Sports Bracing: A Whole New Game

Although it may be a part of the orthotic practitioner's livelihood, sports bracing is also a game in itself. And, as in any game, you can defend your position on the playing field, you can allow yourself to be driven back--perhaps even completely off the field--OR you can choose to compete aggressively and proactively. Ken Gavin While many orthotists are questioning whether such a battle is winnable or even worth the effort, Ken Gavin, CO , Audubon Orthotic & Prosthetic Services, Colorado Springs, Colorado, is not only achieving success by focusing on sports bracing, but also has evolved some enlightened perspectives on earning goodwill and respect and growing his business in this specialized area. Gavin limits his practice to sports medicine, although his partners handle pediatric and rehab as well as foot orthotics. "It's not a done deal, by any means, that the manufacturers' reps or the physical therapists are gaining ground in capturing a significant amount of the referrals," Gavin reports. "Regionally speaking, the amount of referrals is based on the relationship that the practitioner, physical therapist, or manufacturer's rep has with the physician." The ability to professionally fit an off-the-shelf sports brace is probably equivalent, so it comes down to a question of loyalty as well as the relationship with the referring physician. Regardless of who can really fit a brace better, he notes, "the physician historically is not having any problems with patient care with the manufacturer's rep or physical therapists fitting the orthosis--so when the physician makes his choice, it all comes down to loyalty and relationships." The manufacturer's rep has the advantage of selling other items to the physician and also interacting with physicians in the operating room on a daily basis while the relationship grows, based on familiarity and face-time--a luxury most orthotists can't afford. "Very few orthotists are traveling around meeting with physicians on a regular basis about one interaction or another," Gavin points out, "therefore the ability to convince the physician to send a brace to them is limited in the O&P field, where most practitioners are focusing on custom items for patients with more advanced needs." While the O&P industry has some history of releasing sports bracing into the hands of manufacturers' representatives, due to their historically closer relationship with the physicians they visit, the time has come to change this pattern, Gavin believes. To continue the development of O&P as a profession, Gavin feels that orthotists must stay within the medical profession as active participants; they can't afford to cherry-pick, since the likelihood is that off-the-shelf items will become more prevalent and cost-effective, giving the manufacturer's reps and physical therapists an increasingly larger share of the bracing business. "They're not just going to stop with sports bracing," he predicts. The solution, Gavin believes, is threefold: (1) Consider hiring a marketer. Assess the financial impact and the added value that a marketer could bring to your business. Identify someone who can devote the vital time to spending face-time and building trusted relationships with area physicians on your behalf. In the beginning, you are going to have a cost: either a representative, a marketer, or even limiting the clinical work of practitioners within the office to make them available for this duty. In the end, that cost will more than likely benefit the company with increased referrals due to the improved relationship. Granted, it is an investment and no returns are guaranteed. (2) Gavin stresses the importance of developing a strategic marketing plan to serve your specific goal(s). Reevaluate frequently, and if you are not reaching those goals periodically, consult an outside expert to advise you or seek appropriate education for your appointed marketer. "People study and earn PhD degrees in marketing," he warns. "Sending a practitioner out and just marketing may not work. You might consider supporting a local or regional continuing education meeting for the orthopedic community--your sponsorship banner could gain you a lot of exposure." (3) Get involved in education. The medical field is changing with respect to partnering with O&P communities for the sake of interaction and education, Gavin believes--an exciting new threshold of opportunity. Naturally, manufacturer's reps are well positioned to support physicians in continuing education and through financial support for a nonprofit foundation. One way to interact and compete with manufacturer's reps, Gavin suggests, is to support continuing education: Have a seminar--bring in (at the O&P facility's cost) an expert in a certain hip replacement surgery or sports ACL surgery and present a symposium, with a half-day of education followed by golfing in the afternoon or some other related benefit. Consider hosting a sports medicine runners' symposium or a ski symposium, based on your geography. "That is a prevalent or new phenomenon, as well. While you may have a partnership, you need to demonstrate what's in it for the good of the community, as well as for other patients," he advises. "So, offering continuing education would benefit the community and its patients, and position you as a valued partner." Kaia Halvorson, CPO , vice president of orthotics for Hanger Prosthetics & Orthotics Inc., Bethesda, Maryland, agrees that education isan excellent bridge to good relationships. Hanger has been offering educational orthotic symposiums four or five times a month--symposiums which stress the added value of referring patients to certified or licensed orthotists. The symposiums educate referral sources and allied health professionals concerning the advantages to their patients--e.g. the more complete continuum of care an orthotist can provide through follow-up, such as adjustments to compensate for swelling or edema, volumetric changes, and anatomical changes. "I think that's helping in a number of ways," Halvorson reflects. "Even the physical therapists and manufacturer's reps who attend these symposiums are recognizing that there is a lot more to orthotic treatment than just putting on an off-the-shelf AFO or knee brace, and perhaps, considering the different variations and modifications we can accomplish, we can have a better outcome than they might, since they are inside an office or facility that doesn't have the options an orthotic practice can offer." Debunking the Obesity Myth The capabilities of contemporary sports bracing suggest that there are more athletes in the US than the popularity of diet programs and obesity statistics would have us believe. The general healthcare of the country has become a huge opportunity for the O&P industry, Gavin believes. Historically, O&P has focused on people who don't take care of their health, but as people become more health-conscious and take on athletic challenges and abilities, they open up new opportunities in the O&P market--with demands for athletic bracing as well as prophylactic bracing. New Opportunities for O&P "I think it's intriguing that the devices could extend beyond protecting a person after a surgical procedure, and may be used in prevention of an injury and ultimate surgery," he said. "As we make patients and the medical community more aware of the benefits of protecting our bodies from injuries, I would say that we're fending off the negative connotation of weight, cosmeses, and lowered performance. New bracing technology, which places the bracing into alignment with the anatomical configurations of the body, does not decrease performance, but actually enhances performance while it helps to prevent injury." The media attention to obesity, health, and dieting will thus, he predicts, drive the public to adopt a more athletic lifestyle in self-defense. "There's no choice. In order to be healthy, you have to exercise. And in order to exercise, you have to get involved with athletic activity," he says. "Formerly the general population, including backyard athletes, used to get athletic bracing or orthotics after they injured themselves," Gavin continues. "But unless you're a regular athlete who lives athletic activity every day, you're probably not going to receive a brace. We'll need to focus strictly on the athletic community, whose needs are basically performance-related." Gavin foresees a need for the orthotist's services to evolve as the sports bracing trend continues to change. If they can humanly perform better, sports performers will become loyal orthotic patients who continue to benefit from sports bracing and/or foot orthotics. "We need simply to stay in tune with the needs of athletes and use our outstanding resources to meet their needs--that's where bracing is going," Gavin points out. "The idea of the people in our country becoming more athletic leads to a natural marriage with O&P. All we've got to do is decide how to cope with the interaction and the relationship we have with the athletic medical community professionals as well as the sports medicine professionals, as well as the athletic people." Chris Jones, MD , of Colorado Springs Orthopaedic Group in Colorado Springs, Colorado, and a leading authority on sports medicine, agrees that the world's health focus seems to be trending toward a more athletic lifestyle. "We live in oasis of fitness. Colorado Springs was ranked one of the most fit cities in the nation, so I may have a skewed perspective. Obesity is not a tremendous problem here. But from a medical standpoint in general, I think our jobs are taking a little more responsibility in terms of prevention versus treatment. That's definitely true." Professional Relationships Jones also agrees with Gavin that trusted professional relationships between referring physicians and ancillary care providers are essential. "It's uncomfortable when I'm not familiar with the therapist serving my patient, for example, because if we're not communicating, I can't be certain that they're accomplishing what I want them to do. That relationship is important--and the same goes for an orthotist. I want to know that they're going to communicate with me, and if they have any questions about any prescription, or how I want something fitted, that they'll speak to me directly instead of guessing' at the correct approach. I think an open line of communication is very important." Jones encourages orthotists to develop such relationships by coming to the physician's office to introduce themselves, perhaps leaving literature or biographical material to detail their background, their level of expertise, and areas of special skill or interest. "The bottom line is that I'm not going to develop a relationship with somebody I'm not comfortable with to begin with. If I'm comfortable with their level of expertise, that would be the person I could potentially develop a relationship with." Jones recognizes and respects the specialized training orthotists possess. "They know the ins and outs of proper fitting techniques and are familiar with the problems that can arise from improper fitting. So while therapists and manufacturers' reps are trained well to do what they do, generally speaking, orthotists are better suited for the fitting of braces. From a physicians' standpoint, many of the orthotists I work with are probably more knowledgeable specifically about braces than I am. Of course I can and do apply the specific orthopedic or anatomical viewpoint from my perspective, but I rely on them to be good at specifically dealing with braces." Given a magic wand and the power to create an ideal world for himself professionally, Jones would look for even closer proximity to the orthotists he trusts. "It would be nice to have them in the same building, so that if I saw a patient that I wanted to be fitted with a particular brace, I could just tell my assistant to call the orthotic guy next door; he'd come over, take a look, and we could fit the patient right then and there. That would be the ideal way--that way I could actually see the brace on him, give it my thumbs up, and send him on his way." A graduate of the University of Missouri School of Journalism, Judith Philipps Otto has been a newspaper writer and editor and has won national and international awards as a broadcast writer-producer. She also has assisted with marketing and public relations for various clients in the O&P industry.

Sports Bracing: A Whole New Game

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