When you prescribe custom foot orthotics, do you always know what you are getting from your lab?

Not long ago it was clear that if you ordered custom orthotics, you were truly getting custom orthotics. You sent in a plaster cast and the lab made a plaster positive cast, modified it as prescribed, then they would heat and vacuum press a material on top of that positive. The resulting appliance was clearly custom made for a specific patient.

Orthotic fabrication has changed dramatically over the recent decades. More often than not, the lab will no long produce a plaster positive when you send a negative cast. Instead, corrections that you previously performed to create a plaster positive now occur on a computer system. The lab can perform the same corrections on the computer as it did in plaster, then mill a positive cast to produce the orthotic, or the lab can mill the orthotic directly. This technology has allowed many labs to provide their clients with the same quality orthotics while keeping costs, and environmental impacts, under control.

This technology has also allowed the creation of a type of orthotic known as a “library system orthotic”. Library systems allow a lab to scan a negative cast and then choose the orthotic shape from a library of predetermined shapes stored in the computer. A library may consist of a dozen or even several hundred different orthotic shapes. They are not really custom orthotics but more like enhanced prefab devices.

Other questionable lab practices have been to market diagnostic techniques to their practitioners that they label being “state of the art”, but are merely impressions of a compensated foot from a magically programmed pressure mat, relaying. If you have training in biomechanics, you’ll know this. But unfortunately, the consumer does not. Your patient’s insurance providers are now aware of this, and are not covering this type of diagnosis.

Unfortunately, some labs use library systems and promote unprofessional diagnosis techniques to fill prescriptions for custom orthotics without making this information clear to their practitioners. This has great potential to lead to a reduction in positive clinical outcomes, and this can erode the integrity and growth of your practice.

It is believed that the 19th century surgeon Thomas Inman was the one who first said: “practice two things in your dealings with disease, either help or do not harm the patient.” The practices written about above have the potential to do a lot of harm to the patient.

It is imperative that every orthotic practitioner be aware of how their orthotics are manufactured. In particular, if you are ordering custom orthotics, you must ensure that you are doing an accurate diagnosis, and that your lab is truly manufacturing custom made orthotics… your reputation depends on it.

At Paragon, your orthotics are truly custom, every time. Each and every foot is treated with the same time and dedication. We do not use library systems, and our casting/scanning systems are accurate and acknowledged by both insurance providers and professional colleges.