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The hardest part of orthotics and prosthetics is not always the clinical decision. Sometimes it’s getting paid, staying compliant, and keeping a clinic running while everything around you changes. We sit down with Teri Kuffel, JD, Executive Director of the American Orthotic and Prosthetic Association (AOPA), to talk about the business engine behind patient care and why so many of today’s practice challenges cannot be solved inside the walls of a single facility.

Teri shares her unusual path into O&P through operations, contracting, and advocacy, then gets specific about what makes an O&P practice succeed. We dig into clinic scale and leadership, why a startup often needs both a strong clinical mind and a strong business mind, and how payer contracting and reimbursement realities can make “billing” very different from “getting paid.” We also discuss smart location planning using geo access searches and market research, plus real-world financing options from private investment and bank loans to partnerships and private equity.

We then zoom out to AOPA’s role in the profession: advocacy and government relations, coding and reimbursement support, regulatory guidance, education, and the value of bringing stakeholders together when reimbursement pressure, workforce constraints, outcomes measurement, and digital O&P care are all moving fast. Teri also previews the AOPA National Assembly, including hands-on technology in the exhibit hall and the growing focus on digitization, CAD workflows, and additive manufacturing.

Special thanks to Advanced 3D for sponsoring this episode.

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We welcome prosthetist and Niagara Foot inventor Rob Gabourie for a fascinating conversation spanning more than five decades of prosthetic innovation. Rob shares how his career began after his brother's industrial accident, reflects on hand-carving wooden sockets for World War II veterans, and explains how the demands of Vietnam veterans helped accelerate advances in prosthetic technology. Throughout the discussion, he emphasizes a philosophy of practical problem-solving—continually "fiddling" with designs to make them simpler, more durable, and more effective for the people who depend on them every day.

The conversation also explores the development of the Niagara Foot, lessons learned from decades of fitting transfemoral patients, and the importance of balancing engineering with clinical experience. Brent and Rob discuss how additive manufacturing is transforming prosthetics, where 3D printing fits into the future of patient care, and why repeatable, data-driven socket design may be the next major leap forward. It's an episode filled with history, wisdom, and practical insights for clinicians, engineers, and anyone passionate about improving mobility through thoughtful innovation.

Special thanks to Advanced 3D for sponsoring this episode.

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In this episode, Brent Wright and Joris Peels sit down with Fanny Schultea, Executive Director of Live in Motion Foundation (formerly The Prosthetic and Orthotic Foundation For Education and Research), to explore how O&P can reinvent itself for the future. Fanny shares her journey from textile design and military service in Iraq to clinical practice, education, and national leadership within the profession.

The conversation examines the workforce challenges facing O&P, the need for new care-delivery models, and the importance of investing in students, residents, clinicians, technicians, and researchers. Fanny also explains how stronger outcomes research, economic evidence, professional development, and public awareness can help expand access to care and demonstrate the value O&P brings to patients and the broader healthcare system.

In this episode:

• Why O&P must rethink how care is delivered
• Addressing clinician shortages, burnout, and barriers to entry
• Building stronger career pathways for the next generation
• Funding scholarships, professional development, and research
• Using outcomes data to demonstrate the value of O&P care
• Preparing the profession for value-based healthcare
• The role of technology, wearables, and AI in future care
• Bringing greater public awareness and investment to O&P

Special thanks to Advanced 3D for sponsoring this episode.

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