In this new highly volatile medical world of HMOs, consolidated purchasing and billing, and giant medical corporations, the physician is receiving more and more pressure to use the cheapest possible product. In some cases the product may not even work effectively. Unfortunately, most physicians are not trained in biomechanics, mechanical design and engineering, or even the proper selection and fitting of braces. The physicians often rely on their technicians, nurses, orthotists, or physical therapists to help select and fit the proper brace. Even orthotists may not fully understand all of the design weaknesses that are inherent in some of the latest breed of rehabilitative and functional braces, much less the other professionals. The result is that the patient is placed at increased risk without the physician or patient knowing about the risk.

Sometimes the difference between a properly functioning product and one that has many inherent weaknesses is not even a question of the cost. Many companies simply want to sell something and have become very good at marketing! They do not pay close attention to the design details! There is no effort to make the best possible product for the patient in a given price range. They wine and dine the physician in order to get the business. Without adequate knowledge to properly evaluate each product's ability to meet the requirements of the patient and the procedure, the physician is playing Russian Roulette!

The physician holds the ultimate responsibility for the patient's problems, not the manufacturer! As soon as the patient leaves the doctor's office, the brace is no longer the "X brace", it has become "Dr. Smith's brace". The physician has selected the product and placed it on the patient with the patient's full confidence that it was the proper treatment. It is also true for patients that leave the office without a brace (when they could gain significant benefit from one), that they talk about "Dr. Smith's treatment". They discuss their procedure with their friends, and they talk about the differences between the methods of Dr. Jones and Dr. Smith. The physician gets the blame for all of the difficulties that the patient experiences. Modern patients are not ignorant, they talk to a lot of other people!

It is very important for physicians and medical professionals to adequately educate themselves on the products that they use. It reflects on their professional skills. Physicians should never permit the use of a particular product strictly on the basis of its cost. It is never completely a question of price, but rather it is the price performance ratio coupled with the ability to meet the needs of the patient's particular condition that is important. This is called value! Even simple modern medical procedures can cost a few thousand total dollars to the patient and his insurer. The difference between a product that functions properly and one that functions poorly, is often very small relative to the problems that are created for the patient and the physician's reputation. Think twice about the proper product!