Get Ready for a New Kind of Patient

There are developing technologies, techniques and strategies that clinicians can employ in order to stay ahead of the competition. There is also the emergence of the highly informed, highly determined patient who will not take “no” or even “maybe” for an answer. They are focused on what they want and will not settle for anything less. It is a new world, and it is driven by empowered individuals that have heavily researched not only the available technologies, but the clinicians with whom they are interested in working. If you want to succeed, you had better be ready for them.

Internet age

It was not so long ago that a patient was totally reliant on the prosthetist/orthotist for his or her information. There was little available on the Web, particularly with regard to upper extremity prosthetics from which the interested patient could draw in order to assist them in determining the best system to meet their needs. It was not uncommon to have a situation where the local clinician recommended only that particular prosthesis with which he or she felt comfortable, irrespective of its relevance to the patient’s lifestyle and/or occupational demands.

With the exposure brought on by high-profile athletes such as Bethany Hamilton, or recreational enthusiasts like Aaron Ralston, perceived barriers were eliminated for many aspiring individuals who did not feel they were getting the most out of their prostheses or out of their practitioners for that matter. Seeing what could be accomplished by others in similar situations drove many people with amputations to strive for the same level of achievement. In so doing they started investigating their options, including researching advanced technologies, the best insurance coverage for individuals with limb loss or absence and the best support groups and prosthetic specialists, not just in name but in reputation. The Internet has spawned an entirely new breed of informed patients, family members, allied health professionals, and with any luck, prosthetic and orthotic clinicians who stay connected to the pulse of the entire health community, interacting, learning and pushing forward with every opportunity.

Meet challenges

Stack of books and computer mouse
© 2009 iStock International Inc.

Few things give me greater joy in my profession than to be challenged by a savvy patient, intent on interviewing me and trying to find holes in my background, delivery or recommended strategy. I relish these encounters, for not only does it keep me on my toes; it also gives me confidence that this individual will appreciate what I have to offer and what I ultimately provide.

It is not good enough to be one of a few individuals in a small niche, content in the absence of competition. Rather we must always be one step ahead of a patient who is hot on our heels, who understands that they are in command and it is they who ultimately decide who gets the nod. Payers may still be directing individuals to their preferred providers, but do not think for a second that a truly determined patient will not go out of network to find superior care, or do everything they can to convince their insurance group that only the best will do. These are the individuals I long to work with for there is no telling where we both will end up, though it goes without saying it will be a better place for both of us.

Learn a lesson

I have always considered myself to be on the cutting edge, bending or breaking rules that I do not feel apply or are inappropriate. This is why I continually revise my interface designs based on new information or discoveries. Recently, I had the pleasure of working with an individual who was not only demanding, but unrealistic – or so I thought. Right out of the gate I started pushing the interface envelope fully expecting to come up against a wall. Yet, the result was far beyond my wildest expectations and I was secretly proud of what I had created for him. Problem solved. Well, not quite. He wanted me to push it further.

I was fully prepared to engage him and explain that because he had never worn a prosthesis before he did not know how much better this interface was than traditional designs. I intended to tell him that he should try to appreciate it for what it was but stopped myself. As I said before, even though I often think out of the box and this was perhaps the finest example to date of what I thought I could accomplish, I asked myself then and there – why not? Why not take it to the limit of what was truly possible and take the hit if it failed miserably? As long as this patient was willing to go the extra mile so was I, and if the prosthesis went down in flames then that is the price of breaking new ground. As it turned out, luck was on my side and I learned a valuable lesson that will change my perceived limitations of what can be accomplished for the right patient who demands more than I think I am capable of providing or is even possible.

Exceed expectations

Today, the challenge for us is, rather than assuming the patient needs a firm dose of reality, we need to meet and exceed their expectations. They are not so grounded in fantasy as they may have been in the past – based on limited exposure and over-hyped technologies – but rather they are based on comprehensive research and feedback from others like themselves. If we do not give them what they want, someone else undoubtedly will.

The planet is shrinking. Better and brighter minds are looking to become involved in what we do from every corner of the globe and patients are willing to travel to the ends of the earth to get what they need. I am amazed at the diversity of individuals that come to my Web site, from tiny islands off the coast of Africa to Eastern Europe, from small Midwestern towns to Hong Kong and everywhere in between. The world has come to our doorstep and if the welcome mat is not out and the table is not set, they will go where they feel more welcome. I can not say I would blame them. It is exactly what I would do if my life depended on it, because often, this is what is at stake.

Randall Alley, BSc, CP, FAAOP, CFT

Randall Alley, BSc, CP, FAAOP, CFT is chief executive officer of biodesigns inc. He is chair of the CAD/CAM Society of the American Academy of Orthotists and Prosthetists, an international consultant and lecturer, and a member of the O&P Business News Practitioner Advisory Council. Alley can be e-mailed at

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