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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.

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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.

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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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Part 1: Building a Design Firm Around Craftsmanship and Longevity

Mike Laut, founder and president of Laut Design in Raleigh, shared how a freelance operation started from his college apartment at NC State grew into one of the region's leading industrial design firms. Throughout the conversation, Mike emphasized the value of craftsmanship, durability, and thoughtful design, drawing parallels between classic machine tools, family-owned manufacturers, and successful modern businesses. He discussed his passion for restoring vintage milling machines and lathes, believing that older equipment often embodies a level of quality, simplicity, and pride that is missing from many modern products. Mike also highlighted the importance of company culture, surrounding himself with talented people, and only working with clients who share similar values. His philosophy centers on creating products that solve real human problems while building a business designed to last for generations.

Part 2: A Potential Industry Disruptor

After Mike's interview, Brent and Joris discussed the newly announced Formlabs large-format SLS printer, which dramatically increases build volume while entering the market at a price point far below traditional industrial powder-bed fusion systems. They explored how Formlabs is leveraging years of printing data, thermal monitoring, and software development to address some of the biggest challenges in SLS manufacturing, including print consistency and failure detection. While both hosts expressed excitement about the machine's potential to make industrial additive manufacturing more accessible, they also raised questions about first-generation reliability, material limitations, cooling times, and the long-term economics of Formlabs' powder ecosystem. The consensus was that the release could significantly disrupt established players such as HP, EOS, and Farsoon by lowering barriers to entry and making high-volume powder-bed printing attainable for smaller businesses, service bureaus, and healthcare applications such as prosthetics and orthotics.

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In this episode of the Prosthetics & Orthotics Podcast, Reagan Perry shares her remarkable journey from years of limb-salvage surgeries to making the life-changing decision to undergo a through-knee amputation at just 23 years old. Reagan opens up about the realities of becoming an amputee, the emotional highs and lows of recovery, and why the process was far more complex than she was led to believe.

The conversation explores the often-overlooked gaps in patient education, the importance of finding clinicians who truly listen, and the challenges many amputees face when navigating prosthetic care. Reagan candidly discusses her frustrations with traditional socket prostheses, her decision to pursue osseointegration, and how the technology has transformed her daily life by allowing her to focus less on her prosthesis and more on living.

As a future physician and advocate, Reagan also shares her passion for the So Everybody Can Move initiative, which is working to expand insurance coverage for activity-specific prosthetic devices. From the role of peer support to the impact of insurance barriers, this episode offers an honest and powerful look at what life after amputation is really like, and why patients deserve more transparency, more options, and a greater voice in their care.

Whether you're a clinician, amputee, caregiver, or simply interested in the future of mobility, this episode provides valuable insights into resilience, innovation, and the realities behind the prosthetic journey.

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In this episode, Brent Wright and Joris Peels break down the 2025 Embla Medical Annual Report and explore what it reveals about the future of the prosthetics and orthotics industry. While Embla continues to post steady growth and strong profitability, the discussion centers on larger questions: Is the industry's future in acquiring more clinics or creating new products and markets? The conversation examines Embla's expansion into patient care, neuro-orthotics, and bracing, while highlighting a startling statistic that only 30-40% of new amputees worldwide receive a prosthetic solution. Brent and Joris debate whether the greatest opportunity lies not in serving existing reimbursed markets, but in developing affordable solutions for the millions of underserved patients globally. Along the way, they discuss innovation, 3D printing, AI, reimbursement challenges, acquisitions, and what it will take for the next generation of O&P companies to move beyond simply growing revenue and toward truly transforming patient care

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We talk with Arlene Gillis about how prosthetics and orthotics education is evolving and what it takes to train clinicians who can thrive in modern practice. We dig into hands-on fabrication, residency redesign, and the workforce pipeline that clinics need to keep patient care strong.

• Arlene’s path into prosthetics and orthotics through patient translation and a life-changing fitting
• How becoming an educator requires a new skill set beyond clinical training
• What the move to master’s level O&P education changes for standards, scope, and credibility
• Why hands-on fabrication time still matters even in digital and 3D printing workflows
• Traditional residency versus embedded residency and how mentorship can continue after graduation
• Who today’s O&P students are and how goals shift by background and generation
• Work-life balance, debt pressure, and why some young clinicians leave for higher-paying roles
• Business skills employers want most including coding, front office process, and cost awareness
• Digital workflow training including scanning, CAD, carvers, 3D printers, and EMR exposure
• Care extenders as a clinic model to improve access, speed, and workforce capacity

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We break down what we saw at RAPID, from vapor smoothing and metal printing to reinforcement methods and silicone printing that could reshape interfaces. Then we talk with Alex Dahinten about building better socket comfort through real time adjustability and what it takes to get a new prosthetic solution into clinics through Medicare coding.

• Vapor smoothing as a path to cleaner looking 3D printed parts and the safety tradeoffs behind different chemicals
• What a smaller HP powder bed fusion machine could mean for clinic workflows and cost per part
• Foil based metal manufacturing as an alternative to powder handling for tight tolerance small parts
• Reinforcing thermoplastics by injecting fiber and resin into printed channels and why pricing matters

We then hear:
• Alex’s path from biomedical engineering into prosthetics and orthotics
• Upper limb prosthetics as systems integration with higher costs and heavier follow up burden
• Capacity building in global health as the difference between short term missions and sustainable care
• Why the socket interface drives outcomes and how compliance improves comfort without losing energy transfer
• Ethnocare’s Overlay air bladder sleeve for residual limb volume management and the doffing effect problem
• Medicare L5657 and the impact of a fee schedule on clinician and patient access

Special thanks to Advanced 3D for sponsoring this episode.

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