A Chapter Ends

This article is my last as a regular contributor to O&P
Business News
, and as such, marks a big milestone in my career. As a
writer-reader relationship, ours has lasted for 8 years now, and I can not
thank you all enough for the support you have given me via email, phone calls
and in-person comments throughout my tenure as a Clinical Matters/Practice
Matters columnist.


A manly tip of the hat to all column writers throughout the world as it
truly is one of the tougher jobs out there. The hardest thing for me was
juggling my crazy career with that ever-present deadline. I wanted each and
every column to mean something to all of you, not just be faintly interesting,
or slightly amusing. I wanted to sink those words into your soul, make you
think about your patients, your careers, your lives and play some
infinitesimally small role in improving your station, whether clinically or
personally. It is why I chose to spend my time writing opinion pieces. I am
hoping that though my words were not peer reviewed they still meant something
to you.

Better outcomes

The column started out as a great opportunity for me to dispel myths and
prove false the ridiculous mantras in upper limb care that were horrifyingly
effective in keeping good technology or good techniques or simply common sense
at bay. One such mantra: “Always fit with a hook first and then if –
and only if – they are wildly successful with something they may abhor
from the very first sight of it, we may consider additional technology.”
In other words, for some individuals it was the equivalent of saying
“enjoy this glass of sour milk. If you drink it all, we’ll deem you
worthy of something else you might like better.” Or how about this gem:
“The prosthetist has nothing to do with the outcome, so therefore
comparisons between cable-driven and myoelectric systems need only focus on
which type was used in greater numbers.”

  © 2011

And I know I have talked a lot throughout the years about outcomes tools
issues for upper limb patients. I still believe we need to incorporate
prosthetist experience — true experience that is, not just a logging of
years — into outcomes measures, as well as, prosthetist-patient management
skills, a standardized clinical approach, a thorough interface analysis and a
whole long list of additional things that are quietly being ignored in our
quest for outcomes. Even the most ambitious outcomes projects in lower limb do
not come close to analyzing in detail the most important part of the entire
prosthetic system, the interface. How many articles were written and how many
presentations given on the effectiveness of energy-storing feet or of
microprocessor knees? Meanwhile, the femur is sloshing all around inside the
socket, losing energy with every step.

The column then morphed into topics based on reader suggestions, or
current themes or trends at the time that I thought you might find either
inspiring or at least important. One of the strongest set of responses I
received was regarding the product development series that I wrote, and I must
say it was nice to get readers’ e-mails thanking me for giving them that
little spark they needed to get a project started, or in some cases, finished.

Changes in the profession

I leave you with a cautionary note. There are serious moves afoot in our
profession. Has anyone noticed all the manufacturers that are now providing
their own clinical services? Someone let the floodgates open on that one.
Wonder what it was that led them to believe that we as independents, and even
the large national companies, would not have a problem with it? Could it be
they have weighed the possible consequences and decided to shrug their
shoulders and go for it? Well I suggest we start forming a more unified front,
lest we all find ourselves out of a job. Look at who you buy your products from
and ask yourselves, are you propping up your own competition? Remember, as
I’ve said before, though these words are not my own: “There are three
types of people in this world: those who make things happen, those who watch
things happen and those who wonder what happened.” Just food for thought.

I am moving ahead with our own little counteroffensives, for being on
the defense has never been my cup of tea. I expect several clinician networks
to pop up, and do not be surprised if some of these strategic networks do not
possess engineering and manufacturing components as well. Look around you,
exclusive insurance contracts with big, national players, clinical services
offered up if only you hand over your patient to your friendly neighborhood
manufacturer, “just for a moment” and only “for a small
fee.” Don’t get caught flat-footed, and don’t think that
manufacturing is only for the big guy. With current technology making it
relatively easy to design, produce and distribute product, why not consider
yourselves a player? Think big, your competitors do.

And think outside of the box, use technologies that let you be somewhere
else. With the availability of technologies like Skype and others, I have
enjoyed my remote consulting, and especially enjoy my remote meetings with
patients and prospects. Oh the ground I cover these days, all while still in my
bathrobe. Not really, but you get my point.

A goodbye

Well, needless to say, ‘tis time to say goodbye, though I will be
writing in from time to time. My relationship with O&P Business
is a great one, and I have made it fairly plain that I can no
longer juggle my responsibilities at home and in my business and still produce,
on a regular basis, the level of writing that you all deserve. The last thing
you and I need is for me to scribble some drivel down in the nick of time just
to make the deadline. No, I would rather stay connected with O&P
Business News
some other way and they have been gracious enough to offer me
a way to do so, apart from being on their Practitioner Advisory Council. So,
though not with a heavy heart but with some thoughtful introspection, I bid you
all adieu as a column writer, and step into the role as the editor of this
column for the remainder of 2011. I am looking for a few good men and women
interested in contributing. Contact me. As for the rest of you, I thank you

Editor’s Note: Look for the next Practice Matters
column in the May issue with new column editor, Randall Alley, BSc, CP, FAAOP.

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

Leave a Reply

Your email address will not be published.