Pedorthics and Online Sales, Are They Compatible?

With a rise in online sales, comfort shoe manufacturers and retailers are facing a dilemma. Do they give customers what they want through the ease of online sales? Or do they give the customers what they may need with personalized in-person service from pedorthists that potentially can help customers stave off an infection or possibly even amputation? On one hand, pedorthics is a hands-on profession. To help meet the needs of their patients, pedorthists have to see, measure, and possibly make casts of patients' feet to ensure the best shoe and the best fit. At the same time, many comfort shoe customers—much as customers for other retail products—are increasingly making their purchases online whether for cost, a greater selection, or to save the time it takes to drive to a store. "There is no denying that in an ideal world every patient would be better off being fitted by a pedorthist," says Stephen O'Hare, president of Pedors shoes, headquartered in Roswell, Georgia. "But at the same time, you have to sell products because if you don't stay in business, nobody wins." In truth, the experts say, there is no one solution. Instead, it's up to manufacturers and retailers to find the balance that works best for their products and their customers. The Demand for Online Sales Statistics show what many of the experts already know: Online sales are skyrocketing around the United States and are growing much faster than traditional retail stores. In 2017, online retail sales were $453 billion according to the U.S. Commerce Department, a 16 percent jump from 2016. In the same time period, retail sales in physical stores grew by 3.6 percent. Sales in the footwear industry are expected to grow as the economy grows, but much of that increase in sales will come from e-commerce platforms. The statistical research site Statistica estimates that 34 percent of the total market revenue in the footwear industry will come from online sales in 2022. To put it bluntly, this is a market that shoe retailers, even those that specialize in comfort shoes, can't afford to ignore. "I think for any business, you can't ignore the online sales channel. Nobody can," says O'Hare. "If you do, then you run the risk of not being able to stay in business. Anybody who denies that is not being honest." O'Hare says that Pedors has had a website since about 2001, but it began as a catalog, not as a sales platform. At the time, his business model of distributing shoes directly to pedorthists was doing well, and he was satisfied because he felt it was in the best interest of the patients to get in-person pedorthic fittings. "The actual e-commerce came later," he says. "We didn't really jump on the e-commerce [bandwagon]. We left it [alone] because we wanted to remain loyal to our pedorthic partners." That business model lasted until about 2008 when the great recession hit and many of the stores that Pedors had worked with started going out of business. "So many of our partners, particularly the small mom and pop pedorthic stores almost vanished overnight," O'Hare says. "We realized we needed to go down a different path." Now e-commerce accounts for about 50 percent of Pedors' sales, O'Hare says. Its website looks like many online shoe retail sites with the exception of the type of shoes it sells. The Pedors site also has many of the offerings of mainstream online shoe retailers, such as free shipping and the ability to exchange shoes that don't fit for no extra cost. For customers who need the perfect fit—in length, width, and girth—the site has detailed instructions for customers to size their feet. Those instructions include guidance about when to take the measurements (when swelling is at the greatest) and remind customers to order a wider shoe instead of a longer one if there is swelling. However, even with these online resources, O'Hare says, there will always be patients who need an in-person fitting. In some cases, such as patients who have neuropathy and may not be able to feel a shoe's tightness, it can be dangerous if they have the wrong fit. He says he always advises patients with medical conditions to consult a pedorthist. The Need for an In-person Fitting Finding the right balance between online sales and traditional pedorthic practices will probably always be tough, the experts say. While some customers may prefer to buy online, their preferences may not be in their best interest. "If a patient is diabetic or has bad circulation, their feet can change two and a half sizes during the day," says Harrson Bai, CPed, MBA, general manager for Apis, headquartered in Los Angeles, California. "A practitioner can help ensure these patients get the right size and see if a modification is needed on a shoe." He adds that there are a wide variety of medical conditions a patient may not be able to self-diagnose, such as one leg being longer than other, that require specialized footwear. "They may have back pain, but don't know it's the shoe they got for themselves," he says. "They don't have the modifications they need like a shoe lift to straighten their spine." Bai says that even with good online tools, some patients require medical attention that no website can provide. "If they have ill-fitting shoes, they may be wearing them without a practitioner ever taking a look," he says. "They may need modification and support and don't have that. Purchases straight out of our retail website may not address the issues you have with your feet." A responsibility to the customer is even more important for the comfort shoe industry than the rest of the retail shoe industry, experts say. People who seek out comfort shoe sources already have foot issues that they are looking to correct. "We wouldn't recommend buying our shoes online unless you see a practitioner first," Bai says. "If a patient is diabetic, once they get the wrong shoes it can lead to an ulceration and an amputation." He added that many traditional shoe retailers simply don't understand the importance of a good fit for these patients. Still, he noted, in this day and age there will always be customers who will choose to shop online before seeing a pedorthist. For those, the experts say, there are some steps that comfort shoe manufacturers can take to help balance the tension between a customer's desire for convenience and an expert's knowledge of what is good for clients. Some suggestions they have include: Combat online sales with great service that customers can't get online. Have a minimum allowed price (MAP) on shoes so online retailers cannot drastically undercut pedorthic retailers. Know which brick and mortar pedorthic retailers sell the brands you carry so customers can go there for an in-person fitting. If possible, offer those resources on the company website so customers can go to the store in person. Understand your customers and their differing needs and make e-commerce decisions based on those needs. Battling Online Sales With Great Service Sometimes the best way to dissuade customers from purchasing shoes online is to give them something they can't get via that channel—exemplary service. Alan O'Hara, CPed, and his wife Amy own and operate When the Shoe Fits. For their chain of shoe stores headquartered in Vancouver, Washington, they had originally envisioned a store where reimbursement through the Medicare Therapeutic Shoe Bill would be a big part of this business model. The former Nordstrom shoe salesman saw the need for expert shoe advice and thought a pedorthic niche was perfect for his community. "I had all of these grandiose dreams of doing a lot of Medicare billing," he says. Unfortunately, that business model didn't pay enough to be the focus of his business. What did work, he found, was offering expert pedorthic services for patients who needed that specialized care and excellent service and products for everyone else. "We just put the best footwear on people's feet and our reputation grew from there," he says. That said, he still has a website that offers online sales. "We are online because we have a fantastic inventory, and it's ridiculous not to have it out there," he says. "You want to be able to advertise your stuff. "Since you are already there, you may as well make some offerings," O'Hara says. The website is not the focus for his store and he says it makes "maybe five to ten sales on a good week." "It's not even measurable," he says of the percentage of sales that come through the website. "Our resources are better spent being a community resource rather than trying to go after online sales…. Our customers get the experience of someone who understands feet and shoes. They learn a lot of what works, what doesn't work, and what additional support they might need. In return, you get a loyal customer and you become their shoe guy." In his stores, he says they focus on getting the best off-the-shelf products, possibly making light modifications and insisting customers try things on. "Once they do it's like ‘Wow, this is amazing,'" he says. "All of the shoes we carry, people are selling online like crazy. But here they can come in and see if a shoe will fit them and if not, they can find something that will." Understand Customers' Differing Needs One of the best ways to balance online sales versus in-person pedorthic services is simply to recognize the needs of the patients, the experts say. For some customers, buying in-person will always be necessary, and manufacturers have a responsibility to recognize that and push those customers toward pedorthic care. At Apis, where almost all of the shoes sold are for those with a clear medical need, selling online is not a focus at all. Even when there are the few sales, most are customers who are buying an additional pair of the exact shoes and size that were fitted for them by their pedorthist, Bai says. "We understand there are a lot of other shoe companies selling online," Bai says. "But the thing is that those are for the 80 percent of customers who don't have serious foot issues. They have normal feet and need a regular shoe. "With our Apis line, our goal is to provide for those who are having a hard time finding shoes somewhere else. It's a different mentality and market sector we are looking for." On the other side, O'Hare says he focuses on the larger comfort footwear market and his website reflects that. While they do have grinders in the store and are willing to help bill Medicare, the purely pedorthic side of the business isn't his focus, he says. "It doesn't make business sense to limit your customer base to just the diabetic Medicare reimbursement market," he says. "There are millions of baby boomers that need specialty footwear for a wide range of medical conditions." For many of these types of customers, the experts say it may be better for them to have an in-person fitting, but it would not necessarily be harmful for them to buy online. In either case, the experts say manufacturers should support pedorthists because of the valuable services they provide for the customers. Supporting Pedorthists Pedorthists will always be important to the comfort shoe industry, manufacturers say. They see it in their best interest to help support pedorthists in whatever ways they can. For example, Pedors has a strict MAP policy and exerts stringent controls for all online pricing for their products, O'Hare says. By protecting the price, it also protects the practitioner from being severely undercut by online retailers that don't have to have a specialized pedorthic staff or pay for a physical storefront. Sometimes customers get an in-person fitting but then turn to the internet in hopes of getting a deal. By setting a MAP, it helps the pedorthists stay competitive, O'Hare says. "We maintain a retail price integrity," he says. "If they look for our brand online, they will see the retail price is really strong." Another way for manufacturers to help is to know which pedorthists are carrying the brand and send customers to them for the sale. "As a manufacturer, we do not want to undermine the efforts of our customers and the patient care they provide," says Brian Lane, education director at Dr. Comfort, headquartered in Mequon, Wisconsin. "We provide the information of local providers to help encourage people to not purchase products without proper measurement and evaluation," Lane says. O'Hare says he has an online directory of pedorthists bookmarked on his computer. If he talks with a customer with serious foot problems, he can search for certified pedorthists in a customer's zip code. An Unknown Future Predicting what will happen in the tension between pedorthic practice and online sales is a challenge, the experts say. Online sales have shown no signs of slowing and, at the same time, the business model of reimbursement through the therapeutic shoe bill has proven difficult to sustain for many smaller practices. "The pedorthists have had a double whammy of not only having seen the Amazon effect, but also a decline in the reimbursement rates by Medicare who has thrown up all of these barriers for diabetic patients," O'Hare says. He added that it may be that pedorthists focus more on the healthcare side of their business and less on retail. "Our message to pedorthists is to network the services they offer as being an integral component of a collaborative health continuum team, which is the direction Medicare is headed with accountable care practices under the affordable healthcare model," O'Hare says. O'Hara says he still believes that there will always be customers who need professional, expert services and are willing to pay for it. With regard to general merchandise, "I see online sales going up and up like crazy," O'Hara says. "But with footwear, I'd like to think that at least in my lifetime, there will always be a desire [for customers] to talk to somebody who knows their stuff and will advise them about what is best." Maria St. Louis-Sanchez can be contacted at msantray@yahoo.com .

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