State of the Decade: Looking Forward

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In Part II of our 2019 survival guide, published in the March issue of The O&P EDGE, we asked O&P leaders to examine the evolution of patient care since 2009, and we compared their concerns and expectations—then and now. Experts share more of their insights in the Online Exclusive. 

"There's never been a better time to grow old, and people are living longer than ever," said Kevin Carroll, MS, CP, FAAOP(D), vice president of prosthetics, Hanger Clinic, headquartered in Austin, Texas. "Many 80- and even 90-year-olds who are coming into O&P clinics are very active and have high expectations. I just met a 90-year-old man who had lost his leg above the knee, and he continues to jet ski."

David McGill, JD, vice president, reimbursement and compliance, Össur Americas, Foothill Ranch, California, predicted a trend toward manufacturers providing more than just products to support better patient outcomes: "At Össur, we're in the process of creating a new department that focuses exclusively on business services to help O&P practices deal with the increasingly challenging healthcare environment."

He identified this expansion as a holistic new approach to supporting clinicians and, by extension, end users."It's really an important part of that next decade of evolution in this industry."

Michelle Hall, MS, CPO, FAAOP (D), former American Academy of Orthotists and Prosthetist president, Gillette Children's Specialty Healthcare, St. Paul, Minnesota, noted that 3D printing is "not there yet," despite recent media focus on exciting early developments. "They don't follow such stories longitudinally," she pointed out. "A little kid got that really cool purple arm that looked great for the report on day one; but we don't know if it broke the second day, or if it was chafing the skin and they threw it in the closet and never used it again.

"Because of the durability of our current systems—and because we have more standards, more lawyers, and we provide a different level of medical care, 3D-printed devices aren't appropriate," she said. "Right now, we can't very well heat form the 3D-printed sockets—they don't grind or heat mold well enough to serve as more than a quick check socket."

Although there's talk about printing an AFO, "the material properties for a posterior leaf spring AFO—where we rely on that material to deform but not to fatigue over time—aren't there yet," Hall said.

She predicts that perhaps within the next decade, however, new materials will evolve, and more durable 3D O&P solutions might be available for patients in the United States.

To read "O&P Ten Years Later, Part Two: The Economics of Outcomes," visit