Face to Face: Jim Middleton, CP

Jim Middleton says he is living the dream. The Billings, Montana, clinician encountered prosthetics in 1987 as a volunteer at the National Sports Center for the Disabled (NSCD) in Winter Park, Colorado. After talking with the athletes about their prostheses, he decided that a bad prosthetic fit came from one of two problems—the prosthetist didn't listen when told about an issue during the fitting, or the fitting process felt rushed. Middleton says he realized he could be happy both listening and working slowly, and that his amputee patients "also seemed to know something about life that I didn't, and my impression was that through their trauma they were forced to consider what life is about and what was important."

1. What are your professional goals?

I truly am living my dream right now; at the NSCD, I wondered what it would be like to provide prosthetic service to the athletes, and this year, Kathy Koessl, a below-knee amputee who raced three track worldwide and at Winter Park came in for a new prosthesis. In addition, I am looking into ISPO credentialing.

2. What has inspired you in your professional pursuits?

In 2001, I was a resident at the University of Michigan (UM) Orthotic and Prosthetic Center. The director, Mark Taylor, CPO, established a management system that encouraged everyone to grow not only as practitioners and technicians but also as individuals. Bryan Grose, CP, has been the definition of a mentor. He showed me that prosthetics require artistic acumen as well as scientific and technical proficiency. He took his mentorship role to the extreme by helping me start my own practice three years ago. Clinically, I try to operate as if I were a western satellite of the University of Michigan Prosthetic department. I'm on the phone with Bryan on average twice a day.

3. What emerging trends or exciting advances do you see for your field?

I see more Internet and computers—ordering just-in-time inventory, using software to order by just clicking on items and paying via direct draft instantaneously, long-distance consulting via teleconference, and more CAD/CAM.

4. What advice would you give to someone just entering the O&P profession?

Get the best training you can and find a good residency, preferably at an institution where you have the opportunity to work on a varied patient population, with repetition. Don't settle for a residency where your primary function is to improve the businesses' bottom line and your immediate finances. Once you're ready to open your business, be the boss that you wanted to have.

5. How do you set yourself apart from competing businesses and practitioners in your area?

I make the majority of my prosthetics with a laminated theme to match the life led by the customer/patient. The finished prosthesis actually shows patients that during the evaluation and fitting process, I was actually listening to them. I also frequently incorporate a cosmetic theme to the interior. The themed lamination is generally a surprise to the patient, and I make it clear that I'm willing to make more money by covering it with a cosmesis, but only a few people have taken me up on that. Some patients are actually pressuring me to top what they saw on other patients.