A patient who found me on the internet recently presented in my office with a new pair of Orthotics she wasn't happy with, and a new pair of shoes same result. As it turns out, a rather large managed care organization that shall remain nameless, that realizes the value of a good pair of Orthotics but doesn't want to bother to make them in house, referred her to a glorified shoe store that "Specializes" in Orthotics and special comfort shoes.
The first issue with this patient, she was placed on an Orthotic that was in fact a generic yet it was called "Custom" by the store personnel. The store employee had no training in joint mechanics, and didn't even bother to measure the difference in the angle the patients feet hit the ground. Second issue, they sold her size six and a half shoes but, she's a size five.
The audacity of allowing someone to leave your store with shoes that one can fit two fingers behind the heel with the shoe laced up and still pretend that you know what you are doing. Amazing !
Even more amazing, the patient was charged more than my rate for an entirely shoddy job and ill fitting shoes.
Long story short, the patient was fit correctly with a pair of functional Orthotics and is now very happy. I was also able to order her the correct size shoe and now, she's a happy camper.
Moral of the story these VERY large HMO based providers send you to the lowest bidder who often times charges more than someone who will actually do the job correctly.
Cheers, thanks for reading this tale of WHOA ! (I said that with intent BTW)