Are You a Great Technician?
As a judge of the technical fabrication contest at last year's American Orthotic & Prosthetic Association (AOPA) World Congress in Orlando, Florida, I noticed something I hadn't really thought much about before: There are some really great technicians out there.
The task was to fabricate a "prosthosis"-a device to accommodate a mid-foot amputation-and there were some really great entries. Some were more for show, some focused on function, and a few represented what I think a really great technician can do. This led me to ponder the difference between a good technician and a great one, and I came up with some commonalities in great technicians upon which I think we can agree.
The most obvious criterion would be great hand skills. If you want to produce art, you have to be an artist. Even though it is probably the most apparent of all the factors of greatness, it is a very subjective measure. Artists have good control of their hands. They can make smooth lines. They can feel the material they are working with and understand how to coax it to achieve the desired result. They can make objects that are pleasant to look at and feel comfortable to touch. To me this is the minimum benchmark for greatness. Without this skill, none of the others would matter much.
When I started in this industry, I realized that the best route to success would be to find the person who had the skills I needed and emulate whatever he or she did. My first mentor was a guy who was really hard to love. He was never in a good mood, never seemed to want anyone around him to succeed, and he didn't like me. But he was an artist. Every line he cut was straight, everything he made was beautiful, and I could see how he had earned the respect he got from other technicians around him. Fortunately I didn't need to learn how to be popular. I just needed to learn how to make good braces. Watching the sequence he used to complete each task was all I needed. I watched the way he stood at the router, how he held a Surform file, which sand sleeves he used, and everything else he did. Through him I realized that the science of O&P fabrication is at least half art.
To be great at O&P you also have to be great at solving problems, and the first step toward a solution requires a keen understanding of the problem itself. Foot drop presents a problem, a missing limb presents a problem, and to solve these you need to know more than just what you did to fix the problem last time. You have to know what is wrong from a physiological standpoint. You have to know what worked for others, what hasn't, and what might work if you have the courage and imagination to try. If you can envision a holistic solution to the problem, you can deliver amazing answers. Diagnostic skill is unquestionably one of the keys to greatness.
I got fired because of my problem-solving skills once. I was working with a prosthetist who I considered to be a gifted practitioner. He had the ability to home in on a problem and fix it. He always taught me to look beyond the obvious and try to find not just the symptoms but the cause. Once when he was on vacation, the owner of the company asked me to shorten a prosthesis because the physical therapist said it was too long. I immediately thought that was odd. I knew that this prosthetist would never deliver a prosthesis if it was too long. I quickly found out that the length of the prosthesis wasn't the problem at all-the patient simply was wearing too many socks, which prevented his residual limb from fitting all the way into the socket. After removing a few ply of socks the fit was perfect. I reinstructed him on proper sock fit and everybody was happy-everybody except the owner. To him the answer was simple: I should have done what the therapist wanted and shortened the leg. It didn't matter what the actual problem was or that there was a positive solution. Even though I got fired, the patient got what he needed, and I went on to bigger and better things.
I think one other aspect of greatness we could agree on is that a great technician has to have an excellent understanding of materials and tools. Since we make things, materials and tools are critical. Over the last ten years we have seen an explosion in the number of materials available to our industry. We now have dozens of resins at our disposal and a dizzying array of foams, gels, and fibers from which to choose. Having an understanding of these materials, their properties, and even their chemistry can significantly broaden the scope of possible solutions to any challenge that comes our way.
I remember being encouraged to take home catalogs from the lab. Poring over them at home gave me a lot of information about what was out there, and it didn't take long before I developed an obsession with materials. I started subscribing to magazines from the boat and aircraft manufacturing industries; I ordered catalogs from their advertisers and read all of them too-tool companies, chemical companies, even electronics suppliers. Every one of those resources had something that would come in handy, and I even started relationships with suppliers I still go to today when we need to push the envelope.
Mastering the tools in the lab, and even making specialty tools, has always been a part of this business. There are a lot of things we do that tool suppliers just can't accommodate, so being able to adapt tools from other industries or being able to make your own tools has a long history in O&P. I was lucky enough to work in one facility that had been in the same location for decades and had seen a lot of talented technicians come and go. One of the things I appreciated most about this facility was the array of old tools I had at my disposal. There were the usual power tools, bandsaws, routers, and drills, but there was also a great collection of old hand tools. The collection contained everything from pulling tools and horizontal fabrication jigs to one of my favorite rare tools, a bench-mounted press for installing aglets, the little metal ends on shoelaces. That archive showed that through better tooling we could do better and that any one of us has the power to innovate.
Beyond all of these attributes specific to technicians, there are some aspects of greatness that are the same regardless of the industry. I think one of the principal ingredients is a passion for your work. There cannot be a single more powerful propellant toward greatness than a simple passion for the task at hand. If you love what you do, it becomes a part of you. If you think about it all the time and you would do it even if you weren't getting paid, it's likely that you are passionate about your job. And there is a good chance you are headed toward greatness.
All of the great technicians I have known possessed all of the qualities I've mentioned: great artistic skill, excellent problem-solving skills, a deep understanding of the materials and tools we use, and a passion for their careers. They also seemed to have a disdain for the status quo, and most of them had a near-pathological desire for the people around them to be great as well. I have been lucky to know a few great technicians over the past 30 years, and looking at the entries in last year's fabrication contest left me with the confidence that there are plenty more where those came from.
Tony Wickman, CTPO, is the CEO of Freedom Fabrication, Havana, Florida. He can be reached at