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

Other messages in this thread:

---

04/13/2026    Paul Kesselman, DPM

When Did Buying Arch Supports Become a Medical Visit? (Jeffrey Klirsfeld, DPM)

Over the past week(s) there have been many posts
addressing this issue, all of which have focused
on retailers allegedly providing diagnostic
services to consumers without a medical license.
In my humble opinion if an untrained individual
tells a consumer/patient that they have a specific
issue and then they treat it with something they
provide, that is both diagnosing problem and
treating it. It doesn't matter whether they
dispense a cream or an arch support. But that is
my opinion and not necessarily fact.

But as you will see from my explanation (from a
non-attorney's perspective) is that the state
statutes addressing this may or may not agree with
those sentiments.

Solely from the DME perspective from which I can
offer expert advice, custom fabricated orthotics,
in some states require a licensure to provide.
Unfortunately this is where things start to become
both murky and confusing as to what agency
in each state should be addressing legal action,
if any against the retailers. Is it the state
board of podiatry, medicine, O/P, etc or is
it the Dept of Consumer Affairs, Dept of Health,
etc.? It may depend on the state and the alleged
infractions.

In most if not all states, retail store can sell a
wide array of pre-fabricated orthotics without any
issues or conflicts with state law. So one
question to raise here is the retailer selling OTS
devices only after they have scanned and offered a
diagnosis to the patient? If they are, then
perhaps despite our chagrin, the state law may not
preclude them from selling a prefabricate device.
But does the state stature preclude them from
scanning? From diagnosing? Those are another
complex matters which may differ by state.

If the retailers are selling pre-fabricated
orthotics but telling their customers that the
devices they are selling are custom, then perhaps
they are defrauding their customers, yet another
legal infraction. And if state law only allows
licensed professionals to provide custom
fabricated orthotics, yet another potential
infraction of state law.

I may be out of touch with current usual and
customary fees, but I don't know of any
podiatrists, orthotists or pedorthists who are
being direct reimbursed $1500 for a single pair of
"custom orthotics" and if that is 150%or 200% more
than normal or even more, than perhaps
it becomes an issue for each state's dept of
consumer affairs. If the retailer is in fact
dispensing OTS devices at those prices, well for
sure that is price gouging and again something for
another state agency to deal with.

Using my home state as an example, New York where
there is no legal requirement for custom orthotics
to be furnished by a licensed provider, the
regulatory issue is quite different then in New
Jersey, Florida, Texas or PA (and about 19 states)
where there is a licensure requirement to provide
custom orthotics.

Podiatrists, licensed orthotists and pedorthists
in those states where licensure requirements are
in place, should be demanding that any retailer
where custom orthotics are being provided, prove
that licensed individuals are in fact on the
premises and dispensing custom orthotics.

And if those who are orthotists or pedorthists are
not basing the provision on a prescription from a
provider licensed to diagnose and treat patients,
that too becomes an issue. The orthotists and
pedorthists in those states know that state law
requires an order (prescription) in order to
provide custom fabricated orthotics. Can you
imagine a pharmacist providing prescriptive
medications without a prescription? I think not.

This becomes both a question of whether or not the
retailer has employed someone who can diagnose (I
think not), treat (again NO) and provide a custom
orthotic (questionable depending on the state). I
hesitate to simply single out the Good Feet Store
(GFS), but they be the most glaring example.
One well reputed pedorthic facility I know not too
far from my home, has a GFS location within eye
shot of their facility. While they may be
reluctant to get involved on a personal level,
they also tell me that many disgruntled patients
from the GFS often end up in their facility, where
they charge much less for custom orthotics than
GFS. And again because NYS is like the majority of
states, no prescription is required. Hence here
the question then is if the pedorthist is proving
a custom orthotic in NYS are they thus providing
medical treatment without a license? Apparently
the law says no.

As for the pricing, if GFS (and others) are truly
not making custom fabricated orthotics but
charging those $1500+ amounts, that should be
sending off all kinds of alarm bells in every
state's consumer affairs division.

APMA should be assisting in this matter, but this
is far more of a state by state issue and hence
APMA should not be singled out for little or no
action on this.

The other issue is that other than in this column,
there is not much noise from my colleagues about
this. In fact, there are only a few pedorthists
and orthotists with whom I am acquainted with, who
are speaking up on this issue.

In my opinion, there needs to be a ground swell of
voices complaining to a myriad of state agencies
by the various State Boards of Podiatry, State
Boards of Medicine, State Board of Pedorthists and
Orthotists to address these issues:

1) Practicing medicine, orthotics or pedorthics
without a license
2) Advertising custom fabricated orthotics but
dispensing pre-fabricated orthotics
3) Charging excessive fees which gouge the
consumer

Until that happens, and to my chagrin, nothing
will change on this matter.

Paul Kesselman, DPM, Oceanside, NY

---

04/08/2026    Lesley Wolff DPM, MS

When Did Buying Arch Supports Become a Medical Visit? (Jack Reingold, DPM)

After completing my second year at the Ohio
College of Podiatric medicine, I was disillusioned
by their outdated concepts of podiatric
orthopedics. We took it upon ourselves along with
my close friend Dr. Richard Jaffee to personally
invite Merton Root to come and speak to the third
and fourth year students in order to enlighten us
on the latest concepts of biomechanics related to
the foot and ankle.

I personally took Dr.Root up to the infamous
Western Reserve Biomechanics Laboratory and
introduced him to the director. The following year
we twice invited Dr. Tom Sgarlato to come and
lecture to our third and fourth year classes. We
were "hooked " on podiatric biomechanics and
insisted that the orthopedic department include
"Root Biomechanics " in to the curriculum. Along
with a fellow classmate we were able to publish a
early paper in JPMA on Triplane Motion
Abnormalities.

Following graduation I was accepted to the famous
Northlake surgical residency program in Chicago
and had the incredible opportunity to train under
the tutelage of Dr. Lowell Weil senior, Donald
Hugar ( president of ACFS) Steve Smith, Chuck
Gudas and even scrubbed in with the visiting Dr.
Dalton McGlamry. I was procured to join the 2nd
year residency at The California Podiatry Hospital
at CCPM where upon completion of the program was
asked to become chairman of the biomechanics
department by both Tom Sgarlato and Lenard Levy. I
was only 28 years old and due to the constant
conflict between the surgery and biomechanics
departments and my young age, I declined and went
into practice in San Francisco.

Several years into my private practice while out
having lunch at a nearby shopping area, a new shoe
store had a grand opening it was the first store
of its kind in the U.S., it was the "Roots Shoe
Store" promoting the healthful "negative heel
shoe" in all different styles and beautiful
Canadian leathers. The elaborate signs in their
windows described the beneficial effects of their
negative heel design (evidently a knock off of the
Earth shoe of Anna Kelso)

I couldn't resist, I went inside and asked for the
manager and advised him that their theory was
incorrect relative to modern biomechanics . He
subsequently set up meetings with the owners who
flew in from Canada and had me advise them of the
incongruity of their theories.

I briefly became a paid consultant and gave
several lectures on the the action of the subtalar
joint and gait to their managers and staff. Months
later, they flew me up to their magnificent 50
thousand square foot Montreal manufacturing plant
where I met with their designers to help them
design a running shoe since it was the beginning
of the running boom. They finally sent me their
prototype running shoe which I discovered that
they made it all in fabulous rich Canadian
leather!

I didn't think it would be great for running and
told them to call it a tennis shoe..I never heard
back from them and glad they didn't ask me to
design any arch supports

Lesley Wolff DPM, MS, San Francisco, CA

---

04/07/2026    Jack Reingold, DPM

When Did Buying Arch Supports Become a Medical Visit? (Allen M. Jacobs, DPM)

It is interesting to see the recent number of
posts regarding the Good Foot Store. Whether what
they have done over the last 44 years—since the
first store was established—is good or bad, it is
remarkable and perhaps points to a PR failure for
podiatry. My experience with them goes back
further than any other podiatrist because they
opened their first store in 1992 in Solana Beach,
a small coastal town in San Diego County, where I
practiced. They even asked me if I would be their
“Podiatry Director.” In spite of the promised
riches, I turned them down.

This is the history as I know it, from first hand
accounts. In those days, infomercials were big
business, and the money was not in selling the
products but in producing the commercial and
selling the airtime. The founder was in that
business and was looking for a product he could
market, eventually deciding on an “innersole.” In
the beginning, they cost a couple of hundred
dollars and came in only one design. One of his
employees told me they were getting them from
China for $2.50. They have since changed their
marketing plan and now use high pressure sales,
often suggesting an orthotic package costing
around $1,000. I have personally observed this. I
believe there are almost 300 locations now, with
about 30 of them being franchises. Their income is
not published, as it is a private company, but it
is likely in the many, many millions.

Why is this a podiatry PR problem? The public
should be rushing to our offices when they have
significant foot pain—not to a shoe store, a
running store, a pharmacy, a chiropractor, or
Amazon, just to name a few. We have always faced a
recognition problem due to our small numbers. When
I graduated, we had around 12,000 podiatrists for
225 million Americans. Today, we have around
18,000 for 345 million Americans. Due to small
class sizes and the aging of our colleagues, it is
estimated that in 10 years we may number only
10,000. I used to tell patients that podiatrists
were the best kept secret in healthcare. I don’t
have the whole PR/image solution, but we need to
grow. All of us need to talk to every young person
about how great the profession is and what a
bright future it has.

Before I retired, I had about a dozen young people
come through my office, and I am proud to say that
every single one is a podiatrist today. Yes,
having an observer in the office slows you down,
and we all get home late enough as it is, but it
is worth it. Rather than complain about the Good
Foot Store, let’s promote our profession.

By the way, here is another true story I know
first hand of. The head of the California State
Podiatry Board was at the Sacramento County Fair,
where he observed a vendor promoting orthotics in
a “medical manner.” In California, the Attorney
General’s office enforces the medical board’s
laws. He called the AG’s office, identified
himself, and informed them that someone was
"practicing medicine without a license,"
requesting an officer. They told him they had more
important things to do and ignored his request.
Again, it is up to us to determine our future.

Jack Reingold, DPM, Encinitas, CA

---

04/03/2026    Allen M. Jacobs, DPM

When Did Buying Arch Supports Become a Medical Visit? (Joan Oloff, DPM)

Just for the record Dr. Oloff. Not only does the
Good Feet Store chain have orthopedic consultants,
they also have paid podiatry consultants. I must
admit that I was taken back by this realization
when a DPM consultant spoke on their behalf at a
dinner meeting associated with a state meeting.

My former billing supervisor was in a recent
cruise. The cruise ship advertised a free
screening by the Good Feet Store for undiagnosed
foot problems. She attended to see what they do
and to inform me. They diagnosed her with
“pronation” and attempted to sell her over $1000
of pre-made arch supports.

Several years ago, a resident and I attended a
women’s health convention at which our hospital
was exhibiting. The Good Feet Store had an
exhibit. My resident acted like Barney Fife and
asked what was wrong with his feet.
They asked questions, did an examination.
Diagnosed him with plantar fasciitis. The humorous
part was when he picked up a foot model and asked
“ which one in these is the navicular bone “. They
did not know.

When individuals attend the good feet store, and
are diagnosed and treated, there is the potential
that the patient is deprived of the care which
they require.

My question; PM news periodically erupts with this
same concern expressed by readers. IF the Good
Feet Stores are endangering patient health or are
misrepresenting what they sell or are practicing
medicine or podiatry without a license then the
state or APMA should take appropriate action.
However, the periodic concerns expressed in PM
news, will do nothing to alter this alleged
problem.

Allen M. Jacobs, DPM, St. Louis, MO

---

04/02/2026    Joan Oloff, DPM

When Did Buying Arch Supports Become a Medical Visit? (James Whelan, DPM)

I would like to thank Dr. Whelan for taking the
time to shine a light on what has become a
significant problem for many patients in my area.
There is a Good Feet Store close to where I
practice. As a result, I frequently see patients
who share their experiences in the store.

As Dr Whelan stated, the salespeople in their
stores are trained to confuse the public into
thinking they are medical professionals. These
salespeople are the sole evaluators and
“prescribers” of the treatment plan. Patients are
“prescribed” 3 OTC arch supports (which they are
told are individualized for them) and a pair of
Brooks sneakers. The total cost of this
“treatment” is $2,000. I had one lady come in to
see me and started crying in the treatment chair.
These patients are embarrassed when they realize
they were scammed.

I have no issue when a shoe store sells OTC
inserts to their customers. It is not unreasonable
to try OTC treatments before seeing a physician
for a more comprehensive evaluation. What concerns
me is this has progressed to diagnosing and
treating, inappropriately claiming to be experts
who can diagnose and prescribe treatments
(selling) to their customers. I am not anti-
retail. I grew up as the 3rd generation in the
retail shoe business. I refer many patients to
local shoe stores. Many support podiatrists in
their communities.

The Good Feet store chain is cut from a different
cloth than a shoe store. Their charges are
outrageous. By posing as medical professionals,
they will justify these outrageous costs to
consumers. They have hired an orthopedic surgeon
in my community as their marketing director. They
use her image and credentials to pretend to be in
the medical community. I had begged her to walk
away, but she chose not to. They provide
sponsorships for national medical meetings she
produces. They compensate her well.

Dr. Whelan awakened my concerns with this company.
I hope we can move forward as a profession to
address these problems we should no longer ignore.
You have my support and sincere gratitude for
revisiting this problem. I believe we may be the
only group that can effectively address and fix
this ongoing problem that continues to harm the
consumer.

Joan Oloff, DPM, Los Gatos, CA