Virtually Aligned: Smarter Education, Stronger Outcomes with Richard Dubin

Rich Dubin, CEO of LER Expo, shares his journey creating digital educational platforms that foster cross-disciplinary learning for healthcare professionals in the lower extremity market. We discuss how bringing together specialists from different fields—from podiatry to orthotics and prosthetics—leads to better patient outcomes and more innovative approaches to care.

• Founded LER Expo in 2019, perfectly timed before COVID shut down in-person educational events
• Created an engaging digital conference platform that recreates the in-person experience with lobbies, exhibit halls, and networking spaces
• Uses innovative approaches like tournament-style presentations to keep audience engagement high
• Emphasizes the importance of cross-disciplinary education across healthcare specialties
• Discusses concerns about the rising cost of O&P education with master's programs approaching $200,000 in total costs
• Highlights the critical value of mentorship and hands-on experience versus academic credentials alone
• Shares practical advice for clinicians wanting to present at virtual conferences
• Believes collaborative care across disciplines leads to better outcomes for patients
• Encourages professionals to look beyond their specialty silos to find new connections and innovations

Special thanks to Advanced 3D for sponsoring this episode.

Chapters

• 0:00 Welcome to the O&P Podcast
• 0:26 Industry News: Stratasys and Nexa
• 3:36 Rich Dubin and Digital Events
• 9:42 The Power of Cross-Disciplinary Learning
• 17:52 Evolution of O&P Education
• 32:00 Advice for Event Speakers
• 42:26 Key Takeaways and Closing

Transcript

Brent: 0:00

Welcome to Season 11 of the Prosthetics and Orthotics Podcast. 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. Our goal is to share stories, tips and insights that ultimately help our patients get the best possible outcomes. Tune in and join the conversation. We are thrilled you're here and hope it is the highlight of your day.

Joris: 0:26

Hello everyone, my name is Joris Piels and this is another episode of the Orthotics and Prosthetics Podcast with Brent Wright. How are you doing, brent?

Brent: 0:33

Hey, joris, I'm doing well. We have some news to talk about. What, what about? I mean you probably do this saw this coming like three months ago, but with Stratasys buying out all the stuff from uh nexa oh, that that was.

Joris: 0:46

Oh well, that's a good home for them, I mean, I think, I think nexa was I don't know. Nexa was in trouble for a long time. They didn't really have a differentiator. Uh, they didn't uh, and they ran out of cash, I think. I think a long time ago actually, and, uh, you know, so it was already kind of stopped, kind of, it was already kind of like not progressing and rather than it dying.

Joris: 1:06

Now Stratasys buys the assets, which means they may be able to do something with it in some way. Hopefully some people will find some jobs. I don't think that many of them will, but in some way it'll continue. So that's, you know, that's some interesting stuff going on.

Joris: 1:19

I was actually surprised that that was news, not because it happened now, but because they decided to take it over and announce it, more so than than that it was. You know, it was actually kind of surprising. They bought them now, so they must have found something interesting in the ip or some assets there. So, yeah, I think that was actually kind of that's okay sign of the times that now the frothy investment climate narrative is over. People who were good at raising money and also good at making money, uh, running out of options, and other people are just quietly building you know businesses, and that's kind of what we need to be doing. We need to actually have a you know, have actually kind of like an actual business, where you sell something to someone and they pay you more than you make it for that kind of crazy stuff.

Brent: 1:57

Yeah, so that's what I was curious on, because where does Nexa stuff fit in the Stratasys portfolio, right? So they're really pushing into SAF, which is not SLS, and then are they in the resin space. I guess I just don't think of them as resin people, but I don't know.

Joris: 2:15

There's some interesting resin IP there for the systems that they could be using, maybe going forward.

Joris: 2:19

I think just generally I don't think you know, like you know, they have SAF already.

Joris: 2:28

I don't think there's much there in the architecture of the LPBF machines for Stratasys to either use for SAF or some other projects.

Joris: 2:33

It'd be interesting if Stratasys uses this to get also an LPBF offering in addition to their SAF. But I think if I was advising them, I would be telling them that it would be much more beneficial for them to focus on really making SAF work and really making people understand the economics of SAF, rather than deploying just another technology for them to support, which, of course, is going to be very difficult for the poor guy who, at the end of the line in New Zealand or in Peoria, would have asked to support all that all of a sudden. So I think, yeah, I also don't see it there as a you know there is some stuff they could be doing on the SLA, the VAT, polymerization front, with what they were doing. But then yeah, I just think generally they just bought like a bunch of IP and they're just like, okay, cool, an extra X patents and this one technology could be cool and we could do this before and that kind of thing, you know.

Brent: 3:20

Yeah Well, I definitely think they had some innovative people. You yeah, well, I definitely think they had some innovative people. You know, I follow some of the people that were Nexa employees, so I think you're right that they probably have some sort of portfolio of IP. The other thing and it's not something that we talk about a lot on the podcast is the metal 3D printing. What was your take on the Trump getting spun off into that? I mean, that was like a really big deal.

Joris: 3:42

That's what I thought you were going to start about. I was like, oh, the Nexa, what you want to talk about, the Nexa thing.

Brent: 3:45

Well, I mean that's the one that's close to home, but I mean this one is like multi-gazillion dollar type of thing. They were involved in the laser development, all that stuff so give us the rundown.

Joris: 3:58

Trump, if you're not familiar with it, is one of the largest producers of industrial lasers in the world and it also makes a lot of cutting tools, like really large cutting tools and laser tools for car manufacturing. Trump is also a company behind some of the key parts of EUV, which is a technology that Zeiss and ASML are doing, which is a technology that makes most of the cutting-edge chips in the world. It's a family-run company, a family-owned company, a $5 billion in revenue, 19,000 employees, and they're really well respected. I mean it's a bit cultish, I guess, the firm a bit kind of inward in some ways, but people really respect them as a business and people really respect their tools and a lot of the stuff that they make people have for a very long time and they use it for a very long time and they have a global support network, global sales network. It's a quite a formidable company and essentially what they did is they, they, they now they had an manufacturing business. Then they stopped doing it a couple years ago. Then they started a new ad manufacturing business, so they did both lpbf machines and ded machines. So, dd, we don't talk about a lot, so I'll explain that.

Joris: 5:00

It's a directed energy deposition. That's either blowing powder or extruding a wire, or you could do droplets. There's different ways of doing it, but generally it's a process to take a relative inexpensive metal material, generally heating it and then welding it together. So you can actually from some of these things. They have technologies that use TIG and MIG welding heads to do this. So it's a very inexpensive technology to make large structures for oil and gas.

Joris: 5:21

I don't really see an application here for orthotics and prosthetics and that's probably why it never came up, but it could be a way to make a really inexpensive thing. Usually things are really rough and you have to machine them down for them to kind of be able to mate with something or be able to work. But they did that as well and that LPBF machines that are small LPBF machine a metal LPBF machine was really good actually, and some large ones which are apparently good. But I don't know that many people that have them and that's kind of their problem. I think that despite they in my mind, they never got their sales force to adopt their new machines. So if you're selling cutting machines and bending machines or whatever right, and that's your whole thing, you need to make your bonus to then all of a sudden try to sell a completely new machine to this client that may be in their R&D department or maybe a different department, different person, is going to be very difficult for you and it's going to be really tempting to just focus on the stuff that sells, and I've seen this actually happen on the material side and on the OEM side in a couple of companies. It wouldn't surprise me if this happened there as well, and I do indeed anecdotally have some information about people that say they didn't really push hard, even though they were very happy Trump customers in other areas. The other thing is that they never really. It was just a better machine, it seems to be. Their thought was we're going to make a LPBF machine by Trump. It's going to be a better LPBF machine, sure, but they don't have a track record and they didn't really do anything to make people really believe this thing was different or new or better or made more for a particular application. They didn't really do a lot of application level support like for lpbf. It's different than the metal stuff, the plastic stuff.

Joris: 6:52

It's very difficult to get to your first part and normally you would have to have a uh, a uh, let's say, for example, an engineer trained and and designed for additive manufacturing to make that part make sense, and often, if if they do that, a company will start with like a simple bracket and then design a bracket and then it'll end up with a really expensive brink kit without it actually being an advantageous part for them. So if you want to get involved with the metal ILPBF, you have to invest like, let's say, a million dollars and actually it would make sense to get two machines, invest like $2 million and then build up capacity over the course of maybe a year or two and that is what it'll take for you to get your machines used and get everything dialed in and stuff. So that's a big investment and you'll do that if you're Lockheed. You'll do that if you're a Formula One team because you know the advantages are there. You'll definitely do that if you're a space company because you know you can win.

Joris: 7:39

But if that's not the case, there's very few companies in the world that will do this and then if they do it, they'll do it with the specific machines that they know and trust or that can make the big, big parts, which is what the space guys want. And in this case that didn't happen. So they never really found a niche they could exploit and they never gave enough application development expertise for people to quickly learn and quickly invest. If they would have had a much bigger consulting department that would have been able to go to all these thousands of happy, ostensibly Trump customers and really say hey, we're going to make a part that value, that unlocks value for you in additive, and we're going to try and see if you can use this technology first as a service, then we're going to develop more parts and then we're going to let you industrialize it. If they would have done something like that, I don't see how they could have failed. And so the tragedy of this is there's one company in the world that should, from a sales machine tool philosophy, experience with lasers perspective, understand this technology, then it should be well, our Uricom, who also left, or Trumph right. So it's a bit of a tragedy. It's very bad for the industry. They left because another company, a machine tool company or another company will look at this and say, ah, the thing doesn't matter. And I think this is really a bad execution on their part. They did not work on this application development thing, work on making it easy to adopt additive because they weren't used to that. They're used to being the best supplier of some folding machine that anyone who could afford it would want their machine and not anyone else's, you know, and that, I think, is a different kind of you know, you come from that background. It's very difficult for you to switch to to kind of breaking open a market and building a new market. I think they just did that very poorly actually.

Joris: 9:11

The other thing that makes us even more insane is is one click metal. So one click metal was an internal startup inside of trump that made 120 000 lpbf machine right and you could literally put this in kind of semi carpeted environment. It used, uh, usually have this powder and the powder is very dangerous because it can explode and burn. And now, uh, you could use this powder, uh, you know, in cartridges in kind of a semi-carpet environment for 120k and you wouldn't have to pay more, much more than that to really install the thing. You don't need one of these big linda gas things or whatever, the praxair thing in front of your house or whatever, um, and that could have really made this market. Uh, could have really made this market much, much bigger.

Joris: 9:44

Think about how many companies have the CapEx available to be able to invest $2 million and how many have $150,000. You're talking very few companies have $2 billion lying around and quite a lot of companies can get their hands on 150K. So instead of supporting that, they kind of orphaned it and then they sold it all half to a machine tool company called Index and then, I think, they sold all of it to Index as well. So they had a perfectly good strategy to make this market much, much bigger than it is, and they just didn't do it. It's one of the most I'm really annoyed at this. If you can tell, I can't tell, okay, I'm really. I think as a strategy consultant, you always think like, well, I don't know, you don't know everything. But in this case it's like come on, you know if somebody could have made this work as you guys and they didn't, it's really bad.

Brent: 10:29

Anyway, we have a long suffering guest, but I just want to make one point on this, and I think it's super important for the additive manufacturing crowd, and I think you say this over and over and over again you have to have a product to sell and you can be the best at something, and if you don't have it, and explain what it is, it's people aren't just going to come knocking down the doors and, and you know that's. That's one of the things about advanced 3d that I think is interesting. In the same way, I think a lot of people think that we do some cool stuff, but they don't know that they can buy from us and, and so that's one of the things that we've got to get better at, and this is a great lesson in that. But nonetheless, we have a long-suffering guest. Yeah, who is it? Who is it? Who is it? Yeah, so well, I'm really, really excited.

Brent: 11:13

I could hear Rich's eyes rolling. He's like, oh my goodness, what are these guys talking about? They are nerding out about some stuff, but I'm really excited to have Rich Dubin on the show today. He is the CEO of LER Expo. He's started a bunch of magazines. He's kind of found his niche in podiatry, prosthetics and orthotics biomechanics, and he also is heavily involved in education and online education in all those areas. Podiatry I know I was involved with one in podiatry. He does some stuff in orthotics and prosthetics. He's always at the orthotic and prosthetic shows. He has a really cool platform for virtual events and so I'm really excited just to talk to him about the education side, how important that is, how it's changed over the years and dive in from there. Okay, super cool.

Richard: 12:03

Now welcome to the show, rich. Thank you, norris, thank you Brent. Appreciate being here for sure, and I look forward to you know seeing where we can take this conversation so Rich?

Joris: 12:13

first off, do you do like online events, offline events? What exactly do you guys do?

Richard: 12:18

So we do online events. Everything we do is digital.

Joris: 12:21

Okay, and so how did you get started in this online events business?

Richard: 12:25

So in 2019,? Well, I kind of had this vision long ago. So I've been in this space for 35 years, as Brent said earlier. You know I started up in podiatry and quickly left a podiatry publication to go for another one. I got recruited. This is going back to 1989.

Richard: 12:43

In 1994, we launched a magazine called Biomechanics, and Biomechanics was the first multidisciplinary publication serving lower extremity clinicians, and when we talk about low extremity we talk about hip down. So everything from podiatry to orthopedics, to O&P, to pedorthics, ptts, trainers, sports med, physicians, physiatrists I mean you name it we served them all Basically. When we launched, they said it could never be done, you're never going to be able to. You know, have all these clinicians talking to each other? They're all in their own silos and they're, you know, competing with one another. But we were able to pull it off and pulled it off. Well, the owner sold it. Three years later, I got one week's pay handshake and a new employer and went to did the corporate gig for 12 years. In 2009, I started Lower Extremity Review Magazine. I left corporate, went off on my own to serve the lower extremity market once again In my journey 35-year journey I don't even know how many trade shows.

Richard: 13:44

I've been in all specialties, 500 trade shows and all I kept seeing well, all I kept hearing, rather was the grumblings the grumblings from the vendors, right, the grumblings from the clinicians. I got to be out of the office. I can't be practicing, I you know it's expensive, the prices are increasing and the ROI is decreasing. And so, in 2019, prior to COVID, I launched LER Expo, and LER Expo is our online event company, and I had no idea COVID was coming. I had no idea everything would be shut down. Matter of fact, I was at the AAOP meeting in March when the plug was pulled for the rest of the year on all conferences and by June of 20, we did our first event and we had been developing this engaging fun experience online for clinicians and vendors alike and, in three, rolled out the platform that is now LER Expo, version two, if you will.

Joris: 14:42

And how do you do this? Because, like the other alternative, of course, is me to use, you can do like Zoom has events you know. So why would somebody go to a specialized platform? What is the advantage you're bringing in that sense?

Richard: 14:52

Well, it's the experience. So it's literally like you are at an event, like it's. You know Zoom. You have all these little cubes of photos of people. You know some cameras on, some cameras off, or you could turn all the cameras off. It can be somewhat distracting. Those platforms are great. Listen, I use Zoom every day. I'm on Zoom conferences every single day, zoom meetings, but I do not use it. It's not an event platform. So our platform is extremely. It's very graphic, it's very inviting. You come to a building and you're actually looking in a building, and then you enter the building. You actually move into the lobby. So there's a lot more opportunity also for vendor sponsorship to show off certain logos, links, things. Within the actual lobby. We have a lounge area where you could connect with clinicians. In the room you could connect with social media handles. We have an exhibit hall that's attached to the event. So it's literally as though you're at an in-person conference, only you're in your home or office.

Joris: 15:54

And then the one thing I always miss with these online platforms is kind of this happenstance. It's kind of like you meet somebody who's a dentist and you're not a dentist and you find out something about their industry that can help yours. How do you promote that kind of casual interaction between attendees and stuff?

Richard: 16:08

Well, one of the things that we push is we create sort of a little gamification to the event so we track all types. They get different points for different types of activities during the event, so it encourages them to explore the platform fully and engage with one another. One of the things that we hear and that I sort of have hung my hat on is we create the most fun and engaging events on the planet, and one of the things that I've known over the years and I've been to other online events is they're not engaging, they're very one-way conversations. We get tons of interaction from the community, from the actual attendees, lots of questions coming in. We did an event two weeks ago. It was set up as a tournament, it was a surgical event, it was said. It brought together orthopedics and podiatry in this surgical single elimination and podiatry in this surgical single elimination 16 speaker tournament. The audience voted on who moved on to the next round. So we create the interaction which makes it easy for people to connect with one another.

Joris: 17:13

And this tournament thing, wait, wait. So I moved to the next. Like Brent and I are debating this or no, I do the presentation, brent does the presentation, he kind of wins and he moves to the next round. And then what happens?

Richard: 17:26

You have to do another one. Yeah, so all day, exactly. So this event was see, we've done events ranging from three hour events all the way up to 30 hour events over two and a half days. So you better have really good speakers, you better have a heck of a platform that people want to be on for 25 hours or 30 hours, right, and you better bring together an environment where people are enjoying themselves or else they're going to check out and go home. Our platform is set up where you have to click into each session in order to receive credit. So it's not as if it's Zoom, where you can click in in the morning and go golfing all afternoon and come back and still receive your credit. You have to be present in order to receive your credit.

Richard: 18:00

But back to the point of the tournament. So it was a case study presentation, so each round was based on. So first round was forefoot, second round was midfoot, third round was rear foot ankle and the championship round was complications and revisions. So the first round, a clinician had to have a case, a forefoot case, and they presented. We had orthopedics and podiatry competing with one another. We had some and we did a random matchup. So we had in one case. We had two clinicians that are actually in the same practice competing with one another and then the audience voted on who moved on to the next round. So a surgeon, anticipating moving on had to have cases to present at four cases anticipating getting onto the going onto the finals.

Richard: 18:44

And what was funny is we had one speaker. So we had a speaker back out like within the last two weeks and we had to have someone sub in and we had a clinician sub in who had just come off a mission, a visit, a one week mission visit and then a one week visit at excuse me, a one week. What was he doing? Jury duty. So he wasn't even prepared. He accepted the position. He actually was the one that ended up in the finals. So he was the underdog and it was all because the audience voted on his cases.

Joris: 19:14

And I really like this cross, this approach of having very different practitioners all kind of dealing with the same stuff, and I like this. You've probably been doing this for a long time, so it works for sponsors, it works for you know. You know what I mean. Does it work because it brings more people together. Why does this work?

Richard: 19:31

So it works because collaborative care leads to better outcomes. Right? Like you know, o&p does not operate in a vacuum. Podiatry does not operate in a vacuum. Pedorthicsics is not operating a vacuum. We all work together PTs, podiatrists, o&p, pedorthics all of us are collaborating and you get better outcomes when you collaborate.

Richard: 19:50

From a clinician standpoint, we just did a biomechanics event. We had a chiropractor from Canada, we had a podiatrist from Paris, we had a podiatrist from Australia, we had the UK, we had O&P, we had pedorthics. We had every clinician in each specialty speaking right on different topics. We had podiatrists in the US speaking as well. And then from a vendor standpoint, it's attractive because you're reaching a wider audience. So if you're an orthotic lab, for example, if you're talking to not just podiatrists, you're talking to podiatrists, oop, pedorthics all of them are interested in orthotics. So the message is broader and more impactful when you bring together multiple disciplines under the same umbrella. And we've been doing it for so many years that for us it's second nature For a lot of places a certain publication in a given specialty. They don't have contacts and access outside of that silo, if you will, whereas we have been doing this I mean, I've been 30 years doing this- yeah, I think it was really interesting.

Brent: 20:55

I mean, it's been. It might've been about the time that you released your platform, but I remember being on one with you. I think you invited me to speak and it was for foot orthoses, but you asked me to speak on something that would touch on foot orthoses. But really the work that we're doing, even the stuff that I was doing in the developing world, and it was very cool to see because everybody is kind of tangentially related but they will have similar interests and I remember having great conversations with people, even after the fact connecting on LinkedIn, emails, that sort of thing, and people that I wouldn't necessarily have interacted otherwise, and so I think what you have going is very, very neat in that sense, not only from, say, a speaker, personal sense, but then, like what you said, like, hey, the opportunity for vendors, kind of cross pollination networking there's, there's a lot there.

Richard: 21:49

There definitely is. I just I just got a call a couple of weeks ago from someone who was previously at another company that we worked with that's no longer around in 3D printing. I will leave the name, leave the company name. We won't mention the company name, but anyway, she was there. She's not there anymore. I've known this woman for over 30 years. She's now working with another company out of I want to say France, or anyway out of Europe, and they're bringing in a 3D printing technology. And she reached out and she said Rich, this is an ideal platform for bringing a message to the widest audience of specialists that would be interested in this type of technology in their practice. It's an in-office 3D printing technology and so you know there's so much overlap and because I think over the years just bringing together all the different disciplines and creating that community opens the doors for these type of opportunities to come in and the benefits for the fact.

Brent: 22:50

Yeah, I'd like to dive in just into the orthotic and prosthetic education space. I mean, you've been around for a long time. You've seen all the changes not only in technologies but in education not only online education, but education in general for clinicians, residents and that sort of thing and I'd love for you to maybe take us on a little bit of a journey on what you know, what you have seen specifically in the orthotic and prosthetic industry as well. As you know, definite white space, you know, not giving your secrets away or whatever, but white space for other people and companies and such in our little niche industry, because it's definitely unique. We're a unique bunch. You don't have to throw me under the bus too much. You know, but I know I'm unique. So I'd love to just hear your take on the industry from a historical perspective and what you're seeing now.

Richard: 23:42

So I mean, I guess, when you think about education and you think about what we have done in the past, everything is, you know, we've had a lot of in-person conferences, right, we still have all our in-person conferences, all our regional conferences, all our national conferences, whether it's academy or national, we have all those meetings right and typically that's where clinicians have connected at these conferences. We've seen, and I know I hear it all in all that again, going back to the point of just this drop-off, right, there's just a. The program could only be as robust as the money they have to support the clinicians. Flying clinicians in from around the world is next to impossible. For you know, some of these in-person conferences, it becomes very costly, not to mention putting on in-person conferences very costly. So you know there were years listen, I go back, you know when I first started, you know, print advertising was massive. I mean, we had a publication that was, you know, 250 pages and we would stock it with multiple ads from from the same company. It was just, it was amazing, right, and we rode that way for a certain period of time, I think.

Richard: 24:53

I think the industry is at a place, from a marketing standpoint, where we need to show ROI, we need to show analytics, we need to have data to support the efforts that we're putting in. And if you can't provide that and Lord knows, in-person conferences, just don't support that. It has to be digital, because that's the only way we can get the type of visitors clicks opens, those type of analytics. I think that the industry still very much operates in a silo. I think it still very much like keeps it within its own right. And I equated a lot to podiatry, because podiatry is a very similar market in that you know they want to keep things close to the vest. You know we're good at what we do and we want to do it here. But yet you look at the need to interact and work with other specialists. Like OMP needs to work with PTs right, they need to work with PTs. On the rehab side, they need to work with podiatry. Many podiatrists will refer to an OMP facility. So there's this sort of.

Richard: 25:58

I'm a firm believer in networking. I'm a firm believer in opening new doors, opening new opportunities and looking at where can I best serve my community. And the way I best serve my community is not by sitting back and hoping people come to me. It's by getting out there and engaging and interacting with other clinicians in my area, and I don't see that a lot in O&P. I could be wrong, but this has been my experience. I do think and I say that because, again, it's sort of podiatry, very similar. So I think you know there's this. There is I feel like I'm kind of all over the place with it but I think this sort of open-mindedness to listen to other specialists and engage with them so we can all learn together. I mean, that's where we live, that's the space we live in, that's where I want everybody to be, but unfortunately I don't think everyone's there. Does that make sense?

Brent: 26:49

Yeah Well, and I'd love to get your take on it but then yours' take, because I wouldn't have met yours and then the vast amount of people that I've met through yours and just the additive manufacturing side, and I think that's made me a better clinician but then also better on this technology. How important is it to have this kind of cross-disciplinary thing where you have a bunch of people that are passionate about a specific area or technology. They like to see how things work, but they have a broad, well-rounded, I guess, you would say, and introducing people to different parts that may be connected is very advantageous. So I mean, I'd be kind of curious to get your thoughts, but then yours. I'd love to hear your thoughts on it too, with you being in some of the education space but connecting people that wouldn't have otherwise connected.

Richard: 27:38

So go ahead, Rich, and then we'll let yours answer.

Richard: 27:42

I mean, I could only talk from my own experience, right? I think you know, for years and years and this is my experience for years and years I only dealt with vendors, right? My editorial was one side, my advertising was they were very separate and I only dealt with the vendors. I never cross-pollinated and dealt with clinicians. About seven, eight years ago, I started dealing more with clinicians, more with you know, more engagement. I started opening new doors. I started seeing more possibilities. I started aligning more of where I wanted the editorial vision to go right. I started bridging the gap between clinicians and manufacturers because, as we know, it's the clinicians that are using the product that are the best representation of the product, not the developer of the product is not always the best representative of the product because they want to sell the product right. So we're even launching we just launched a new venture called LER Conversations, where we're going to bring together an innovative product. We're going to bring together a clinician using the product and we're going to have a conversation. They've never met or maybe they have, but we want to increase the awareness and the visibility and the importance of networking and communicating cross-pollinating.

Richard: 29:01

I think that is where we really grow. We can't grow if we're only talking to ourselves. It's just not possible. And that's true in life, right? If you didn't meet new people, you wouldn't get new ideas, you wouldn't see new possibilities, you wouldn't, you know, if your kid was sort of, you know, stayed in a little ball all the time, they wouldn't get to see you know what else the world has to offer. So I'm just a firm believer of opening our minds and seeing other opportunities and possibilities and then connecting people where there are real connections and keeping those relationships going through those connections. Right, I think we all learn that way.

Brent: 29:38

Yeah, I'd like to get your take there, Joris, on that.

Joris: 29:41

That's kind of the Go ahead, I think yeah, I think the cross-pollination thing is super important. My favorite example is this one In 2011, I was working at Materialize, which is a Belgian 3D printing company, and I was lunching every day when I was there with colleagues who were doing CMF implants custom guides for dental at the time and also for surgery and also orthopedic stuff and I was also at the same time for them. I was testing we were testing some desktop 3D printers to see if it could play a role in what we're doing. But the Enable project when it came out, this idea of printing prosthetics on a desktop printer, was a complete revelation to me and I was just completely overcome by like, oh wow, that's a great idea. Why didn't I think of that? You know? So something super obvious, right, but it doesn't come about.

Joris: 30:31

Another favorite example I have is at one point in the Stratasys stand, there was this part, and it was a part where they had used for a hand layout part like a carbon fiber part. They'd used the support material. So they only 3D printed the support material and then ended up printing the part around it, if you will, and then remove the support material by washing it away. It was like a washable support material and that would have facilitated them making this. I think it was like a mandrel kind of thing or something like that, and that to me was a completely novel idea, even though I was familiar with both those industries, you know, and it was a car part as well, and I was doing a lot of car stuff as well back then a long time ago.

Joris: 31:01

But but these are the kind of things where you need sometimes this kind of this different way of looking at things, a different way of seeing things. Another example is like the reason for this podcast, or one of the big reasons for it, is that we have we looked, we were brent and I was having a discussion about how fast things were going in dental and we were both very curious and saying is additive going to go at the same pace in orthopedics, is it going to be as important as it is in dental or not? And what could we learn and what's not happening? So I think this is really important and I have the most insightful things I've learned over the years just an additive have come from just casual stuff, like, just like meeting someone and finding out about something I had no idea was happening. So I think this is really really, really, very, very important.

Richard: 31:38

Yeah, I agree completely with that.

Joris: 31:40

So I agree completely with that.

Brent: 31:41

So I think the other thing that I'm kind of interested about is also I mean, you've had interactions with. You've seen it go from like a certificate program essentially to a bachelor's program. There was a bachelor's program, now to this master's program. On the education side of things, just curious to see you know from your perspective and I know you're not necessarily in the weeds what has that meant for O&P? So requiring a master's versus a bachelor's, a bachelor's or the certificate program, yeah, yeah, well, I think that.

Richard: 32:15

Well, I think, if you look at it from just strictly educational perspective, I think if someone is in theory right, if they have a master's versus a bachelor's or a certificate, they're quote unquote more qualified, supposedly Right. I think it elevates the clinician to a certain extent Right, gives them some more. You know initials behind their name, but I don't know. Listen, I'm not a clinician, my and I don't have a master's Right, but I've launched several businesses and I've't have a master's right, but I've launched several businesses and I've learned in the trenches and I think that there is a lot to be learned when you are in the trenches and you're around the proper mentorship, right. So that's a really difficult question. It's a little loaded right, because if I say, well, the master's is more qualified, but I know people with MBAs that I could work circles around and I only have a bachelor's, so it's a very fine line. Education doesn't always equal experience and education doesn't always mean the person is smarter, better, faster, you know. It just means they have more education.

Brent: 33:26

Yeah.

Richard: 33:26

Right, and so you know. And again you know in O&P I guess you know when you're talking they're more, it's more hands on, but still, when you're treating patients it's a totally different thing than when you're in this classroom. Yeah, and so you know. I understand why they're doing it, but or why they did it. But I don't think even pedorthics. I mean, look what happened to pedorthics. Pedorthics is almost a profession that has literally been eliminated because they made it so difficult. They just made it so difficult for the pedorthics to succeed in this world right now.

Brent: 34:02

Yeah.

Richard: 34:02

Through that educational requirements.

Brent: 34:05

Well, I think you hit the nail on the head and is you you? You get out of it what you put into it. So if you just go to school and think that it's going to be amazing once you get out, that's probably not just because you have the master's doesn't make you good. I mean, at at East point, we have been blessed with our residents Just amazing. They're go-getters, they want to learn, they jump in when they're you know. You don't have to ask them to jump in, they just jump in. They're helpful. It's been great and they make what they want of it.

Brent: 34:36

I think one of the things that I see and I loved your point about mentorship is it's this first five years after school, even three years, call it three years. Find a place where you're going to learn the most. That's right, and with a leader that will bring you up. It's hard to say this, but you kind of have to turn a blind eye to the money side. You know those places probably aren't going to pay you the most, but you're going to learn a lot, which then gives you the opportunity to climb the financial scale. I think one of the things and this is what I would encourage, especially people looking for residencies. If you, if, if people, a company, are giving you big money out of out of school, you're going to have expectations that are put on you for revenue generation, and that's not a good place to be in, and so my encouragement is find somebody that will invest in you, grow with you, maybe take a little bit of less money, but the upside, on the back end of this, is going to be much better.

Richard: 35:39

I agree with that completely. The issue is now you've gone and you've gotten a master is just out of control with this master stuff.

Brent: 35:45

I mean, I was just looking Northwestern just for the education side of things, not living expenses. But two years at Northwestern is pushing $100,000. And so you toss in living expenses in downtown Chicago. I don't know what that would be, but I'm guessing it could easily be $ $25,000 a year just to live, or more.

Brent: 36:26

So you're talking 150,000, $200,000 coming out of debt, in debt, if you're not paying for this, and it's not like a ton of people have $200,000 laying around for this. And then you take a look at the salaries and then you compare that to the equal amount of somebody that's getting a master's, say, a master's in engineering or something. This industry profession. It becomes more of a calling, so to speak, especially for these first few years. I mean, there's financial upside, but you have to have experience with that, whereas if you you know, we see it, we're seeing it a lot People that have master's degrees, they have master's degrees and a lot of other companies.

Brent: 37:08

They don't care that it's a master's in O&P, but they might have you, might be a great salesperson or a great educator, and just because you have a master's in P&O, they may offer you a bunch more money than actually practicing in O&P for something completely unrelated selling computers, selling software, what have you and so we just have to be really careful with that. I think our accrediting bodies are really taking this seriously and they're trying to help lower costs through scholarships and stuff, and I think there's a lot of more room to help with this. But it is on our profession industry to figure out this education thing. So we don't saddle these students with that.

Richard: 37:49

Absolutely. I think that it becomes almost impossible to succeed in the first three to five years with being saddled. It's the same thing with, you know, with even if it's not an O&P. Listen, I have a daughter going off to Bentley University in the fall. She's my fourth kid that I put through college. That's no joke, right, and that's just for a bachelor's and it's four years, right.

Richard: 38:19

So to require an O&P clinician to go get a master's, I think it's not how I personally believe. Now that we're, you know we're doing this, talking about this, I don't know that it's really helping the profession long-term. Yeah, saddling somebody with another 150 or $200,000 in debt to come out of school, like you said, they're not sitting with this, you know, with a with a treasure chest ready to go put it into OMP education, right, and you know, put that person in a good program out of school where they can train under proper mentorship. Get the experience seeing patients understand what that, you know, is like. Get that long-term experience. That will be much more valuable than sitting in a classroom or a lab or whatever with a professor talking about, you know, theories and some of the other things that they might be addressing in this master's program in a classroom or a lab or whatever, with a professor talking about, you know, theories and some of the other things that they might be addressing in this master's program. That's just my feeling, yeah.

Brent: 39:16

Yeah, I think there's definitely a balance. So, yeah, I appreciate that perspective, yoris. I mean I know you know that probably the education in the US. But I mean, when we talk about some of those numbers, does that seem excessive? That seems insane.

Joris: 39:31

Yeah, I just kind of calculate. If they put interest on that, like, even if it's really low, that's like it'll be very difficult to pay that off If you just like need to have like a salary to live and stuff, you know. So this is, this is completely crazy, I think. I think if you can do any kind of on the job training, that that seems like you know, know, even working on the job for five years and then, and then you know, earning half of what you normally earn, would maybe even make sense if you don't have to do that extra 200 grand. So it's kind of crazy. And and the problem there's another problem, of course that that that at one point then the profession could not be viable, as you will exactly, people would be motivated to say like let's do something like you know, maybe in orthotics there would be money or something, and then prosthetics wouldn't be. And then at one point that becomes a big problem, I think as well.

Brent: 40:13

Well, I think back to Rich's, maybe to bring this back full circle too is you know, the orthotic and prosthetic industry is considered allied health care, so it's definitely parallel to say, a physical therapist, occupational therapist, even into some of the physiatrists.

Brent: 40:30

They don't necessarily want to do the work that we do, but it is in their scope technically. And so I think this idea of interdisciplinary with a specialty is very, very interesting, whether it's a physical therapy with some sort of fellowship in orthotics, prosthetics, or even dividing it up into more niche type of things where maybe you're looking at upper extremity, robotic stuff and that goes through OT, and then physical therapy, maybe lower extremity stuff, and you know, I think that there's a lot of opportunity. And the reason why I think that becomes interesting is because physical therapists can bill for time. Orthodontists and prosthetists cannot bill for time, and so if you're able to bill for time as well as bill for a product, it's a win on both sides, and I think that is where I see a lot of the future going. And we don't have enough clinicians in the world, but definitely in the United States, to take care of our aging population. It's going to be a massive. We just don't have enough people, so I think it's interesting.

Joris: 41:29

Yeah, that's crazy, I'm going to make a massive. We don't just don't have enough people. So I think it's interesting. Yeah, that's crazy, I'm gonna make a first orthotist robot. Oh goodness, one thing. I want to circle back to the events before I forget this question. First off. Imagine I'm listening to this and I'm saying, hey, I want to be on one of your events, I want to actually be a speaker. How do you get noticed to be a speaker? Because I know as well we I program some events as well with some people and you know, noticing the first speaker and getting that person who maybe is not well-known or hasn't spoken before, that's difficult. It's easy to get if you're the CEO of some big company or if you've done this a bunch of times before. But what advice would you give me if I'm, like you know, not so well-known and I want to get in this gig?

Richard: 42:10

Do I just email you? Is there a way to get? Yeah, what would you suggest? So you know, if you're someone who's an expert in your space and maybe you haven't lectured a lot but you have some experience and you know, maybe you've done some research or maybe not, typically, so I go on sort of my experience, I go on the people I know ask, like Brent said he was on, uh, you, you were on the 3d printing event that we did with fit 360. Right, so you know Brent and I had met, we know each other and so if we were to do, let's say, a 3D printing event, then I would lean on the people that I know in that space. If you don't know anyone in that space, then the best thing to do is be on LinkedIn. See who's active. I mean, I found three speakers for this biomechanics event off of connections that I've made on LinkedIn because they're connected with other people that I know in that world. You know there was a clinician in Paris that that we use, that I had never worked with before Nominal guy the woman in Australia, anna Palin, who I've never worked with. Actually, she's pretty involved in 3D printing as well over in Australia. I don't know if you know her name.

Richard: 43:09

You best way is to get connected. Get connected, let people know you want to speak. It's an area. Let them know what your expertise is, whether it's me or even a conference or anything that's online. We encourage clinicians. We have clinicians come to us OMB podiatry orthopedics but they come to us and say, listen, I have an idea for an event. I think I'd like to do something in this space. This is an area of expertise for me and then we start to develop an event around that top and then look at different sponsors. Some clinicians work with individual manufacturers who will sponsor an event. Some clinicians just want to be speakers. It really all depends. The best way is to just reach out and make sure your name is put out there as someone that has an interest in this particular topic or an expertise in this particular category.

Joris: 44:03

Yeah, I think it's tempting to get to know the number one 3D printing people or something. But what we do when we go to events we really look at we want new people, right, you don't want the same five people all the time, 100%. So as an event organizer, you're really looking for new new folks. So we look at the large format rail 3D printing people and ask them who they know.

Joris: 44:22

So it's also being really well, relatively well known or being known as an expert in or being useful to some open source project or a standards organization in a niche is actually a really really good place to start, because we go to literally the best rail person I know and I ask her like hey, who's relevant, who can do this, who can do large scale parts? So it's like in that specific area, you don't have to get to know the number one person in your industry. Get known in your area, your expertise, that kind of thing. And then another question for Richard's like okay, so let me imagine I'm going to do one of these events. Do you have any best practices on doing like an online kind of webinar kind of presentation thing? You know, what should I be looking at to take care of?

Richard: 45:02

Yeah. So if you're a presenter number one, you want to be engaging, you want to have a personality, you want that personality to shine through on the screen. You want want to connect with the attendees and you want to have an expertise in your category. We don't, we don't work with the. I mean we do have, you know, top of the top. You know like we're doing an event and you know we have David Armstrong speaking. I mean, he's the most cited podiatrist in the world and we have him speaking at one of our conferences. But for the most part, I, I'm, I'm with you. You know you, you want some. You want someone that's up and coming, someone that's energetic, someone that brings personality, someone that brings authenticity. You know you don't want to talk about an area that you're not really familiar or super comfortable with. You know you want to have good visuals and you know there are professional speaking coaches out there. Actually, I've spoken with with one. He's in, he's in, I think he's in Ireland. I didn't speak to him for me, we just were talking about collaborating. I think, most importantly, you want to bring personality and and energy to your talk, whatever that may be on, and you want to bring passion, because when you're bringing that, you're connecting with the audience, and when you're connecting with the audience, you're going to create more engagement and more engagement. More engaged learners learn better. That's, that's my two cents on presenting, and I've seen them all Listen.

Richard: 46:25

We we took over a conference called the no nonsense podiatry conference. We took that over virtually six years ago and I basically eliminated three quarters of the faculty. After the first year I said these people are tired, they're old, they're talking the same story. They've lectured the same lecture for year in and year out. There's nothing fresh and we want to bring some energy into it. And now we're sick. We're going on our sixth year in 2026. And this is a 30 hour event with, you know, 40 speakers. It's a monster, and you know so there's. There's some things that you know speakers need to be aware of when they're presenting at these conferences.

Joris: 47:01

And how about technically? I mean, do I need to get a mic? Do I make sure that I'm? You know, I have a lot of light, or whatever.

Richard: 47:06

Yeah, Simple things like that. Well, you don't. I mean you need to, because you know everyone's different right. So we have, we have, we do. Also, we do a journal club once a month and you know my two hosts. They both have these great mics and awesome lighting, and you know, and, and they're great at that.

Richard: 47:26

I personally don't. You know, I have a good background. I have a nice background behind me. I'm not where I am right now, but when I do my events I have a good background, my lighting is good, my sound is good. That's important.

Richard: 47:36

You know your connection super important, like what type of? I mean I connect directly in. I have a direct connection. That's critical. We cannot rely on Wi-Fi, because there's so many glitches in Wi-Fi and we've had them happen in events where their connection is bad. It's not a function of the platform or the event, it's just the individual Internet connection. Oh, I lost connection. Oh, I'm out of it. Oh, I can't get in. Oh, I can't share. You know all of those things. So you got to make sure your Internet connection is fine.

Richard: 48:16

You know how to log into the platform and share your screen, what we do. Unlike any other event organizer that I'm aware of, I sit down with every single speaker before every event. We're doing an event next month 44 speakers. I meet with every one of them, from anywhere from five minutes to 30 minutes, depending on the conversation, and we go over logging in sharing your screen, because sometimes there's settings that need to be adjusted and if those settings are not adjusted prior to the event, there's nothing worse than being on screen and having someone struggle to share their screen or log in. Three minutes online when you're watching somebody is an eternity. So what I do is I make sure to sit down with every single speaker prior to our events. If you don't sit down with me before an event, you don't get to speak.

Joris: 48:56

Yeah, I think that's a really good thing to do. And just also, if you're speaking, if you're working with somebody who's not all about that, then it's not a good sign. By the way, right, that's right. But you can always like, like, use a tool if it's via zoom or whatever tool you're not familiar with If it's freely available. Like, try, test it out as far as you can, make sure it works with the browser using, make sure your browser is up to date. That's also fun. And and also just like, try test, call a friend or a family member or something like that, cause that also could maybe help. And yeah, I've kind of stuff. Yeah, thanks for your tips, rich, and thanks for coming on today. This was a great, great look into your world.

Richard: 49:31

Thank you, man. I really appreciated the time.

Joris: 49:33

And thanks for being here as well, Brent.

Brent: 49:34

Oh, this was great and Rich. Thank you for sharing your journey and your experience, and just sharing like experience really makes a difference. I thought the comments on mentorship, education, where education is going. I think that was all really fun, so I know our listeners will have a lot to glean from this episode. So thank you Awesome. Thanks a lot.

Joris: 49:53

And thank you for listening to another episode of the Prosthetics and Orthotics Podcast. Have a great day.