What It Really Takes To Scale 3D Printing Across Multiple Clinics with Maurice Johnson

We talk with Maurice Johnson from Floyd Brace and Limb about what it really takes to scale digital fabrication in a multi-clinic prosthetics and orthotics business without losing quality. We get candid about software friction, printer economics, adjustable socket ethics, and why turnaround time and cash flow often matter as much as the tech. 

• Floyd Brace and Limb’s growth from a one-office shop to a multi-location model 
• why centralizing fabrication matters when clinicians need to stay patient-facing 
• the industry’s fragmented scanning to CAD to print workflow and why it blocks repeatability 
• what Floyd prints today and why definitive sockets still often stay carbon fiber or outsourced 
• real-world cost targets and the volume problem with larger printers 
• AirFit-style transtibial consistency as a way to reduce heavy CAD dependence 
• Formlabs size limits, throughput questions, and hybrid print plus outsource strategies 
• adjustable sockets as both a patient benefit and an ethical billing discussion 
• material extrusion TPU flexible inners as an alternative to powder-bed fusion variability 
• early thinking on 3D printed SMOs and by-measurement versus cast-and-scan workflows 

Special thanks to Advanced 3D for sponsoring this episode.

Transcript

Season Welcome And Mission

SPEAKER_00 0:01

Welcome to season 13 of the Prosthetics and Orthotics Podcast. This is where we connect with experts in the field, patients who use these devices, physical therapists, and the vendors who help bring it all together. Our mission remains the same: to share stories, tips, and insights that help improve patient outcomes. Tune in and join the conversation. We're glad you're here and hope it's the highlight of your day.

SPEAKER_01 0:25

Hello, everyone. My name is Yoris Peels, and this is another episode of the Prosthetics and Orthotics Podcast with Brent Wright. How are you doing, Brent?

SPEAKER_02 0:32

Hey, Yoris, I'm doing well, man. Funny enough, supposedly, like the Midwest has been in an Arctic freeze. And I'm guessing you do you get snow in Spain? I'm guessing not, but maybe.

SPEAKER_01 0:45

Everybody would be really kind of worried if we got snow around here, I think. I think.

SPEAKER_02 0:48

So anyway, it's coming to the south and the southeast. And uh so there is no bread or milk in the uh grocery stores because that's just what we do. We go buy bread, milk, and uh all the toilet paper.

SPEAKER_01 1:00

Yeah, yeah, all the toilet paper disappears. It's really funny. Do you know that? But it's all psychological this stuff. Like you know how everybody uh like uh like how the all the toilet paper in the world disappeared at one point with the global health emergency. Yeah. Uh and uh and except for in Holland, it didn't happen because there's one guy on like uh he had like and he he was on like uh um what is it, one of those uh uh uh forklift, right? And he just drove around while playing like a really cool song. He drove around a toilet paper factory showing people like there was like holes and holes and holes of uh of toilet paper everywhere, and then it was like, yeah, we're not gonna run out. And then so it didn't run out for a while in Holland as well. That was just that one guy with his little viral video, but yeah, it's a very normal thing to see. I think all those panic buyings. Hope it's hope it's uh over pretty soon.

Maurice Johnson And Company History

SPEAKER_02 1:46

Yeah, yeah. So well, I'm excited about today. Today's gonna be a good one. So we have Maurice Johnson from uh Floyd Brace and Limb. It's a company that's been around that has a lot of history, and so I'm really excited about hearing from him about kind of the journey so far, and they've done a lot of stuff in the digital space, and so I'm kind of curious on uh, you know, some lessons learned, uh some things that they might do differently. And I think our listeners are just gonna get a lot from it because not only are they a regional company, but they all also are smaller as far as like more of a family-owned company, and so those decisions that they make can also have a greater impact on what other people uh potentially may make. And so I'm I'm excited just to hear about you know what's value, what's not valuable, and then um and go from there.

SPEAKER_01 2:41

Awesome. Um, so welcome to the show, Maurice. Thank you for having me. How are you? I'm good, I'm good. We're we're both on good, I think. And and how are yourself?

SPEAKER_03 2:48

Man, I'm doing good. I tell you, Jared got me on this call this morning without expecting it. I will tell you, Floyd Brace, can I tell you more about our company and kind of tell you how we got where we are? Floyd Brace has been around since 1942. Well, when I started at Floyd Brace Company, and I started here in 1993. Floyd Brace had one office in Charleston. We had two technicians fabricated prosthetics. We handmade uh Charleston bending braces, we handmade everything. I actually was hired as a technician. I'm an Army trained orthopedist. I was trained in the Army at Wolf Reed Army Medical Center. And again, I was probably more of a technician when I started. I later got BOC certified, eventually went back to school. I got my master's in orthotics and prosthetics. But I've only I've always only done orthotics. When we look at the fabrication processes, and I think that's where we are right now, like I said, we did everything by hand, and it was our goal in Floyd Brace Company to centralize some of our fabrication techniques. And we started by 3D printing our prosthetic sockets. The challenge that we still face is finding an economical way to still 3D print and provide good margins in the OMP space and still 3D print. Ask me a question.

Why Floyd Chased 3D Printing

SPEAKER_01 4:19

No problem. So when you look at 3D printing, like I think, I think, was it what why did you start looking at it? Was there a cost thing that you wanted to do? Did you want less labor? Did you think it would fit better? What were the real reasons why you did it? And and how'd you go about it?

SPEAKER_03 4:32

Okay, so I'll tell you as an owner of a company why we did it. So we've always done, we always had systems in the orthotic space. We'd we always central fabbed in the orthotic space. So I'd evaluate somebody, maybe get a cast and send it out. I was trying to find duplicatable systems within the prosthetic space for, I don't believe clinicians should be fabricating. I believe that clinicians that are in the back fabricating are not in the front scene patients. And if a clinician is in the back fabricating, they're not making money for the company. So I was trying to find a system whereas my clinicians could, I don't want, I don't want to say, I'm not trying to make it like I'm trying to find a duplicatable system for fabrication for the prosthetic space, like I did on the orthotic side. So that's when we started 3D printing. Go ahead, ask me.

SPEAKER_01 5:30

Okay, and and then and you didn't look at it for orthoses, because we are seeing a lot of people look at orthoses and 3D printing orthoses, but because it kind of is easy and all did you look at that at all or not really?

SPEAKER_03 5:40

Yeah, we we tried to find orthotics, but so who has the system? Who has a system to scan, who has a system to modify, and then who has a system to 3D print? There's no system out there that you could do all three of them that you could present to an O and P company and tell every clinician this is the system and on which you do it.

SPEAKER_01 6:02

So literally, like your ideal solution would be like, you know, bobs scanning or whatever, one size fits all, one number to call, one press of a button kind of system, not like a bunch of different vendors, different material. You don't want to like have to change anything. You just want it to work from day one, right?

The Software Problem Nobody Solves

SPEAKER_03 6:16

Brent's special. There are not a lot of Brints in our P industry. Brent could do, he could he knows a system to scan, he knows a ski system to modify, and he has a system in which he could 3D print. The average O and P clinician coming out of school doesn't understand that they you don't want a clinician having to jump between three, four different softwares to get one device fabricated. That's the problem with the industry, it's all fragmented right now.

SPEAKER_01 6:45

I think that's a really great point to make. I mean, you don't want that from your point of view. Like clinicians should be clinician, let's say, and fabricators should be fabricating. Like you don't want them just messing about with like, yeah, start a software, another software, change it. And I guess also from a maintenance point of view, you don't want to like call a guy and say, oh no, no, the problem's on the material. It's it's it's a printer, it's not us. So so I I understand that that point of view.

SPEAKER_03 7:09

So we went a year meeting weekly trying to just to figure out a system in which to operate. Okay, so let me give you some history here. Okay, so we did everything by hand. About five years ago is when we started. We started buying, so I have everything in OMP. I have a carver, I have the uh the roboticom carver, and we bought the carver because we wanted to eliminate plaster. Then we have we also have the we have Vorum's software for can fit for fabricating, I mean for modifying. We have the foot orthotic for freedom foot orthotic for custom fabricating foot orthotics. We have four CNC machines for carving foot orthotics. So my my point in in saying all this is in the process of trying to find a solution, we bought everything that's out there in the market. We have what's the machine called? What's that thing called to uh modify by hand? The uh the haptic device? We have the haptic device. So we we bought everything out there just to find solutions for the clinical staff. But again, like I was saying, there is no system that's out there that's not without clinicians going from one space to the other. So we went through a process of elimination, trying to find a solution to get things fabricated. And my goal was to not have to central fab. So I didn't say that part. I was trying to get from around central fab central fabrication because of the costs associated with central fabrication, and also to get quicker turnaround times on our autos.

SPEAKER_01 8:56

But that seems a really sensible approach. What's interesting to note, by the way, is that in dental, for example, there are these solutions where they say, hey, well, send to the machine, the post-processing equipment, the software, all from us, all with the same manuals, all with the same training and everything. So in dental, this does exist. So we I think in in OMP, we maybe, you know, you just we just need a little bit more maturity, and and maybe at one point somebody will offer that solution. But I think, especially for people like the Poto printer guys, equal and stuff like that, that I think is the the the place they need to be, is to be at that place where they can be this one-stop shop from acquisition to to fitting, let's say. So yours is is it Joris or something like that. It's fine. Yours is fine.

Volume Math For Big Printers

SPEAKER_03 9:33

So so how are you gonna do it though? Because remember this in Deno, there's nobody's gonna wait bear on a denture. Nobody's gonna wait bear on this stuff. So the so the problems that we're having. So we've looked at the HB printer. So what's the problem with the HB printer? HB printer, how many devices are you gonna be able to print in one run and it still be cost effective?

SPEAKER_01 9:56

Yep, exactly. Hit the nail on the head. That is totally the issue with that thing. If you have a constant volume of devices all the time, that thing is gonna make money for you. That is gonna be great for everyone. And if it just if you have a lot of fluctuation where you don't hit that constant volume, it is gonna be a huge weight on your bottom line. Completely agree. That is the the the shortest summation of the the issue with the uh with the MGF. And then also the other issue is that if you have a little bit more than one machine can be filled, then also it's a noise, it's suboptimal, right? So so if your volume measures what you can get from that one machine or from two or three or whatever, then it's a it's an absolutely beautiful business. But I agree, you hit the nail right on the head that that's just that's the big issue with these bigger machines.

SPEAKER_03 10:34

Okay, so so currently we're using a so every prosthetic 90% of our prosthetic sockets are 3D printed. And how that system works, clinicians still cast, they scan inside the cast for um to modify using Omega's Woolowitz software, upload it to Omega Woolowitz, modify it, and then we're 3D printing a check socket or test socket. We're fitting that test socket, and again, we have seven offices in the state, about to have 10, and they're fitting those test sockets, wrapping the test socket with fiberglass, but we're still fabricating the definitive by hand out of carbon fiber.

SPEAKER_02 11:20

Yes, I'm kind of curious on on that aspect, race is uh so where when does the like when you're looking at all the spreadsheets and all that stuff of the the actual value, where because when you have carbon fiber and you have the labor to do that, you you're I would say fairly cost effective on the material cost of things, not considering the technician's time and all that stuff. But where do you see the or what what would be the tipping point for you when you're looking at the financial aspect of that?

SPEAKER_03 11:53

And what do you mean? So you're talking about the cost.

SPEAKER_02 11:55

So so you're doing all the your check sockets, so you've seen a financial value of doing the check sockets in-house, you're turning around stuff quick. How about when it comes to definitive? When when would you say yes, now it makes sense? Or what is your criteria that you would use to say yes, now is the time?

SPEAKER_03 12:13

So let me help you first. So I'm trying to grow our company. So I do understand that there are going to be more costs associated right now. We're trying to find a solution. So we currently, and this is the other thing I didn't tell you, right? We're central fabbing most of our definitives. We're not necessarily making those in-house. So those costs are staying about the same as they were before. So majority of the other definitive software are being fabricated centrally, centrally fabricated. My goal, however, was to see how could we 3D print a definitive socket and save costs on the 3D printing of a definitive socket. There's no such animal, unless you do you know of one?

SPEAKER_02 12:59

So I think that's where, so when you say central fab, you're central fabbing like somebody outside of Floyd or like Floyd. Okay.

SPEAKER_03 13:06

No, somebody outside of Floyd.

SPEAKER_02 13:08

Okay. So I think probably, you know, my guess is that you would be, and I'm just making an assumption, is looking at some sort of lateral move financially, potentially, hey, can we turn it around a little bit quicker into the 3D printing space? And that's that's what would actually start tipping the scale. And then as volume would increase, you either bring it in-house via machine or the volume increases on the central fab side where your pricing keeps on getting better at at scale. No, no, no.

SPEAKER_03 13:41

So so I will tell you that the problem again with with that, I I've even looked at using a print farm to print definitive sockets. And actually the cost is more than having it laminated.

SPEAKER_02 13:54

So so but if it wasn't Yeah, what was it? If it wasn't the so I and I don't know, I I mean, I guess I don't I don't know how much you want to share or don't want to share, but like, is there a number in your mind? Hey, if I can get a definitive socket and then a definitive socket in with a flexible enter under this much, then stuff gets interesting.

SPEAKER_03 14:15

Yeah, what do we pay now? Yeah. I think we paid between seven and eight hundred, and sometimes it's a thousand dollars, depends on who you're getting it for. It was my hope, which is unrealistic, that you can do a socket for five, six hundred dollars 3D printing, and there's no such thing.

SPEAKER_02 14:30

Man, it's been a while since we talked, Maurice. Maybe offline off this one. Yeah. So anyway, I mean that's an interesting thing. So I and I think that's pretty much what I'm seeing on the contract manufacturing side of things is a carbon fiber socket is gonna run you anywhere between, depending on the size and components, five uh thousand bucks for trans transtibules, nothing too crazy like adjustability and that sort of thing. So um so so can I can I make a point though? Yeah.

SPEAKER_03 15:01

So so can I tell you what my goal was though?

SPEAKER_02 15:05

Yeah, sure.

SPEAKER_03 15:06

So my goal is so we have new clinicians, we have residents, and my goal was to find a solution, like I said, that's duplicatable, but software is also the issue. When you say software is an issue, I mean you could 3D print all day long, but you got to get to that point. You can't get to that point with somebody right out of school. You can't get to that point with CanFit, then we got Omega, then we have, man, I tried our companies tried multiple softwares. There's no solution. What are you using now? We we've done, uh what did Josh do? Josh did uh yeah.

AirFit And Repeatable Transtibial Fits

SPEAKER_02 15:46

Yeah, you've done a lot. So I think this is this is where things get really interesting. And I actually just, well, obviously we've got uh Jared back in the uh background there too, a little bit listening in. And you know, I think one of the things that I think I'm really proud of what you guys have going is that you're looking for clinically relevant solutions that can be replicatable as you scale and grow. And so one of those solutions, and I can just speak from personal experience and I can't wait for you guys to get your hands on it, but um, I and I would say that I was a little bit skeptical at first on the airfit system, right, for transtibule sockets. So transtibual sockets make up a pretty large percentage of all the prosthetic uh sockets in in the United States compared to say transfemoral. And one of the things that I believed, you know, uh my belief along the way was how can I create a socket with my hands that fit all the patients? Yeah. And the reality is I can do that, right? So I am one person, I can do that, but I am not available to be in multiple offices like what you're scaling now. Yeah. So one of the things that I think is so great, and one of the things that's been challenging for me because of the work that I do in in Guatemala and some of the developing world stuff is how do you scale that side to be as close to software free as possible, right? So for Transtibules, I'm talking specifically for transtibules. What I've found with the Airfit system that gets me so excited is no matter the limb shape and no matter how they present, how gnarly it is, I've been in the ballpark, you know, I would say hitting a home run every single time with that system. And I'm into the double digits now with that system, just over the last few months. And so that to me is very interesting because if you can do the transtibial sides and say scan, you know, regardless of scanner or what have you, and literally it's a smooth-of-the-model alignment, which is a clinical decision, and then into your test socket, into your definitive, what that does is everybody, like if you're going to 10 offices, everybody gets on the same page and everybody knows what the results will be from that sort of situation. And that then takes the overall pressure down and you can really focus in on some of the other things that aren't so cookie-cutter, like you know, transfemoral socket, even though we're working on that side or some of the dynamic AFOs, things of that nature. But you've taken it's almost like a pressure valve. You've taken this pressure valve of a high volume thing and made it very clinically relevant, but consistent to where you're successful, you're minimizing follow-up appointments, any skin issues, things of that nature. And to me, that's what's exciting is how can we get to that point where that cast or that image is what you're going for in the final socket.

SPEAKER_03 18:48

So, Brent, so you're saying we're going from cast to socket to definitive with this system. I'm confused. Yes. So you're saying we're we're not using software, the software component is out of there.

SPEAKER_02 19:04

For transtibule, you can scan and smooth and go straight into an automation to create the sockets and you're done. Yes. So you may smooth in, you know, whatever software you want. There, and I'm happy to share more about what we're trying to do to do on the cost effective side of things. Yeah. Uh, for the smoothing and the alignment side, which is a clinical input. But uh yeah, I mean, I haven't even done a I have fit the last seven patients that I've done. I didn't, I went straight to definitive. I didn't even do a test socket. And these are like gnarly, like crazy limbs that you would you would think that this would be a two or three test socket deal. And that was not the case at all.

SPEAKER_03 19:48

Yeah.

SPEAKER_02 19:49

But that's what's exciting is that you could do it, Jared could do it, the new resident could do it, and they would be the exact same as what I would do. And I think that's that's the exciting part is this hybrid, it doesn't take away from what we do clinically. It's just that we're front loading all that information in so we don't have that middle section of guessing essentially the modifications and then doing it, then you go into the test socket and then the definitive. And I think that's the exciting part is we're putting the value of the data front loaded by the clinician to create the output that we want.

Cutting Time To Improve Cash Flow

SPEAKER_01 20:26

And then and then Brent, if you if okay, that sounds great. You you should get these Airfix people to pay you. So you should be like a spokesperson. Hi, my name is I'm a spokesperson for Airfix. Uh, and um, and then what would you advise for them later on? What could they be looking at if they if he wants to get the cost down? This seems sensible, right? Airfrit sensible. What would you advise for them like if you go later into like actual making the things? Like, would you should he look at a print farm type of thing? Should he look at maybe uh, you know, you could outsource it still. What would be the solutions if you know if if you're if you're like you know, like these guys you're looking at costs, what do you want?

SPEAKER_02 20:59

Yeah, I mean, I think the the biggest thing is is being laser focused on where to save the biggest amount of time. So, yes, can you find a 3D printing socket for five to eight hundred dollars? Yes. But what about those sockets that do reimburse better, say something with an adjustability or something to that effect? That would be a pretty interesting way to do it because not only is your turnaround quick, but your access to a clinically relevant good patient outcome thing with the adjustability and a higher reimbursement, your that time gets compressed between the start and the the finish where you actually get your money. And I think there's a lot of value in that. And so there's there's different ways to do that. Yes, there's bigger machines that you could put multiple things in, but then I in yours, we've talked about it. The form labs fuse one with. Nitrogen runs runs like we call it our nitro material, which is the PK 5000. You can almost fit most transtibules into that socket or into that machine. And it's a very cost-effective machine to run. And then maybe that's the way you start is hey, on this on the ones that we can fit into the machine, we're gonna drive our material cost down to next to you know a really good value, and then we're gonna outsource the bigger ones to get rolling, and then just see where that takes you. And I think that gets very interesting.

Formlabs Limits Size And Throughput

SPEAKER_03 22:32

So we looked at form labs. And the the problem I had with form labs is you know, we're in the south, man. There are not a lot of people whose socket is the size that'll fit into a form labs 3D printer. Again, I looked at um my um MJF and SLS. Opinion, my opinion, and my very little research, you're gonna get a similar product. I've also found that SLS printers you could find for a whole lot less expensive than the multi-jet fusion, which HP has. Again, the form labs, when we looked at the form labs, is just too small. It's just not I mean, how many sockets you want to get out of form labs?

SPEAKER_02 23:18

Yeah, but if your material cost um is$150 or less, that might be something worth looking at.

SPEAKER_03 23:27

So how long does it take take to print a Form Labs socket?

SPEAKER_02 23:30

I mean, you you would be, I mean, with the Fuse One Plus, I think you're into that part in under 24 hours.

SPEAKER_03 23:37

Okay. So so this is the point I'm trying to make. For an office that has, for a company that has seven locations that's fitting sockets every day, how many of those are you gonna need just to to make that one system throughout your whole company? Every office I have to will have 10. Will I need 10 of those just to just to support my company? That's the problem. I'm that's the problem I have.

SPEAKER_02 24:03

So I and I think these are good good discussions to to have. But I think so. What what really corner, but I'm just telling you, we've looked at all of this. This this is the way that I look at it. So, okay, so if I know that my material cost, let's just I'm just gonna use$150. It could be less, could be a little bit more. I can't believe it would be much more than that just because of this as a smaller build chamber. But let's let's just pretend that you are able to uh get let's call it three adjustable sockets into that machine a week. We're not struggling hard. This is during the day, you're harvesting all that stuff. So you have generated.

SPEAKER_03 24:44

Can we do this? Can we not say adjustable socket? Can we say just a regular socket?

Adjustable Sockets Profit Versus Ethics

SPEAKER_02 24:49

Well, I want to uh so yeah, we can say a just uh uh regular socket, but the adjustable socket gets really interesting because now you're spread between what uh yo, you are already going to have for a socket, a regular socket, let's call it six to eight hundred dollars that you've got your sunk cost into that. You're already going to pay that no matter what.

SPEAKER_03 25:15

Yeah.

SPEAKER_02 25:15

Let's say for another six hundred dollars, say you're in the twelve to fourteen hundred dollar range, that's assembled, adjustable socket. That's that would be your cost if you contract manufacture. But now your spread is three thousand dollars more plus your base codes. Now we're talking a pretty good spread. If you bring it in-house, it's even a much better spread because then you're only looking at your material cost and your cost of goods for, say, bringing the reels in. And so that spread is can literally be thousands of dollars. And if you do three of those a week, 12 of those a month, you are you are printing money at that point.

SPEAKER_03 25:54

I I get that part, but this is my problem with the adjustable socket. Because I've thought about this. The same exact thing. Am I gonna tell every clinician that works for me to put everybody in an adjustable socket? How ethical is that? I mean, I This is another discussion. Yeah, this is another discussion another day. But I will tell you, you know, when when the idea of being able to put or bill for the adjustable socket was out there, am I supposed to tell every clinician to put everybody in an adjustable socket? That's why I wanted to do it based on a regular socket to see if that'll pay for it before I even did.

SPEAKER_02 26:34

Yeah. Well, I think the I think there's meat on the bone. I was just saying that there's there's a lot of meat on the bone when you're talking adjustable. And then, you know, I mean, would you say that many of your patients wear socks and change socks throughout the day?

SPEAKER_03 26:48

That's a good one, man.

SPEAKER_02 26:49

Yes. Okay. So if they had the opportunity to adjust and not use socks, is that the right thing to do for the patient?

SPEAKER_03 26:56

That is the right thing to do. Okay. So yeah, I'm an orthodist. Go ahead.

SPEAKER_02 27:00

Yeah, yeah, yeah. Yeah. So so uh the bottom line is uh um you you absolutely, as an owner of a company, should not dictate uh whether you're a prosthetist, orthopedist, or what have you, your clinician's decisions. But uh, you know, I can just say from say an East Point side of things, is if the patient has the ability to think about that, and if they do change in volume, it is absolutely the ethical thing to do to get them an adjustable socket. But we're not going to mandate that. Yeah, but uh, we have created a system to where, you know, those sockets, if you traditionally fab them in-house, you know, you're talking about an eight-hour day for a technician for one socket. And then if you outsource that, you're gonna get hammered, you know, these are 20, 22,$2,500 sockets. There's no meat on the bone after that, and then you're you're pretty exposed financially, especially if you don't get the code for the adjustability. But if you have that same ability to put adjustability on and it costs you the same amount other than the real to make, but it takes a little bit more on the design side of things, you're you are not leveraged like you would be with in a contract manufacturing side of things. And so from the from the financial sense, that's where that's where it makes sense, but it's also the right thing for the patient. That's that's why I love the adjustable socket thing. But yes, uh, as far as uh can you for the sockets, let's just say you did 20% of your sockets in the form labs, which I know you would want to do more, but the ones that could fit in, um, you know, your your material costs at$150 a piece, you're still saving uh you know, say let's call it$400 pretty easily per socket. You would easily be able to pay for a system within a within a matter of months.

SPEAKER_03 28:55

So let's build my system since we for your for your listeners.

SPEAKER_01 29:02

Yours is loving this. I love I am I'm loving it. This is my this is like literally my favorite episode so far. This is wonderful. I love this. So let's build my system. I love the honesty. I love the honesty. I think this is great. It's wonderful. Yep.

SPEAKER_03 29:14

So we're saying we could use the what's the system called? The AirFit. All right. So we get a model with the Airfit. We scan the inside of that model with a scanning app or the combs app or the the i scan.

SPEAKER_02 29:31

Yep.

SPEAKER_03 29:31

Right? And we're going from there to a definitive, correct?

SPEAKER_02 29:36

So it depends on how you how you want to work it. So I'm not saying, so I am comfortable going to a definitive, but it's gonna take some of the other clinicians, especially if you don't know the the system well. Yeah. Where you say, let's just say you didn't pump it up enough or something to that effect. You're gonna have to throw in a pad, or you you just don't want to go into definitive right away. Yeah, it's okay to go to a test socket. So so the system would be air fit, scan, yeah, software, and there's simple software to align smooth. You know, if you have a wrinkle in your in your model or something, you could definitely take that out. And from there, the socket is automatically generated and it goes straight on to your 3D printer.

SPEAKER_03 30:20

Okay, so the adjustable comes in for the definitive.

SPEAKER_02 30:24

Yes. Yep. Now you could do like the if you wanted to just see how the adjustable works for you could do like this a surface mount and you could keep those around for test sockets. So whether you do a posterior hinge style or you're cutting out uh a multi-panel type of thing, you could do that, take a little bit more work, or you could, I mean, you could print that. It wouldn't be as automated to get the the panels out. We could, now that you say that, we could make that automated, but um, so you could get a test socket and print those panels out. But that's the way that you would check to say, okay, is this and if that if that helped you feel better about the process that you actually are trying the adjustability in the check socket, I think that's a win.

SPEAKER_03 31:11

Okay. So for your listeners, we're we've ordered the AirFit system. Yep. FYI. Jared is gonna come on here after he uses it. And I'm gonna get, you hear me, Brent? I'm gonna get a Form Labs 3D printer.

SPEAKER_01 31:27

Wow, very good. No, I th I think I think for your setup and the volume, I think it it's tantalizingly close to making a lot of sense. But the thing is, I think you were looking for a one-size-fits-all kind of solution, and we're just not, but I don't think we have that maturity at the moment. It's kind of like when they used to like make Model T kind of vehicles, and it only took a couple of years before anybody started having a vehicle that you could adjust to make it into a delivery van, an ice van, and a repair van and all these things, you know? And we're just not there with exactly having the total lineup that the the that you would need to just have a like, you know, you phone. And that's why you can make money with this. It's because you are, in essence, a pioneer, because it isn't as easy as just ordering, doing an online training, and then off to the races. It is still difficult, you know?

SPEAKER_02 32:11

Yeah. And I think Maurice, you hit the nail on the head though. You have a Jared, right? People like Jared don't grow on trees. So having the human capital to to do that and the passion behind it, you know, somebody that's not going to be like 501, it's time for me to go, you know, head out the door. That's a that's a big, big deal. And, you know, not all companies have that luxury in that. So, but I think what this has shown is it is a pain, right? It's a pain point for many business owners, and there's not a great solution that covers it all. But it also shows that our field is it's it's unlike aerospace, it's unlike other things because our patients are moving targets. They're getting smaller, they're getting bigger throughout the day. Um, they don't show up for appointments, they all of a sudden show up for appointments. We have insurance things. It's the that whole package is a difficult one to solve. It's a it's a difficult problem to solve. And and taking that first step, sometimes I mean, you've found that out. Yeah, I think you you Maurice, you and I might have be uh be very close to the amount of money spent trying to figure out solutions.

SPEAKER_03 33:21

Everything. I have everything, everything there's out there, I have. So as we as we talk right now, I'm sitting here thinking of a system because I have clinicians who are definitely not like Jarrett. I have uh one clinician, he loves to do everything by hand. But as you for me as a growing business owner, I'm trying to find a system that when somebody leaves Floyd Brace Company with the socket, it's a unique socket to Floyd Brace Company. And I want something that everybody, I won't say everybody, because every clinician makes something different and everything looks a little differently, but I want something that's unique to the company that everybody, and I'm talking as a business owner, I'm not talking as a clinician, that I want everybody to want. I want everybody to find to want my system, I want everybody to be able to get in and be serviced faster than normal. So I think my Airfoot system, my form labs printer, and all that combination might help us. I don't know.

SPEAKER_02 34:26

Yeah, well, let's I mean, since we've we've been so honest, you know, and I'll uh and I could start here, but how important is cash flow to you?

SPEAKER_03 34:34

My goodness. I need it. Yes.

SPEAKER_02 34:37

Yeah, so so if you can shave two weeks off a delivery time, there's value to that. Yes. Or because you get your money two weeks earlier. Yes, yes. That's the goal. Okay. That's the goal. So yeah, so I think, and we don't we don't get into this as much uh yours just for you, and then for I mean, we have some non-clinicians that that that listen to this too that that wonder why it's so hard to even sell into the orthotic and prosthetic industry. Even if the product is better, you're not waiting an extra two weeks if you can do it traditionally. Is that a fair statement? Right. That's fair. We cannot we cannot wait on the cash flow. We've already sunk in clinician time, parts. A lot of times we've already paid the invoice, a net 30. So, so if the the real trick, and I think the opportunity for additive manufacturing is to tell the story to business owners and to deliver that hey, this item that currently takes you this amount of time, we can squeeze that time down and get you great patient outcomes, great clinical outcomes, and your money faster. That's a good story to tell.

SPEAKER_01 35:45

No, I think I think that's a really great story. And okay, so let's talk about this case a little bit more because I think this is really cool. Like given the setup here, given what Maurice's infrastructure is and what he wants to do, like there could be two other options, and and and and Melissa already talked about it. Like one is a print farm kind of thing, and the other one would be kind of like getting an equal or a proteor, like the Filament Innovations larger material extrusion system kind of thing. Would you recommend either one of those, Brent, as an alternative path? Because see, on the on the if we're looking at this, this, this as a capex, uh kind of cash flow type of deal, right? What can we invest now, which is limited because we have limited cash flow generally and limited margins? And also in the same sense, what can generate me more cash in the future in an incremental way that with an investment that is manageable today, then you know, material extrusion with these cheaper desktop printers that are less capable but could be very capable for certain things, uh, or less capable of details and essentially, or like a really larger, much larger kind of like pellet-based or other kind of system. We could be making a lot of low-cost parts as well. Would you recommend that as well in this setup? Or would you say, you know what, go with the form labs and then and then that'll really gauge the value, and then later on maybe look at these other things?

SPEAKER_02 36:54

Boy, Yoris, you know how to ask the questions, don't you?

SPEAKER_03 37:00

So so Brent, I gotta, I gotta agree with him because this is the other thing that the you're talking the Icarus printer, correct?

SPEAKER_01 37:06

The filament and any any 3D printer that prints either pellets or or um so anyway equal proteor, whatever they have the but the the we were we like we had a lot of filament innovation guys on, and that that is a really great robust system. Yeah. And it's it's not super expensive, and the costs are not really high. And you've got me all worried about how big Southern people are.

SPEAKER_03 37:29

So well, but you're also talking about a larger something printer that I could print TLSOs in as well. There's some more orthotic stuff that you could do in that in that larger printer. Am I wrong or right, Britt?

SPEAKER_02 37:41

So so one of the things that I I wouldn't, but that's interesting. That's a really interesting you said that.

SPEAKER_01 37:46

But yeah, go on, right now.

Moving From Powder To Material Extrusion

SPEAKER_02 37:47

So one of the things, and I don't think I've ever said this on the show. So one of the things about powder bed fusion TPU is that it goes through three thermal cycles. So the first one being the printing process, the second one being the dyeing process, and the third one being the vapor polishing process. At any time in those three cycles, you potentially can run into tolerance issues. And it just is what it is. And we got tired of that. And I've never said this on the show, but we have actually started moving away from powderbed fusion TPU for most of our sockets because we have, I would say, the best FDM wizard in the world that's able, he's able to dial in settings on printers and that sort of thing. So we've gone and we've significantly, and and and um Maurice, we can talk further about this too, but for flexible inner sockets, we have lowered the price so much by doing it that way using material extrusion or uh fuse deposition modeling. And I learned from yours last week that it's material extrusion, we're trying to get better about that.

SPEAKER_01 38:51

But using people are making fun of me with uh just like defense, don't worry. I wasn't trying to like maybe feel bad.

SPEAKER_02 38:58

But uh no, but so all that to say is with some of these uh lower cost printers. I'm talking of uh Bamboo H2S, Bamboo H2D, the uh Creality K1 Max, uh even the Neptune um Elegou, whatever, you know, Max. Um those are capable of producing beautiful, flexible inners that you're that you can be proud of that have the lattice structures that we've been using with powderbed fusion, and they just flat out work. Um, and so we've been doing that for probably goodness, about the last year, and it's been pretty incredible. So, all that to say, when you're taking a look at your actual cost, taking the powder aspect out of the TPU lowers your material cost significantly for a wonderful end-use product. And we're really excited about that. So you use still have your frame with uh the nitro material, the PK, but you're doing a material extrusion flexible inner that then if you choose not to do adjustability. Guess what? If they go up to five ply and they're consistent, you just reprint one of those flexible inners and reduce it five ply, and you're off to the races. And you could do that. I mean, you could charge for it, or you could do it for free and you would be out next to nothing, other than a little bit of design time.

SPEAKER_01 40:26

And that's what we are excited about. Yeah, I think that's amazing, but I think that's a really amazing approach. It's really, but that is like you're changing your system, your entire design system, your workflow to figure out like to work within the the realities of the manufacturability of these devices at this point, and kind of zigzagging through this process. I think that's really great. And on top of that, I think for orthosis, for example, I would look at the smaller systems, right? Personally, or maybe belt-based printers or that kind of thing, just to keep that that that kind of low uh caught low cost as an investment, but also just that that that also is completely doing on a low call, lower cost system, in my mind. And I think that would also really reduce your prices. So I think but would you you would agree with me on that one? I think Brendan on.

SPEAKER_02 41:08

Yeah, I mean, one of the things too, Maurice, I know we've talked about this early on. We believe and we are starting to deliver SMOs with material extrusion TPU inners and with these frames. And it's it's it's pretty amazing the results. And I'll Maurice, I'll shoot you a text of the latest one that we did. But it's it now starts making sense, um, even for some of those smaller things, like like the SMOs and such, where you can, you know, turn around quickly, get them the exact way that you want them. Um and it's it's it's it's a really neat thing. So the the material extrusion side of things and not having to worry about TPU and powder has really been an eye-opening experience. And I would say even more eye-opening over the last three to six months. And so, Maurice, we hadn't talked probably for that amount of time. Yeah. And uh, so it might be due, you might be due to come up and and visit again on some of that just so we and we're happy to share in some of that, you know, when we look for a small tribe of people that believe in taking care of the patients the way that they need to be taken care of, care about outcomes, and then care about share sharing knowledge across some of the platforms, all the while creating your look and feel for your specific company.

3D Printing SMOs Without Overload

SPEAKER_03 42:33

So, so Brent, you sped past something, and I I want to go back.

SPEAKER_02 42:37

Okay.

SPEAKER_03 42:38

So let's talk 3D printing SMOs. Are we are these SMOs by measurement?

SPEAKER_02 42:42

So you can do by measurement.

SPEAKER_03 42:45

And if they're not by measurement, how do you get to the to the final product? Are we saying we scan a cast, then we modify using what software, and how do we get to the end? Because again, yeah, remember that's the challenge. The challenge is getting to the final product and making it duplicatable for every clinician. So the most most of these people, most of the people you probably have on this are people who understand the process of 3D print, people who are looking at additive manufacturing and they're doing it every day. I'm a I'm a business owner who's looking for to reduce costs, speed up service time, speed up wait time, speed up reimbursement time. So I'm finding, I'm looking for processes, but I can't tell you that every clinician, and and this is what is the holdup, and I know we're going back in the conversation, but the holdup is not every clinician is gonna be able to do what you do and what Jared does.

Wrap Up And What Comes Next

SPEAKER_02 43:45

Yeah. Well, and I think that's where it becomes how to so on the SMO side of things, the design. So, like for East Point, I can tell you what we do. So, I mean, Sure Step does a reasonable job on their smaller one. By measurement, you know, whether you're like two, two and a half inches on the ML at the Metheads, you can get away with pretty much everything. They they really struggle and they know they struggle when it goes bigger than that. Or you're going to what they call the big shot or the big shot light. Yeah. Yeah. So at East Point, because those are expensive products anyway, that's where we have started to concentrate as big shot, big shot light. Something that if you can get a cast or a scan of one side, we can always mirror to the other side to make make a bilateral set. And so that's been kind of our thought process. All the while we're we're really leaning into and trying to validate our by-measurement system to see if we can we can actually have some of the replicatable ones for the smaller feet so you don't have to take a cast. But this was a way, this was a pain point for us is we would have big shots and big shot lights that would not fit. And I don't think we're in the minority with that. And so we're like, hey, we're having to go back anyway. If we brought this in-house, we're saving a clinician uh something, we're also saving costs, and we're putting out a product that's unique to what we do. And that's that's that's how we've started. And the by measurement is definitely where we're wanting to get.

SPEAKER_01 45:18

All right, guys, I really love this episode. And but we need to stop here before before first off, Maurice is gonna put me out of a job, or if we keep on going, we'll put a but we'll put Brent out of a job. Yeah, uh, I thought this was great, guys. I thought this was a really wonderful kind of like I love your honesty here, Maurice just being like, hey, so what what works? And and I really, really thought this was a very, very valuable episode for people listening. So thank you so much for being on with us today. Thank you for having me. And uh yeah, we look forward to having Jared back and uh then and you know finding out the uh you know what you guys found of how you're you're working with the foreign lamps thing and how you're working with the airfix system. Uh that would be wonderful to figure out like how progress is uh being made there. So that'd be cool. So we'd love to have Jared on uh later. Thank you. And uh yeah, Brent, you I know you love this, right?

SPEAKER_02 46:04

Well, it's it's it's fun to have the honesty, and I'm not gonna I'm you know, I'm not gonna edit out anything, even like the some of the costs and such. And and the the reason being is that it's always so nebulous. And I and and Maurice can kind of sh you know speak to that too. It's like, hey, this is the kind of pricing and that sort of thing. But no, let's get some real live numbers and let's let's let's run them and see if it makes sense business case wise, and when does it make sense? And so I think that's where this value, this, this episode is so valuable.

SPEAKER_01 46:33

Yeah, awesome. So thank you for listening to the Prosthetics and Anatolics podcast. Tell all your friends about us and uh have a great day.