
accountability, and without the obligation to put
patients first.
James Whelan, DPM, Beloit, WI
