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December, 2010

Choosing Your Next Orthotics Vendor: The Key Characteristics

By Ramon G. McLeod, Editor-in-Chief

Orthotics are a major chiropractic product and more companies, --particularly consumer shoe manufacturers--have recently entered the field. But your best choices, and your patients', are those companies that make professional grade products.

To that end, we've sought out experts for their advice on what to look for when researching products and also asked them for tips on how to properly present the benefits of these devices to patients.

Obviously, an expert allied with a particular company will tend to be biased to that company's products. Therefore, in this series, Dynamic Chiropractic PracticeINSIGHTS provides comments that reflect a consensus on the general characteristics that make for a good product in order that you may make an informed decision.

First Steps: Company Characteristics

Kent S. Greenawalt, President and CEO of Foot Levelers, Inc., Roanoke, Virginia, said that the first question a practitioner should ask is what kind of research does a vendor to have to back up claims.

"It's very important to choose a company that has published research in peer-reviewed journals to validate its product," he said. "Actual studies proving the effectiveness of the product are critical. In today's world saying the product is 'used by a lot of people,' or 'we have good results' isn't acceptable."

"Research conducted by professionals and published in research journals separates the leaders and innovators from the rest. Your practice should offer - and your patients should receive - products that are proven to be effective," Greenawalt asserted.

How the vendor actually produces orthotic products was also described as a critical factor by several of our experts. According to Paul Smith, President of Integrated Orthotic Lab Inc., Brownsburg, Indiana, the majority of manufacturers use similar manufacturing concepts and materials. Therefore, he said, a practitioner should question a vendor about on factors such as "product turn around times - patients don't want to wait 3 to 4 weeks from the date of casting to receive their devices."

"Does your lab of choice offer advanced technology? Systems to allow proper scanning can increase turn around times, save material costs and enhance the patient experience," he said.

Practitioners also need to ask about the variety of devices available, said Bruce Marrison, President and CEO, The Orthotic Group, Markham, Ontario. "Practitioners should partner with an orthotic laboratory that has a solution for every type of patient," he said.

"Every custom laboratory worth its salt should be able offer a wide variety of orthotic solutions for a wide variety of foot types," Marrison remarked. "For example, some patients require more of a flexible, stabilizing, type of orthotic device while patients in need of more support will benefit from a semi-flexible or semi-rigid orthotic device. Our Chief Medical Advisor puts it best when he stresses 'Different people are different', and a "one flexibility fits all" solution just will not cut it."

One test to discover whether the lab can really do the job, and whether you should keep the vendor or look elsewhere, is how they respond to the prescriptions you send them, said Louis J. DeCaro, a podiatrist and co-owner of Nolaro24, an orthotics manufacturing firm located in Massachusetts.

"The most important factor to me as a practitioner is actually seeing what the lab will 'accept' as a cast and prescription," DeCaro said. "If a lab accepts a simple cast without any feedback I know the lab cannot possibly make a good orthotic for my patient.

Biomechanical workups need to include detailed patient biomechanical evaluation and medical history, weight bearing foot tracings, digital photos and digital gait video with the patient walking on the floor or on a treadmill for 20-30 seconds. This assures that at least the lab has all the important information needed to assure a successful orthotic outcome," he said.

Even with a meticulous approach to making your choice of vendor, the extreme variability in human anatomy that doctors encounter in the clinic should also be the cue that it's unlikely that any one vendor can meet every need, said Verne Bintz, founder of the Verne Bintz Company, Wheaton, Illinois.

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