When Rachel Eisenfeld, CPed, decided to pursue a career as a pedorthist, she knew that she wanted to follow a less conventional path. Hoping to improve customer satisfaction and reduce orthotic fabrication time, Eisenfeld established Soleful Orthotics and Footwear, a mobile orthotic business.
“Time is a big issue. Doctors do not have enough time to spend with patients, and for pedorthists, there’s the issue of getting the patient his or her orthoses in a timely fashion,” Eisenfeld said. “I wanted to make it more effective for everyone.”
Eisenfeld approached this issue by creating a mobile practice. She first operated out of the back of her car, and would visit patients at their homes or local doctor’s offices to evaluate them and then return to her own home where she had a lab. She was able to fabricate orthoses within a week and a half at first, but managed to decrease the turnaround time to 1 week by limiting her travel distances.
Images: Rachel Eisenfeld
“After I figured out that I could do this in less than 1 week, I decided that I wanted to take the fabrication time down to 1 day,” Eisenfeld said. “And the only way that I was going to be able to do this was by taking my lab with me.”
Have trailer, will travel
Soleful Orthotics, which services patients in Washington, DC and Virginia, is now housed in a box trailer, which is outfitted with a patient evaluation area, grinder, vacuum press, and other necessary tools and resources to properly assess a patient and fabricate his or her orthoses.
“I decided to go with a box trailer because I could stand in it, and it has a wheelchair accessible ramp that is accommodative to a lot of patients,” Eisenfeld said. “Now I could evaluate them, cast them and fit them, and patients can walk out with their orthoses in about 3 hours.”
Eisenfeld uses 3-inch fiberglass tape to cast her patients, because it sets in a matter of minutes. Once the cast is made, Eisenfeld can fabricate a custom orthosis within an hour and a half.
“After I cast them, the patient can go back into the house or leave, and in an hour and a half I will call them,” she said. “The nice thing about being at their house is that they can bring their other shoes out and we can make sure the orthoses fit in all of the shoes the patient is hoping to wear.”
Challenges to consider
There are several challenges to consider when developing a mobile business. The first challenge Eisenfeld discussed was the environment. Poor weather can hinder travel as well as deter patients from choosing a mobile office.
“If there is extreme heat or rain, I will usually have patients remain in their homes or doctor’s offices,” Eisenfeld said. “I will cast them inside, and then go back to my trailer to create the orthosis.”
There are also several operational challenges, such as start-up costs, choosing the vehicle itself, how the vehicle will be towed, if a trailer or similar agent is chosen, as well as acquiring a means of electricity. Eisenfeld uses a 4,000 watt generator inside of the trailer and also has a long extension cord that can be plugged into a patient’s home or a doctor’s office if available.
“You also have to figure out what area will be covered,” Eisenfeld said. “I had to figure out what my cost vs. distance was, as well as limit the number of follow-up visits for patients.”
Eisenfeld confines her travel time to an hour and a half in one direction, and also limits her patients to three complimentary follow-up appointments before charging them. Payment options are also an important factor to consider.
“I try to stay out of the insurance circle as much as possible, so everything is out of pocket,” Eisenfeld said.
According to Eisenfeld, patients are extremely satisfied with their orthoses and appreciate the convenience and ease of being seen at their home.
“Pedorthics has entered a new era, and we need to do something to make ourselves more available and get noticed,” Eisenfeld said. “I think a mobile orthotic business is one of the ways to do that.”
Disclosure: Eisenfeld is the owner of Soleful Orthotics and Footwear.