Reimagining Mobility. Advancing Research. with Fanny Schultea

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Welcome to season 14 of the Prospects Protopics Podcast.
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This is where we connect with experts in the field, agents who use these devices, physical therapists, doctors, and defenders to help bring it all together.
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Our mission remains the same: to share stories, tips, and insights that help improve patient outcomes.
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Tune in and join the conversation.
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We're glad you're here and hope it's the highlight of your day.
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My name is Doris Beals, and this is another episode of the Prosthetics Orthodox Podcast with Brent Wright.
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How are you doing, Brent?
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Hey Yoris.
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I'm doing well, man.
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Uh I had a question for you.
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You know, when we first started this podcast, I mean it's been almost four years ago or what have you.
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Yeah, it's been a while.
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Would you would you say, uh I know you say that you've learned a lot, but uh like I posted this post uh a couple days ago on LinkedIn, and I literally had a contract manufacturer reach out to me and say, Hey, Brent, love what you do.
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We want to get into O and P.
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If you can just spend like a couple hours with our engineers so we can learn how to make prostheses, we're gonna be good to go.
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And um sounds like a credit, huh?
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And I was like, it's gonna take a little bit more than a couple hours.
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And uh but but all that to say is I was able to kind of direct towards our podcast and be like, hey, these are some things that you may want to consider and just educate around it.
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But as we get further and further in, and I know even for me from the clinical side, I it's it's amazing the body of knowledge that is even untapped within OP.
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You know, we've captured a lot of it on the podcast, but it's like we just keep on going deeper and deeper and deeper.
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And it's like you're not gonna capture anything in two hours.
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So, but I do know that like even when we first started, you and I were having the discussion of like, why doesn't everybody have a desktop printer and print their own prosthesis?
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It seems easy.
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Would you say your opinion has evolved over time now that we're getting deeper into this?
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Or or where where are we at?
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It's still well, what I what I think I kind of knew in the beginning, but has really crystallized for me, is the whole idea that it's quite a unique profession in essence that it is a lot of people stuff, people work.
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There's artisanship, there's engineering, and there's also a lot of management work in the sense that that you're even in a really small team, you're probably managing a couple of people or a couple of interactions.
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And then on top of that, there's also like all this paperwork and stuff like that.
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And and the whole insurance paperwork thing is just stuff the stuff I did not know anything about.
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Um I did not anticipate how big of a deal that was for for individual practitioners.
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But that kind of really varied kind of thing, that you're an entrepreneur in some cases, or even if you work for your own boss, you have to do a lot of different things at the same time.
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That was something I really got an an uh an appreciation for while doing this.
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How varied this is how different it is from nearly all jobs I know.
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And that that that on one hand.
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And on the printing side, I mean, I I've seen it be more applicable, but maybe really very to very specific areas, where in the beginning I was like, we're just gonna print everything.
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You know, so I've become much more nuanced and saying, okay, it could be really good for areas where we really literally the interface layer between the human and the prosthetic.
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And then beyond that, well, okay, if we can just get that interface layer right, would we solve so many issues and so many problems that that that could be uh it should be a real area of deep focus rather than like kind of more naive seems now like let's print all the processes all the time kind of approach that I had before, you know?
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So that's a bit different, I think.
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Yeah, yeah.
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And how about you?
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Have you learned stuff though?
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Because I know I'm learning that crazy because I didn't know anything when we started, but how about you?
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Are you learning stuff?
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Well, so I think one of the things that I've just learned over the years with this is you have to have kind of your foundational point.
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And I know you and I have always discussed, like, where do you start?
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And it's always the scanning.
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And I've always skipped that step because I felt like that we've had we have really good tools for one, and we just go straight into printing and then, you know, powder bed fusion.
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And what happens is that so many times people are like, hey, Brent, you're doing some really cool stuff.
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And I know I'm never gonna get there, so I'm just not gonna start.
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And so we've kind of had to step back and be like, okay, we don't want that to happen.
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We want you to start.
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So how do you get going just with scanning?
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That's the foundational aspect of making anything, is you've got to have a well-fitting socket, good data.
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How do we get that into the digital space?
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And then we can build from there.
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And that's really kind of the drum that we're beating now is like, get yourself started, get scanning, and then you can build from there.
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Okay.
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All right, that sounds very sensible.
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So, um, uh, who is the next person to join us on this journey?
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Who's who's gonna who are we gonna be uh talking to today?
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Well, I'm really excited to have Fanny Schulte on the podcast today.
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She brings a uh we're gonna have a lot of fun because there's so many hats that she has worn in her.
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She has a military background.
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She was actually uh deployed in Iraq back in the early 2000s.
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And then from there, she went on to become a prosthetist.
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And she worked for some of the big clinics uh hangar, um, sablich.
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And then she became an assistant professor at Baylor College of Medicine.
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She was also part of the American Academy of Orthodox and Prostus.
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And I think one of the things that I'm really excited for her to dive into on, not only that whole journey, but where we are today is she's the executive director for the Orthotics and Prosthetics Foundation for Education and Research.
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One of the neat things that they do is they create both microgrants and larger grants to help research and education in the orthotic and prosthetic space.
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So there's a lot of cool things coming down the pike, and they're doing things different.
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And that can sometimes be very positive, but then you're also trying to buck a trend of being complacent, I guess, for the many years that we've been complacent as a field.
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And the neat thing is they're an independent organization, so they can do whatever they want.
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And so they can also guide and direct where innovation is going to happen in orthotics and prosthetics and in the education space.
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And so I think it's going to be a really good discussion today.
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Awesome.
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Sounds good.
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So welcome to the show, Fanny.
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Thank you.
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Thanks for having me.
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And uh so tell us, how did you get involved with OMP?
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Yeah, isn't that the origin story question?
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Uh so I have a pretty diverse background.
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Like Brent was saying, I've this is my third career.
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Um, so I actually started out, I'll I'll keep it short, but the journey is relevant.
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I uh started out in um textile design um and fashion design back in the 90s, doing a lot of work with trying to develop wearable technology at a time where it wasn't really uh part of the zeitgeist or the conversation.
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Um, there was a lot going on at the time, including uh 9-11, which was really my uh my call for uh for service to our country.
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So I'm a post-9-11 uh combat veteran.
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So I signed up uh for the U.S.
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Army pretty shortly after 9-11 and uh made my way to Texas and uh was stationed here at Fort Hood and and deployed to Iraq in 2005.
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Didn't realize it then, uh, but was exposed to quite a bit of trauma track injuries and um limb loss and certainly uh mobility challenges uh in my colleagues, my peers, and and others.
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So I was, I guess, exposed initially to ONP that way, but it did not occur to me to pursue it as a profession.
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So when I uh finished my time in service, I actually got into um exercise physiology.
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I became a strength and conditioning coach through the NSCA.
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I was also a certified sport nutritionist.
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So I was really on the trajectory of exercise physiology.
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I was getting ready to apply for PhD programs.
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I mean, I was a completely on a different track.
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And we had some colleagues uh that were rock climbers.
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I'm a rock climber, and one of them was um physician assistant at the VA.
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And they encouraged me to come check out the prosthetics department just because of my combination of interests with, you know, human movement and performance, as well as my background in fashion and textile design and wearable technology, they said, you know, this is kind of an interesting convergence of all of those spaces in your past.
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And so I just, you know, I figured I would just go check it out.
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And I did.
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And I actually walked by a um shoulder disarticulation, like myelectric, full myelectric fitting.
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And I was like, holy moly, what is this?
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This is this is incredible.
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And so literally just like that, I kind of dropped out of uh the PhD process and redirected my time to just volunteering in the prosthetics department at the VA in Central Texas by Ford Hood.
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And one thing led to another.
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And I um was actually one of the inaugural uh graduates of the Baylor College of Medicine program down in in Houston and worked a little bit in clinical practice and uh realized that I would have a greater impact if I went into education.
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So for the last 10 years, I spent on faculty at the Orthotics Prosthetics program in Houston, at their master's program.
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It's uh was the first integrated program.
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So those are academic programs where the students continue under the oversight of the program to perform their ONP residency.
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And so we were the first, and it was an incredible experience.
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And again, I was able to, you know, impact more patients through education and, you know, elevation of standards through teaching.
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But I also realized that I think Brent alluded to this, the academic environment was a little bit more limiting for me.
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And some of the changes that I wanted to see and hopefully influence and impact across our profession was just not feasible from that, from that vantage point.
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So in 2023, I joined the ONP Foundation, which was the result of a merger between the smaller grant and scholarship funding entities under AOPA and the Academy.
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And we became completely independent.
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So we're the only, the first and only 501c3 public charity that serves ONP professionals across the continuum of care, across the continuum of the professional space.
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So we support students, residents, orthodists, prosthetists, pedorthists, ONP assistants, administrators, fitters.
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We support researchers at all stages of their career.
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We support clinicians at all stages of their career.
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So ideally, if you want support as an ONP professional, you can turn to us to support.
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And that that support comes in the form of funding, so money.
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And uh so this I like that you've had so many very, very clear choices and differences of stuff.
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Is it if we look at and I like that you're kind of uniquely positioned to to to to uh answer this also because you're viewed vantage point now?
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If we're talking about the the the individual profession, like OMP professional in today's labor market in today's world, is that a really challeng is that a really challenging position?
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Is it a really desirable position?
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You know, does the industry have to worry about making that job more challenging or more rewarding or pay more?
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Or is there anything, you know, with the core job, the core orthotest and process profession profession, is that still valid and is that still very, very uh a nice place to be at the moment?
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That is a very loaded question that I will unpack.
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I'll unpack that carefully.
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So our field, our profession is always rewarding, right?
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It is probably one of the most rewarding professions you you can have.
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I mean, you are spending a tremendous amount of time with patients more than any other healthcare provider.
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You are restoring, transforming people's lives, all right, giving them their families back, their careers back, their, you know, self-esteem back, their purpose back, and their confidence.
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I mean, who who would not absolutely love to engage with that daily?
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It's also a profession that appeals to people who enjoy solving complex problems.
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I mean, look, that's that's why I got into it.
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You know, I was looking at it initially as a way to engage with the man-machine interface, right?
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With wearable technology, with how do we bridge that gap.
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It's a complicated problem to solve.
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And that continues.
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It is still a complicated problem to solve.
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It's become more interesting and complex because of the advancements in material science and manufacturing techniques and all of the things that you are uh both very aware of.
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But there's additional complexities.
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And I think those are the more difficult complexities to address.
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Those are the environments of the healthcare system, the payment structure, the policy and the regulatory construct in which all healthcare providers have to interact and operate.
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But for us, we're uniquely positioned because we're at the intersection of a really innovative and technologically advanced industry sector and a architecturally antiquated healthcare profession that is catching up to the rest of healthcare, but also healthcare in itself is an antiquated model that is not designed to foster innovation.
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And so there's sort of two conflicting agendas and incentives that collide at the workbench and at the bedside of the orthodost.
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And so it's it's an interesting challenge, you know, from my perspective, with an organization that funds programs to support professionals who ultimately, at the end of the day, without these professionals, patients can't access the care that they need and deserve.
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And for these providers, it becomes more and more challenging because we have fewer and fewer CPOs.
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Many are leaving the profession.
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Many are struggling with balancing the patient load that they have because we have so much demand across the US and, you know, don't even get started on global demand.
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But in the United States alone, with the generations shifting and the need for orthotics and prosthetics increasing at an exponential weight, we're just not, we're not able to keep up with our training and preparation for our clinicians.
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So it's challenging.
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It's a challenging space to be in for sure, but it's incredibly rewarding and and very worthwhile.
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And so the real complex problem to solve is how do we continue to provide the highest quality, most accessible care to the patients who we enjoy serving every day in the healthcare system with technologies and innovations that can really move the needle on outcomes and still keep the clinicians engaged for a lifelong career?
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And that there's a there's this weird thing because normally, hey, if there's increasing demand, some we're all going to make more money, right?
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Or we're gonna be utilization rate's gonna be better, so then we're gonna be paid more.
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So is there a bit like is there like a market mechanism that's broken here that is keeping that from uh kind of the market from solving itself?
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Or is it is it a different kind of problem that is really uh fundamental?
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Yeah, there's definitely there's definitely a problem.
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So I think part of the problem is the construct of the care delivery.
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We I think the best example is when you go to a dentist's office, right?
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You go to the dentist's office, you interact with several different care providers before you get to the dentist.
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Everyone has a very well-defined, clear role.
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Um, there's incredible technology at the dentist's office, actually.
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I just had a an implant done last year, and uh everything was 100% digital, 100% 3D printed, 100% smooth, and the outcomes were incredible.
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And I probably spent only a few minutes with a dentist at each of my visits.
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And so really, I think what we need to be considering is innovation and care delivery to replicate a little bit more of what a dental office feels like, right?
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You have price transparency, you have someone who's in charge of speaking to you about that, you have someone who's working on, you know, your outcome measures, you have someone who's working on, you know, some preliminary assessments or measurements.
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And then you have the clinician that comes in for the core of their work, which is really to evaluate a patient and generate a treatment plan and oversee a care team.
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You know, the care team could be anyone ranging from an orthotic prosthetic assistant to an orthotic fitter, technicians are part of the care team, office administrators are cared part of the care team.
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And really, we should be getting to the point where we're coordinating care for our patients.
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So we'll be able to see more patients, provide them with higher quality of care.
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And so we just don't have the mechanisms built out yet for that workforce pipeline.
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So there are many entities working on this.
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We're funding programs to help, you know, a little bit to support folks to get into that space.
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And there are many uh care delivery organizations or, you know, patient care organizations that are working to this end as well.
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I think everyone recognizes the problem.
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And we can only generate so many clinicians every year.
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So we need to generate the support network for those individuals.
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Okay.
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That seems like a really sensible thing.
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But but and and us to those people that are leaving, do you know why they're leaving?
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Is it have we been able to study more about like what the because we've heard kind of vague people, you know, in one way or the other saying about why they would want to leave or why they see there's a pressure.
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Do you see where where why the what are the individual reasons why these people or folks are leaving kind of mid-career after doing the study or after being in the uh in the uh in the field for a bit?
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Yeah.
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So there's unfortunately there's no like formal study or or any meaningful research in this area.
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I think we just all have some anecdotal assessment of it.
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You know, I think it depends on the generation that's leaving, right?
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So if you have someone who's mid-career, I think in many cases there's limited upward mobility for practitioners.
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And so I think after a certain amount of time in a career, people look to expand outward.
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And if that opportunity is not available in patient care in the clinical practice, there's other opportunities, whether it's education, working with manufacturing and research and development or different opportunities that are um sort of auxiliary, but the people still stay in the space.
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You also have younger, um, younger practitioners who are just starting out who really went straight from college, incurred a fair bit of debt to go into this field.
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That's another kind of interesting area that we're dealing with right now at the federal level.
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But the reimbursements are decreasing.
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The salaries may not be reflective of the investment in time and expense in getting into this field.
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And so that might be just an early deterrent burnout.
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So again, a lot of people need our care, and there's not enough of us to provide it.
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So inevitably, that burden is on the clinicians.
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And with a care delivery model that doesn't integrate care extenders and assistants and fitters and the like, um, you just that burden just gets passed on to the clinicians.
00:19:10.319 --> 00:19:18.559
So I think you have burnout and you have sort of an immediate straight to master's option, whereas many other spaces you can kind of progress.
00:19:18.720 --> 00:19:34.160
You know, if you start off as a technician or start off as an assistant, then you can get a sense for what the space is like and then continue to to kind of move up the stair stair steps to get into clinical practice and and perhaps have a better sense and more of a commitment once you get there.
00:19:34.319 --> 00:19:38.559
I I think there's tremendous barriers to to entry in the first place as well.
00:19:38.720 --> 00:19:40.720
Just the cost of education is increasing.
00:19:40.880 --> 00:19:43.759
This is not isolated to orthotics and prosthetics.
00:19:43.920 --> 00:19:48.319
There are some federal activities right now that are highlighting this phenomenon.
00:19:48.400 --> 00:19:53.359
You know, there's student loan caps that are gonna go into effect this summer for graduate schools.
00:19:53.440 --> 00:20:02.160
This is going to impact orthotics and prosthetics master's programs, and the ability for more people to attend those programs is going to decrease.
00:20:02.400 --> 00:20:11.519
There's other things down the pipeline with the Department of Education regarding reporting about salaries and prospective earnings for graduates.
00:20:11.680 --> 00:20:19.920
This is really good for the student loan crisis, but this may create some initial disruptions for for orthotics and prosthetics, as it will for other healthcare professions.
00:20:20.160 --> 00:20:20.319
Okay.
00:20:20.559 --> 00:20:21.519
That sounds really sensible.
00:20:21.599 --> 00:20:30.400
And and and, you know, beyond this, I think I think are there other solutions to just because it, you know, it seems like the the logical solution there would be to have really efficient operators.
00:20:30.480 --> 00:20:34.319
And then we get to this whole like ginormous McDonald's-like corporation takes over.
00:20:34.480 --> 00:20:35.200
But is there a solution?
00:20:35.359 --> 00:20:38.000
Let's say I have my own practice, because all these practices have the same problem.
00:20:38.079 --> 00:20:39.680
Like I don't have anyone that takes it over.
00:20:39.839 --> 00:20:42.559
I have too much work, and there's a young person who's not earning enough.
00:20:42.640 --> 00:20:54.160
So it seems to be that the that like rather than selling your practice to someone having kind of an earn-in kind of option and then making that process more fluid to take over that business, seems like it could deal with a lot of problems at the same time, right?
00:20:54.480 --> 00:21:01.759
I mean, yeah, you know, there's a lot of different things happening across um across the industry in in the US to try to solve these problems.
00:21:01.839 --> 00:21:05.920
And I think it's just a matter of time to see which approach will be the most effective.
00:21:06.160 --> 00:21:28.079
I think from the ONP Foundation standpoint, where we see the opportunity is that if we know that there's a need for more care extenders and we know that there are barriers in the cost of education, we can't change the system, but we can fundraise, raise awareness, and put some of those investments towards breaking down some of those barriers.
00:21:28.319 --> 00:21:41.680
You know, we're working very hard over the next couple of years to scale this more so that we can have a greater impact, so that greater investments can go towards addressing these issues while they're being resolved at a system level.
00:21:42.000 --> 00:21:43.839
This is really similar with research.
00:21:44.000 --> 00:21:56.000
You know, you may not be aware, but federal funding for research in orthotics and prosthetics has been functionally absent for the last several years, and it's not looking like it's coming back online in a meaningful way.
00:21:56.160 --> 00:21:59.759
And we are also going to start over the next few years perhaps seeing.
00:22:00.960 --> 00:22:08.559
In the researchers who are expert in this space, which, as Brent alluded to, you know, it's a very nuanced field.
00:22:08.799 --> 00:22:14.240
And losing talented researchers in a very nuanced space is a huge loss.
00:22:14.400 --> 00:22:31.680
And so, you know, whereas we can't, we're not in a current position to provide safety net funding or anything, you know, significant to that effect, but, you know, our goal is to be able to do that one day and to highlight some of those deficiencies and challenges, just like those that are facing students and early stage clinicians.
00:22:31.839 --> 00:22:37.759
And the same is true again, you know, with clinicians who are working, who are considering leaving the profession.
00:22:37.920 --> 00:22:53.119
Maybe they're not getting the appropriate amount of professional development so that they can sort of self-actualize as an orthodist prosthetist or feel like their employers are investing in them or feel like they're getting new skills and attributes to bring back to their patients.
00:22:53.359 --> 00:23:09.680
And so we support continuing professional development programs so that we can try to, you know, recognize clinicians, give them an opportunity to continue to develop their skills to learn about the different innovations and bring them back to practice and bring them back to their patients.
00:23:09.839 --> 00:23:20.720
So it's it's kind of like a multi-pronged approach to help with some of these issues while the entire profession really needs to examine systems level changes.
00:23:21.039 --> 00:23:23.759
So we've heard the character and the thing come up a couple of times.
00:23:24.000 --> 00:23:25.680
How is it going with training these people?
00:23:25.759 --> 00:23:33.759
Is there like other tons of people who would want to become this, or do we still need to do more to uh, you know, attract people to this as a profession?
00:23:33.839 --> 00:23:36.079
Is that is there a pipeline of these people coming or not?
00:23:36.480 --> 00:23:44.160
There's different entities doing different things across our space to try to bring in these individuals, train these individuals.
00:23:44.319 --> 00:23:48.160
There's currently no kind of standardized approach or pipeline.
00:23:48.400 --> 00:23:59.759
And I think uh, you know, ABC over the last few years has engaged in some very robust awareness campaigns just around our profession in general, regardless of clinical position.
00:23:59.920 --> 00:24:04.000
And it's clear that there is a like a professional awareness deficiency.
00:24:04.160 --> 00:24:07.279
So I would say it extends to this community of folks as well.
00:24:07.519 --> 00:24:12.079
You know, I think there's a low awareness that this is even a career pathway.
00:24:12.319 --> 00:24:16.720
We don't even have that many certified ONP assistants out there in in general.
00:24:16.960 --> 00:24:24.319
And I think the over the next several years, you'll see more and more training opportunities and programs kind of coming online.
00:24:24.640 --> 00:24:32.720
I think you'll see um increased sophistication in the pathways that are available to these individuals, as well as the awareness campaigns around it.
00:24:32.880 --> 00:24:36.640
So let's the other thing is is is we're seeing well, so a little bit about technology.
00:24:36.720 --> 00:24:46.400
I think it's it's it's interesting you worked in wearables like way back when, say, and now we're getting these aura rings and smart watches for for for kind of uh, you know, your phone could do a lot more.
00:24:46.640 --> 00:24:50.400
How are you seeing this wearables impact the OMP world now?
00:24:50.559 --> 00:24:54.240
It could be a tool, it could also be a threat to certain extent to a certain extent.
00:24:54.400 --> 00:24:57.359
How do you see that wearables world now and OMP kind of go together?
00:24:57.680 --> 00:25:01.680
Yeah, I mean, definitely goes together very well, right?
00:25:02.079 --> 00:25:14.640
And certainly from our standpoint as an organization that supports less so on the research and development and really more so on kind of implementation science, outcomes research, and and really clinically relevant research.
00:25:14.880 --> 00:25:28.240
I think wearables and and tracking devices are going to be an important piece of that puzzle so that we can, you know, demonstrate the value of the work that we do through through data collection, through these, these wearables, whatever they may be, right?
00:25:28.319 --> 00:25:38.720
It could be your your Apple Watch, it could be your Aura ring, or it could be um, you know, a ONP specific device that's installed within a socket or within a brace for wear time.
00:25:38.799 --> 00:25:46.640
And um, there's without that data, it's it's gonna be hard to be as effective um at at collecting those outcomes data.
00:25:46.799 --> 00:25:48.720
So I think it's uh gonna play a really critical part.
00:25:49.119 --> 00:25:52.880
And just just a little bit more generally about research, where is it really needed?
00:25:53.039 --> 00:25:55.519
Where do you see a real frontier for OMP research?
00:25:55.680 --> 00:25:57.440
Or where is it really needed to do more?
00:25:57.519 --> 00:26:00.000
And and where would you like to fund more if you had like more money with the phone?
00:26:00.400 --> 00:26:00.559
Yeah.
00:26:00.720 --> 00:26:06.720
Um Well, I think the research across all the whole space needs to be increased and improved.
00:26:06.880 --> 00:26:21.759
But from our standpoint, or organizationally, I think that our main priorities are to really facilitate research initiatives that will support the orthotics and prosthetics and pedorthics profession to demonstrate its value in the healthcare landscape.
00:26:22.000 --> 00:26:24.480
So, what kind of research initiatives do that?
00:26:24.559 --> 00:26:27.119
You know, it's really outcomes research.
00:26:27.359 --> 00:26:29.759
It's economic analyses, right?
00:26:29.920 --> 00:26:35.759
It's comparative research for demonstrating the value of the interventions that we provide.
00:26:35.920 --> 00:26:38.000
How does this improve patient outcomes?
00:26:38.160 --> 00:26:42.000
How does it improve the quality or, you know, how are we working to improve the quality of care?
00:26:42.240 --> 00:26:45.440
Care system is moving towards value-based care pretty rapidly.
00:26:45.599 --> 00:27:00.640
And I think we have an opportunity to engage in the type of research that will support the infrastructure for value-based care for us to be able to participate in that and to keep our sustainability as a profession that has a tremendous impact on patients.
00:27:00.799 --> 00:27:04.960
We just historically haven't done a very good job on communicating that impact.
00:27:05.119 --> 00:27:09.119
And we're sort of at a an inflection point now where we need to start doing that.
00:27:09.200 --> 00:27:17.599
So it's going to be any research that demonstrates our impact to the third-party payers, to the regulators, to the legislators.
00:27:17.759 --> 00:27:20.319
You know, we want to increase access for patients.
00:27:20.720 --> 00:27:21.920
And and that's kind of interesting.
00:27:22.000 --> 00:27:23.759
This value-based shift, right?
00:27:24.000 --> 00:27:28.720
That's kind of interesting because it seems like it could really benefit OMP because I couldn't walk, now I can walk.
00:27:28.799 --> 00:27:29.839
That seems like a no-brainer.
00:27:30.000 --> 00:27:33.279
Like, but do you have any kind of insight on is that a positive development?
00:27:33.359 --> 00:27:39.519
Is it does it look that good, or is it going to allow a lot more kind of vague interpretations that will actually make it more difficult?
00:27:40.000 --> 00:27:40.960
It's a great question.
00:27:41.039 --> 00:27:43.599
You know, I don't think anyone has an exact answer.
00:27:43.839 --> 00:27:51.599
Actually, AOPA had a leadership conference earlier this year where there was every single attendee participated in a huge debate about this, actually.
00:27:51.680 --> 00:27:52.640
You know, is it gonna help?
00:27:52.799 --> 00:27:53.440
Is it gonna hurt?
00:27:53.519 --> 00:27:54.400
And what do we think?
00:27:54.559 --> 00:28:10.160
And I think the verdict is still out as a non-traditional healthcare field, we will not be brought into value-based care in the same way that that other healthcare providers are, just by the nature of the way that we bill and and you know, the way that we get paid for our services.
00:28:10.319 --> 00:28:22.480
But I think as a proxy and by extension, working with referral sources and and partners that are held to the standards of value-based care, by extension, that that that will be put on us.
00:28:22.720 --> 00:28:29.039
So I think the sentiment is why wait until someone else determines the value that we provide?
00:28:29.200 --> 00:28:37.440
Or why wait until someone else outlines what is considered quality or not in orthotics and prosthetics care?
00:28:37.680 --> 00:28:42.240
That is really the onus is on us to start mapping out what that what that looks like.
00:28:42.480 --> 00:28:49.759
Because there will be a time in the next 10 to 15 years where someone will impose that on us if we don't do it ourselves first.
00:28:50.079 --> 00:29:05.920
I think one of the things that I'd like to for you to dive into a little bit is one, what led you to the Orthotics and Prosthetics Foundation for Education and Research and kind of where you see some things going, and maybe even touching on some of the programs that you currently have.
00:29:06.079 --> 00:29:24.240
Because I think it's super important, like what you were saying, is how do we retain the people that we have, create awareness around our field in general, and then help people achieve milestones, stepping stones, whether it is through assistance, the pedorthic side of things.
00:29:24.480 --> 00:29:33.440
So I'd love to hear that journey, just so our listeners can also see where, you know, it casts a little bit of a vision for the for the future as well.
00:29:33.759 --> 00:29:34.000
Yeah.
00:29:34.160 --> 00:29:37.440
Well, I definitely can talk about that for, you know, the whole day if you have.
00:29:37.680 --> 00:29:43.680
Well, you know, what was attractive to me about the foundation was that it was the result of a merger, right?
00:29:43.839 --> 00:29:55.920
It it marked the recognition that two entities operating in silos realized and and fully acknowledged that they would not be as effective separate as they would together.
00:29:56.160 --> 00:30:02.160
And so that in itself was, you know, very attractive to me because it was different than what had been done previously.
00:30:02.400 --> 00:30:12.799
It was a group of people that clearly acknowledged some of the challenges we face, which I do believe are the very siloed, you know, industry, profession, organizations.
00:30:12.960 --> 00:30:18.960
Everything is really not as integrated as it should be, especially for the complex problems we've we face.
00:30:19.279 --> 00:30:21.920
So that was sort of number one, attractive.
00:30:22.079 --> 00:30:29.920
Again, the people who were involved, the transition board, the leadership at the time were, you know, they were, they were visionaries, honestly.
00:30:30.079 --> 00:30:41.039
They were looking to serve the community without the construct of another organization's oversight and to create something different and an opportunity uh for support for everyone.
00:30:41.200 --> 00:30:51.759
And so it's evolved since then, even in the short time that we've uh been independent, really two years, we've changed and shifted our programs.
00:30:51.920 --> 00:30:53.440
This year's been really exciting.
00:30:53.519 --> 00:30:56.559
So we have kind of like three pillars, if you want to look at it that way.
00:30:56.720 --> 00:30:59.839
We have education, research, and clinical practice.
00:31:00.000 --> 00:31:06.559
And so, you know, with education, we have scholarships and award programs for students and residents, research.
00:31:06.640 --> 00:31:13.279
Of course, it's research grants and uh for clinical practice, you know, professional development opportunities.
00:31:13.519 --> 00:31:22.880
So, you know, just as an example, last year we offered the largest scholarships ever offered in OMP at$20,000 for students' tax-free scholarships.
00:31:23.039 --> 00:31:29.200
Uh, student loan debts are so tremendous,$20,000 is, you know, probably not even enough.
00:31:29.440 --> 00:31:33.119
And those scholarships were increased because we conducted focus groups.
00:31:33.279 --> 00:31:37.119
So we we actually just wrapped up our focus groups just a couple of weeks ago.
00:31:37.279 --> 00:31:47.680
And we have an open comment period right now, and this is how we inform our program development because we serve the community and and who better to hear from their needs than than the community.
00:31:47.839 --> 00:31:56.480
And so the feedback we got is that, you know, these students are extreme uh, you know, experiencing tremendous hardship, and the scholarships need need to be increased.
00:31:56.640 --> 00:31:57.519
So we did that.
00:31:57.759 --> 00:32:00.240
We offer conference travel awards.
00:32:00.319 --> 00:32:08.559
Um, it used to be under NCOPE, but now we've taken over the Larry Lange uh travel awards for residents to be able to attend uh professional conferences.
00:32:08.720 --> 00:32:12.000
That's, you know, extremely beneficial for residents.
00:32:12.160 --> 00:32:20.880
We have a few other scholarships as well, and we just launched actually today um Pedortist as well as OP assistant scholarships.
00:32:21.039 --> 00:32:26.160
So these are kind of full ride scholarships for the both of those clinical disciplines.
00:32:26.319 --> 00:32:30.000
So we're really excited to see the response to those.
00:32:30.240 --> 00:32:40.240
We also are offering conference travel awards for Pedorthists and ONP assistants who typically don't attend in really high numbers our professional conferences at a national level.
00:32:40.319 --> 00:32:42.799
So we're excited to be able to offer those opportunities.
00:32:42.960 --> 00:32:48.880
And also in professional development, the first time ever, we're offering a healthcare quality fellowship.
00:32:49.039 --> 00:32:51.440
So this is an opportunity for anyone in ONP.
00:32:51.519 --> 00:33:04.640
I mean, it could be a clinician, an administrator, a you know, business owner, anyone to pursue credentialing in healthcare quality or to pursue like postgraduate or educational programs in healthcare quality.
00:33:04.799 --> 00:33:17.359
And then of course, with research, we we kind of have a cool model where we create like a stair step where we have, you know, starts off pretty small with microgrants that are small accessible grants for various initiatives.
00:33:17.440 --> 00:33:20.799
You know, clinicians can apply for these, students can apply for these residents.
00:33:20.960 --> 00:33:26.720
You know, if you have a little project that you have in mind and you need some funding, it's kind of like the perfect solution for that.
00:33:26.799 --> 00:33:31.039
And then we have more structured research grants like the mentored pilot grant.
00:33:31.200 --> 00:33:37.519
This is for either PhD students or ONP residents that are doing research with the oversight of a mentor.
00:33:37.759 --> 00:33:46.640
Then the opportunity to get the experience to apply for grants, the experience to like run a research project with structured oversight and funding.
00:33:46.799 --> 00:33:56.240
And then after that, they can stair step and apply for an early career research grant with us, which is for researchers that have 10, 10 or less years of experience.
00:33:56.400 --> 00:34:05.279
So this is really kind of building up these researchers' portfolios, their experience level, and you know, their track record for earning grants.
00:34:05.519 --> 00:34:14.000
Because at the end of the day, if you want to compete nationally for federal grants, because we all hope that one day they will be restored more or less.
00:34:14.159 --> 00:34:17.920
To be able to compete for federal funding, you often need pilot data.
00:34:18.079 --> 00:34:22.400
You certainly need a track record of receiving grants and you need that experience.
00:34:22.559 --> 00:34:24.400
And, you know, the proof is in the pudding.
00:34:24.559 --> 00:34:31.280
Many past recipients of grants have kind of stair-stepped their way into larger national funding opportunities this way.
00:34:31.440 --> 00:34:33.440
So a lot, lot, lots, lots going on.
00:34:33.599 --> 00:34:35.519
We also have a technician award.
00:34:35.679 --> 00:34:48.800
So this is an opportunity for technicians to branch out and expand their skill set, you know, and learn an additional technical skill, do a training, do a course, or get an additional credentialing.
00:34:49.119 --> 00:34:59.280
And, you know, whether it's advanced manufacturing techniques or kind of any sort of new approaches that they can bring back to their everyday work and ultimately benefit patients.
00:34:59.440 --> 00:35:01.599
So lots of new programs coming up.
00:35:01.679 --> 00:35:02.800
I'm very excited about.
00:35:02.880 --> 00:35:08.800
And I think there's a part of your question I didn't answer with respects to kind of what's coming up.
00:35:08.960 --> 00:35:22.559
You know, all of these programs are really great, but at the end of the day, if we only offer one or two awards in each program, while it does benefit those individuals, it doesn't quite move the needle as much as if we were to offer 10 gram.
00:35:23.039 --> 00:35:31.440
And so, you know, we've received over the years financial support and of course, like, you know, engagement support from the ONP community.
00:35:31.599 --> 00:35:40.239
But one thing that we've come to realize in the past year is that at the end of the day, um, we need to raise awareness about this field more broadly.
00:35:40.480 --> 00:35:48.800
We need to gain support both financially as well as, you know, from a communications and marketing standpoint, more broadly.
00:35:48.960 --> 00:35:52.639
And so we are turning our attention outwards to the public.
00:35:52.800 --> 00:35:58.000
And so we actually have a lot of changes coming up at the ONP Foundation over the coming months.
00:35:58.079 --> 00:36:15.599
So stay tuned for those, where we're really going to try to um to raise funds and increase our ability to invest in all of these programs and others so that we can move the needle and increase the impact and broaden the impact.
00:36:15.760 --> 00:36:25.599
And hopefully also bring some attention to the field from corporations, individuals, and entities who might not otherwise would have been looped into what we do.
00:36:25.840 --> 00:36:36.159
Because let's be honest, as soon as someone finds out what we do every day for work and what the patients get from the work that we do, it's a no-brainer.
00:36:36.400 --> 00:36:39.519
Everyone just absolutely falls in love with this space.
00:36:39.679 --> 00:36:45.360
I just think we've historically been pretty bad at bringing anybody else in.
00:36:45.679 --> 00:36:47.119
And it's been pretty insular.
00:36:47.199 --> 00:36:50.880
So I'm excited about the opportunity the O and P Foundation has to do that.
00:36:51.199 --> 00:37:00.400
Do you ever, when you meet somebody for the first time, kind of hold back on, well, I've been to orthotics and prosthetics because sometimes that that rabbit hole can go deep.
00:37:00.639 --> 00:37:01.679
I know I do sometimes.
00:37:01.760 --> 00:37:02.719
I'm like, you know what?
00:37:02.880 --> 00:37:06.639
I don't really want to because people are super interested and curious about it.
00:37:06.960 --> 00:37:08.400
I'm like, I'm in healthcare.
00:37:08.719 --> 00:37:09.039
Yeah.
00:37:09.199 --> 00:37:12.480
You know, every time I go to the doctor, they're like, are you in healthcare?
00:37:12.639 --> 00:37:17.039
Because I always ask, you know, these like kind of pessimistic questions about billing and coverage.
00:37:17.280 --> 00:37:19.840
And, you know, I'm like, yes, I'm in healthcare.
00:37:19.920 --> 00:37:26.400
And, you know, I know that if I start talking, it's going to be a, you know, a 15-minute conversation.
00:37:26.559 --> 00:37:28.880
And because everyone is very, very interested.
00:37:28.960 --> 00:37:31.119
And so I actually do talk about it.
00:37:31.360 --> 00:37:34.000
I'm mentally prepared to talk about it.
00:37:34.159 --> 00:37:36.960
But you're right, I think there is so much interest.
00:37:37.119 --> 00:37:39.920
And I think there's interest because no one's ever heard of it before.
00:37:40.079 --> 00:37:48.719
And there's also interest because at the end of the day, one out of four Americans is going to experience some kind of physical disability at some point in their life.
00:37:48.880 --> 00:37:58.320
They may not necessarily receive a prosthesis or need to use a prosthesis, but I guarantee they will engage or interact with an orthotic device at some point in their life.
00:37:58.480 --> 00:38:02.400
And I think that's also something people come to realize when they hear about the work that we do.
00:38:02.480 --> 00:38:20.719
They're like, oh man, this is probably something I'm where, oh man, grandma or my daughter had to get something like this, or my husband is, you know, um recovering from surgery and you, you know, using a post-op or, you know, there's all sorts of connection points that people make once we start talking about the work we do.
00:38:20.800 --> 00:38:23.360
So I think that also leads to longer discussions.
00:38:23.599 --> 00:38:25.119
But in my eyes, those are good things.
00:38:25.280 --> 00:38:27.119
We really want to spread the word more.
00:38:27.280 --> 00:38:36.079
And I think once people realize how many people we impact, it gets pretty compelling that they would want to support or further their interest.
00:38:36.400 --> 00:38:38.239
We just don't do it often enough.
00:38:38.480 --> 00:38:40.239
And maybe it's because of that, right?
00:38:40.400 --> 00:38:41.599
You don't want to get into it.
00:38:42.400 --> 00:38:42.960
Something else.
00:38:43.119 --> 00:38:45.840
And then you say, well, I make artificial arms and legs.
00:38:45.920 --> 00:38:47.280
It's like, oh, okay, let's ask more.
00:38:47.440 --> 00:39:00.079
And I'm like, well, I'm actually, I mean, I enjoy what we do, but I am kind of curious about some of the uh, you know, other people that are doing the quote unquote more boring stuff, because that's what they'll say.
00:39:00.480 --> 00:39:03.679
I'm just, I just uh I'm a I'm an accountant or what have you.
00:39:04.000 --> 00:39:10.639
I'm like, man, there are definitely probably some stories in that realm that would be uh very interesting to hear.
00:39:11.039 --> 00:39:13.840
Oh, well, you know, the grass is always greener on the other side, right?
00:39:14.159 --> 00:39:14.639
That's right.
00:39:14.880 --> 00:39:16.480
And that's that's the other thing.
00:39:16.559 --> 00:39:28.480
You know, we have been communicating amongst ourselves about what we do for so long that I think just, you know, as a profession, we have lost that glimmer in our eye, right?
00:39:28.559 --> 00:39:37.920
Like that excitement and that inspiration that maybe we had early on, or that maybe we would have if we engaged more with the public.
00:39:38.079 --> 00:39:40.719
And again, it's I don't think this has been intentional.
00:39:40.800 --> 00:39:44.800
I think it's just what happens when a group becomes too insular.
00:39:44.960 --> 00:39:50.960
So, you know, the more we expand out, the more we can kind of restore that excitement and energy.
00:39:51.119 --> 00:39:55.519
And I just think it it's going to be positive uh across the board for everything.
00:39:55.679 --> 00:39:59.039
You know, I think this is probably true for technology and innovation.
00:39:59.119 --> 00:40:10.559
You know, if you it's kind of hard to innovate and build new technology if you're always interacting with the same materials or the same people or the same group of professionals and you're never branching out.
00:40:10.719 --> 00:40:14.400
I mean, some of the greatest innovations happen because there's cross-pollination.
00:40:14.559 --> 00:40:20.480
And I think that's that's true when it comes to funding, supporting, and raising awareness.
00:40:20.719 --> 00:40:33.039
And just like you said, I would love to cross-pollinate with some accountants because there's lots of really interesting accounting problems that, you know, maybe if they heard someone else be very excited about it, they would be reinvigorated about the work that they do.
00:40:33.360 --> 00:40:33.519
Yeah.
00:40:33.760 --> 00:40:36.079
I'd also like to just explore a little bit.
00:40:36.159 --> 00:40:39.840
We have a lot of people that are residents are looking to get into the field.
00:40:39.920 --> 00:40:45.519
So we we covered just a little bit on the orthotic prosthetic assistant side of things.
00:40:45.679 --> 00:41:00.719
But you can you just speak a little bit to, I mean, you you, when I look at your history, you were very intentional about the steps that you took to get the experience needed to become a good clinician, and then obviously into the education.
00:41:01.039 --> 00:41:15.360
Can you just share with our listeners a little bit about, you know, probably shouldn't wing it, and just being intentional about the steps moving forward, specifically when you're talking about this field?
00:41:15.760 --> 00:41:16.000
Yeah.
00:41:16.159 --> 00:41:19.920
I I mean, I think on one hand, things can happen organically.
00:41:20.239 --> 00:41:21.440
Men often do, right?
00:41:21.519 --> 00:41:30.320
When you talk to people who reflect back on their careers, not every step was planned, but I think one thing everyone has in common is that they have voiced interest, right?
00:41:30.559 --> 00:41:36.800
Or done some self-reflection to really think about what they really want and to not be afraid to communicate that.
00:41:36.960 --> 00:41:43.440
You know, I think if we talk about residents, for example, you know, residencies are gonna be variable, right?
00:41:43.679 --> 00:41:46.960
Depends where you're at, depends who your preceptor is.
00:41:47.199 --> 00:42:01.119
But one thing that's pretty consistent is that if you are motivated and know what you want to see, know what you want to learn and understand more or less where you want to go and voice it, people will respect you.
00:42:01.280 --> 00:42:08.000
Likely you will get what you're asking for, or at least make it known and sort of manifest that for yourself.
00:42:08.239 --> 00:42:09.920
I know that's what I did in residency.
00:42:10.000 --> 00:42:14.239
I was very clear about my interests, about what I wanted to focus on and prioritize.
00:42:14.400 --> 00:42:21.679
And you know, when people heard me share those things, they worked to help me get exposure to them or facilitate opportunities for that.
00:42:21.840 --> 00:42:36.960
So I think kind of step one is educating yourself about what is available and voicing your needs and your thoughts about what you would want to be able to take advantage of, knowing what's available to you, and trying to build the relationships.
00:42:37.119 --> 00:42:45.039
You know, I think too often residents and students don't realize that relationship building starts like now or yesterday, right?
00:42:45.119 --> 00:42:46.719
It should have started yesterday.
00:42:46.880 --> 00:42:48.960
And you can kind of see this at conferences.
00:42:49.039 --> 00:42:54.960
You know, a lot of them don't necessarily attend or don't see the value because maybe they aren't needing CEUs yet.
00:42:55.039 --> 00:42:59.760
But what they're missing is this opportunity for connection and for sharing their interests and thoughts.
00:42:59.920 --> 00:43:05.440
You never know who's going to share that interest and thought, and you never know where an opportunity will arise.
00:43:05.679 --> 00:43:08.159
And again, the time to start that is today.
00:43:08.320 --> 00:43:20.000
So I think taking advantage of professional opportunities, national conferences to understand the landscape and understand maybe where you might want to put your energy and ask for it.
00:43:20.239 --> 00:43:21.440
What's the worst that'll happen?
00:43:21.599 --> 00:43:22.880
Someone will say no, right?
00:43:23.119 --> 00:43:23.679
Right, right.
00:43:24.000 --> 00:43:25.039
You just ask someone else.
00:43:25.119 --> 00:43:33.360
Um, and then you just keep asking until you get it, or until maybe you self-assess and you realize there's a different pathway for you.
00:43:33.679 --> 00:43:41.440
But I think too often, you know, we see a lot of these young adults are coming straight from a bachelor's program, straight into a master's program.
00:43:41.679 --> 00:43:43.840
There's fewer and fewer adult learners.
00:43:44.000 --> 00:43:49.199
So a lot of these folks in residencies went straight through school and this is their first job, right?
00:43:49.280 --> 00:43:51.440
This is kind of a hard first job.
00:43:51.679 --> 00:43:52.079
Right.
00:43:52.320 --> 00:43:52.639
Right.
00:43:52.719 --> 00:43:54.320
And and it's intimidating.
00:43:54.400 --> 00:43:59.599
And so I think there's a little bit of a life experience, work experience challenge.
00:43:59.840 --> 00:44:14.159
Um, and so maybe whereas someone who had had a little bit of work experience, had had several other careers, or, you know, was 40 years old is gonna have a totally different way of self-advocacy than a 24-year-old who's only been in school.
00:44:14.320 --> 00:44:24.719
So I think some networking, you know, connecting with other people who are in the same position as you and talking through different approaches that have been successful for other residents are really important.
00:44:24.880 --> 00:44:33.280
And that's again the value of going to these professional conferences and meeting others and connecting with others who are kind of at the same professional stage as you are.
00:44:33.519 --> 00:44:39.119
And I think one last question that I have for you before we close everything up is kind of the rise.
00:44:39.280 --> 00:44:43.119
We haven't talked on this about 3D printing, but just technology in general.
00:44:43.280 --> 00:44:49.039
I mean, you mentioned the shoulder disarticulation and everything that make goes on to make that is technology.
00:44:49.199 --> 00:44:51.280
How do you connect all that stuff together?
00:44:51.440 --> 00:44:57.119
And now we have this whole AI thing that's happening right now, AI and machine learning.
00:44:57.360 --> 00:45:01.440
How do you think that impacts uh our field moving forward?
00:45:01.760 --> 00:45:08.320
Yeah, I mean, honestly, no, no way of knowing what the world will be like in a year, let alone, you know, six months.
00:45:08.480 --> 00:45:11.840
I think it's gonna be another care extender, right?
00:45:12.079 --> 00:45:16.639
Just like it is in other areas of people's work lives, right?
00:45:16.719 --> 00:45:19.119
It allows people to be more efficient.
00:45:19.280 --> 00:45:23.760
It allows people to, in some cases, be more present with their patient.
00:45:23.920 --> 00:45:35.679
It allows more brain capacity or brain power to go towards activities that, you know, require more complex thinking and problem solving, which our field has no shortage of.
00:45:35.840 --> 00:45:47.920
And, you know, in terms of technology, I mean, it's gonna revolutionize many, many technologies in our space, especially like control strategies and different things like that that are already, it's already being integrated.
00:45:48.159 --> 00:45:54.480
So I think it's for clinical practice, it's gonna be sort of a different type of care extender, a non-human care extender.
00:45:54.559 --> 00:45:56.960
And it's gonna be another member of the healthcare team.
00:45:57.199 --> 00:45:57.519
All right.
00:45:57.679 --> 00:45:58.159
That's awesome.
00:45:58.719 --> 00:45:59.679
Fanny, thank you so much.
00:45:59.760 --> 00:46:01.440
I think we can talk a lot more with you, I think.
00:46:01.519 --> 00:46:06.960
Uh, but but thank you so much for for the time you've given us today and uh uh giving us uh your viewpoint on things.
00:46:07.039 --> 00:46:07.280
Thank you.
00:46:07.519 --> 00:46:08.480
Well, thanks for having me.
00:46:08.559 --> 00:46:12.559
I we'll have to do a follow-up when you know the world changes in a year from now.
00:46:12.719 --> 00:46:14.639
I'm sure our answers might be different.
00:46:14.960 --> 00:46:15.519
Totally, totally.
00:46:15.679 --> 00:46:18.960
And uh yeah, and thanks uh as well for you being here as well, Brent.
00:46:19.360 --> 00:46:20.000
This is great.
00:46:20.159 --> 00:46:26.239
And one of the things that I love is this is not a part of ONP that I think a lot of.
00:46:26.400 --> 00:46:40.719
But now that I'm kind of in my second half of my career, I guess you would say, this is the part that I do care deeply about is what's going to happen with the next generation of clinicians, and what does our the future of orthotics and prosthetics look like?
00:46:40.880 --> 00:46:46.719
Uh healthcare environment that we're in with kind of the the cards that we've been dealt.
00:46:46.800 --> 00:46:50.960
And so I'm super excited to continue this discussion for sure.
00:46:51.199 --> 00:46:51.679
Awesome.
00:46:51.840 --> 00:46:54.000
And thank you very much for listening.
00:46:54.159 --> 00:46:56.960
Have a great day, and thanks so much for the prosthetics on