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Business Strategy

Last week I talked about the historic outcomes of business strategy during previous economic downturns. The jury is still out on whether we will officially enter a recession, but facts are facts. We are experiencing significant inflation, which means the cost of existence is increasing. The rates of inflation vary across markets, and even without a supply shortage, the cost of transporting those goods to the end-user is increasing with no good solution in sight. 

So, I stand by my statement that the business decisions you make in the near term can have a serious outsized impact on your future. The good news is that your OPIE System, which is so much more than a patient record system, is the most powerful tool available to O&P practices as you seek to strategically manage your practice. 

The “best practices” identified and vetted by your peers have informed the business intelligence tools and the Choice Acuity Reports that give you unprecedented and unparalleled insight into your operations and the opportunities for improvement that can most impact your business. As times get harder, your best chance of success is to focus on your output. This means to take a fresh look at your mission, your purpose, and determine how you can fulfill that despite the fresh challenges. 

While your first reaction is to minimize losses and protect what you have, that approach is the one that is most likely to lead to your downfall. Roughly 4 of 5 companies that take this approach underperform their peers coming out of a recession, according to the Harvard Business Review. The course of action most likely to lead to success is one where you strategically invest in your people, processes, and tools to reduce your operating costs by increasing efficiency and productivity. This allows you to avoid staff reductions and other painful actions. Your goal should be to eliminate wasteful spending and make the most of the resources available to you.  

How are your people spending their time? How much does it really cost you to deliver an AFO? A TT prosthesis? How many visits does it take your practitioners to “get it right?”  How many follow-ups, on average does each practitioner have? Could their time be better spent on Evals and Deliveries? How much time does your CPO spend fabricating? 

How long does it take you to bill for the services you provide? How many days, on average, does it take from when the clinician sends the codes to admin until we deliver? Or send the bill to the payer? Are there things you can do in your practice to speed this up? A dollar today is worth more than a dollar tomorrow, so how do you shorten the time it takes to collect those dollars? 

OPIE Business Intelligence makes it easy to find opportunities to improve. If we can help you save or find just 48 minutes per day in “wasted” activity, that equals about an extra month in the year. How much more revenue could you achieve with one more month? Do you think that could give you a competitive advantage? 

At OPIE, our team is committed to your success. Let us help you make the most out of your practice. 

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Practice Management Response to Recession

As an O&P practice owner, the decisions you make in the next couple of weeks may determine whether or not your business survives the next year or two. It is no secret that the United States is experiencing record inflation. Inflation in and of itself is not necessarily a bad thing and The Federal Government has mechanisms to keep inflation in check. But the levers require a deft touch. Most economists are predicting that the United States will experience a recession and some are arguing that we are in the beginning phases now. The next actions to be taken by The Federal Reserve (the Fed) will be critical to successfully managing the risk. But now we have another shock to our system with the war in Ukraine. According to an Economic Report from Market Watch, as well as observations we can make on our own, prices are increasing at the same time as our economic growth is slowing.  This combination can create a very difficult scenario called ‘stagflation,’ which the United States has not experienced for nearly 50 years. Let’s hope we do not get there!  

On March 14, 2022, the Wall Street Journal’s Dion Rabouin warned us that Fed policies could send us into a recession. A recession is a significant decline in economic activity that lasts for months or years. It is declared when a nation’s economy experiences negative gross domestic product (GDP), rising levels of unemployment, falling retail sales, and contracting measures of income and manufacturing for an extended period. It is too early to have the actual GDP numbers for the current period, but leading indicators are strongly pointing toward recession. Without decisive action by the Fed, the likelihood of course correction seems slim. So, what can you do? 

There is little research that has been done on strategies to help companies survive a recession.  The most common advice is to get ahead during the good times so you have the resources to weather the storm. According to the Harvard Business Review, “historically 17% of companies will go out of business during a recession.  And only nine percent were operating at or above their pre-recession levels three years after the recession ended.” HBR goes on to say that “firms that cut costs faster and deeper than rivals do not necessarily flourish, have the lowest probability—21%—of pulling ahead of the competition when times get better.” Conversely, those that invested boldly only had a 26% chance of emerging victoriously. And about 85% of the leaders going into a recession were toppled during the tough times.  

Do Not Panic! 

HBR’s researchers classified three types of responses to a recession: 

  • Prevention-focused companies: those which make primarily defensive moves and are more concerned than their rivals with avoiding losses and minimizing downside risks. 
  • Promotion-focused companies: those which invest in more offensive moves that provide upside benefits than their peers do. 
  • Pragmatic companies: those which combine defensive and offensive moves. 

There is a great deal of discussion we could have about each of those responses and as you might expect, each of these approaches has some merit. I have listed them in order by how likely each of those responses is to produce a winning outcome (outperforming their rivals by 10%), post-recession: 21%, 26%, and 29% respectively. 

There is a fourth approach that has a 37% chance of outperforming your rivals and that is what the HBR researchers called “progressive companies.”  These companies deploy the optimal combination of defense and offense. The companies most likely to outperform their competitors after a recession have an “attitude of looking away from first things, principles, categories, supposed necessities; and of looking toward last things, fruits, consequences, facts.”  These companies understand that it is necessary to cut costs in order to survive a recession, but that investment is just as important to spur growth.  These companies know that they must manage both at the same time if their companies are to emerge as post-recession leaders. They primarily slash costs by improving operational efficiency rather than cutting employees.  Many of my blogs talk about identifying opportunities to improve your operational efficiency. 

These companies invest in their future in part by looking for new business opportunities.  By focusing on the output, they develop creative ways to deliver that output (think quality patient care) in new, less costly ways. Using the data you have in your patient management software to understand your business objectively is a great start to strategic planning what you should be doing right now.  Your OPIE Business Intelligence Dashboards and your Choice Acuity Reports are great places to start. 

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Cybersecurity… In Bit-Sized Chunks

This week in our OPIE ShopTalk we covered many areas of cybersecurity and how you and your team can stay ahead of the ball. The topic of cybersecurity may feel daunting, but I want to ask you: how do you eat an elephant? In bite-sized chunks. In our session this week we learn how to take small steps toward protecting your data and we learned how to spot the most common scams in seconds. I know we’ve all probably gotten that age-old email that says “I’m the Prince of this country, send me money to get money!” but scammers always adapting and consistently working to make their pleas more believable. According to the FTC, the top 3 kinds of cyber scams are: 

Identity Theft: The illegal acquirement and use of someone else’s personal information to obtain money, credit, or information. Look out for bills for products or services you did not purchase, suspicious charges on your credit card or new accounts opened in your name that you did not authorize. 

Imposter Scams: This is when you receive an email or call from a person claiming to be a family member, friend, or government official requesting personal or financial information. 

Debt Collection Scams: This is when someone tries to collect on a fraudulent debt. Warning signs for a fake debt collector are requests to be paid by credit cards, gift cards, or wire transfers. 

In 2021 alone there were 5.7 million reports of these 3 types of cyber scams. These mentioned categories generalize a wide variety of fraudulent activities you may encounter online. Digging further, Heimdall Security Blog outlines different scenarios for how each of these types of scams can occur and I would like to share them with you so you know more about them and how to spot them! 

Phishing Scams: Communications are made via email, websites, and social networks in which a fake message tricks you into providing sensitive data like your login credentials into fake forms online. Phishing attempts are made to look almost identical to the real websites or emails they are emulating, which is why they are hard to identify. 

The Nigerian Scam: One of the oldest and most popular Internet scams revolves around the story of a wealthy Nigerian family asking you to wire them money in exchange for their fortune in the future. This type of scam can come with different background stories – but the red flag is always a stranger online asking you to wire them some money for a promise of a big reward. 

Greeting Card Scam: During the holidays, you could receive a dangerous e-card that links to a malicious website or contains a virus as an attachment. 

Bank Loan or Credit Card Scams: If you are offered a pre-approved credit or loan offer, research more online about that bank to check that they are reputable and have not been reported as scamming others. Only apply on the official bank website, and never by clicking links in emails. 

Lottery Scam: This entails an email or pop-up message informing you of a money prize you have won and need to pay some small fees to collect. 

Hitman Scam: This scary type of email can threaten to kidnap a family member unless a ransom is paid in the given time frame. These messages can contain personal information about the victim that has been collected from social media. Instead of complying with these demands, report these threats to the police immediately. 

Online Dating Scam: These scams often take place on social dating networks or through email by targeting a multitude of people with the same message, luring you to send money before meeting them on a date. 

Fake Antivirus Software: Messages appearing in your browser such as “You have been infected! Download antivirus now to protect your computer!” are typically malicious and likely to damage your system. At work, our organization should have trusted Anti-Virus, Anti-Malware, and Firewall systems in place, so there’s no need to download unknown programs on your computer. At home, be sure you have a reputable Anti-Virus software from companies like ESET, Kaspersky, Norton, McAffee, Webroot, all of which are verified and recommended by the tech industry. 

Social Media Impersonation Scam: A person’s profile can be hijacked or recreated, including your friends’ profile or even your own. To prevent this, do not accept friend requests from people you don’t know. A giveaway that a Facebook profile has been affected is if they keep sharing the same website or tagging many people into the same non-relevant post. Facebook phishing scams are rampant – make sure when logging into social media that the URL is correct. 

‘Make Money Fast’ Scams: This is often the promise of a quick and easy job to “get rich quick” by working from home. These scams collect your personal information and should not be trusted. If it is too good to be true, it probably is! 

Travel Scams: Are you being offered a great deal to travel somewhere fun and relaxing? Be aware of hidden costs not mentioned in promotional advertisements. If the travel offer is only good for a limited time and requires a small payment up-front – it might be fake. Check trusted travel websites and use a VPN for the best travel rates. 

These scams happen every day, and you may not know you are a victim until it is too late. One of the biggest things we covered in the ShopTalk is the topic of prevention. The more you know and are familiar with the latest and most popular scams, the more likely you and your team will be to spot them on sight. I strongly encourage you to check out this Pass it On page created by the FTC and feel free to share it with your family and friends—it is extremely helpful! Be sure to check out our next ShopTalk in April where will be discussing how you can optimize your use of the OPIE Help Portal! Register for that event here!

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That’s A Wrap!

What an eventful week it has been! The OPIE Choice Network and OPIE Software teams are currently in Atlanta for the 48th Annual Academy Meeting. So far, we have had an amazing time seeing so many of you here at #AAOP2022! If you were not able to attend this year, Paul and I presented some strategies that you may recall me mentioning in the past: how to increase profitability and how to use your data to rethink the clinical encounter. 

We all know that navigating the O&P profession comes with many obstacles from the time you first see the patient up until the final delivery appointment… and beyond. This is exactly why we have been refining O&P workflow best practices and have created education to accompany those practices! We have looked at leadership, financial management, patient management, fabrication management, the differing daily workflows that happen in an O&P practice, and most importantly, the long-term viability and profitability of a practice. 

The result of all this work is a revolutionary process for teaching everyone who works in an O&P practice how to be more efficient, more aligned, and provide better patient care while effectively managing a business inof the O&P profession. We continue to explore all these education topics in our monthly Workshops and other ongoing education events! Up next, we are hosting an OPIE ShopTalk on March 9th, 2022 to discuss Security Concerns in O&P Practice. Register for the upcoming OPIE ShopTalk here! 

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A Way To Stop Workers From Quitting

I cover a lot of ground in this blog, from leadership to execution, from theory to practical advice, all focused on helping you keep your O&P business thriving. In late 2021, I talked about the “Great Resignation” after 4.4 million workers quit their jobs in the US. Today many business owners are still dealing with the highest turnover rates in history.  So it may be a great time to remind you to focus on making lemonade out of lemons. Lucky for you I came across a new recipe for lemonade and you should try it! 

Earlier this week I came across an article in the Wall Street Journal titled “ Quitting Can Be Contagious at a Company. Here’s How to Stop It” written by Anthony Klotz. If you have been in the business world for more than a few years, you probably can bear witness to that statement. The article goes on to describe a powerful way to help mitigate the impact of a departure. It is something I had never heard of in all my years, nor have I knowingly participated in it. 

After reading the article I reached out to a friend of mine in the HR world…I could not wait to share the great new concept with them. I went through my whole thing, and they said, “Yea, we do that!” Like so many things we discover, what is new to us is not new to someone else. So even though I was a little bummed that I hadn’t learned of this sooner, it made me realize once again the power that is in community. So as a community, we are altogether way smarter than any one of us.  

Our community of MasterMinds has discovered many great things that have value across all practice sizes. One of the most powerful things the community found that you can do to help your practice run more smoothly is to implement a weekly admin-practitioner WIP review. This meeting highlights those patients that are most in need of your services that week and makes sure everything is ready for them. (If you want to know more about that, reach out to your OPIE Customer Success representative and they can fill you in.) What the community of HR people has “discovered” is that it is important to identify those employees or the issues that need your attention. I am not suggesting a weekly 1-1, but what the experts are recommending is a “Stay Interview.” 

We’ve probably all heard of an exit interview, where you get to tell the company all the bad stuff as you walk out the door. But this is a Stay Interview, where, according to the Society for Human Resource Management (“SHRM”) managers seek “to understand why employees stay and what might cause them to leave.” At the end of the day, this comes down to all the things we talk about, a strong culture that is aligned to a clearly articulated vision and mission, and employees who hold similar values. SHRM has published on their website a list of stay interview questions that you might find helpful. 

Take a look, try it out, and let me know your thoughts! 


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Well, Duh!

You know how headlines can be., sometimes we see something that is so obvious that we think, “Well, duh! How much money did they spend figuring that one out?”  That was my thought when I read a headline the other day. Tony Robbins gets real about success in life and health: ‘Just thinking positive is B.S.’  Well, duh! You know, you have to actually do something if you want to be successful. Lest I throw Tony Robbins under the bus, let me elaborate. 

We have all heard about the power of positive thinking. I do not want to dismiss the real power that a positive attitude can have. We have all seen it and we have probably seen the effects of the reverse. Self-doubt or a fear of failure have either kept people from trying things or have become self-fulfilling prophecies. I remember my mother reading the American folktale, The Little Engine That Could to me as a child. Clearly, the message was that positive thinking would help you overcome difficult challenges. 

In an interview, Tony Robbins was asked for his advice for people, especially those impacted by COVID, who have felt discouraged or confused and are struggling to find hope and happiness. This is the context in which he said, “…just thinking positive is B.S. I don’t believe in just thinking positive.”  He goes on to say that you should not go out to your weedy garden and start chanting, “there are no weeds, there are no weeds, there are no weeds”  but “you have to see the weeds so you can rip them out.” Robbins encouraged listeners to “…use intelligence…and have courage and take some risk. Create.” 

I can get behind this. His advice goes to the heart of the message we have been delivering for the last decade at OPIE: Being courageous does not mean you are not scared, it means that you overcome your fear to take yourself someplace you have not been. Robbins goes on to say, “there is nothing on this earth you can’t make happen through the power of your mind and your heart with persistence and consistency. We just need new habits of thinking, focus, and action.”  Amen! 

Approaching your challenges with new thinking allows you to gain perspectives that may have been lacking. It may allow you to recognize that the environment in which you are operating is changing, giving you the opportunity to make adjustments that may be critical to your success. What gets you to where you are may not be what gets you to the next level. Well, duh!  

That train in the story had to get over a hill. The train had a destination, a vision if you will, and the engines it typically relied on did not embrace that same vision and were not willing to even try. Along comes an unlikely contender that believed in the vision and agreed to take on the mission, to do the work against all odds.  

Can you relate that story to your business? Is there a ‘little engine’ around that you can employ to drive your train to its destination? 

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Leadership vs Management

I think we struggle sometimes with really understanding the difference between leadership and management. We talk a lot about being a good leader, but then we get lost in the process of managing our business. Leading and managing are really quite different and it behooves us to understand how they differ. I want you to think about ways the two functions differ in an organization. 

Process vs Vision 

In a nutshell, it is the leader’s job to implement the corporate vision. But they do it by strategically driving change, by setting goals, and thinking ahead to position the organization so that it can capitalize on opportunities. 

On the other hand, managers implement processes to achieve organizational goals. They do the budget, they organize the staff, and they keep everyone on task. 

The leader’s focus should be on fulfilling the organization’s mission and vision by creating strategic priorities for each division that align across those divisions to drive everyone to the same point. The managers then work with other people to make sure the goals set by the leader are executed. 

Leaders often try to create more productivity, but determining which goals and objectives should take precedence is fundamental to leading. Greater productivity without the proper focus can just lead you further down the wrong road. Doing the right things at the right time takes both focus and practice. 

Laurie Baedke, MHA, FACHE, FACMPE, director of healthcare leadership programs, Creighton University, says that “it’s a leader’s obligation to answer the following questions: 

  • Are you fulfilling your organization’s mission? 
  • Are you aligned to your defined strategic priorities? 
  • Are you becoming the leader you want to be? 
  •  If your answers are “yes,” you are on the right track. 

Organizing vs Aligning 

Warren Bennis, in his book On Becoming a Leader lists some key differences between managers and leaders: 

  • The manager administers; the leader innovates 
  • The manager maintains; the leader develops 
  • The manager focuses on systems and structure; the leader focuses on people  

He goes on to say that managers “pursue goals through coordinated actions and tactical processes” that reach a certain outcome. Leaders, he says are less focused on organizing individuals to get work done and more on “finding ways to align and influence them.” 

“Your central function in a position of leadership is to mobilize others so they can execute a set of individual and collective tasks,” says Harvard Business School Professor Anthony Mayo in the online course Leadership Principles. 

It is crucial that leaders set clear expectations and focus on what’s strategically important to the company. It requires consistent communication with the managers and the discipline to step back and let the managers manage. The roles are not interchangeable. 

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Into The Unknown

If you are a regular reader, you know that I am a proponent of data. For over twenty years I have talked about the importance of objective data to tell the story of O&P. The most common response I get is that “we don’t get paid to collect data.” I understand that, to a degree. But I want to challenge that thought a bit. When it comes to knowledge there are three categories: The things we know we know (known knowns), Things we know we don’t know (known unknowns), and things we do not know we don’t know (unknown unknowns). It’s typically the largest chunk of knowledge available, but it is a “black hole” in our minds. It’s the unknown unknowns that typically bite us the hardest.

Discovering our unknown unknowns is part of life’s journey. It’s the wisdom we gain from mistakes. If you think about just your professional life, regardless of your role in the company, there are probably aspects of your job that you can do in your sleep. There is no doubt in your mind that you can handle anything that comes your way in those areas. These are your known knowns. 

There are other areas where you might encounter a task or a challenge that you don’t deal with often and you know that you need to consult with someone else. This is an example of a known unknown. We know enough to tread lightly and seek advice before getting into a mess. Your awareness of the potential for an undesired outcome is sufficient to create a sense of caution. You may make a mistake and learn, but because you were already aware of the potential for encountering something new, you (hopefully) make an effort to mitigate the risk of catastrophe. As you gain experience, the size of the known pie slice gets bigger.  

But the unknown unknowns are the things that can really get us. We look back and say “wow, I never saw that coming!” or “geez, I really thought my plan would work.” Because we don’t know what we don’t know, there is no possible way for you to be on alert. You cannot anticipate an adverse outcome because the condition that contributes to the adversity is not anywhere in your awareness. If it were, it would be a known unknown.  

This is where data comes in. To me, data leads to knowledge. We gather good data. We may not have an immediate use for that data, but we gather it because we know it will lead to knowledge. But we must not waste our time gathering data just because we can. Just because we can measure something doesn’t mean we should. So you must discern the elements that are most likely to shed light on that black hole of unknown unknowns. Or even bring clarity to the known unknowns. This is the basic process of learning.  

Once we collect the data, we need to ask questions, typically, if you see a pattern, do you understand why that particular pattern emerged? If not, try to figure it out. If you were expecting a pattern and none emerged, why not?  

If we are looking at outcomes data on a particular patient, answering those questions can allow you to adjust a treatment plan, or re-evaluate the patient to see if there is something you missed initially. 

If the data is based on workflow processes, what is it telling you? Is there a better way to perform a routine task? 

We do not collect that data simply for the sake of collecting data, no, no one is going to pay you directly because you consistently measure your patients’ progress over time. But once you can start to ask questions and tell stories based on objective data, you become more valuable, your work becomes better, more efficient, more effective. And that, my friend, translates into dollars. 

Group of young athletes celebrating success while standing in a huddle. Successful team of athletes cheering victory.


It is easy to look back on the last two years and come up with a thousand things that went wrong. Chumbawamba, in their song Tubthumping, wrote these timeless words: 

“I get knocked down, but I get up again 

You’re never gonna keep me down.” 

So, I want to challenge you to think about what went well this year. What good came of the struggles? How were you able to take a challenge and turn it into an opportunity? Are you getting up again? 

I asked this question of some of the top thinkers in O&P and heard some interesting remarks. More than once I heard that staff loyalties were revealed. “Some of those who we thought were loyal to us turned out to be selfish, others were extremely dedicated to the success of the business.” Another theme was that businesses were able to reevaluate their processes. They reimagined and recreated workflows to be more efficient. One said they figured out a new way to do business, improving their bottom line which allowed them to buy their building. Another mentioned it was a time of intensive but successful team-building with the intent of keeping the administrative staff and clinical staff connected, even though they were physically separated. One owner said, “a stressor like that on your company really reveals your culture. Whether we were repainting a room or seeing a patient, our staff was willing to do what was best for the business. The attitude was we not I, and the challenges really pulled the staff together as a team.”  

These themes are very consistent with the best business practices we have been exploring and teaching over the last decade at OPIE. Change is hard, but there is nothing like a real struggle to help us make tough decisions. At the end of the day, it is that desire to move forward, to approach the challenges with a fresh idea that helps identify the companies that will continue to drive our profession forward. 

While the end of COVID seems like the end of a rainbow, never quite in reach, we can remember the positives that came through such as the comradery and improvements you have made. The good that has come from the struggles must not be forgotten when we return to our new normal. These are the qualities and attributes you want to foster in your culture as we work together to improve this incredible profession. 

Smiling female manager listening to colleagues at a meeting

Seize The Day

It seems like every time we turn on the TV, there is more bad news. From the economy to the supply chain to employment to COVID…it is very easy to feel pessimistic. We don’t like change and we certainly don’t like having to deal with things that seem so out of our control. But with every challenge, there is opportunity. It may be hard to find, but there is bound to be a silver lining in the apparent chaos that is all around us.  

Hopefully, you’ve been reading my blogs and you have a great staff who are engaged. If you haven’t done so already, maybe it is time to bring your team together and layout all the challenges. What is your company’s mission and how is the current environment hampering your ability to execute on it? 

What can you think of that may seem off-the-wall that you can do to get your company back on course? Are there opportunities you have never considered before because they seemed impractical? How can you use these new ideas to further integrate yourself and your practice into the professional healthcare community?  

If you are not the owner, you still want the practice to be financially successful so it can afford to continue paying your salary. The awesome thing about this profession is the fact that you can literally see a massive change in your patients in a very short period of time and you can know that the change is a direct result of your actions. That is incredibly rewarding and should be a huge motivator to keep things moving forward. If for no other reason, the change you make in your patients’ lives can be extraordinary and freeing for them. So how do we make that even better as we navigate the challenges (opportunities) ahead? 

If you are the owner, in addition to the questions above, how does your business play into your retirement planning? I do not pretend to be a professional retirement planner (and you most definitely should be speaking with a professional for that) but there are things you should consider. First, your practice is an asset and you need to protect its value. Sure, you can probably “fire sale” it to one of the big players, but they are going to extract some value. Just because you did well in the past does not mean the business will continue to do well especially if you are not responding the new environment. Now is a time to shore up the long-term value.  

One of the best ways to do that is through the success of your practice. Creating strong processes around referral management, patient care, billing. The core functions of running a practice. Think about how you might explore new opportunities to create value from your expertise. To a potential investor, a well-running practice with a motivated staff that knows what to do and when to do it is worth way more than a place that needs to be torn down and rebuilt.  

So, what can you do to turn today’s challenges into tomorrow’s opportunities?