Maximizing Your Relationship With Your Orthotics Lab

© 2024 HMP Global. All Rights Reserved.
Any views and opinions expressed are those of the author(s) and/or participants and do not necessarily reflect the views, policy, or position of Podiatry Today or HMP Global, their employees, and affiliates.

Welcome back to Podiatry Today Podcasts where we bring you the latest in foot and ankle medicine and surgery from leaders in the field. I'm Dr. Jennifer Spector, the Assistant Editorial Director for Podiatry Today. And today, we're excited to have Dr. Nick Romansky with us as our guest for this Orthotics Q and A to talk about maximizing relationships with your orthotics lab. This concept could prove transformative for both patient outcomes and management of your practice, so we're looking forward to hearing his insights in this area.

Doctor Romansky is a fellowship trained Diplomate of the American Board of Foot and Ankle Surgery. He's a Team Podiatrist for the US Men's and Women's National and World Cup soccer teams, a design consultant to multiple shoe gear companies, and a medical consultant to many of Philadelphia's professional sports teams. He's also a podiatrist for the Major League Baseball Umpire's Union. Doctor Romansky, thank you so much for being with us today.

So, getting into how one relates to their orthotics lab, what are some key factors that in your experience that go into choosing an orthotics lab that's best for your practice?

Well, I think you should, interview or search ankle multiple companies that potentially can work for yourself. So, there's a lot of labs out there, and I think one of the key things in my opinion is the support system and the customer service. So, the support system in a sense that this, number 1 is that whether you're a new, starting off podiatrist in practice or just coming out of fellowship or residency, you may or may not know as much in orthotic fabrication as you've been focusing on hospital, medical treatments as well as surgery. One of the things that we don't stress upon in school as much or residency is orthotic fabrication. So, I think you really have to look at that as or quite honestly, if you've been in practice for a while and you're just not into the groove anymore, you're kinda doing the same things. You just need a little update or just a little tune up, so to speak. You want a lab that can provide some support and insight, as well as the customer service. Many podiatry, orthotic labs have courses they can offer, like, what we one of them we call is called grinders and glue, where you can just, you know, ask questions or go to a course online or in person around the country. Or we actually go to the lab and just see the process and see how they do it. Also, that most labs have an internal factor that they ink put into their orthotic devices that you may or may not know. And you need to know them. The inner workings of how the lab processes your orthotics and see how that fits into how you perform your casting whether using the a foam box, plastic material, or different types of scanning instruments or platforms that are there now. So I really I really do think that the support is critical.

A lot of times you just in You need some help on what device to use, what material, what top cover, how deep the heel cup should be, all the, features that you should in include in an orthotic device and if it's truly going to be custom. Some podiatrists just kinda give the same device for everybody. It's graphite, it's polypropylene. And it seems like they all get the same device without actually putting in a thought process that really makes it truly custom. So I think that's what really the one of the key things you guided that. It really if it's going to be custom. It really should be custom. Your lab should have the appropriate materials you you need and the input that you need to make the appropriate device.

And again, it's that relationship that you create or want to create that makes it just easier for you and the input you can get to get the ultimate orthotic devices that's gonna allow that person to minimize their medical issues, and perform at the highest level in decreasing symptoms. The other thing is you want easy access to the lab. You want a good variety of product. Obviously, you want a good pricing and margins. You want a lost policy. So, if the person, the patient loses their orthotic, or it gets thrown out. We we've had so many stories of how they've lost their device, that there's a lost policy and there's a warranty policy. And if they outgrow it, the device, or they want a 2nd pair, there is actual warranty that you can get, for an extra fee that may be all part of the, orthotic relationship that you have.

Next and last thing on this when we go to lab is a lot of times when I cast somebody, I'll actually send the specific shoe, sneaker, or whatever. And if I can't, then I'll at least send a tracing of the insole so we don't have any problems with it. So I think that's, one of the little tidbits that you can pick up with that. And lastly, in regard to the lab angle is that, you know, when you're making looking at the orthotic fabrication, it's not based on their foot type. It's really based on their needs, their specific problem, as well as, you know, their medical needs or sports participation, that angle. Allows that device to be more customized.

There's definitely some significant opportunity there. You've gotten into this a little bit, I think. In your experience, how can clinicians leverage that relationship to improve outcomes for their patients?

So again, you go down to what are the what are the specific needs for this patient that really you believe needs a custom device. And some of the some of the I think having that relationship with the lab and getting the input from them from the other side. And then you see, what do you most commonly see that you really think you can use a truly custom orthotic? Not an arch support, not an, over the counter device. Some specific needs I look at right off is Lis Franc injury or issue, acute and chronic ankle sprains, neuroma, 5th metatarsal base, Achilles tendon problems with Haglund's deformity or ankle. These are all the, like, they might be the top 5 or 6 that are in my world. Maybe shin splints as well. And that, you know, so those that's really where you can use that device. And I think in the beginning, if you're uncomfortable, I mean, really limit to those 5 or 6 abnormalities, diagnoses until you get comfortable on fabricating that device. But again, that lab input when that customer service person that you can have one contact that becomes your customer rep for your account can you got you can have a good working relationship. You can bounce things off that you can really make that device work, with a less chance of failure.

You make sure you get a lab that can have a money back guarantee, or you as an office, or as the physician, that there's a money back guarantee. So I don't have orthotics, honestly, floating around, outside my office that are not working. So if I can't get a device that really can't work as a even maybe even recasting them or whatever, talking to the lab, Then I will offer them a  money back guarantee as long as they exchange the device for their money back guarantee. So that gives a little bit more responsibility, accountability of that. I'm gonna try my best to give a true custom device to make work for their medical and systemic and sports needs.

So, to round out this conversation today, are there any other resources that might be available from orthotics labs and their associated professionals that can help clinicians improve our own techniques when it comes to the prescription, casting, or capturing, and dispensing processes?

So, I think, again, as I spoke earlier, a lot of the labs offer, online classes, in person classes, local courses that you can go to on a Saturday or Sunday or some night. Also, I actually say if you're close with some of your podiatrists in your in your area. Many of them are more skilled or have more experience… get a well-rounded opinion that works for you, then you develop your own technique that works for you that makes it maximally efficient. At a lot of the meetings, you know, nationwide or the actual lab itself offers online or in person construction casting classes. Lastly, really, to sum it up is that pick your orthotic lab that actually can work for you. And if it doesn't work, you move on to the next. We'll have 2 in the beginning, and then you can fine tune that. You know, with logistics nowadays, a lot of times these labs cannot get the materials, the top covers. And you may have to use another lab because logistics right now, they're a problem with materials.

Thank you so much for sharing your experience with us today, and thank you to the audience as well for joining us. Don't miss past and future episodes of Podiatry Today Podcasts on podiatrytoday.com, Apple Podcasts and your favorite podcast platforms.