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Why do orthoses cost so much?

Answer this delicate question with facts...

Who has ever been caught out by the mysteries of this question by a duly nervous client?

If, like me, when you first decided to put a price on your services, you felt an almost instant pang of ‘Am I really good enough..?  How do I justify this price..? What Happens if someone call me out on it? What happens if it doesn’t work?

In this short series, Footprint Hub business boffin Stuart Roeszler considers the basic economic, environmental and social impact of what we manufacture for our clients and puts forward what to consider when paying for and our charges of modern medical foot orthoses as part of a balanced outcome driven clinical therapy.

Temptation to discount:


" You don't pay for the nail being hit. You pay for the time of the professional that knows where and when to hit it... "

S Roeszler, Footprint Hub 2020

Part 1: The Rule of Three's

Time and again I notice a pleasantly simple representation of how things in my work (and life) seem to always show up in threes. Acknowledging that this more likely is the case that my slightly bent mental antennas are instinctively wired to see these patterns, we see many examples of the rule of two-thirds / one-third in the design, graphics, photography and even military planning arenas.

When applying this somewhat crude rule to the structure of things, I more than often find it a very powerful tool in assisting decisions and confidently progressing where I would otherwise fear to tread.

What is the rule of Threes?

The Rule of Threes is simply breaking items down into one third / one third / one third. Depending upon the topic and groups involved, the ideal mix of assets seems to consistently meet the simple mathematics that are divisible by “3”, always.

For instance, a delightfully simple and quick of business inputs to profit can be applied to the 1/3 rule. Time and time again, from global corporations to local vendors, we see one-third of revenues apportioned to profit, one-third variable costs’ (like materials and those associated with delivering the products / service) and one-third apportioned to wages & salaries.

Q: Who likes to get paid well for the hard work they do? 

A: Me… You… Your Staff… Everyone.

If we acknowledge human nature and sprinkle that with a smidgen of business sustainability (I love Kate Raworths “donut model of economics“), we can justify the cost of an orthoses in a direct relationship to what we would like to get paid. Remember this in those tricky “why does this cost so much” conversations. It takes knowledge and skill to successfully navigate a personality through a rehabilitation program that includes orthosis therapy. 

Let’s do the math and hypothesise how much you charge for a complete therapy program that includes custom orthoses. Consider it takes you a combined total of one hour of your time for you to assess, prescribe, design, coordinate deliver and educate a patient all they need to successfully manage a lower limb condition (that includes orthoses). A tall order right?… but let’s work with this.

For this time, you believe all your years of study and commitment to the craft and industry education demand a minimum of £150 / hour fee in for your time. A level not unreasonable in a modern professionals market.

  1. Profit to Sustain a healthy business in various economic environments
  2. Costs of Supply. The costs that are associated with producing our outputs. ie: what we pay the lab for a custom orthoses
  3. Wages, Salaries, Fees. These are typically the largest piece of the pie in any business.

Typically the highest cost is the one to factor by three. The purpose for this is it tends to account for mathematical errors and ever-present unforeseeable’s that occur in the management of any human system.  

Have a look your own  division of costs in theses areas, and bingo… you now have an idea of how much to charge &/or any business efficiencies you may wish to invest in.

For this example, this highest cost is at your desired £150 per hour. A this point you should be charging around £450 for a professional device… if you sold 8 pairs a day with no cancellations or other chargeable services…

Are you charging enough? Is your business operating efficiently? Are you paying your lab enough for the services they provide?

Remember :
Communication is successful only when both the sender and the receiver understand the same information.

A quick PodByte.

” The advent of modern technology has not changed the need for a clear understanding and communication process to deliver information essential for manufacturing. The assumptions contained within the tech has, in real terms, made it more important to follow a clearly defined, industry recognised clinical process “
Check out more videos and discussion topics at ” PodBytes “. A collection of tools designed to help you on your journey through the challenge of biomechanics, 3D design, manufacture and its delivery.