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In this episode with Elizabeth Mansfield, we explore the evolution of prosthetics and orthotics, emphasizing the influence of education, technology, and personal stories on patient care. She shares her experience and perspective, addressing current challenges and discussing the importance of engaging the next generation of professionals.

• Personal stories shaping careers in O&P
• Shifting educational standards from certificates to master’s programs
• Importance of marketing and continuous education in O&P
• Challenges in reimbursement impacting independent practices
• Attracting and retaining talent in the O&P field
• Integration of technology and robotics in patient care
• Collaborative efforts leading to better outcomes and solutions

Special thanks to Advanced 3D for sponsoring this episode.

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Show Transcript

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Welcome to Season 10 of the Prosthetics and Orthotics Podcast.

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This is where we chat with experts in the field, patients who use these devices, physical therapists and the vendors who make it all happen.

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Our goal To share stories, tips and insights that ultimately help our patients get the best possible outcomes.

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Tune in and join the conversation.

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We are thrilled you are here and hope it is the highlight of your day.

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Hey y'all, I wanted to give you some context to this episode.

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So this episode was recorded last year, so you'll hear some times and dates and such that refer to some acquisitions and things that happened last year but nonetheless still relevant for today.

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So with that, let's hop in.

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Hi everyone, my name is Joris Peebles and this is another episode of the Prosthetics and Orthotics Podcast with Brent Wright.

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How are you doing, brent?

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Hey doing well, joris.

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You know, what was funny is we had that episode come out about the mergers and acquisitions and all that stuff last week and you know we made a couple good guesses on what really went on and it was funny to get some of the messages and things of that nature of like, hey, it was a good guess and you're kind of on the right track and it's not exactly how it went down, but it was fun to get that feedback.

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You know, it's like we're not talking into a chamber, right?

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People are actually listening and finding out.

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And then, you know, your penchant for names was very funny too, yeah.

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I'm sorry, equal.

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I still don't know how to spell it, dude.

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I'm sorry we have to call know how to spell it, dude.

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I'm sorry we have to call them out on this stuff because otherwise it's only gonna get worse.

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And then, and then, 10 years from now, it'll be like equal buys, plink last and schwingling and all this.

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You know it's only gonna get worse.

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If we tolerate it.

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It'll only get worse well, that's how you get the money, though, right, you gotta have the most uh name possible.

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Yeah, exactly, okay, okay, but I'm glad you got a lot of feedback on that.

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That's good to hear, man.

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You know, one of the interesting things on the feedback and maybe our guest today can speak to it and maybe not, I'm not sure but what's interesting on this upper extremity stuff is the reality is the market is so small and it is quite saturated, right?

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These companies typically are acquired when they run out of funding for, like, grant research and and and things of that nature, so that you know they have something that's very, very promising, but the the, the runway has gotten shorter and then it's like scramble mode, and so it appears like some of that happened in all of this as well, where there is something that you don't want to have lost for the sake of great patient outcomes and such, and that's when a company comes in and gobble some of it up.

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But on the TASCA equal side of things, I think what's very interesting is it is a very high-end hand, so for equal to essentially be vertically integrated and be able to provide that hand to their customers is what vertical integration is all about, and you can't get much more double dipping than that.

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You know, not only fabricating the hand, selling the hand to yourself, and then also be getting reimbursed.

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So what a great move.

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Okay, agree, agree, okay, so this episode, do we have a sponsor?

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Do we have maybe a, I don't know, maybe a specialized 3D printing service for orthopedics and you know anybody like that to sponsor us?

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today.

00:03:54.270 --> 00:03:57.774
Yeah, so we've actually got two sponsors for this episode.

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So the first is Advanced 3D.

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I'm a part of that, along with Paul and Tyler.

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We're a contract manufacturer.

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The idea is, yes, we do stuff for O&P and we want to meet you where you are.

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So, whether it's you've never scanned before or you want to look at some definitive sockets and how to incorporate that into your business, or we've had some people say hey, brent, I want to be, I'm a clinician, I'm on the end of my career, I want to go golfing, I don't want to spend time in the lab, so I'm looking for a contract manufacturer that can go ahead and make these things while I'm out on the golf course and then I go fit them, and so we'll help with that as well.

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That's super cool.

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And the second sponsor.

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Yeah, the second sponsor is really great too Limguard, and we've talked a lot about how to protect patients after they've had surgery, and so the percentage of falls of people after they have had surgery is super high and I forget what the exact data point is, but a simple device like Limguard, which is essentially a helmet for somebody that's just had an amputation, is a great way to go great patient outcomes.

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And I think the really neat thing about that is it's a great way for businesses and clinicians to be part of clinical care up front.

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So just part of the program hey, the surgeon says, hey, you're going to have surgery, You're going to get this protector.

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Then four to six weeks later you're looking at some sort of follow-up and then here's a timeline of when you're going to take your first steps on your prosthesis.

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So if you get to do a lot of that up front on the back end, not only is it great patient education, but you're just already part of patient care early on.

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So not only is it great for patients, but it's great for business.

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So I think that's really neat.

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And they offer some branding options too for the socks, so you can have logos on your socks and that sort of thing, so patients know exactly where they got their device.

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So I think it's really neat.

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I think it is definitely underutilized and there's no reason for that.

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The data definitely shows that early post-operative care provides best outcomes.

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Okay, all right outcomes.

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Okay, all right, that's great for LimbGuard and, yeah, you're protecting the leg at his most vulnerable point.

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It seems to be a very, very solid idea indeed.

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Okay, so Brent, who's on the show today?

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Well, I'm really excited to have Elizabeth Mansfield on the show today and I think we're going to really enjoy the conversation.

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She's been around O&P for a long time, not only in the US but internationally, as she does a lot of the planning for shows and such specific shows for orthotics and prosthetics, not only in the United States but for the International Society of Prosthetists and Orthotists as well, and so coming at it from an education side of things is very interesting, specifically when you have the amount of experience that Elizabeth has over an extended period of time to some of the more technologically advanced.

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But then I would guess that she would also argue too that maybe we haven't changed as much as what we thought we've changed as well.

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So, coming from the education side, being in the field for a long time, it's going to be really neat to hear her perspective.

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Okay, well, welcome to the show, elizabeth.

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Thank you very much.

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I am so excited to be here and I think that when Brent says amount of experience I just wrote that down in quotation marks that he was kindly saying she's super old.

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No, no, no, no no.

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That's exactly what I was saying.

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I was like, wait a minute, I'm going to write this down because it sounds like he's being delicately stepping around.

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Like how long has she actually been around?

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But I am so delighted to be here.

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Thank you for having me.

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Okay, and so when did you like you know how did you first get involved in OMP?

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Well, I was literally born into it.

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My dad was nine years old.

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He got run over by a truck when he was putting on his birthday roller skates.

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He was on the sidewalk, he wasn't in the street and a ball bounced out in the road and the truck driver thought a kid was going to chase the ball and he went up onto the sidewalk to avoid the kid that he thought would run out to get the ball and he actually smushed my dad up against a wrought iron fence at his family's house in Brooklyn and he lost his, ended up losing his leg above the knee, and so eventually, as he got older, his prosthetist suggested that he would be a good person to be a prosthetist orthotist.

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So he was going to school at NYU in the certificate program he was working there at school during the day and working there at night, and my mom was a physical therapist at the hospital for special surgery and I was born at NYU hospital while he was going to school and then from there it just continued on and they were in the Peace Corps in the seventies and my dad started the O&P department of the Suva Kripple Children's Hospital.

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So we were very involved in international prosthetics and orthotics.

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That's sort of where my whole interest in ISPO and USISPO sort of came out of.

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And then, when he was the director at Newington Children's Hospital in the late 80s, he came home one day and I don't know what happened at work, I can't ask him anymore but he came home and told my mom that he had quit his job and he was starting his own private practice.

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And my mother said Elizabeth can help you, she knows how to type, because in 1987, you had to file all of your insurance claim forms on the.

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You know you had to type them up on the typewriter and I did know how to type.

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So I worked with him for a little bit while he started his practice.

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I finished college, I have a degree in marketing and communication and when I came back after I graduated, basically it was a brand new practice, still right.

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So my marketing and communication skills were heavily used there in the beginning and then we ended up having a couple offices in Connecticut and he retired in 2001.

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And I just went into marketing consulting for I've only ever worked with prosthetics and orthotics because for me that is the field I'm most passionate about and, uh, you know, just really love the people and everything about it.

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So that's my, that's my origin story in a nutshell.

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We've had several people in here that were it's like a multi-generational family business in this.

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So why?

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What made you step into it?

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Cause you could have just said, oh my God, I'm going to do like children's toys or aircraft marketing.

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You could have strayed from this right.

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Were you a little tempted?

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Or what made you stick to this industry?

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You are correct.

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It is often tempting of like chamber of commerce activities and stuff.

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When I was involved in patient care, specifically when I was working in my dad's practice, I would meet people and I would tell them what I do and they'd say I've got an oil company or I'm a veterinarian.

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Can you help me with my marketing?

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And my go-to thought about marketing is marketing, is marketing right.

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So if you see a really good marketing idea, in whatever field or industry it is, you probably can apply that to your own O&P business that you're doing or anywhere else.

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So don't always try to reinvent the wheel like I have some.

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You know what is it Amount of experience that Depprent said.

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I like to know what it is that I'm actually, you know, working on in terms of marketing.

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So I don't want to learn everything about the oil industry or a veterinary practice.

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So I stuck with O&P because one it is one of the, I think, most rewarding careers you could possibly be in.

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You know just the ability to make people mobile right on a daily basis.

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It's so rewarding and being able to share that story and help spread awareness.

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I think that's what it is.

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You know it doesn't get any better than O&P in terms of a marketing client.

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Okay, cool.

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And then at the moment, what kind of services do you do right now as your own company?

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So pre-pandemic.

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We did a lot of continuing education, what I call education-based marketing.

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So continuing education for orthodontists and prosthetists to provide to PTs and OTs for continuing education credit right.

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So, similar to other programs that I'm sure that you've heard of, you go in as an integral part of the rehab team.

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You teach your colleagues about what it is that you do.

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You're not a caterer, you don't need to bring lunch or any of that stuff.

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You teach your colleagues about what it is that you do.

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You're not a caterer, you don't need to bring lunch or any of that stuff.

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You're providing them valuable education.

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But that was pretty much non-existent during the pandemic.

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What has been consistent for many years now that has just, for me, gotten bigger and bigger is I help O&P, state associations and chapters with their annual continuing education event and I also, as a volunteer, like Brent mentioned before, I do a lot of work with the ISPO and USISPO as a volunteer on their events too, in certain capacities.

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So that's been the, that's been the primary time.

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Time use for me this last four, four years is the continuing education events, either virtually or in person, for state and chapters.

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Okay, okay, cool, and so I liked that.

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The variation there as well, in different locations, so you're always going, you know I'm going to roll up in some place and I'll have no idea what's going on.

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I like that yes because I was called like event organizer.

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It's kind of like going camping with work.

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Yeah, you have to kind of think of like it's camping, right.

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So if you're questioning about do I need it, like take it, you know, yep, because you're gonna need it, you're gonna definitely need the extra pair of scissors.

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That's the one you're gonna need that one screwdriver and you're gonna need to label it right so that somebody else doesn't walk off, or they, or, and then I bring.

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I sometimes like to bring my label maker so I can label other people's stuff, because you wouldn't believe I know you would believe how many chargers and mice and whatnot that people leave behind yeah, leatherman tools and duct tape, yeah, okay, cool.

00:14:58.962 --> 00:15:08.841
So so do you have any best practices for organizing event, except for, you know, apart from getting lots of scissors and labeling everything like are there any good ideas or just like that you should always do when you're organizing events?

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bring a printer, that that would be the most basic my life changed when I I in the beginning years ago, so I think it was the midwest chapter my daughter was in I don't know middle school at the time and it worked out with her vacation, and she woke me up in the middle of the night.

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She said, mom, you're crying in your sleep and I was like, okay, never again, I'm not.

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This is I'm obviously very concerned about this.

00:15:31.428 --> 00:15:36.307
And those were the days when you didn't travel with a printer.

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Right, you either print, had stuff that was pre-printed, and then, of course, people would show up and need a badge or you need an extra agenda, and so it was.

00:15:48.068 --> 00:15:49.816
That was a life-changing move is a little Canon printer that fits in my suitcase.

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I can do anything.

00:15:50.197 --> 00:15:52.764
I can print your, your return labels, I can.

00:15:52.764 --> 00:15:57.043
You know, whatever it is, your plane ticket, whatever you need, I've got the printer there.

00:15:57.043 --> 00:16:03.328
So that was, that was huge, and things that you can do just to reduce the amount of stress.

00:16:03.328 --> 00:16:15.490
And obviously the online registration systems and those kinds of platforms were also a huge time saver and also allow you to be a little bit more green.

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You know, I can say nope, I'm not printing anything else.

00:16:17.988 --> 00:16:18.903
Go online and look at it.

00:16:18.903 --> 00:16:29.499
Right, it's up there, it's current Do that, so I don't know what other kind of operational things would be really okay.

00:16:29.558 --> 00:16:32.570
And and then how about like, like, like, more about socializing?

00:16:32.570 --> 00:16:39.879
Because it's so weird because at one point, some events are really successful because of the bar right, some events are really successful because people meet on the floor.

00:16:39.879 --> 00:16:42.164
Some of the lectures do you have to choose.

00:16:42.164 --> 00:16:42.405
Is it?

00:16:42.405 --> 00:16:45.341
Is it one or the other, or or can you balance these things?

00:16:45.621 --> 00:17:02.499
I mean, you know what are some key things there to make sure that people actually mix and learn that is an excellent question and very timely because, as you guys know right, you're on, you're online doing this right now, and I know that you both do a lot of online education.

00:17:02.499 --> 00:17:17.136
So, since the pandemic, just the explosion of continuing education that you have available to you and and a lot of it for free is kind of a challenge if you're doing in-person events.

00:17:17.136 --> 00:17:41.881
What I think is that people are looking for now or at least I believe that people are looking for now and I think we've proven that the last couple of meetings that we've done this year they want to have value in the program, so they don't want to see same old, same old and they want to have things that are very specific to where they are, whether it's in state or where they are in their practice.

00:17:41.881 --> 00:17:54.646
But they also really want to have fun and if they don't want to participate in the fun event itself, they definitely want to be fun adjacent.

00:17:54.646 --> 00:17:59.721
So, for example, last year in Alabama we had a cornhole tournament.

00:17:59.721 --> 00:18:10.076
So there weren't that many people I mean not everybody participated, but everybody definitely participated in the watching right and the clapping and the cheering and everything else.

00:18:10.076 --> 00:18:11.180
That was really fun.

00:18:11.621 --> 00:18:18.412
We did a bowling fundraiser for this so everybody could move efforts and also the legislative efforts in New York.

00:18:18.412 --> 00:18:31.176
And somebody actually said, hey, I wish we had done this on the first night and I said, well, we tried, but there was an actual bowling league on the first night of our meeting so we couldn't take over the bowling alley.

00:18:31.176 --> 00:18:33.701
They had a really good time doing that.

00:18:33.701 --> 00:18:39.997
We went to the Durham Bulls game this past Friday night, got to meet Wooly Wooly Bully.

00:18:40.798 --> 00:18:42.040
That was really fun.

00:18:42.040 --> 00:18:48.528
We had people are still talking about that one and then the people that went to the game, you know, went out after together.

00:18:48.528 --> 00:19:01.489
So it was a real bonding experience because all of those people I knew them all, but they didn't know each other and so we had a really good you know, a really good time, which I think was very just helps lift up the whole event.

00:19:01.489 --> 00:19:06.586
We've had other things like that and we're planning on doing go-karting at the Texas meeting.

00:19:06.586 --> 00:19:13.709
So anything that will get people to right have a good time together.

00:19:13.709 --> 00:19:17.545
So I think that's very key for the coming events.

00:19:18.105 --> 00:19:20.001
Okay, and also, I think, maybe for OMP.

00:19:20.001 --> 00:19:26.000
I know in 3D printing it's like this In 3D printing a lot of people are very fidgety and they're very engineering used to touching things and stuff.

00:19:26.000 --> 00:19:41.226
So we've noticed in 3D printing events it's a really, really good idea to have stuff to give to people for them to play with, or just a table for them to just interact with stuff, especially in our business, as compared to, I don't know, the space business or something else right, where people are a little bit different.

00:19:41.226 --> 00:19:46.026
And is it the same in OMP, because everybody's such a tinkerer, a maker and creator?

00:19:46.026 --> 00:19:49.859
Is it really good to have a lot of physical?

00:19:49.859 --> 00:19:53.967
If you're going to the event or if you're showing off things, you have a stand, it's really good to bring stuff.

00:19:54.788 --> 00:20:04.143
I think that is such a great point and it is a fantastic observation because you are 100% correct.

00:20:04.143 --> 00:20:16.180
The amount of people that I see that can't sit, can't or don't want to sit, still while it could be the most interesting presentation in the world, but they've got to get up, they've got to move.

00:20:16.180 --> 00:20:16.922
So what?

00:20:16.922 --> 00:20:22.829
What I've been using a lot of lately are these event I call them event centers.

00:20:22.829 --> 00:20:27.843
Right, it's your non-traditional, it's not a hotel, it's like North Carolina.

00:20:27.843 --> 00:20:34.082
We use the Durham bottling company, so it's an old bottling company that they turned into a co-working space and an event space.

00:20:34.082 --> 00:20:36.346
So it's very casual.

00:20:36.787 --> 00:20:57.214
I mean, we still have our right, we still have the projector, we still have the screen, we still have the microphone, we have our presenters, but just the vibe of the space makes it so much less like, hey, you're going to get right, you're going to get in trouble if you stand up and go to the bathroom or go to the refrigerator and get a soda or, you know, walk over to the ice thing.

00:20:57.275 --> 00:21:02.164
So I really do think that, uh, we'd love to have more interactive events.

00:21:02.164 --> 00:21:15.436
I think it's harder to get the, the content to um be able to provide that right, because if we're in a smaller space and everybody isn't the same discipline.

00:21:15.436 --> 00:21:33.260
Yeah, there'll probably be orthotists that want to play with some prosthetic stuff or things like that, but I'm going to think more about that and get back to you, maybe later, because you've given me something that and I don't want to spill all my secrets on this, because I know you have a big audience and I'm like I have some really good ideas.

00:21:33.260 --> 00:21:37.409
I'm writing them down right now and we will talk about them after they've been implemented.

00:21:37.409 --> 00:21:38.817
But short answer, doris.

00:21:39.179 --> 00:21:42.707
Yes, and one thing that I'm kind of curious about.

00:21:42.707 --> 00:22:02.503
I mean, everybody points to 2020 and the COVID and all that stuff changing business, changing the way, these types of things and other types but specifically these types of meetings where it's in some ways hybrid, some ways more intimate.

00:22:02.503 --> 00:22:09.825
What do you think was the biggest thing for you challenges and opportunities because of 2020?

00:22:10.046 --> 00:22:11.368
Holy cow, how much time do you have?

00:22:11.555 --> 00:22:14.303
because of 2020.

00:22:14.324 --> 00:22:15.988
Holy cow, how much time do you have?

00:22:15.988 --> 00:22:21.178
I'm going to say all of it is an opportunity, right?

00:22:21.178 --> 00:22:22.140
That is just the way that we need to look at it.

00:22:22.140 --> 00:22:29.338
But I can tell you, what I miss most about providing education during the pandemic was Brent.

00:22:29.338 --> 00:22:31.785
You, specifically, are an excellent example of this right.

00:22:31.865 --> 00:22:39.421
So, since we've been back in person, how many times have I reached out and been like, hey, are you going to even be anywhere near where we're having this event?

00:22:39.421 --> 00:22:41.142
And you're not.

00:22:41.142 --> 00:23:04.780
But during the pandemic I could get you, I could get somebody in England, I could get people that we would never be able to get in person because of just sheer financial limitations or the fact that, hey, I can't fly you in from Florida or North Carolina or whatever to come up to Virginia for a half an hour presentation.

00:23:04.780 --> 00:23:25.586
So I really think the biggest challenge is trying to replicate the quality and the value of the programming that we could do online with unlimited access, and trying to get that in person, because obviously nobody wants to sit there and play games.

00:23:25.775 --> 00:23:34.185
I know they have the whole gamification thing and that's great, maybe like the tech world, but, as yours pointed out, we have people that are not used to spending the day.

00:23:34.185 --> 00:23:42.605
We might be used to spending the day on the computer, right, but your orthodontists and prosthetists are not, and that is really hard for them to have to sit there.

00:23:42.605 --> 00:23:49.303
And you know, it doesn't matter how interactive it is online if they don't have something that they can put in their hands.

00:23:49.303 --> 00:24:09.483
So I think that for me, the best part about it was having access to all of those incredible speakers from all over the world and trying to replicate that when we get you know in person now, um, but, and and not having um people, just you know, turn their, turn their computer on and walk away and go do what they have to do.

00:24:09.625 --> 00:24:16.883
So and I'm curious cause you're at these events a lot, so you get to meet a lot more people than other people, right, especially in lots of different areas, I mean yes.

00:24:16.883 --> 00:24:19.703
So is there typically?

00:24:19.703 --> 00:24:23.026
Well, first off, how do you feel that the industry is doing?

00:24:23.026 --> 00:24:25.881
Just from your lookout, like you know, is everybody rolling up in Ferraris.

00:24:25.881 --> 00:24:28.125
You notice, you know what I mean.

00:24:28.125 --> 00:24:31.575
How do?

00:24:31.595 --> 00:24:32.596
you feel that the industry is doing at this moment.

00:24:32.596 --> 00:24:43.611
Well, I think it depends on the state in terms of because that's what I've noticed a lot about doing these smaller meetings that are in-state.

00:24:43.611 --> 00:24:53.910
So one of the things that we're concentrating on for this year is I like to tell people I'm not a weather person, but I am all about the hyperlocal.

00:24:53.910 --> 00:25:19.811
So if we do want to have a meeting and we want it to have v

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