Appreciation: Reflections on 2010

This article marks the last of the year for me and so I wanted to
reflect a bit on my experiences in 2010 in the hopes that you gain some
valuable insight from them. Most importantly, I want to show my appreciation
for the opportunities I was presented with both as a clinician and as a
business owner in this amazing time of technological advancement despite an
uncertain business climate.

Teaching moments

Throughout the last year, biodesigns inc. has worked with a number of
independent practices and several have distinguished themselves through their
clinical capability and willingness to roll up their sleeves and dive in with
me on complex cases.

This was a departure from my “previous life” where many times
I would be left to fend for myself and the local patient while the clinician
was busy with other matters or simply AWOL during crucial teaching moments.
This always left a bad taste in my mouth because of the opportunities lost to
that patient, the local practice and its community. This is the cost of
short-term thinking – where revenue is the focus – versus the ability
to recognize the long-term benefits inherent in immersing yourself in the
clinical process, gaining knowledge that would differentiate your practice from
the competition.

As a business owner, I can stipulate with whom and under what conditions
I work and my business model requires that when I consult with someone, they
are fully present and accounted for during the entire fitting or I will not
take the case. This is not for my benefit, in fact many consultants would love
to simply roll in, get the job done and roll out with the cash, believing the
less they teach the greater the opportunity for a return visit. I have found
this to be a fallacy, as I have often been asked to help out with cases where
another consultant had been brought in previously, the practice’s chief
complaint being they did not feel they got their money’s worth the first
time. I believe in long-term relationships and as I have stated before, there
is more than enough work for me out there without having to worry whether I am
offering too much information to my clients during my visit.

Professional appreciation

In addition to all the great facilities I have worked with these last
couple of years, I would like to take this time to offer some high praise to
two practices in particular, Next Step Orthotics and Prosthetics of New
Hampshire, with whom I have had an outstanding relationship for many years
coinciding with our collaboration on the Luke Arm project, and Optimus
Prosthetics of Ohio, with whom I have just started working but whose owners
have shown an incredible level of professionalism and hospitality to me during
our work together on some rather satisfying upper and lower limb clinical

Both of these companies go above and beyond in the treatment of their
patients, their employees and their guests, and have made the value of clinical
and strategic collaboration apparent. These companies stand out because of the
atmosphere they have created and one of the most noticeable aspects is that
their employees enjoy being there. Their enthusiasm is directly attributable to
how they have been treated and the level of respect they have for the owners as
well as for the patients with whom they interact. The simple secret for just
about any business is that if the employees are happy, their customers will
similarly benefit. My most sincere thanks to Matt Albuquerque and Peter Couture
of Next Step along with Dave Beauchemin and Dave Newman, and to Scott Schall
and John Brandt of Optimus and the respective staff members of each company,
for not only making biodesigns feel more than welcome, but for “showing
‘em how it’s done” in the competitive field of independent
clinical care.

Strategic collaboration

I encourage clinicians who own independent practices to identify
like-minded practices that are willing to consider a collaborative environment
that goes beyond the occasional greetings and platitudes at the national
meetings. Gather strength from one another and if it makes more sense because
of the intimacy of your particular community, then team up with practices
hundreds or thousands of miles away.


There is a lot of strength to be gained through strategic partnerships,
and not just as a result of the obvious clinical techniques shared but also in
the development of those business practices you perhaps had not thought of or
were concerned would not work. If you want to outperform your local
competition, strategic collaboration is an excellent way to do it.

Personal appreciation

For those clinicians who have a significant other that has provided you
with a sense of purpose and kept you in the game, now is a good time to show
your appreciation. For all the times we have “allowed” them to carry
us, they simply do not get enough credit for letting us pursue our dreams.

I wanted to honor someone who has made my life more than it would have
been without her. My wife has held the business together, sometimes with strong
cement and other times, through no fault of her own, with bailing wire and
chewing gum, despite the responsibilities inherent in raising two children
while running a business. She has allowed me to innovate to a level I could
never have done with a mere business partner.Thank you Julie, for all that you
have done, especially with our awesome kids, Naya and Roark.

Professional challenges

I am grateful for having had the opportunity to work with the brilliant
minds of
ne time my greatest disappointment was the belief that I was
not capable of offering assistance directly to the soldiers coming off the
battlefield due to the political environment surrounding the key military
hospitals and their decision to go with sole service contracts. What should
have been a revolving door of motivated clinicians and open collaboration,
turned into something altogether different, and in my mind vastly inferior to
“what could have been” for our active duty personnel injured during
their service to our country. I should have known then, as I truly do now, that
life has a funny way of taking care of you, and if you believe in karma, as I
resolutely do, all I had to do was wait for my golden opportunity to arrive, as
it now surely has. To be a part of this project is the culmination of a
career-long dream.

Veterans Day recently passed, and yet I can honestly say that my
participation in the Luke Arm project makes every day Veterans Day. To the men
and women in our armed forces, you are much more deserving of the meager praise
I can offer in these words. I only hope that what comes out of this project
goes some distance in making up for what little I have been able to do for you
in the past. I look forward to our future work together.

Looking ahead

I have always had the desire to write technical, clinical pieces for
educational purposes, but have also wanted to write pieces that give a
perspective. These pieces can be more powerful than the former. These pieces
can motivate a person to change course or try something new and I hope my past
columns have had a positive effect on you.

As clinicians, we either do not get much of a chance, or more likely do
not take advantage of the opportunities to thank those who have made our
existence possible — our patients and clients. I am thanking you all now.

Thank you 2010, for all the wonders of this year and the promise of
things to come.

Disclosure: Randall Alley, BSc, CP,
LP, FAAOP has been hired as a consultant on DEKA’s Arm Project, as part of
the Revolutionizing Prosthetics Project, which is sponsored by the Defense
Advanced Research Projects Agency and the U.S. Army Research Office. It is on
this project that Alley worked closely with Next Step, who has also been hired
for this Arm project. Alley has previously been hired by Optimus as a

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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