“What are the advantages or disadvantages of having your business in a rural or urban area?”

Houston [is] the fourth-largest city in the United States. There’s a large client base, and there are a number of support and peer counseling groups. With [many] practitioners and facilities in the area, there’s a lot of infrastructure that’s already been set up through the years. That’s what’s nice about the urban environment.

Where the challenge comes in is [that] what works for one individual does not necessarily work for another individual. But [patients] come in wanting a leg just like Joe they met at the supermarket. I’ve had that happen with a lot of my patients. And they’re expecting the prosthesis can do it all for them.

I’ve got a lady, 62 years old, [with] chronic pulmonary dysfunction, [who requested] a sprinting leg, because she saw a person at Wal-Mart running around on their running leg. She never started running or jogging, [but] we were able to increase her activity level [with] a lightweight foot and it improved her outlook. We were able to get her [from] staying in her assisted care facility to [being] able to go out with her friends to tea houses and have fun.
John Gibson, CPO, LPO
Hanger Prosthetics & Orthotics Inc.
Houston, Tex.

One of the biggest challenges we have is a very large coverage area—we may have [only] 45,000 people in Grand Island, but [we’re] probably serving 100,000 throughout central Nebraska. Some of those communities are 100 [or] 150 miles away, so we might have a 300-mile day of driving [when we do] clinics.

[NOPS has] four physical locations, but each of those locations also does clinics in other communities. Grand Island does clinics in McCook and North Platte, Hastings does a clinic in Columbus, Lincoln does a clinic in Beatrice, [and] Omaha does a clinic in North Fork.

I’ve seen us grow in the last eight years from having one part-time person to two full-time office staff, just to be able file claims and chase money. It’s hard, because you have to hire more people to do it, but in order to hire more people, your practitioners have to be busier and bring more in. It used to be [that] I might do 6-7 patients a day, but now I see 15-16 a day. So [we have to] expand out of our normal area to pick up that business.
Cory Schutte, CO
Nebraska Orthotic & Prosthetic Services Inc.
Grand Island, Neb.

Everything is close by—everything we do is pretty much within Manhattan and the surrounding boroughs, within a five-mile radius. I use public transportation to do everything. [The lab is] about four blocks [away]. I sometimes walk back and forth three or four times in a day.

[New York City] is just so much denser, population-wise, that there [are] many more patients [than in a rural area]. There’s more competition in terms of practitioners, but [with] so many more patients, we don’t go out looking for work; it pretty much comes to us. Once you’re established with the doctors, they have plenty of business to send your way.

[NEOPS works] out of NYU Medical Center. We have a small office [where] we do the inpatients in the Rusk Institute, which is the rehab part of NYU. The doctors also refer work to us [for] their outpatients. A lot of the doctors just give [patients] the prescription and say, “Go see the fellows in room 312.” Sometimes it’s a little crazy for us, because they just show up at the door, but it’s convenient for the doctors and the patients.
Tom McGrath, CP
New England Orthotic & Prosthetic Systems LLC
New York, N.Y.

The advantage of the Schererville location is that it is [part of] the greater Chicago area, so a lot of the physicians in the city are also covering clinics in the smaller towns. Having a footprint with facilities [both] in the city and the surrounding areas allows for better patient care.

Those doing the care in the [more urban] hospital setting, [who] handle the most serious cases, are often asked to cover the outlying clinics. So “Dr. Smith” in the University of Chicago hospital covers the clinic in southwest Illinois, and his patient who comes to him from Indiana can receive consistent care from the same company both in the metropolitan and the rual area.

If I were a patient, that would be an advantage to me. If I live out in the country but I still want access to the best quality care, but I don’t want to drive into the city every time to get it, I can get it locally. By the same token, when I’m in the city, I want to get as much done as I can while I’m there. It works out well.
Marty W. Buckner, CPO
Scheck and Siress O&P Inc.
Schererville, Ind.