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40 years of heel pain - GONE!

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Dieter Fellner, Aug 17, 2006.

  1. Dieter Fellner

    Dieter Fellner Well-Known Member

    Members do not see these Ads. Sign Up.

    Apologies if this topic has been covered

    For some weeks now I have spotted these advertisements in national newspapers. I have only yesterday checked out the website. It is worth taking a look. If for no other reason, the marketing spin is amazing. It is aggressive promotion on a breathtaking scale, at least for the UK, I think.

    This provider of orthotics with fees ranging from £250-£700 is making some interesting statements. Claiming a 98.95% 'success rate' a non weight bearing cast of the foot is taken with a 3-D optical laser foot scanner.

    Here are some of the statements:


    All of which I guess is fine ... our world is changing and we are seeing much more aggressive marketing of services and will see much more of this as the changes in health care trends are reverting to the marketing model pitting disciplines against one another. Should we learn from this?

    I read the spin and what good stuff: imagine my disappointment when I saw the orthotics on the website. After all this technology and circuitry patients get something that closely resembles my own modest efforts. I don't know what I was expecting- more somehow, but I feel deflated. Time for coffee
  2. Jamie

    Jamie Active Member

    Dear Dieter,

    You are right this has been covered in the Threads below
    http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=2550 - value for money for Orthosis

    http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=2279 - More Snake oil as Orthotics.

    But it doesn't mean that it can't be covered again, I am not sure if we came to a definitive solution.

    The Marketing term for the Q&A is called "POSITIONING". He is trying to position himself above Podiatrists by calling himself an Orthotic Consultant and making the glaims about his "rogues gallery". I would be surprised if he has a bit of paper as a Qualification in the field which he says he has 98.95% success rate. It puts the learned debates on this forum into perspective with the massed ranks of MScs, PHD's etc giving academic arguement and somebody puts an advert in the Daily Mail slagging it all off.

    BUT it doesn't matter the HPC have no juristriction over him and he is purely commercial, maybe Trading Standards or the Advertising Standards Authority will get him, but they probably won't bother - Quite clever really.

    Quack Quack

  3. Parish and bell

    Dear Dieter

    I Am shocked and appalled! :eek: I E mailed this company some time ago (see attatched) and was assured they would be changing their website. :rolleyes:

    -----Original Message-----
    From: Issacs Robert (Maidstone Weald PCT) [mailto:rissacs@nhs.net]
    Sent: 21 July 2006 08:54
    To: info@parishandbell.co.uk
    Subject: Interesting website

    Dear Sir / Madam

    I was reading your rather interesting website when i came
    across the following statement:-

    "The NHS method of drawing around the foot and cutting an
    orthotic out of leather or plastic is at most, making a "pad"
    and at worse, a waste of time and risk's making the heel spur

    A few points sprung to mind. Firstly i would suggest that to
    make such a statement without researching whether it is true
    is at best irresponsibly and at worse actionable. Every
    department in the NHS does things differently but i have
    never in nine years come across one which does only this. The
    department i lead uses a variety of methods for assessing and
    prescribing orthotics including Cad Cam (a method you appear
    to claim is excluesivly yours!).

    Secondly your "unique Co polymer" is a type of plastic and i
    am guessing your top covers involve leather. This makes your
    rather dismissive statement about leather and plastic
    somewhat misleading.

    Whilst i am sure your product is wonderful i would suggest
    your refrain from trying to improve your image by denigrating
    other professionals.

    I look forward to seeing if the website changes. If it does
    not i shall consider passing the blatant self serving
    inaccuracy to Trading standards for their consideration.


    Robert Isaacs
    Lead Podiatrist in biomechanical therapies.

    Dear Robert,

    Thank you for your email.

    Some of the statements you made have been bought to my attention and I agree
    that certain statements on the website are probably a little outdated.

    Regarding the statement about a method used by the NHS has been explained to
    us on many occasions by various practitioners and patients. However, I now
    agree that it should be highlighted it is one method used.

    With reference to the co-polymer we use, we are assured it is a patented
    formula made by our American lab and certainly a particular model we use was
    invented by our Senior Biomechanics consultant and a lab technician. This
    particular model is not available to any other healthcare organization in
    the UK.

    I am positive we do not claim the 3D lasers are exclusive to our clinic but
    should you have noticed anything I have missed please inform me and I will
    look into this immediately.

    Please be assured the above change will be made including some others I have
    noticed whilst reading through our site. We have never intended to improve
    our image by denigrating yourself or other professionals and can only
    apologize if it has offended you.

    I would appreciate it if you could email me your address and allow me the
    privilege of sending you a letter and the newest edition of our information
    pack when it is reprinted.

    Once again thank you for taking the time to write with your concerns and
    allowing me the opportunity to address them.

    Kind regards
    Samantha Williams

    Oh it makes you want to cry. I truly beleived they had seen the error of their ways! :D

  4. Jamie

    Jamie Active Member

    Hi Robert

    Don't be upset, it will take more than a letter to make them change.

    I have on my desk a leaflet from the HPC saying - "we were created to protect the public."

    But the above falls outside the remit of the HPC. So lets look at the marketing.

    On Radio 4 last week there was a review from a comedy act the Edinburgh Festival. They were taking the mickey out of QVC and the American infomercials by talking about the virtues of a cheap and nasty ball point pen. (if you want to listen go to this weblink http://www.bbc.co.uk/radio4/comedy/looseends.shtml - it is a bit over half way through). To sell the ball point pen they went over the basic facts of a ball point pen - ie it writes, it writes in blue ink - WOW!

    Some people sell Orthotics the same way.....Its made from Plastic, its made from Co-Polymer Plastic - WOW! So are Shop signs!!!!!!!!!!!!

    Co Polymer is actually one of the the cheapest Plastics available and is not normally used in FFO's because it isn't strong enough to take the loads at low thickness in small surface areas such as 3/4 length insoles, but it moulds well and is used a lot for AFOs, which strengthen with the wider surface area and moulded curves. But who cares about accuracy. Look at the Beauty companies TV ads and their white coat marketing and made up words ending in -inism or -ix

    TGI Friday, Have a good weekend

    Last edited: Aug 18, 2006
  5. Dieter Fellner

    Dieter Fellner Well-Known Member

    Further post to said company

    I have sent the following e-mail. I doubt it will achieve much but if there are more perhaps it will do something...... :rolleyes:

  6. Jamie

    Jamie Active Member

    Nice letter, Good luck with the response.

    If there isn't an acceptable one there are alternative strategies. I would like to know the HPC's s stance on this to "protect the public." The HPC leaflet also goes on to say how they protect the public - "We keep a register of Health Professionals who meet standards for their training, professional skills, behaviour and health." ....But obviously if the "Biomechanics Consultant" hasn't bothered to qualify for anything in the first place the HPC probably can't intervene. But perhaps they will - they could certainly do with some good publicity.

  7. DaveK

    DaveK Member


    In the interests of fairness I'd like to respond to a few points made in your letter.

    FYI I have NO connection with this company and I am HPC registered. :)

    I think you have confused yourself in relation to the technologies. P&B (based on the pics) use a Sharpe Shape scanning device to cast their patients. This IS electronic casting and IS more accurate that POP casting but more due to the reduction in human error that much else.

    This techhnology bears no relation to the other systems that I think you are referring to in your point in the letter.

    As for the marketing/legal side of things - thats for smarter people than me to comment on. :)

  8. Dieter Fellner

    Dieter Fellner Well-Known Member


    Hello DaveK,

    Thanks for commenting on my letter. This company has delivered a resounding slap in the face to foot health professionals. I am sure this particular company can and will answer for itself and accommodate a little gentle sarcasm.

    Are you really defending this type of technology and business method???

    Accuracy: Do you have evidence to back up your assertions? Have you worked with this technology? If so please explain how the clinical process can be improved with the scanner, over other casting methods. What evidence supports this methods’ superiority?

    After 16 years in practice I am quite familiar with the variability of clinical skills. You might be surprised how many competent practitioners there are. The point is this marketing strategy belongs in the gutter.

    If I AM confusing technologies (you are making an assumption) it is because the information provided by the company is not transparent to the casual reader. If I should be confused the layman will be totally befuddled.

    I will be happy to discuss any part in more detail but will not reply if a post carries a cloaked identity and a partial name. Perhaps you would care to reveal your identity so that I can know who you are, where you practice, and any affiliations can be explored? If you prefer not to do so in public you can send a PM.
  9. Letters


    Loving Your letter. Further than i dared go. Possibly when i've clocked up 16 years and a little more bile i'll be capable of that ;) . BTW have you been talking to the good Mr Spooner?

    I would like to expand a point made by DaveK, Specifically

    "This could involve CAD-CAM technology, plaster casts, cardboard templates, foam casts and other techniques.
    True to point. Most of these latter techniques are out dated and inaccurate and fruitless in most orthotic therapy protocols."

    1. Which of these techniques are out dated, inaccurate and fruitless?
    2. Can you enlarge on why you think this please
    3. What does anyone else think?

    For my 0.02$ there is a place for all of these techniques and i have used them all at different times with great fruitfulness.

  10. Dieter Fellner

    Dieter Fellner Well-Known Member

    Parish & Bell : The Response

    Well that's ok then. I can rest now and I am reassured..... :confused:
  11. Was bored so i had a squint at this website to see if they had changed. Interestingly they had taken out the more ridiculous statements, however there were enough left to justify another e mail.

    I know. I'm petty. I was bored and fancied a rant. :rolleyes:

    Seriously is there any evidence on the repeatibility of CAD CAM?

  12. Robeer (it is thirsty Thursday),

    In my experience it's not the cad/cam you need to worry about here so much as the scanning technology/ variability.

    Here's a story for y'all: Some moons ago a young researcher worked for a company developing foot scanning technology and conducted a brief repeatability study on weightbearing scans: lots of within-day and obviously even more between-day variability. However, the same might be said for plaster casting. So, nice little study for someone to perform comparing the two. Long story short the scanner was a dog- bits used to fall off it and it had real trouble with black skin not reflecting the beams. Things have moved on since this time though.

    He also worked for a sister company based in the same building that "made custom" orthotics. I say made, they actually used preform shells and applied extrinsic posting- he had to sign a secrecy agreement at the time. His boss at the time was called Mr Bell. Nice guy, but he had previously been a bankrupt after selling orthopaedic pillows (not enough- clearly) and so lived in a mobile home.

    Time passed and the somewhat older and less naive researcher, is now working in private practice. Not too long ago he had a patient come to see him who had visited the 98.5% success clinic- guess she was one of 1.5%. What was interesting was just how similar the devices were to those he used to help "put together" for Mr Bell. Our hero made a pair of custom devices t' old fashioned way and the patient got better.

    The best thing to do if you want to test people like this is send them a really cavus foot and see how well the orthoses fits the foot contours.

    Me? All I know is that storing lots of plaster casts takes up too much space. In general, I'm moving to cad/cam and scanning technology, but I'm sure in some situations I'll still do it "t' old fashioned way".
  13. Simon

    Thats a very interesting story. Thanks for sharing it!

    Don't want to turn this into a whats-the-best-way-to-duplicate-the-foot thread (heaven knows we've done that already) but it strikes me that any method can be effective and any method can balls it up. At the end of the day most people hold the foot in a certain position when casting / imaging and many modify the cast after that. I suspect it is this which causes poor repeatibility rather than the technology. Erra Humana Est or some such latin triteness.

    Interesting that the systems which claim to be perfect / better than all the others are all the megabucks companies. £700 seems steep even for a custom made set of devices to me, i'd want them gold plated for that (what would that do to the force vectors :rolleyes: )


    (whats today, fremlins friday?) ;)
  14. If I get time I'll make one out of "virtual gold" and run the FEA on it.

    BTW, like most days, today is a Carlsberg day (he want's it back tomorrow). Too many years in Northampton trying to complete a PhD and living opposite the brewery. Who said advertising doesn't work, opening my curtains and seeing their sign day in day out...hmmmmmmmm.
  15. Akbal

    Akbal Active Member

    Dear All,

    I have seen a number of people that have been to parish and bell.

    I think I should point out my observations, they have always reported that the clinician(biomechanical consultant) has taken a foam impression as well as flashing the laser at them, I can only wonder why this is the case.

    The £600 figure is about half of what these patients have been charged. They also claim on their reciept/contract that the impression is sent instantly to the US and is been manufactured as the patient walks out of the door.

    I wonder if this is the case as Les Bailey and Sam Williams are directors of 2 companies one is parish and bell ltd and parish and bell orthotics ltd based at 2 different addresses.

    Very interesting in any case. They seem to be doing very well as a business ;)
  16. My patient reported the same...
  17. I'm shocked. Maybe i could make my own "laser scanner" out of a washing up bottle, a shoe box, a torch, some tin foil and some quality street wrappers and some double sided sticky tape. I could wave that around the foot take a foam impression and charge £700 quid! :D

    And i cannot BELIEVE people are actually paying over a thousand quid. :eek: Thats not even funny.

    How depressing.

  18. Ian Linane

    Ian Linane Well-Known Member

    Hi Robert

    I saw a lady who had been to see a UK based consultant podiatrist and biomechanics specialist. He provided a consultation, supplied one pair of devices (polyprop with a bit of poron to the base and medial arch), gave one follow up. At the follow up the lady suggested that things were not improving. Advice was to give it time. Charge for the whole lot £1700.

    At least at Parish and Bell (who I think are very misleading btw) you get more than one pair!!

  19. davidh

    davidh Podiatry Arena Veteran

    I had the said cavus foot in a couple of weeks ago. Needless to say, the various devices fitted did not work :cool: , and he was eventually refunded his £1500.
  20. I did'nt think of myself as naive. Now i do. Can anyone beat £1700?!
  21. davidh

    davidh Podiatry Arena Veteran

    Hi Robert.
    I can think of two patients over the last two years who told me they paid £3000 for their 5 prs orthoses (1 pr for every pair of shoes) at Parrish and Bell.

    Also, do you remember an ad in a Daily newspaper a few years ago which promised mail-order custom orthoses (at around £300 a pair). When the pt received the measuring kit, the ones I spoke to were more than a little dismayed to find that it consisted of a paper template which they had to place their foot on, and draw around the outline.
    Hmmmmm :cool:
  22. Could be worse

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