The Prosthetics and Orthotics Podcast
The Prosthetics and Orthotics Podcast is a deep dive into what 3D printing and Additive Manufacturing mean for prosthetics and orthotics. We’re Brent and Joris both passionate about 3D printing and Additive Manufacturing. We’re on a journey together to explore the digitization of prostheses and orthoses together. Join us! Have a question, suggestion or guest for us? Reach out. Or have a listen to the podcast here. The Prosthetic and Orthotic field is experiencing a revolution where manufacturing is being digitized. 3D scanning, CAD software, machine learning, automation software, apps, the internet, new materials and Additive Manufacturing are all impactful in and of themselves. These developments are now, in concert, collectively reshaping orthotics and prosthetics right now. We want to be on the cutting edge of these developments and understand them as they happen. We’ve decided to do a podcast to learn, understand and explore the revolution in prosthetics and orthotics.
The Prosthetics and Orthotics Podcast
Beyond the Clinic: Experience and Building a Future with Ben Wright
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Ever wondered how recording a podcast live at a bustling conference feels? We don't know either! But you can join Brent in Charlotte as we broadcast directly from the AOPA conference for the first time ever.
In this episode we dive into the world of orthotics and prosthetics as we unpack the ongoing excitement and occasional weariness surrounding 3D printing technologies. We also shed light on the fluctuating funding climate in the sector, discussing why impactful, application-focused companies continue to capture investor interest despite a slowdown in startups.
Could large corporations be losing their grip on emerging technologies? We explore the precarious balance big players like HP, Stratasys, and 3D Systems must maintain when investing in 3D printing. We discuss the brutal reality of corporate decision-making and the potential risks of shifting focus to new trends. This discussion offers a crucial lens into the strategic movements of industry giants and the ripple effects on innovation.
Then we meet Ben Wright, a passionate prosthetist and orthotist who takes us on his inspiring journey from manufacturing engineering to opening his own practice. Learn about his strategic decisions and the challenges he faced, from choosing a clinic location to securing funding and building strong local relationships. Discover the advantages of integrating digital scanning technology into clinical practice and the value of maintaining small, personalized clinics in an industry increasingly leaning towards consolidation. This episode is a treasure trove of insights, packed with real-life stories and practical advice for anyone interested in the evolving world of orthotics and prosthetics.
Special thanks to Comb and Advanced 3D for sponsoring this episode.
Prosthetics and Orthotics Podcast Updates
Speaker 1Welcome to Season 9 of the Prosthetics and Orthotics Podcast. This is where we chat with experts in the field, patients who use these devices, physical therapists and the vendors who make it all happen. Our goal To share stories, tips and insights that ultimately help our patients get the best possible outcomes. Tune in and join the conversation. We are thrilled you are here and hope it is the highlight of your day.
Speaker 2Hello everyone, my name is Joris Peebles and this is another episode of the Orthotics and Prosthetics Podcast with Brent Wright. How are you doing, brent?
Speaker 1Hey, joris, I'm doing well, guess what, what, what. So we you will be dialing in, but I will be there in person at AOPA and recording live the Orthotics and Prosthetics podcast. So we're going to have an opportunity to talk with a few different people, and so, you know, the idea is we'll be able to do that live right from there. You'll be dialinging in, but then we've got some other kind of cool stuff happening. Uh, the stuff that we've been talking about that we'll release at some point in time. Uh, because we do want to get you this way, but it just uh, the schedules didn't just align that way and that's okay.
Speaker 2But this is going to be fun.
Speaker 1This is going to be the first time aopa has had somebody to do something live ever in the history of their show, and so for us to be able to do that is pretty cool yeah, it's super cool and then I hope it isn't too difficult on you, like that, to be able to try and record and then the background noise and all the stuff, the technical stuff.
Speaker 2I hope it's okay, man yeah.
Speaker 1So I think what I'm going to do, I want to make sure that I have uh, well, I'm going to test it a few different ways, but I'm going to have make sure we have separate tracks. But, um, you know, those road mics are pretty amazing.
Speaker 1The, um, the, the wireless go okay and so I'll be doing that, and then, um, but the idea is is that we'll still have separate tracks coming into our riverside and so hopefully, hopefully, it all works. So we'll be testing some of that out in the next few weeks to make sure it's all gonna come together, but we'll definitely make it work. So I'm excited about that. It's going to be a big show. There's it's there's a lot of additive manufacturing type of stuff, and so I'm really curious to see where that goes, because I feel like the additive manufacturing side in the omp space. I think some people are tired, and I think people are just tired of hearing about additive manufacturing in general, but I think that there's an excitement around now that everything is kind of dying down.
Speaker 2What is happening actually in the trenches and where does it make sense, and so I like before it was like something cool on the stand, almost you know, and now it's like okay, we've gotten used to it, but this is what we're actually doing is actually day in and day out, we're making this part or this liner or this thing yeah, 100, and you know I'm kind of curious just to get your thoughts on the overall climate.
Speaker 1I mean you see it a much bigger scale than what I see it right like. I'm not going to stop 3d printing because it literally changes my patients lives and the you know and it makes sense as far as the way that we use 3D printing. But I mean we're in for some bumpy times in the overall global health of additive manufacturing right.
Speaker 2Well, I don't know. I think it depends on who you are.
Speaker 1Okay.
Speaker 2So what we're seeing is that the deal flow has really stopped. So the whole thing of of getting a startup funded from angel investment to see around, to selling it to someone has really, really slowed down. It's almost in aspect, kind of like frozen almost, but there are companies that are raising tens of millions of dollars now. Those types of companies are different than the ones that are raising tens of million dollars years Now. Those types of companies are different than the ones that were raising tens of million dollars years ago. So we're seeing, like a company that will print battery anodes, right, so it's application-focused companies, so a company that says we have a solution that will make a big difference in this really big multi-billion dollar tech space, this engineering space, and that has a big effect on the economics of batteries or engines, or heat sinks, heat exchangers, rocket engines, stuff like that, and that stuff is still getting funded.
Speaker 2What's difficult to get funded now is companies that sell machines. We're seeing generally a reduction in CapEx and a reduction in confidence. I think Everybody's waiting for the outcome of the US election, but people can't tell me what would make them optimistic about the outcome, what would make them pessimistic? So there's just uncertainty and generally, what we've seen with COVID and all these other things is that uncertainty is kind of the new normal for a lot of people. They're just a lot more uncertain about things and a lot more focused about whether the future will be good rather than just doing their work or building their business. So this is another limiting factor.
Speaker 2The performance of the large publicly traded companies in additive is not stellar, and being nice there and is is is set to, for some of them, be under a cloud and some of them are going to meddle through, depending on who it is. Some other companies will do very well, so some people are really investing very, very fundamentally in that, which means that the winners are bigger and the losers are bigger. If you win out on a contract, you don't win out on a contract for one machine, you win out on a contract for 20 machines, forever right. If they do make an aircraft part, you're going to be qualified for that aircraft, for you know the life of the frame 30, 40 years maybe uh, that's that, that's a business or 20 years, depending on the type of vehicle or part, um, and and so the the winners and losers are going to be bigger, let's say, and there are companies that are doing well, um, and, but on the whole, the media is kind of like, kind, kind of like now very, kind of very negative about, about the outcome, but then they're what they are doing is they're talking about little points of light.
Speaker 2So we have to see it a little bit more as kind of you said it already yourself, I think with like it's not, it's no longer some like awesome sauce you can put on something or just say, oh, we're doing 3d printing or doing additive, it's going to be cool. You now have to really make stuff work, which, of course, a lot harder. It takes a lot longer, uh, it takes a lot more expertise and and it's a lot more difficult, but when you win, it's a lot more fundamental. And we're seeing where we're winning in orthopedics, for example, uh, in souls, for example, uh, we're doing a lot of work in in uh, uh, insoles, for example, uh, we're doing a lot of work in in uh for orthotics, right. And we're winning also in orthopedic implants and things like that, because we're the best way to make a certain type of implant, uh, that you can make the, the characteristics, the wicking and the, the bone ulcer integration stuff, optimize that in a certain way. So we're winning there.
Speaker 2And, uh, we're winning in space propulsion, where all the space propulsion companies are using it. We're winning there. We're winning in space propulsion, where all the space propulsion companies are using it. We're winning in RF, so that's RF radio frequency equipment for antennas for military vehicles and satellites and things like that. Increasingly, we're being used a lot in satellite space and defense and we're being used a lot in MRO.
Speaker 2And dental is, of course, a very big market still, and things like 3D printing in hospitals is growing. So the industry is healthy, but it's far from the like. Everyone will have a 3d printer and make everything with it. You know, which is kind of what the media latched onto in the 2010s. You know it's like certain industries, it makes a lot of sense to have a 3d printer and it's cost effective and, like you say, it'll help your patients or it'll help your practice save money or it'll help you. After making an investment, after learning the technology, you can actually then save money with it and make better products.
Speaker 2But that's like it's a very much more difficult path. You know what we have to come to grips with and I think the media does as well is, if you make a 3d printer, it's much more difficult to making like instagram, right? You know that's not technology. All the things that people have said, like everyone always says, hardware is hard. No, no, like like software, stupid easy sometimes because you're making essentially like a web-enabled color filter, right, that stores photos. Oh my goodness, it's so difficult.
Speaker 2Um, so that that's not actually technology in my mind. You know, can it make a of money? Of course it can, but it's not technology. They've been deluding themselves in that technology.
Speaker 2We have real technology, which means you have to make a machine which is part software, it's part mechanical engineering. There's some electronics engineering going in there as well. There's some physics going on, there's some material science. It all has to come together and in a 3Dd printer the feedback loops the one thing and it affects another thing negatively, that makes it affects another thing are also very complicated and complex, like in powder diffusion for metals. We don't actually really understand what's going on, right, it's actually really kind of scary, but we don't know. We're kind of getting an inkling, but it's kind of like a black box, a black hole in a black box, kind of thing. Um, so it's kind of like a little bit crazy if you think about it. Um, so, we, we.
Speaker 2So this process is really complicated, and getting a uh, a 3d printer to work and getting to work at a client site and get to work and make aircraft parts is, of course, going to take a long time and that means that your revenue is not going to rise from one printer to 10 printers, 100 printers or 1000 printers, but it's going to take a lot longer. It's going to take a lot longer for people to trust you, qualify parts, make it work, and I think that's the investment picture. That's also a little bit more complicated. It's going to take longer. We're on a revolution. We're still going to grow by at least about 10% a year this year, which is still okay. We're still going to be like a $15 billion industry, which is not a lot. We're still going to be doing okay and we're still going to be doing fundamentally interesting things, but it's not going to be like the zero to hero by tomorrow kind of thing that maybe some people are led to believe.
Speaker 1So yeah, talk to us a little bit about this. I mean, the reality is, what was did you say the total for?
Speaker 2let's say it's about 15 billion. It depends on what you count really 15 billion, and it's not a lot right.
Speaker 1I mean well, that's so that's, that's part of what I, you know it's. It doesn't seem like a lot, right, but then, like when you're talking about the, the, the percentage of companies, how does that makeup look? Like HP and Stratasys and that sort of thing? What piece of the pie would you say they're getting?
Speaker 2Well, it depends on what you count as well. Is it the services? Is it the total revenue? Is it total revenue? Is it the parts produced or the revenue of everything? What's also happening is they're growing to a certain extent, um, but they're also simultaneously getting disrupted and a lot of things. They're not actually getting disrupted, but the guys are actually kind of competing in areas that people will not. You know, people are buying $200 printers who are not going to ever buy $200,000 printer, you know.
Speaker 2So it's a bit more complicated than that, but a significant percentage of the industry is these larger companies. But think about this right. So even the revenues of the largest publicly traded companies, they're $300 to $500 million or something like this. So, out of a total pie, even those companies of which there are five to six are not a significant part of the total Right. But the problem is that analysts and we don there are five to six uh are not a significant uh part of the total Right. And the problem is that analysts and we don't have that many analysts they tend to follow these companies because those are the ones that are.
Speaker 2People ask guidance about these publicly traded companies, but there's, you know, there's not that many of them Right and uh, and two of them are essentially still very dependent on a particular sales channel and a particular approach to the market. That makes it very vulnerable. Especially, stratus is very vulnerable to competition from below, from Bamboo Labs, and 3Systems is very vulnerable as well in certain aspects. Less so for the immediate next couple of months, but you know. So what we're seeing is that these companies are being overly watched, but they're not indicative for the health of the total. No-transcript we're now getting kind of. Now people are going to be critical of that, even though the rest is doing okay, and I'm saying okay in a context where usually we grow by about 30% a year and 10% a year is still okay, I think, in that context, and we have been doing 30% a year consistently for more or less the last couple of decades.
Potential Risks for Large Corporations
Speaker 1Do you find it like a concern, though, like with some of these bigger companies? I'm trying to think when I think of a big company, you know definitely Stratasys, but there are 3D printing and there's some other things you know auxiliary things that they do. 3d systems also has some of the medical modeling side of things, so they're a little bit diverse. But then you you look at another big company like HP. That is massive and they're quite diverse, right, they're in financing and they're in personal computers and printing and that sort of thing. Is there ever a fear? Like you know, you said three to 500 million and I don't know what, how much HP makes up of that. But it's like, will the bean counters be like? We're not interested in a three to 500 million, we are interested in multi-billion dollar businesses. And will the patience dry up for something like that?
Speaker 2I totally think. If you look at HP as a conglomerate, it's a really large company, and even the entire 3D printing industry does not assure them of a future as a corporation. So there is for these kind of companies. We see the same thing with the materials businesses. Really large material businesses were all in 3D printing and almost all of them left. Apart from Arkham and Lou Rizal, I think. All the other guys are out of the business now, even some of them after investing a couple hundred million dollars or more.
Speaker 2So these guys really literally did what you're just saying. They say, okay, we are a $100 billion business, this is a $500 million business unit and is growing by 30% a year and we don't care, you know. So that is a real worry at any time. You're dealing with very, very large companies and HP is one of the largest companies on the planet, um, so, so, so that's totally something that could happen. They could be very aloof. It's the same problem that we've seen hang over. It's a cloud that's hanging over.
Speaker 2Uh, ge, additive, uh, which is now the name I keep. It escapes me, but it's the same thing. People are like wait is, is GE committed to additive or are they going to sell it. It's always that kind of worry. It's kind of a diseconomies of scale of being a larger company. So that definitely does. But it could also be that the guys at HP decide to double down and then they purchase, merge with Stratasys and or someone else to play a more dominant role Again in an HP context. Writing the business off or selling it and then having a stake is all not that really important, right, okay, and again, and they could find a shiny new bauble. I think I wrote an article. One of the things I'm terrified about is HP and AI, you know.
Speaker 2You wake up one morning and say AI-enabled mice and headsets, and then, oh, you know, there's a little shiny new thing to focus on and we all of a sudden are dreams of yesteryear, you know. So that is totally I think I would love to tell you. I, so that is totally I think I would love to tell you. I know you're very HP dependent because your machines are from that. I'd love to tell you like they're in it forever. But you know, you know large corporations, I mean, they don't know anything forever, you know.
Speaker 2I think, my favorite example is that and a friend of mine was thinking about taking a job at Pfizer and I said to her I said, look, what you need to know about companies like this is that they closed the research center that invented Viagra. That's what you need to know about these guys and I would never do that. I would never do that. And Viagra made them I don't know how much money, I have no idea right and I would never close that research center. But Pfizer did that. You know. They just at one point were like you know what we need to centralize stuff? Let's close the research center at the event in Viagra. And you know that's the corporation. There's no room in a corporation to be sentimental and you know there's even a fiduciary responsibility to not be sentimental. So we can't ever be assured that they'll make that, they'll continue to do it unless it really makes sense.
Speaker 1Well, Joris, we have a long suffering guest, but we do have to get to our, oh my God, this patient man.
Speaker 2Who is this?
Speaker 1Well, let's quickly do our sponsors, and then we'll hop in.
Speaker 2Oh my God, I'm sorry, dear guest. He probably left. Probably made coffee.
Speaker 1All right, who's sponsoring us and uh, yeah, well, I mean you, you probably have a good guess of one of them and we introduced the. Uh.
Speaker 2The other one, oh, advanced 3d, yeah, so advanced 3d, yep, so that's a service bureau that does engineering services, that does 3d printing, that can make you test sockets, that can make you components for your invention or can bring your invention to life and works specifically for and with the orthotics orthopedics community in North America.
Speaker 1And around the world for that matter. Oh yeah, sorry, sorry, yeah, yeah.
Speaker 2Definitely, and around the world. Yeah, nice people, I'm told.
Speaker 1That's what I hear. Yeah, so it's Paul Tyler and me, and I mean you covered it well, we just try to get more people using additive manufacturing. We've seen the benefits in our patients, with the outcomes that it provides, and we're excited to share that with you. So definitely reach out to us. The other sponsor is ComScan, so yeah, let's share a little bit about that.
Speaker 2ComScan is amazing and I think it's a 3D scanning product that I can actually use. So ComScan is an app that you can use, or your customers could use, or your customers' customers could use, depending on who you are to using their cell phones to a fairly straightforward, uh, detailed enough to get prints of it, make an orthotic, do stuff like that, um in in a number of minutes. And you know what. A lot of people have said that 3d scanning is easy and it isn't. I mean, I think we can conclude it isn't, but uh, you know, com scan is the first product I've seen that is like like reliably consumer-friendly enough for you to be able to deploy it like in a practice environment or in a, you know, central fab to office environment where you're thinking you can use pretty low-cost devices or devices people already have to actually get like a result you could make a device from. So I think it's really awesome actually.
Speaker 1Yeah.
Speaker 2And I have no idea how much it costs or how it costs or something, but I think it's. But at least the functionality of it, which I got to test out, was really, really nice.
Speaker 1Yeah, so fairly affordable. You can get a trial, so reach out to Alex at ComScan, but it's roughly I think it's $750 a year and everything gets. So it's resident on your iPhone while you're scanning but then it gets pushed to the cloud once you hit Wi-Fi and so all that's HIPAA compliant. It's a record that stays there forever. So, while it is maybe seem more expensive than, say, some of the free versions or low cost versions, there's a whole backend that goes into this. There's also a whole algorithm to make sure that all the uh, the hardware and the software talk to each other, that you get a a consistent result. So definitely check them out.
Speaker 2Okay, and now it's time for the most.
Speaker 1Oh my goodness, we we we podcast guest in the history of podcast guests in additive manufacturing. He's a very talented prosthetist and orthotist. He likes to push the boundaries of what's possible, hop into the weeds of not only like device type, but also is the alignment correct? How can we make the alignment better? Are there pads and support that we can do? That is definitely hopping into the weeds and the details, but ultimately the outcomes for patients are better. And I talked to Ben actually, so he just is opening a brand new practice. So it's fairly unusual for people to open practices, especially in this climate, and he has also said said hey, I want to do a podcast about what it's like to open a practice at o and p um. And so I said hey, I'd love for you to share a little bit about what you're up to um on our podcast and hopefully we can give him a springboard um to to really get going. So I'm I'm excited to have on. We can go a bunch of different ways, but yeah, so I'm excited.
Speaker 2Me too. Hey, Ben welcome to the show.
Speaker 3Thank, you, I appreciate it and no worries at all. I mean, that is not what you guys were talking about with 3D printing. That is not something that I hear every day, so it was interesting to hear that.
Speaker 3So, ben, tell us how you got started in? Uh, yeah, omp, yeah. So I was uh born and raised in uh, southern oregon, a little town called medford, um, and when I was a teenager, I was a boy scout and one night and we would do like career nights every once in a while and so I got to take a tour of a prosthetics and orthotics clinic. I was probably about 13 or 14 at the time, um, and at the time I was kind of like, oh yeah, you know, that's cool, all right, whatever, um, and then ended up going to uh getting my undergraduate degree in manufacturing engineering technology at byu in ut, and while I was getting my degree, like all of my friends were getting into engineering, you know jobs, you know like going to work at Tesla or a food processing plant or you know, it was very process engineer, quality assurance type stuff and I was like for me at the time I was like this does not sound very fun to me, like I want to work with people more, like I want to help people. So I was my wife luckily she is very patient.
Speaker 3It took me a little while to figure out what I really wanted to do and but, seriously, one morning I woke up at like four o'clock in the morning and that tour of that clinic that I took as a Boy Scout just came into my mind and I was like, well, for me personally, I'm a fairly religious and faith-filled person and so I personally feel like it was divine intervention. And so I called up that prosthetist orthotist that gave me the tour. He still lived in my hometown and I said, hey, I think I might want to do this for my career. What do you think?
Speaker 3That prosthetist orthotist that gave him the tour? Um, he still lived in my hometown and I said, hey, I, I think I might want to do this for my career. Like, what do you think? And he said, yeah, you know, I think you, I think it'd be great. So I ended up going back to oregon doing an internship with him for a summer, loved it, um, and then I graduated and I ended up going to baylor college of medicine for my, um, my, my graduate studies. And here I am.
Speaker 2That's interesting With your engineering process and engineering background. What did you think of the OMP, the engineering portions or the making portions of the courses?
Speaker 3It was fantastic, and that was the thing about manufacturing engineering that I loved the most is it was very hands-on. So a lot of the classes that we had were like working in a you know, working with a lathe in a mill, you know. Or like working with milling or doing computer-aided design and, uh, you know, doing stuff with solidworks. Uh, a lot of what we did was actually katia. Katia is a cad software, um, for like milling metal and stuff.
Speaker 2Milling.
Starting a New Orthotics Practice
Speaker 3essentially, If you want to work with Tia, you can use Tia Right, and I don't even know who uses it now. So that was a lot of what I did, but even like 3D printing and laser cutting same thing. So we did a good amount of that and that's what I loved the most. I also had composites classes, material science classes. That kind of stuff was fascinating to me. I had also taken a couple of anatomy classes and physiology. I was really excited about the fact that I would be able to work with my hands but also help people. The combination of those two things was really. It was like yeah, this is, this is me. So Okay.
Speaker 2Well, ben, thank you for coming on the podcast. That's all we have time for Not kidding. And why okay? So why are you now opening your own practice? What made you think that that was the way to go forward? What led you from graduating to to here?
Speaker 3Sure. So I've worked at a couple of different clinics since I graduated and they've all been great experiences for me. One thing that I've been how would I phrase it? Part of my role.
Speaker 1Yeah.
Speaker 3Yeah, part of my role at each of my clinics that I've worked at has been doing a good amount of marketing and referral education and bringing more patients into the clinic, and so I had a good amount of experience with that. One was a private clinic, two corporate clinics and another private clinic, and so each one, um, I just I really took on that role and I really really liked it. I liked meeting with physicians, I liked educating them and physical therapists and teaching them about what we do, um, and I and frankly I was pretty good at it and so I would get new patients to come in and get new referral sources, and that was a great experience for me. So the reason that I ended up starting my own was I was working for Autobock Care and it was great. I really loved working there. It's more of a corporate type of company, obviously, and fortunately I had someone reach out and he is an investor and he let me know that he had a sufficient amount of money for me that if I wanted it, I could have it and start up a clinic, and the offer was good enough that it was just kind of hard to pass up. The offer was good enough that it was just kind of hard to pass up.
Speaker 3And so, with the experiences that I've had and you know, working with new referral sources and getting you know patients, um, starting to work with new patients I figured you know what I think I could, I think I could do this, um, so I I decided to just roll with it. Um, and one of the big challenges Brent and I were talking about this earlier but one of the big challenges of starting up a clinic is having insurance contracts. So, fortunately, I know a clinician who was. When I talked with her about starting a new clinic, she said well, if you would like, you can use my contracts while you're working on getting your own. And so that was huge. So we're going to be starting to bill insurances right out the gate, which that's a big deal.
Speaker 2Okay, that's super good, and are there any stuff that? Is it hard? Is it difficult? It seems like it could be difficult when I do something like this. First off, where do you put it? That would be my biggest concern. Do I put it in some new neighborhood where there's nothing? Do I put it far away from everything?
Speaker 3else.
Speaker 2Sure, yeah, yeah, do I put it close to a really big industrial plant? What's my point? Totally.
Speaker 3So one thing that comes into play I do have a non-compete with Autobach, my previous employer, and so that was one factor. I couldn't really put the clinic inside that non-compete radius. So if you're starting up a new practice, that's one thing to factor in Um, but the other factor is the city in which my clinic um is. It's fast drop Texas, Um. This clinician that's helping me, she actually had a practice in this area and there are no other orthotics and prosthetics clinics in this county, in this city, much less the county Um, and so that was another one as well. So, as far as access, the patients that have orthotic and prosthetic needs, they were traveling into Austin, which is where I live, for all of their care and that's anywhere between a 30 to an hour, 30 minutes to an hour drive. So quite a bit of travel, and so putting a clinic in this area has actually proven to be a huge factor in just preventing or allowing patients to not travel as far for their care. So that's another thing.
Speaker 2And did you look at the demographics at all? Did you look at? Is it a small town? Is it a big town? What was it? What were you thinking about? Did you look at? Is it a small town? Is it a big town? What was it? What were you thinking about? Did you look at if it was growing, that kind of stuff?
Speaker 3Yeah, yeah, definitely so. Demographics-wise yes, I did look at that. That wasn't a huge factor, but it was partially. The growth was a big one. So Bastrop is one of the fastest-growing cities in Texas Again, growing cities in Texas, again. So Bastrop is the bigger city or town within Bastrop County. But then there are surrounding cities or towns that all kind of come either to Bastrop or to Austin for all of their medical care and stuff like that. So it's kind of having a clinic in kind of the center of Bastrop County allows these other towns to come in here rather than going to Austin. So and a lot of this kind of data and stuff did come from this previous clinician that I'm talking about. She had a practice here for a while. So that kind of helped me to get things rolling.
Speaker 2And how did you want to do this? Did you want to do like really big marketing launch, go, go, go kind of thing, or do you want to kind of soft launch it and kind of a little bit by bit get stuff started? What was your strategy there?
Speaker 3I don't know, I don't know if I would describe it as really big or small. It's been mostly so like, so far what I've done is mainly just stopping by all the you know physicians, pt clinics in the area, dropping off business cards, you know prescription pads, and then asking to set up a meeting and so and that's what I've done in the past and it's worked very well. I've heard of clinicians and also do like. I've heard of one clinician that actually had a billboard and she said that it was a huge factor in success. So I've thought about that. I haven't done it yet, but so yeah, as far as like the marketing push, it's fairly big but a lot of it.
Speaker 3What I found is a lot of it. What I found is a lot of it is word of mouth, especially if you specialize in something Like at previous clinics I've done a lot of pediatric orthotics and once in my experience, once enough physical therapists or physicians or even patients hear that there's a good pediatric physical orthotist in the area, I mean it's kind of wild how word of mouth can help things to grow. So I'm going to be relying on that somewhat as well. So it's been a combination of all those things. I mean, it's kind of wild how word of mouth can help things to grow, so I'm going to be relying on that somewhat as well. So it's been a combination of all those things, I guess.
Speaker 2Okay, cool. And are you really big on metrics and stuff? Because, like, for example, you could for word of mouth, you could do NPS and take a survey to see if it's actually working. You could try to see how many people go on your website.
Speaker 3Are you really all about that, or are you more kind of like let's do the general marketing things you should and and wait for stuff to roll in? Or I haven't used a lot of data up until now, but I'm, I'm looking into it, so like now. So my website is up and we have a google account, so I've I haven't thought of looking at that a whole lot, but I probably should, um, so so yes, to answer your question, I guess I am interested in I. I just haven't done it up until now.
Speaker 2Did you get local press? Totally get local press. Everything is really effective. Seriously, it's crazy effective.
Speaker 3That is a good point, so I probably will do that. Thank you for that recommendation. I'm going to write that down because I did have one. Oh sorry, go ahead.
Speaker 2Especially with the human interest angle, like this is mirror. She used to have to go over an hour in the car, you know it's nice.
Speaker 3Yeah, definitely. Um. So yeah, I I think that again, in my previous clinics I haven't necessarily done that, but I'm sure here I mean I'm sure it'd be very, very effective.
Speaker 2So, thank you, I appreciate that I think I should especially if you're opening it and stuff just have a big opening day for the community and stuff, and that would be good, I think. And so how about the building itself? Did you like Brent and his crew they have got these trucks and stuff like that. Did you want to have one central office? Did it take a long time to figure that out? If you wanted that, what was it going to look like?
Speaker 3It what it was going to look like, or, um, it's not huge, so it's about a thousand square feet, um, and we were able to find some good space and I didn't have to put up any walls or anything.
Speaker 3There are three rooms, so one's my like office space, one's a patient care room and then there's a lab, um, and so it was. It ended up working out fairly well, um, it had been available for a little while, um, and while backdrop is growing, it's not like office space is super, super rare, and so it was also cheap enough that we felt like we could handle it well, and so outfitting it has been kind of fun getting the tools that we need and the software and building desks and benches and stuff. I really enjoyed that side of it, and so I actually have my. The patients that I've seen so far I've seen remotely, but I have my first patient coming into the clinic this afternoon, so it's kind of a big deal, yeah, very exciting and and um, about this, this, this, the, the, the patient coming in and you starting this clinic or something.
Speaker 2I mean, I think what was it? The thing that really drove you to do this was like a financial thing, or was it like a? You know, you controlled it kind of, or you controlled your own destiny. What was the real thing? That said you know what? I'm going to do this Totally.
Speaker 3Um, I would say two big things. So Brent may know this, but so I part of it is. I really I feel like I'm fairly good with people and the idea of managing um like being a manager or, like you know, a leader. I think that's something I'm fairly passionate about. Um, and so that's one thing like I would like to create an area or create a clinic or business where people can come and they feel valued and they get their, they feel like their work is enjoyable and they are fulfilled by their work, and I would love to create a space where that is possible and where that happens. So I would say that's one part of it. I want to be, I want to have that kind of environment for myself. I don't want to create that for other people.
Speaker 3Um addition, though, I have a fairly large family. My wife and I have six kids, and so financially, in the previous clinics where I've worked, I've done, I think, fairly well for our field. But owning and starting up my own clinic, obviously I get a little bit bigger piece of the pie if things go well, and so I think finances was also a part of it, not like the main part, but a part. So I would say those two things. Fortunately, at the clinics where I've worked in the past, I've been able to provide the kind of care that I've wanted to provide. So it hasn't been like, oh yeah, that previous clinic, I felt like I just wasn't able to do what I wanted to do. That really hasn't been part of it. I've I've been fortunate enough to work for great people, great companies, where I've been able to do that. Um, it was more just being able to create the kind of environment that I want and um be able to support my family.
Speaker 2Six kids with braces.
Speaker 3You're going to have to make a lot of braces.
Speaker 2You know kids. Fortunately we haven't had to do that yet, but they are quite young, so yes, and and what did you think of like? Because there's a couple options here you could go well. First of all, are you, did you hire just yourself? Or did you go like we have a receptionist and a technical person? What did you do? Or did you kind of, yeah, what technical person? What did you do? Which way did you do it that way?
Speaker 3We're keeping it fairly lean. Right now it's just me and then my wife is helping with the books, with insurance contracts and stuff like that. I have another clinician that is going to be starting at the end of the month, more of like a part-time role, um, so for now it's just going to be me and him. As far as the, we're trying to keep it as lean as possible. Um, so, a lot of the scheduling and a lot of the billing and that kind of thing we're going to be trying to automate as much as that as possible to keep costs down. Um, and so, yeah, obviously eventually, as we grow, that will probably become necessary to hire a front desk administrator, but at this point I'm able to manage it fairly well by myself, along with my wife helping. So, yeah, and as far as a technician, we're going to be doing everything central fabrication so that we haven't hired a technician either.
Speaker 2What do you mean by that? Is it you're going to send everything out, or are you going to do everything yourself?
Speaker 3Yeah send everything out. So, yeah, we won't be doing any fab in-house Eventually. We haven't bought one yet, but I think eventually we'll get a 3D printer for check sockets and maybe even inserts or AFOs. We'll see, but yeah, so we're definitely looking at that in the future and does that have to do?
Speaker 2because, like it's interesting, was that like a personal decision? Are you like I'm all about the people, so I don't want to start making stuff? It's like more you're more focused about that people, person, stuff, or or what was it with the motivated decision to kind of really outsource like most, if not all, the stuff?
Speaker 3I've done that uh two of the previous clinics where i've've worked and I've liked it quite a bit. So the model generally speaking I mean again cost wise you're able to keep personnel costs down but also just the model of being able to choose who I want to make a certain type of device. I like being able to do that. Not, of course, that you can't have a technician who's really good at everything, um, in house, uh, but I like the ability to say, oh, if I'm going to make a pre-fed carbon AFO, I know exactly where I'm going to send it. If I'm going to make a thermoplastic AFO for a kiddo, I know exactly where I'm going to send it. And so, to get the best quality for different device types, um, I feel like I'm able to be a little bit more selective about that.
Speaker 2So the cfab model um I again, I've had some good experience with it and it's worked fairly well, and so, um, yeah, this is interesting, I think, because a while ago you would have been like okay, I'm outfitting my thing and then in my lab I'm going to put like a carver or something.
Speaker 2You know what I mean. You would have already started buying, you would have already gotten a milling machine or all sorts of stuff you know, right and um. So it's interesting to me that you can make this choice and that you are quite remote from other clinics and stuff and still the economics of this works out and you have a network of suppliers that can uh, uh, you know, in a reasonable amount of time get you all the stuff you want. So I think that's, that's a that's an interesting thing. I mean, I think economic has got to be an interesting thing as well. So I'd be really curious to see you know how that works out with the stacks. And you say a printer would be nice. How about a printer for orthotics? Because that could be a real money maker as well, I think.
Speaker 3Um, it totally could, because that's actually so. I work with a podiatrist I work with um one podiatrist specifically who's sending a lot of custom prototypes, so right now I've just been sending those out, but I bet we could lower costs a good amount by going with a 3D printed one. So that's been on. I have a pretty long list of to-dos right now. That has definitely been on there as far as like, okay, if we wanted to go this route, what type of printer would we get, what type of software? And so, brent, I will probably be reaching out to you about that if you have any ideas.
Speaker 2I was going to say out that, um, if you have any ideas. But I was gonna say I know a guy, yeah, and then another thing is like so what is your? So this is interesting, you found this investor. That's also kind of, uh, I think you got. Really I'm not taking away from your business ability, but I think it's lucky to have a person say you know what I want to invest essentially in your business, but also you as a person, right, I mean, not a lot of people have that opportunity.
Speaker 3How do you do that? I should say so. This investor is actually my brother, and so he is done fairly well for himself and he loves investing, and he's been pushing me to start my own thing for a while, previous to this. It just didn't quite seem to make sense, and so he was just like then it's, you should do this.
Speaker 2It's like okay, so yeah okay, that's good, that's good, it's good for you to say, but and then? But how did you make that kind of like, what plan did you make? Right, because I said, money's only a problem if you make too much or too little. Right in the middle, you know, uh, it's all good. But but how did you kind of like, did you really have a big? You have a big covenant with all sorts of uh, uh deals and agreements, and if this, this, or is it more of a handshake kind of thing, or like, um, you know, did you, did you try to say, hey, what happens with this in 10 years? Did you? Did you spend a lot of time on stuff like that?
Speaker 3not a whole lot because again I how to phrase this my brother is a very good person. He does. He basically said, Ben, if you lose this money, it's not going to affect our relationship at all.
Speaker 1I like your brother too. Yeah, so do I. Are we looking for podcast sponsors? I?
Speaker 2mean right oh and Pete has a nice ring to it.
Speaker 1That'd be well happy to send people your way.
Speaker 3Yeah, I wish I were enough money to do that. So basically he said so the plan right now is he pretty much fronted me you know a good amount of money and said look, you look. So right now the way the business stands is so he owns a certain percentage, and so do I, and the idea is that I will pay him. I will basically buy him out over the course of the hope is about five years and so at that point the clinic would become 100% mine and there was an agreement written up for that. And of course he owns enough of a percentage that he can still influence decisions and stuff. But he's been fairly hands-off but at the same time interested enough when it comes to big decisions that he wants to be involved and so frankly, it's been fantastic and I'm very, very grateful. So, yeah, if that answers your question.
Starting an Orthotics Practice Financing
Speaker 1Okay, cool Ben, I wanted to just hit on some of the. So you really are in the minority as far as you have kind of grown your career, you've gotten your experience, kind of time in the saddle and moved into essentially business ownership, believing in yourself and that sort of thing. I mean it's that used to be. I mean, I feel like it used to be kind of the dream for you know clinicians. But I'm not seeing that as much these days and and maybe that I'm just not looking. I mean, what do you? Would you say that you know you're kind of pioneering your own path, and especially in this time, I would say that, yeah, it's, it's been, I know.
Speaker 3So, again, I went to Baylor college of medicine and I know of at least two, two other guys, um, they are guys, um, but they, they have started their own clinics as well. I worked for one of them, um, and so he started up his own clinic as well. And then I know another guy that did the same thing and so, but you're right, I feel like it's not as common. I know I have another friend who bought is in the purchase of buying a clinic, um from from um someone that he worked for before going to school. Um, I've seen both, but I may be wrong here, and this is one of the reasons that I want to possibly do a podcast about this is because, as far as barriers to entry, I feel like finances are a big one. So, again, me, for example, especially student loans I went through school and we already had two kids when we started school, and by the time I was done with my graduate degree, we are, we were up to four, I think. Um, I lose track sometimes, so forgive me, um, but we, you know, we came out of school with some debt, not as much as like a doctor, of course, but we're working to pay it off. But it's tough when you're in that kind of position. You're like well, I have these student loans I have to pay off, and then I'm trying to make as much money as I can as a clinician, but where do you get the money to start up your own thing, like that's? That's tough. And so, again, I'm very, very fortunate that I have family, that my brother specifically, who is willing to do this, but not everyone has that. And so then you're like well, what do I do? And so there are franchise-type models where I know of clinics that say hey, if you want to start up a clinic, we'll give you what you need and then you'll own a certain percentage. That probably won't be as much as if you started it up on your own. I've heard of some offers where it's like a 50-50 kind of deal, and so I guess, to answer your question, brent, I would say, yes, I am kind of pioneering my own way, but not on my own.
Speaker 3Even when I was thinking about starting the clinic, I called every business owner that I know and I was like hey, if you were to do this again, how would you do it? And and I also asked them, like I'm thinking about doing this, what would be the possibility of working with you on this? Like, if I wanted to do like a franchise type model based on your you know, connected with your clinic, what would that look like and what would the ownership look like? And would I need to practice there with you or what can I? Can I practice here where I live and so having so I guess what I'm getting at is where to get the finances to do it, but also, do you have enough connections with people in the field that you can learn how to do it and do it well? I know some great clinics and clinic owners that have been so helpful with advice and ideas and that's just been huge for me. So having mentors and having access to funds, really that's been huge, and so, even though I am doing my own thing, it is definitely not a one-person show.
Speaker 2Like I am relying a lot on other people for help, which I'm fortunate to have it's interesting to point out those student loan, because that might be the one thing that's holding people back. I mean it's you know. And then also like the just lack of finance. If you can't find someone to to finance it, or another businessman you happen to know, or something like that, yeah, what are you gonna do? Go to a bank. They're gonna be like, oh, I'm straight out of college, like give me a couple hundred grand to do this. I think, yeah, I don't think that's gonna, uh, you know, work or and the interest rates on those kinds of loans are not small.
Speaker 3Like you're, you're gonna be paying a lot, and then you know over time to pay that back, and so yeah it's tough, okay, and and and and okay.
Speaker 2So you said you want to specialize a little bit in, like the pediatric sciences. You've done that. Did you want to offer absolutely everything, because that could be a little bit easier, because you're doing the c-fab thing right. So did you want to just say, oh, you know, we do obviously everything you can come in, like pets, I'm good anything. Or, or were you more selective in trying to specialize?
Speaker 3um, it's a little bit of both so right now. So, yes, my and brent will tell you this, but I love orthotics and prosthetics, I love all of it. Um, I would say I I love lower limb orthotics a little bit more, um, so that has been where I've kind of built up my niche. I would say I have done a good amount of prosthetics and other types of orthotics as well, also some I've specialized a little bit in scoliosis, um with, like the wcr brace from you know, rigo, chanel and stuff. But um, so, yes, I I think, as I have started here, I've kind of already had a name for myself in this area and so that's kind of helped to get the business off the ground, because I have already made some connections with referral sources and some patients to kind of get going with the pediatric and adult lower limb orthotic side.
Speaker 3But as we grow, we definitely will be building that side of things more. So it's all different types of devices and patient types. So, and as we, as we grow, the hope would be to hire clinicians who who would be able to specialize more in lower limb prosthetics or upper limb prosthetics, like I'm. I'm a big fan of that type of thing being able to do what you, you know, what you really feel passionate about. So, yes, right now we are offering everything, and again, again, I feel like I'm still a good prosthetist and I do a good job, um, and so, yeah, I think for now, that's how we're getting, how we're getting our start, but we will grow into pretty much everything in the future and how about like scanning?
Speaker 2we talk about 3d scanning a lot. Is that? Was that really important for you? Were you like, oh wow, we're working with the cfab, so we need to scan because it's going to make everything cheaper to get it to the people who are going to do the work, or has that kind of you haven't spent a lot of time on the scanning part of things?
Speaker 3yeah, that was actually something I was doing at the previous two clinics that I worked at, because, yeah, with the cfab model, you have to either send out a cast or do it, you know, by measurement, or you send a scan and so, just for turnaround time sake, um, I mean, you know, you sending out a cast just to ship it through, you know, ups, fedex, whatever it sounds like cheap, like I sent a cast out the other day. It was like 60 bucks or something. I was like this is insane, um. So, yeah, I my I like to cast um for lower limb orthotics when necessary. So, especially when there's a lot of deformity correction, and I'm really trying to get my hands on there and trying to get the foot and ankle in the right position. I usually do that a lot, but if I don't need that, I'll totally scan for afos.
Speaker 3Um the scanner. I did get a? Um an eye scan, uh scanner. Uh, one reason is that we would like to uh provide uh cranial helmets, and so I wanted to have a good scanner for that and I thought really good things about that scan scanner. Um, so I didn't get one of those scanners and then I'm probably going to get a subscription as well, for, you know, when I don't necessarily have to use the eye scan, um, but maybe I'll just use the eye scan, and brent or yora said you have to hear your feedback on that, if you need both or if one is good enough. So, yeah, I would say so. Actually, maybe just kind of a sidebar One of the CFAPs that I use for carbon EFOs.
Speaker 3They don't have a carver and so they can't really take scans, they can only take casts. So what I previously did was I actually either took a cast or a scan, I modified it digitally and then I would have it carved and then have the carving sent to them, and so, even though that didn't necessarily decrease the shipping or like turnaround time, it was actually doing. Prepreg. Carbon is less complicated with a foam mold than a plaster mold. You don't have to put mold than a plaster mold. You don't have to put it in the oven, you don't have to dry it out as much. The turnaround time is a little bit faster, and so, um, that was one thing that we we did that a couple times and actually ended up working out pretty well, and so that's one thing that I thought about, as well as possibly going to having it carved by someone else, shift there and then decrease the natural turnaround time in-house. So that's another option.
Speaker 1I love that you got the EIN scan. I think that's it's a great scanner, so funny. Funny story for those that are EIN scan either the H or the H2 users is so there's two modules. There's the main module, where you can do bigger things, kind of what you use for scanning to grab something for reverse engineering. And then there is the helmet module that you can scan helmets with.
Speaker 1Well, I was having all kinds of problems with the helmet side of things. I was losing tracking it was. It was literally a complete disaster. Uh, I wanted to send the whole thing back because I didn't need just another scanner for um, reverse engineering. I've got plenty of those. I needed something to do.
Speaker 1Helmets, I mean, it's a. It's a very difficult thing to do to capture the head of a baby that's moving and nobody really has a great video. And even if you talk to the main people at Shining 3D, they do not have something to say other than just try to get the baby to stay as still as possible. And I'm like, no, that's not very helpful. So for the people that and maybe it's just me because I'm slow but the trick to scanning with the iScan H or the H2 is you need to calibrate in the cranial module, and once you do that tracking, everything works. If you only calibrate in the main module, that file doesn't transfer over to the helmet module and it's just not going to work well, I appreciate that Rich Pro tip for future reference.
Speaker 2That's good, very helpful, very helpful and generally I think line scans are good. It's like the first time, kind of like an intermediate price, relatively budget price scanner actually works well. Right, I think it's a good product right.
Speaker 1Yeah, for that $5,000 range, I mean I can't think of a better scanner and it's a massive step up from the like EinStar, you know, sub $1,000. The like einstar um, you know, sub a thousand. Now what I love what ben said is I think I'll get a subscription to the um comb scan stuff. Um too, I think, absolutely.
Speaker 1I think, having having the scanner with you in your pocket, um, and even if it's not your actual phone, um, the crazy thing about the any of the iphone scanners is that it is very hardware dependent and apple tries to put the. You know they. They stay consistent but they try to put the cheapest hardware in to get their margins and so as they've moved up this, the, the hardware side has gotten worse and worse, while the software side has definitely been better. But it appears that the 12 is kind of the sweet spot for the 12 mini, specifically for the comb scan. It fits in your hand really nice, but you're going to get really good, accurate results. So you can get those phones unlocked on Amazon for a couple hundred dollars. So it's such a great value. So even if you don't use it as your phone, it would be great to have that one for your scanner.
Speaker 3Yeah, and that's the thing I've used it in the past and it works pretty well, and so, yeah, I'm thinking about having both, just for, like I can't. I might be doing a good amount of traveling to see patients at nursing homes or hospitals or whatever, and bringing the eye scanner just isn't going to work, so just bringing the code will be a lot easier.
Speaker 1Shining 3D did just release a wireless scanner. It's it's a pricey one, it's all in one with a screen and all that, but, um, I haven't seen anybody use it. Um, revo point also released one. I, you know some people have been impressed with it. I was not, um impressed with it. It's okay, but it's not. It's not great. So, who knows, shining 3D may have hit on it.
Speaker 3Well, I'm glad that I made a good choice.
Speaker 1At least it sounds like it. It sounds Well, and here's the cool thing Going ahead and making the decision that digital is going to be a big part of your practice is a big deal, and the scanner is the foundation of of everything. Um, and is, in fact, going back to our first pod, or is one of our first podcasts Joris and I had with Paul Sugg, the founder of East Point. His first thing that he did was buy a scanner, and at that time scanners were about $60,000. So I think he took out like $100,000 or $150,000 loan and the scanner and software was like $60,000 or $70,000 of that. So that is how important he felt it was to have that digital foundation, and so it's really good to hear you doing the same thing, and I think that'll pay dividends for sure and make your practice super unique.
Speaker 2Yeah, I think so Cool. And then and then, Ben, what kind of software did you get?
Speaker 3So that's your question. I actually I haven't gotten software yet, and so it was. That was one of the things about leaving auto VAC. I was, I was pretty bummed about. They have some pretty solid software, um for afo modification, um that I don't have access to anymore, which is a bummer. Um for prosthetics, I'm actually like using their, their tt modification software. So I I, until I get my own 3d printer, I will probably for trans tibial and maybe transfemoral sockets, I'll I'll either use them or use a central fab here if I take a cast um, um or or I mean I'll look into some of the c-fabs as well.
Speaker 3But um for orthotics, I actually wanted to ask. So I've I've used bre Brent in the past for AFOs. I don't think I've done any prosthetics with you, brent, but so I haven't found another software that is powerful enough to do the kinds of things that I want to do. That is also within my price range, um, so, brent, if you have, or yours I mean, I don't know how much you know about, uh, omp software stuff but um, if you have any recommendations, I would be happy to check them out. Um, I again, as Brent will tell you, I get a little bit picky about my orthotics stuff. Um, prosthetics, I would say I'm not quite as picky, just because I feel like you can do with most O&P software. I feel like I can do what I would like to do with prosthetics, but orthotics I don't know, Maybe I just need to chill out a little bit, but I'm a little bit more picky about it.
Speaker 3So yeah, I would be open to your thoughts on that.
Speaker 1I mean I would definitely check out what Arthur Hobden has going on with Nomad Sculpt. It's an iPad app that's $20. And so you can use your Apple Pencil, you can set regions, you can do a whole bunch of stuff. So if your cast is good and you don't care about circumferential measurements because you know your cast is good, I would definitely look at that. It's pretty slick. Especially, that helps you get kind of your flow down or get some at least ideas down on pencil and paper. And then you could also send what you have and say, let's just say it's not smooth, like you've got all your regions in and it's just needs like a couple of smooths or whatever, and you it's not something that you want to do. Then having a contract manufacturer just do a blanket smooth would be um, fine too. Um, so there's there's some really cool things in nomad sculpt. So I would definitely check that out or talk to arthur about that sweet the the one question I had.
Speaker 3So and I can talk to arthur more about this. But the thing that I like to do with orthotics is I like pushing and um and relieving and so and creating like a good toe rocker kind of thing. And so I don't know if you could do that kind of thing in nomad sculpt. That's probably something I might have to have you do, brent, but that's the kind of stuff, and so I don't know if you could do that kind of thing in nomad scope. That's probably something I might have to have you do, brent. Um, but that's the kind of stuff that I feel like a lot of. Being able to tweak those kinds of things like buildups are fine, but creating a good space to really push in with like a pad or do something like that, I just feel like I don't know I haven't seen a lot of software and really get that down really well, but I would totally check out. Uh, it was nomad sculpt, that's what it's called nomad sculpt.
Speaker 1Yeah, just hit up, arthur yeah, and I know yes, you can do all that stuff, and the cool thing is is that, um, this software also allows you to bring in other files. You have a toe rise or something that you really like to use, um, you can actually scale it in app. I mean like there's just so much that can be done. It's not going to be the most efficient way like having Freeform, but you're not spending 12 grand for Freeform but you can get some of those things in place and then create some. We can definitely help you on the back side. If you do your clinical stuff and then we just actually do the brace side, that is fine and it saves a lot of money that way. And and I'm sure there's other people that will do it but nomad sculpt is uh, yeah, hit them up for sure.
Speaker 2Yeah, we'll do and then other stuff that you bought, like. I'm just interested to see if, like, uh, uh, like, like, did you need any more tooling? Did you get any more tools besides this, or you're basically just more like doing like desks and stuff at this time?
Speaker 3uh, yeah, pretty basic tools. I got a pretty good you know like work bench from like home depot and I just got a bunch of tools like harbor freight um, so nothing like super you know expensive um, I think I guess I got another bench and then also some storage racks. Um, the pile of boxes and garbage in my lab right now is obscene, um, so over time I'll just be taking runs to the dump and the garbage, uh, to get rid of all these boxes, from all this stuff. But um, and then, yeah, parallel bars, you know mirror um. Uh, chairs, you know nothing, nothing super crazy uh, printer, um, yeah, that's really cool.
Speaker 2And did you have, like a, um, you know, do you have a plan for yourself? Like you said, you had a, you know. You had a kind of financial plan with your brother. Like you want to buy him out at one point. Grow the business. Do you have, like you know, do you want to make an empire? Do you want to, like, go head-to-head with hanger and have a hundred of these?
Speaker 2you want, you know, you want to kick back no, do you want to kick back at one point? Go to hawaii. What's your, what's your plan here?
Speaker 3so that that's a good question. Um one, my brother and I have explored a couple different ideas here. What we were talking about about new clinicians, clinicians not having a way to get their own thing started We've talked about ways to kind of address that. So, you know, setting up some type of financing thing for new clinicians or so some kind of way to help other clinicians get into the field in this way. I think that would be really rewarding. Um, so that's one thing that I've that I've thought about.
Importance of Small Orthotics Clinics
Speaker 3As far as the clinic side, we'll see. I mean, I don't, I don't see myself. One of the things that I think I have seen is as far as culture. Like I mentioned before, it's hard to maintain the kind of culture and work environment that you want to have once you get really big. And Hanger is obviously, you know they have great clinicians, they have great, you know they have great everything.
Speaker 3One of the things when I was looking at working for them when I first came out of school was it just seemed like for me, um, it was kind of hit or miss. Uh, wherever I went to work, like I heard some clinicians say, like dude, I love the clinic that I work at. Like it's amazing, like I, I don't feel the need to go anywhere else. Some clinicians I heard the opposite Um, and but it seemed like it was almost drawing the hat, drawing the name out of a hat to to know what I would get, um, depending on which clinic I went to. And so that that makes me kind of resist the desire to get really big, because I would like to keep it small enough that I can maintain the kind of culture and environment that I want, um, and also keep a good handle on who's being hired and, um, what you know, having a good relationship with employees and stuff like that, and so that would be one thing that would keep me, I think, from getting really big.
Speaker 3Um, but maybe, if, if we want to go more, maybe like the financing or like, I guess, franchising type thing, maybe that would be a way to grow but allow people to kind of take ownership of that for themselves and their own clinic. So instead of you know, keeping it all centralized kind of, yeah, go ahead and start your own thing, and maybe here's a little bit of money to get you started, but really this is your thing, I think that seems like it would be a little bit more advantageous. I, yeah, like I said, I have six kids. I want to spend as much time with them as possible. I really love patient care, though, so I don't really see myself getting out of that maybe one day, but I just don't see that happening, so I'd love to keep seeing patients.
Speaker 2And then another question I think it's really interesting you mentioned the autob, auto block. Of course, there's other device manufacturers that are essentially like kind of competing with you. Did you kind of, when you were selecting vendors and selecting, because you kind of had to make a kind of list for yourself, like, if this, then this product, right, if this, then this, this did you think, oh, those guys are competing with me, I'm not going to pick them as a as a device supplier, did you? Did you let that kind of factor in? Or you're like no, no, no, I just want to go with the thing that makes the most sense.
Speaker 3Well, I would say two things about that. One, while I was at Autoblock and I appreciated this a lot I never felt pressured to use Autoblock products. I was working in Autoblockox corporate headquarters in austin, um, but even there, like, yeah, they would talk about like certain devices like the c brace, which is, you know, aside from the tectus, which is another c brace-esque brace, um, there really is another option aside from the c brace than the c brace. And so, you know, yeah, they would talk to us about fitting c braces and I was like, yeah, that's fine, was like, yeah, that's fine, I like the Seabrace, that's great.
Speaker 3Or like the Microbane that's another 3D printed helmet which I fit because I genuinely really like the Microbane. And so it wasn't necessarily it was being pushed on me, it was just like, oh, yeah, this makes a lot of sense, like I, that's just kind of a natural thing. So that was one thing about Autobot that I really really liked. If I had felt more pushed um or more pressure to push Autobot products on patients, then I would probably feel a little bit more of what you're feeling, but I didn't Um. The other side of things was when I, when I decided to leave um, the, the uh healthcare, the, the Ottawa healthcare side of things, which is kind of funny that it's called that. But like the sales and the product development, like the people in those departments, when I let them know I was leaving almost without fail, all of them were like oh, that's awesome, You're still going to be our customer, like that's great.
Speaker 3You know, like, no hard feelings at all, go kill it, you're going to be awesome. Like they were super nice about it, like they were not. You know like, oh, now you're going to be competing against us Like it wasn't like that at all. And so again, if it had been different, maybe I would feel different, but I, I don't. I never felt that. And so for me it's like, yeah, we are competing against each other, but I also am still. I still have a good relationship with my previous boss and, uh, I, I'm, I'm not going to do anything to bad mouth them at all.
Speaker 3Like I'm not going to try to tear them down at all. I'm just going to try to provide the best care that I can, and we'll see how things go.
Speaker 2And what made you really decide? Because if you look at the financial clouds I mean what we always think and it's kind of like without fail. I think a lot of people in this industry kind of think the same thing there's more CFAB, less mom-and-pop shops and more consolidation. And what made you think like no, no, there's a place for at least one small clinic, and maybe even more is somewhere, if I put it, if I do it right. What made you believe it? Did you just believe in yourself? Or did you think no, no, no, there's always room for that personalized service thing? Or what was like the logic that made you believe that this was like a worthwhile pursuit?
Starting a Pediatric Orthotics Practice
Speaker 3I think that's a really good question. I think one reason I felt like it would be possible was as I've been in the different clinics in states and cities where I've worked. One of the things that I have seen multiple times is the bigger the company gets and this is not necessarily always the case, but the bigger the company gets, um oftentimes the the less focus there tends to be on really, really great patient care. Um, now again, that's that's painting with a very broad brush or stroke. Um, so I I'm not trying to say that that is how it is everywhere, but, generally speaking, especially when you get into the corporate style or corporate setup, you have a bottom line and you have to make more business decisions, which, of course, as a business owner, I'm going to have to make decisions business decisions too, but those will be mine. I will have control over when I need to spend more time with the patient and when I don't, and when, like, I don't know. Instead of those decisions being taken away from me as a clinician, I feel like I want to have the ability to make those decisions for myself, and so, yes, I do also believe in myself as a clinician, like I feel like I'm, I think I'm a pretty good clinician Um and I've um. I think I don't want my ability to provide really high quality patient care to be affected by um a a more of, I guess, a corporate mindset of um. You know we have a bottom line and we need to meet it um, no matter what the cost Um.
Speaker 3One factor I would say as well is when I came here to the Austin area again, pediatric orthotics is kind of how I kind of got things moving here. I there was kind of I heard this word used by other physical therapists and doctors. The word monopoly was also used Like there is a monopoly on pediatric orthotics. There is practically one clinic or one group of clinics that I can go to for pediatric orthotics and there's pretty much no one else. And the quality I mean we're a capitalist society. I mean when there's a monopoly there's not really a whole lot of motivation to do it better, and so that was also a reason that I felt like starting up something here was a pretty good move, because people, the more I would say that I was you know I did a lot of pediatric orthotics the more people were like awesome, there's someone else, you know, and that was a big draw. So as long as we can keep the quality up, then I feel like getting a better share of the market won't be too difficult.
Speaker 1I love that. I mean, I think it's a great way to build a practice. It's a great way to quickly cash flow. That's actually how I built the Raleigh branch, for East Point was predominantly through pediatric orthoses, and then the prosthetic stuff came um and it wasn't you know a super, super, not a ton of prostheses, but what was cool is, when they came in, that just it was.
Speaker 1It was a nice compliment to everything else.
Speaker 1It wasn't like you were, you know, not the feast or famine, like if you didn't get a prosthesis you know this month or a couple. You had this like very consistent uh group of people and and and all the pediatric people talk to each other. So, as the parents are on their Facebook groups, the physical therapists are talking to each other, the schools talk to the physical therapists and those you have school physical therapists, regular physical therapists, like there's there's so many good things about it and I I feel a lot of times, um, at least it was my experience uh with uh, seeing some of the, some other companies is you, it was always the bottom of the totem pole to see the kids, you know, at the practice. So you never, you always got the resident or, like the, the guy that was, you know, first or second year in practice, and so you never had somebody that was truly passionate to take good care of kids and have experience at the same time. So I love that. I think it's a great way to build a practice.
Speaker 3And just to add on to that, at my previous clinic I saw a new patient and they came in and I asked the mom how did you hear about us? She said, oh, facebook. I was like, what, what are you talking about? She's like, yeah, there's a, there's a facebook group for kids with cp or that need bracing in this city, and I was. I heard multiple times that this is the place to come for pediatric bracing. I was like, well, great, great, I had no idea that even existed.
Speaker 1But yeah, it's a pretty small community and, again, word of mouth it's a pretty big deal, and so, yeah, of Ben's journey and such anything stick out as like a surprise or you know something that you really hadn't thought about. As far as you know, a journey of somebody that is looking to start on their own clinic.
Speaker 2Nothing. No, I'm surprised that it's possible, I think you know, that's the thing. The big surprise is that somebody would do it and that it'd be possible. Now, like, the funding aspect is really the difficulty here, and the drive seems to be there. There's a plan, there's a vision, there's something, and there's also a lot of stuff that Ben doesn't know which I think is really healthy Absolutely, and I think that kind of humility in front of this task is really kind of you have to get the right humility, slash enthusiasm, slash optimism, balance right.
Speaker 2And so, you know, it seems pretty logical, I think you know. And with regards to the CFAP thing, yeah, I think it goes either one of two ways Either you do everything yourself right, and you really really go heavy on the manufacturing and you really kind of vertically integrate, yeah, or you really outsource absolutely everything, you go like asset, like you know. I think those are the most uh, uh things. The only thing I'm really I'm kind of missing maybe we just didn't talk about that enough is like it's more like this looking at like the, the, the, the service concept, overall, you know, or do we want people to come here, do we want to do, do vans? You know what I mean.
Speaker 2I think, uh, the, you know he wants to travel a lot, so he's going to like, see the territory a lot, uh, but then at the same time, it's like, yeah, what do you? You know how are you going to reach absolutely everybody in their territory? You know, um, but on my top, but just generally, I think, I think, yeah, it's pretty much seems like a really solid idea and just like, but it's really kind of sad to realize that that you really need to have a relative that believes in you for the two. You know what I mean, um, you know what I mean, I think. I think I think that's the, the, the, the kind of thing that we're where.
Speaker 2That's probably why we're not seeing a lot of this um, and I think you could make a real breakthrough if you just pick the right area and you have the right level of service. I think it's an important decision for a lot of people. It's something you wear every day. So if you impress upon everyone that you're the logical choice, then I think you could build a very flourishing business. It's not going to be easy, but I definitely think all the elements seem to be there definitely.
Speaker 1Yeah, I think all the elements seem to be there, definitely, yeah, I love that. I think a part two would definitely be very cool in a few months, and then obviously we're willing to help you anywhere along the way for anything on the podcast side of things. As far as helping you with that journey, I think that there's a lot of interest in that side of things. As far as helping you with that journey, I think that there's a lot of interest in that side of thing and, who knows, you might start a movement of these younger clinicians really looking to open up their own practice, and that would be cool and kind of counter-cultural as well, and I think there'll potentially be a lot of power in a movement like that as well, specifically for the O&P industry.
Speaker 3Thanks guys, I really appreciate it. This has been great.
Speaker 2Yeah, totally dude. Well, and Ben, thank you so much for being on our podcast today.
Speaker 3No problem.
Speaker 2And thank you as well, Brent, as always.
Speaker 1Man, I just get confused on the Ben and Brent. You know I don't know. Oh my goodness. Yes, so yes, this was great. Thank you, ben, for sharing your journey. It's neat to see it all coming together and looking forward to following it as well.
Speaker 2And thank you so much for listening to another episode of the Prosthetics and Orthotics podcast. Have a great day, hey.
Speaker 1And that wraps up another episode of the Prosthetics and Orthotics podcast. A big thank you to Ben Wright not to be confused with Brent Wright for sharing his expertise and insights today. If you enjoyed today's episode, make sure you hit the subscribe button so you never miss out on future episodes. And a special thank you to our sponsors, comscan and Advanced 3D. And thank you for listening and we'll catch you on the next time on the Prosthetics and Orthotics Podcast.
