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.
00:00:00.620 --> 00:00:03.810 Welcome to Season 10 of the Prosthetics and Orthotics Podcast.
00:00:03.810 --> 00:00:11.788 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.
00:00:11.788 --> 00:00:20.131 Our goal To share stories, tips and insights that ultimately help our patients get the best possible outcomes.
00:00:20.131 --> 00:00:23.207 Tune in and join the conversation.
00:00:23.207 --> 00:00:27.329 We are thrilled you are here and hope it is the highlight of your day.
00:00:27.329 --> 00:00:31.047 Hey y'all, I wanted to give you some context to this episode.
00:00:31.047 --> 00:00:44.756 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.
00:00:44.756 --> 00:00:46.905 So with that, let's hop in.
00:00:47.707 --> 00:00:53.491 Hi everyone, my name is Joris Peebles and this is another episode of the Prosthetics and Orthotics Podcast with Brent Wright.
00:00:53.491 --> 00:00:54.112 How are you doing, brent?
00:00:56.546 --> 00:01:29.233 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.
00:01:29.233 --> 00:01:33.010 You know, it's like we're not talking into a chamber, right?
00:01:33.010 --> 00:01:35.748 People are actually listening and finding out.
00:01:35.748 --> 00:01:41.790 And then, you know, your penchant for names was very funny too, yeah.
00:01:42.653 --> 00:01:43.433 I'm sorry, equal.
00:01:43.433 --> 00:01:44.725 I still don't know how to spell it, dude.
00:01:44.725 --> 00:01:45.983 I'm sorry we have to call know how to spell it, dude.
00:01:45.983 --> 00:01:48.436 I'm sorry we have to call them out on this stuff because otherwise it's only gonna get worse.
00:01:48.436 --> 00:01:54.457 And then, and then, 10 years from now, it'll be like equal buys, plink last and schwingling and all this.
00:01:54.457 --> 00:01:55.703 You know it's only gonna get worse.
00:01:55.703 --> 00:01:56.466 If we tolerate it.
00:01:56.546 --> 00:02:03.465 It'll only get worse well, that's how you get the money, though, right, you gotta have the most uh name possible.
00:02:04.686 --> 00:02:08.211 Yeah, exactly, okay, okay, but I'm glad you got a lot of feedback on that.
00:02:08.211 --> 00:02:09.032 That's good to hear, man.
00:02:09.592 --> 00:02:26.068 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?
00:02:27.280 --> 00:03:05.592 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.
00:03:05.592 --> 00:03:32.730 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.
00:03:32.730 --> 00:03:38.844 You know, not only fabricating the hand, selling the hand to yourself, and then also be getting reimbursed.
00:03:38.844 --> 00:03:39.948 So what a great move.
00:03:40.969 --> 00:03:45.042 Okay, agree, agree, okay, so this episode, do we have a sponsor?
00:03:45.042 --> 00:03:53.909 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?
00:03:54.050 --> 00:03:54.270 today.
00:03:54.270 --> 00:03:57.774 Yeah, so we've actually got two sponsors for this episode.
00:03:57.774 --> 00:03:59.395 So the first is Advanced 3D.
00:03:59.395 --> 00:04:01.497 I'm a part of that, along with Paul and Tyler.
00:04:01.497 --> 00:04:04.223 We're a contract manufacturer.
00:04:04.223 --> 00:04:08.545 The idea is, yes, we do stuff for O&P and we want to meet you where you are.
00:04:08.545 --> 00:04:36.872 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.
00:04:37.740 --> 00:04:38.343 That's super cool.
00:04:38.343 --> 00:04:39.247 And the second sponsor.
00:04:39.639 --> 00:05:12.432 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.
00:05:13.220 --> 00:05:25.269 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.
00:05:25.269 --> 00:05:31.672 So just part of the program hey, the surgeon says, hey, you're going to have surgery, You're going to get this protector.
00:05:31.672 --> 00:05:42.182 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.
00:05:42.182 --> 00:05:52.471 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.
00:05:52.471 --> 00:05:56.394 So not only is it great for patients, but it's great for business.
00:05:56.394 --> 00:05:57.535 So I think that's really neat.
00:05:57.535 --> 00:06:05.560 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.
00:06:05.560 --> 00:06:07.307 So I think it's really neat.
00:06:07.307 --> 00:06:13.673 I think it is definitely underutilized and there's no reason for that.
00:06:13.673 --> 00:06:20.391 The data definitely shows that early post-operative care provides best outcomes.
00:06:21.673 --> 00:06:26.560 Okay, all right outcomes.
00:06:26.560 --> 00:06:29.005 Okay, all right, that's great for LimbGuard and, yeah, you're protecting the leg at his most vulnerable point.
00:06:29.005 --> 00:06:31.932 It seems to be a very, very solid idea indeed.
00:06:31.932 --> 00:06:34.382 Okay, so Brent, who's on the show today?
00:06:34.923 --> 00:06:42.225 Well, I'm really excited to have Elizabeth Mansfield on the show today and I think we're going to really enjoy the conversation.
00:06:42.225 --> 00:07:23.596 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.
00:07:23.596 --> 00:07:32.413 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.
00:07:32.413 --> 00:07:38.324 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.
00:07:39.326 --> 00:07:40.851 Okay, well, welcome to the show, elizabeth.
00:07:42.000 --> 00:07:42.901 Thank you very much.
00:07:42.901 --> 00:07:54.076 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.
00:07:54.879 --> 00:07:56.315 No, no, no, no no.
00:07:57.803 --> 00:07:59.009 That's exactly what I was saying.
00:07:59.701 --> 00:08:04.399 I was like, wait a minute, I'm going to write this down because it sounds like he's being delicately stepping around.
00:08:04.399 --> 00:08:07.149 Like how long has she actually been around?
00:08:07.149 --> 00:08:09.185 But I am so delighted to be here.
00:08:09.185 --> 00:08:09.987 Thank you for having me.
00:08:10.550 --> 00:08:15.351 Okay, and so when did you like you know how did you first get involved in OMP?
00:08:16.319 --> 00:08:19.370 Well, I was literally born into it.
00:08:19.370 --> 00:08:22.048 My dad was nine years old.
00:08:22.048 --> 00:08:25.990 He got run over by a truck when he was putting on his birthday roller skates.
00:08:25.990 --> 00:08:57.330 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.
00:08:57.330 --> 00:09:22.562 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.
00:09:22.562 --> 00:09:28.102 So we were very involved in international prosthetics and orthotics.
00:09:28.102 --> 00:09:34.941 That's sort of where my whole interest in ISPO and USISPO sort of came out of.
00:09:35.562 --> 00:09:54.042 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.
00:09:54.042 --> 00:10:04.532 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.
00:10:04.532 --> 00:10:07.264 You know you had to type them up on the typewriter and I did know how to type.
00:10:07.264 --> 00:10:11.342 So I worked with him for a little bit while he started his practice.
00:10:12.085 --> 00:10:21.240 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.
00:10:21.240 --> 00:10:33.162 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.
00:10:33.162 --> 00:10:50.346 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.
00:10:50.346 --> 00:10:54.381 So that's my, that's my origin story in a nutshell.
00:10:54.964 --> 00:10:59.101 We've had several people in here that were it's like a multi-generational family business in this.
00:10:59.101 --> 00:11:00.085 So why?
00:11:00.085 --> 00:11:00.986 What made you step into it?
00:11:00.986 --> 00:11:05.571 Cause you could have just said, oh my God, I'm going to do like children's toys or aircraft marketing.
00:11:05.571 --> 00:11:07.788 You could have strayed from this right.
00:11:07.788 --> 00:11:09.383 Were you a little tempted?
00:11:09.383 --> 00:11:11.328 Or what made you stick to this industry?
00:11:11.649 --> 00:11:12.291 You are correct.
00:11:12.291 --> 00:11:22.409 It is often tempting of like chamber of commerce activities and stuff.
00:11:22.409 --> 00:11:33.450 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.
00:11:33.450 --> 00:11:34.601 Can you help me with my marketing?
00:11:34.601 --> 00:11:40.220 And my go-to thought about marketing is marketing, is marketing right.
00:11:40.220 --> 00:11:52.155 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.
00:11:52.155 --> 00:12:01.350 So don't always try to reinvent the wheel like I have some.
00:12:01.691 --> 00:12:04.394 You know what is it Amount of experience that Depprent said.
00:12:04.394 --> 00:12:11.068 I like to know what it is that I'm actually, you know, working on in terms of marketing.
00:12:11.068 --> 00:12:16.466 So I don't want to learn everything about the oil industry or a veterinary practice.
00:12:16.466 --> 00:12:25.913 So I stuck with O&P because one it is one of the, I think, most rewarding careers you could possibly be in.
00:12:25.913 --> 00:12:33.668 You know just the ability to make people mobile right on a daily basis.
00:12:33.668 --> 00:12:38.763 It's so rewarding and being able to share that story and help spread awareness.
00:12:38.763 --> 00:12:40.345 I think that's what it is.
00:12:40.345 --> 00:12:48.114 You know it doesn't get any better than O&P in terms of a marketing client.
00:12:49.556 --> 00:12:50.255 Okay, cool.
00:12:50.255 --> 00:12:54.652 And then at the moment, what kind of services do you do right now as your own company?
00:12:57.023 --> 00:12:58.765 So pre-pandemic.
00:12:58.765 --> 00:13:04.336 We did a lot of continuing education, what I call education-based marketing.
00:13:04.336 --> 00:13:12.860 So continuing education for orthodontists and prosthetists to provide to PTs and OTs for continuing education credit right.
00:13:12.860 --> 00:13:19.903 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.
00:13:19.903 --> 00:13:21.046 You teach your colleagues about what it is that you do.
00:13:21.046 --> 00:13:22.652 You're not a caterer, you don't need to bring lunch or any of that stuff.
00:13:22.652 --> 00:13:23.936 You teach your colleagues about what it is that you do.
00:13:23.936 --> 00:13:26.644 You're not a caterer, you don't need to bring lunch or any of that stuff.
00:13:26.644 --> 00:13:29.070 You're providing them valuable education.
00:13:29.610 --> 00:13:32.969 But that was pretty much non-existent during the pandemic.
00:13:32.969 --> 00:14:00.892 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.
00:14:00.892 --> 00:14:04.375 So that's been the, that's been the primary time.
00:14:04.375 --> 00:14:14.546 Time use for me this last four, four years is the continuing education events, either virtually or in person, for state and chapters.
00:14:15.227 --> 00:14:16.855 Okay, okay, cool, and so I liked that.
00:14:16.855 --> 00:14:22.682 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.
00:14:22.682 --> 00:14:26.802 I like that yes because I was called like event organizer.
00:14:26.802 --> 00:14:28.368 It's kind of like going camping with work.
00:14:28.368 --> 00:14:30.783 Yeah, you have to kind of think of like it's camping, right.
00:14:30.783 --> 00:14:39.019 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.
00:14:39.620 --> 00:14:46.937 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.
00:14:46.937 --> 00:14:58.903 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?
00:15:10.024 --> 00:15:24.688 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.
00:15:24.688 --> 00:15:28.822 She said, mom, you're crying in your sleep and I was like, okay, never again, I'm not.
00:15:28.822 --> 00:15:31.428 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.
00:15:36.307 --> 00:15:48.048 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.
00:15:49.816 --> 00:15:50.197 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.
00:16:15.490 --> 00:16:17.988 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 value to the people in that state like what is going on in that state that we need to help people with or we need to inform people about so if you are in a state that has great voc rehab or great reimbursement rates for Medicaid or things like that, I think those states are probably unique.
00:25:20.096 --> 00:25:30.808 But there are other states that are really, really struggling and I think everybody in that state is struggling, not just the independently owned practices.
00:25:30.808 --> 00:25:44.407 New York, what we're working on right now, the Medicaid fee schedule is like 40 years old, right and so to try to get that updated, because it's not just the reimbursement rate, it's also all the codes that haven't been added.
00:25:44.407 --> 00:25:48.695 So that is hurting everybody and makes it really difficult.
00:25:48.695 --> 00:25:50.436 And then there's other states where you know they don't.
00:25:50.436 --> 00:26:02.442 They don't have that necessarily have that problem, but I I don't think I don may or may not be somebody that's going to come to the meeting, either if it's the next week or the following year.
00:26:02.442 --> 00:26:23.817 So that's.
00:26:23.817 --> 00:26:32.000 I think that is kind of maybe right, indicative of how well and about these sales, because you talked about it.
00:26:32.141 --> 00:26:36.643 The perception is that there's large groups buying up lots and lots of practices, right?
00:26:37.163 --> 00:26:37.325 Yes.
00:26:38.356 --> 00:26:41.634 Is that also what you think or do you think just based on your anecdotal evidence?
00:26:41.634 --> 00:26:43.040 We'll say that we'll qualify it right now.
00:26:43.040 --> 00:26:53.300 But based on your anecdotal evidence, is it also kind of more regional groups buying up like four or five, let's say, in Phoenix and being kind of like more bigger in Phoenix, or is it more of these larger companies going national, if you will?
00:26:54.342 --> 00:26:57.244 I think that you are correct about.
00:26:57.244 --> 00:27:05.412 There are people that are buying that I don't think the general public realizes.
00:27:05.412 --> 00:27:14.536 So there's some.
00:27:14.536 --> 00:27:16.824 I wouldn't necessarily call them stealth, but people go oh Oser's buying, bach is buying, oh Equal's buying.
00:27:16.824 --> 00:27:25.182 But nobody's necessarily saying like, oh well, look at what's happening over here or look what kind of companies are buying or looking to buy right.
00:27:25.182 --> 00:27:39.644 So I don't think we have a good handle on the industry trends as a whole, because I think what makes the most noise and gets the most publicity are the things that everybody knows about.
00:27:39.644 --> 00:27:41.748 Right, does that make sense?
00:27:42.095 --> 00:27:43.599 Yeah, exactly that's a factored in.
00:27:43.599 --> 00:27:45.546 Everybody talks about it because everybody talks about it.
00:27:45.546 --> 00:27:51.862 But if there's some guy building up a little empire in Phoenix, we wouldn't know because it's, you know, it's Mary's orthopedics Nobody's heard of them.
00:27:52.423 --> 00:27:58.165 Right, Right, and nobody's talking about it, Like it's not, like the Phoenix sales rep is talking to the North Carolina rep.
00:27:58.165 --> 00:28:03.385 And then you hear about it in North Carolina Cause, like oh hey, my buddy in Phoenix said you know this is what's going on.
00:28:03.385 --> 00:28:04.641 So yes, I agree.
00:28:05.382 --> 00:28:18.011 And also the other thing is like we're kind of like we see what keeps coming back is that this is an industry where we're kind of a little bit worried that younger, like sprint especially is always where the younger people are not attractive enough to the industry.
00:28:18.011 --> 00:28:19.032 Is that the same thing?
00:28:19.032 --> 00:28:24.306 Or are you seeing a lot of fresh faces, a lot of people kind of appear at these meetings that are more interested than usual?
00:28:25.816 --> 00:28:27.179 You're getting me with all the good questions.
00:28:27.179 --> 00:28:28.041 It is.
00:28:28.824 --> 00:28:31.460 Answer well, be a good girl.
00:28:31.755 --> 00:28:33.922 You're being Elizabeth, you're being judged.
00:28:33.922 --> 00:28:34.984 Watch your mouth.
00:28:34.984 --> 00:28:49.367 So my dad was in the late 60s, early 70s, so I have tons of old pictures of people he went to school with and I know a lot of them still.
00:28:49.367 --> 00:28:51.068 I mean, they're in their 80s, I in their eighties.
00:28:51.068 --> 00:28:53.811 I don't know about a lot, but, right, it's never been a big field anyway.
00:28:54.372 --> 00:29:06.358 But if we are doing an event, that where we are close enough to a school, we I always make sure that they know one, they know they're invited, that students can come for, you know, for free or very, very little.
