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What do I need to open a Lab?

Discussion in 'General Issues and Discussion Forum' started by UA101, Apr 1, 2009.

  1. UA101

    UA101 Member

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    Hi gang, complete newbie here doing some market research, stumbled upon your forum, and saw some smart input, maybe you can help me as well.

    My friend owns a medical rehab centre in Toronto, and we have about 3-4 more medical centers who are owned my close friends. Too many clinics popping out on daily basis, so I suggested maybe opening an Orthotics lab and with time expand it to prosthetics as well. Now there are many labs in the Toronto area, but I’ve spoken to a couple established podiatrist and most say the labs are not good enough here and the quality is not up to par, specially when insurance companies are involved. The only lab they held high is Langer, which is an American based lab. But even though some of these labs are not very high standard they still all make money since insurance coverage in Canada is very pristine and has some loop holes.

    Now our idea is to open a lab which will make only very high quality products and most importantly constantly be on the innovative side of things and trying new materials.

    So I need a break down costs of what equipment is needed for the lab that would be as automated as possible with ability to have fewer hands involved in the process, but also must be very flexible operation so traditional methods must be implemented as well where automation is not 100% accurate. But time is money so I would want it to have equipment which speeds up the process as much as possible without compromising quality and accuracy. So my guess is some type of CAD/MILL would be part of the operation.

    I do realize that there is no idiot proof system and would have to learn as we go along what’s needed and more used and that’s collecting dust. But at least if you guys can give me a full list of all the possibilities that a quality lab should have then I can make a balanced list of cost vs. effectiveness of the equipment and % usage of that equipment.

    The main problem is of course Orthotist/ Biomechanics person, which is a very rare profession by itself. My starting point would be finding a professional who knows not only how to make orthotics , but must be very knowledgeable in biomechanics. If I can’t find that person then the business will fail. So that is the number one priority.

    What is the average salary of that person? Do any of them work on percentage for example, we give that person 20% of net profit so if we grow quick they grow as well?

    At full speed with proper equipment how many pairs do you think we can make per week, of course each case is different, but at least give me an average, so I can project profits and what numbers we need to hit on monthly basis to have any profits at all.

    Another question I have is the carbon fiber industry, I know there a lots of hybrid carbon thermoplastics materials like the TL-2100… on the market which are now used in orthotics industry,

    Has anyone found a successful way to use pre-peg carbon fiber (not thermoformed hybrid carbon fiber) with some biomechanical design implementation so it saves on weight, but still has the flexibility of a plastic? If yes, what percentage of the insoles do you sell are carbon fiber made, because if that percentage is high then we would need completely different machinery to work with carbon fiber.

    Basically as you see the direction is to go as light as possible in weight, but still have 100% full functionality of more traditional materials.

    Also what about supplies for taking patients molds …. Do you buy it from the same lab that makes the Orthotics for you or do you find a cheaper source?

    How much does cost factor into your decisions. For example a lab can make you two identical insoles which will give you the same effect, but one is cheaper and maybe slightly heavier in weight, the other is lighter and slightly more expensive. Do you go for the best possible quality, or does profit come into play here? This of course is also influenced by the insurance coverage factor, if a person is covered or paying straight up.

    Another issue is returns, if a customer returns the product and it needs modification or simply does not fit, who covers what in that situation?

    I will probably have many more questions once I get seem more feedback, so if some of these sound stupid, please be patient, I’m learning as I go.

  2. joejared

    joejared Active Member

    Your hardware costs would range from as low as $10K used to as high as $90K new, dependent on the quality of cnc you purchaced, primarily, but this particular part of what you're striving towards is only a secondary issue. Software costs vary, and some, like my own system, are royalties based. Some employ both methods of charges, and others also have periodic license fees as well.

    This would be your primary issue. I'd recommend at the bare minimum, to get some technical training or at least an apprentiship somewhere. Simply buying a cnc and scanner would in no way make you a lab, but rather a big boy with big toys. As your friend likely has no lab experience himself, training will be your number 1 focus, learning techniques and methods to produce orthoses. I have 2 such customers who started where you are, and their start was bumpy one at best. There is absolutely no system, short of a printing press that would allow you to push a button and watch money come out of it.

    Exactly. There are many threads here that describe techniques for production of orthoses, but nothing compares to hands on training.

    Management of a lab typically has a higher salary than that of a lab technician. The pay ranges are typically starting at a couple dollars above minimum wage for lab technicians, and much higher for management. Obviously, cost of manufacturing plays an important role, with manufacturing time and overhead expenses being a limiting factor. I know of at least one person in management that makes more than $80K/year.

    It depends on the quality of machine, and the machining methods used. My own patented method is 85% faster than longitudinal machining, and 115% faster than lateral machining, for example, on the same machine. However, you can also throw enough money at any problem to produce a part at just about any expected timeline.

    In the past month, I purchased a used techno-isel router and programmed it to produce my product. It has the production speed of 45 minutes using techno-isel controls, and using Acroloop controls, a production speed of about 30 minutes for 4 1/2 pairs, both using an average spacingof 1.7mm between milling passes. The main reason for the differences is the controller itself. LM628/629 based controls are really not designed for contour machining, unlike the acroloop series. I plan to also implement a galil control as well, which has contour machining capability, but I'll likely have to purchase another machine before I do further experimentation, as I'm already using it for production of both scanners and orthoses.

    Carbon graphite is typically molded only. Materials I know of in use for machining include delrin, polypropylene, and occasionally, oak (wood), and particle board for positives.

    Delrin is a viable low bulk replacement for carbon graphite. Most of my own customers rarely mold positives, but of the labs that do, I rarely see more than 100 pair/month of production from either of them.

    Plaster? Just about any hardware store carries that. As to making a low bulk orthotic, commonly, shaving the orthotic along the lateral column is common, as well as having a varying thickness in the heel center. This provides strength where the device needs it the most, in the medial arch area, while keeping the rest of the device relatively thin.

    If the quality is there, the money will follow. Anyone can make a cheap orthotic, but it's the aptitude of the lab technician and lab manager that defines the quality of the product. I'd personally recommend against bonuses for productivity, but rather quality. At least one lab in the States offers their employees piece work, and the results are tragic.

    That depends on whether or not you want to keep a given customer/doctor. I'd recommend that you assume the problems are your fault at least initially, as you're still learning about the industry. As you become more experienced in the profession, recognize the ever decreasing return rates. Keep in mind also that your mistakes could actually hurt people.
  3. Phil Wells

    Phil Wells Active Member

    Hi (Please supply a name as it helps us to help you)

    About four years ago I seriously thought about setting up my own lab. I had the CAD/Cam knowledge, experience of working in the industry etc.
    In the end I didn't do it but opted to work within an existing orthotic company and to up-grade the FFO set up. The reasons included the following thought patterns
    1. Who would be my sales force, administration team, etc. I would obviously be too busy making the products.
    2. As part of the business plan, I needed to included a research and development budget so that I didn't stagnate and fall by the wayside - a very expenses over head.
    3. As I grew the busness, who could I hire to help me - issues of trust etc.

    The over riding concern of your customer is 'can I rely on this new supplier?'. You MUST deliver on your promises.

    The biggest issue I have experienced regarding resources has always been skilled staff - it is fairly easy to get hardware but getting the skills verse attitude matrix right within the company is tough at best.

    Regarding new materials, before worrying too much about them ask yourself if a solution is really needed. Polypropylene, EVA and PU orthoses do the job 99% of the time so why fix something that isn't broken.

    I don't want to put you off but please be aware of the above 'softer' components of running a lab.
    If you want more specific info, please email me privately.


  4. UA101

    UA101 Member

    The name is Boris. Sorry I can't keep it short.

    Phil I’m only doing market research for now not 100% sold on it yet. And yes my biggest concern is stuff. I have high standards and last thing I want to be is another “Me Too” lab which is on the same level as others. Why anyone would would want to do business with me if I offer the same thing as others. That’s why I asked how much automation I can get to lessen the hand on approach with less stuff and newer materials. I’d rather pay more to a very qualified person then have three people who do less of a job. And it looks to me that finding a skilled person is almost an imposable task, since most of them either run their own labs, or like yourself are working in a such a comfortable environment that simply don’t want to change their situation.

    What confuses me is who is the architect in this position. Does the podiatrist actually make a recipe on what materials should be used in a certain device, or does the lab manger reads the diagnosis of a podiatrist and makes the recipe of materials for a devise and makes the devise as well

    Assuming it’s the lab that has to do all the recipes based on diagnosis, does the person who corresponds with the podiatrist makes the recipe and also makes the devise, or does that person passes on the info with materials and recipe to a technician who does not need a lot of experience since there is a clear instruction on what goes where. What is the proper working chain of events here?

    My direction is slightly different, I want this lab to steer in the direction of sports orthotics mainly hockey skates, since it’s the biggest cash cow in this town and everything is related to hockey. You and Joe mentioned that 99% of all devices are still made from traditional plastic materials which might not be the lightest on the market. Now in hockey industry everything now is all about weight and energy transfer. So carbon fiber type materials or anything in the same weight / strength ratio must be used. Guys will compromise comfort for weight reduction in some cases, so the aproch is slightly different

    The average player size would be over 6 feet tall and 200+ lb and these guys are 2-3 hours a day on the ice, so they destroy very stiff skates very fast. I have some small contacts with a couple NHL/AHL guys which might help me get my foot in the door as far as starting to make custom insoles for hockey players. On a pro level teams have large expense accounts so if my products give a player at least 5-10% improvement the team will cover that expense on behalf of the player. But while I try to pursue the hockey direction I still need to stay in business for at least one year to get some sort of reputation, this is where I can still make use of traditional materials, so the lab must be flexible to cover many bases.

    That’s why I need to know more of a technical input from you guys on what percentage of you use new age materials and is there a material which is on par with carbon fiber in weight and strength and also widely used. And most importantly can these new age materials substitute traditional materials. How many of your clients are athletes and is there a range of some sort where large percentages of your athletes are comfortable with certain new age material, or is it always strictly case by case?

    I do realize that most people have their own secret materials and methods which they might not want to reveal, so my search is very broad in all directions at once, which shoes my inexperience in this field. But I have to learn some how and I can only do this by asking stupid question and doing more research.

  5. Phil Wells

    Phil Wells Active Member


    Thanks for the additional information re the Hockey Players.
    To try and be specific I can give you the following advice-

    To help with your business profile, aim to digital capture all foot images - its not the panacea medically speaking but the layman is always impressed. The cost of a simple 3D scanner as an out right purchase is $3000 ish per unit.

    The image has to be processed but I would suggest that an automated CAD/CAM system may not be flexible enough for your needs. Get a good system and spend time learning how to use it to make anything - this would give you the skills to offer something new to the market. I use CopyCad software (A triangle modelling approach which is possibly easier to use than solid modeling) at a cost of $15000.
    The CAM software for the milling is a tricky one as the skill to use it is very specific. I would hope that a supplier of the software could automate this for yopu. this is what I did when I started and I used Delcam Powermill and Powershape for extra design functions - cost $30,000.

    The mill itself needs to be fairly standard but the comments made by Joe are key - you need it to have a control/processing unit that has a good 3D milling capabilities - I would assume a 3 axis machine like a Haas mini mill at $35,000 + should be ok.

    The rest is fairly standard - vaccum forming is ok but if you want to use higher quality materials such as reinforced polypropylene - A cracking material that would do what you want but would cost extra due to the need to create both a positive and a negative mold as you would need press molding machinery.

    The over riding concern for a lab is patient compliance - prescriptions will vary from one practitioner to another but the patients will reject the device if they can't tolerate them, fit them in their shoes etc. I beleive that the lab should never prescribe the device only facilitate the practitioners choice e.g offer advice on material, trim, finish etc.

    Hope this helps

  6. joejared

    joejared Active Member

    Actually, I referenced Delrin as a carbon fiber alternative to molding carbon graphite. From a per sheet cost basis, it is about 2 1/2 times more costly than polypro (about the same in cost as T6-6061aluminum), but offers significantly higher tensile strength characteristics than polypro. In terms of machining characteristics, it appears to be about 1/3 of the chipload of aluminum, and significantly better thickness tolerances than polypro when machined.

    The only material I have been considering that seems more rigid than polypro recently has been ABS plastic, simply because it has better machining characteristics and is also heat moldable. It has a weight density similar to polypro, is less flexible and likely a little more brittle. I use this material for the chassis of my scanners, partially because of its machining characteristics, and partially because of the textured surface.
  7. joejared

    joejared Active Member

    The last scanner I sold was $1200.00, including the laptop. By the end of year, I'm expecting to go down from $800.00 for the scanning hardware, thanks to my newest router. Labor expenses per unit dropped more than $100.00 per unit because of it.

    The techno-isel line of routers also would work with acceptable quality, but I've already posted on its weaknesses, all solvable. Cnczone discussion and images One of the labs I work with will be sending me their z-axis for retrofitting to my new motor mount design, which allows the use of angular contact bearings instead of opposing mounted spherical bearings, offering better thickness tolerances and surface quality. Material costs for me are about $30.00 in bearings for all axis and under $10.00 in raw materials. Replaced is the motor mount and plate below it, and all thrust bearings for all axis as by default they use radial bearings, which are not designed for thrust loading. After I've worked with a more modern machine, confirming dimensions, I'll have the parts available online.
  8. UA101

    UA101 Member

    Phil can you please go into the press molding machinery in more detail. The way I see it milling probably will only be used only for clients who don’t need carbon fiber type materials. But for the very rigid heat moldable carbon hybrid materials will vacuum forming be bale to mold it properly? If I used a much stronger pump like 2HP? If not then to properly mold a rigid material there has to be a negative and positive or male and female which press on the material from both sides or at least strong support on the bottom and weight pressed on top. Will the cast of patient’s foot withstand enough pressure from the press for it to mold properly? Then we encounter a new problem, if there is a 2mm thick material used for this sandwich method, then both the positive and the negative has to take into consideration that there is a 2mm thickness between the two so each one has to be made bigger or deeper, and that will screw up the precision of the final product. Unless there is a system which can project in calculation how much to modify the sandwiched parts to fit in a 2mm thick material. Of course maybe I’m completely off on this issue and you can explain how to work around this.

    Next issue is posting? When you guys use your CAD mill to mill out the final product, do you mill it out already with a shaped post on the bottom as a one piece insole? Or do you still have to attach the posting separate and also maybe mill the posting separate?

    Joe how much heavier is Derlin in comparison to the carbon fiber hybrid materials? And how thin can you go on it to still be able to produce a rigid product which is in comparison to carbon fiber?

  9. joejared

    joejared Active Member

    Proper temperature is probably your larger issue. I've seen vaccuum presses in the labs I work with with pumps as low as 1hp, grossly insufficient for a vaccuum chuck, but more than enough to mold heat moldable material. I believe the labs that mold carbon products also lay a heat resistant cloth over the surface as well, to protect the vaccuum rubber.

    Probably not.
    That sounds more like an rfwidena issue from my perspective, for the final product, or by making a 'soft' accomodative device from wood to mate to the positive mold. It would probably be sufficient to just add 4mm to the rearfoot width, but there might also be a need to add a forefoot extension using exky, exly and their associated variables, to perfectly match the positive. You're describing alot of extra work, though, where I believe the solution is temperature control.

    That's a data entry issue here. Any cadcam system that can't provide posting shouldn't even be considered as a viable package for production, unless it's simply for production of positives. As for forefoot posting, There's more than one kind of forefoot posting, however, intrinsic posting (top surface), extrinsic posting, (bottom surface)), as well as bar posting (bottom surface).

    One lab just texted me at least twice as strong, but from its machining characteristics, it's probably closer to 2 1/2 to 3 times stronger than polypro. I don't have a comparison to carbon. I rarely see a device thicker than 5mm in polypro, and believe thicknesses of half in delrin mate pretty closely in terms of tensile strength.

    In terms of weight, 1"x12"x24" = 9 lbs in polypro, 15 1/2 lbs in delrin, so roughly, 72% heavier by volume.
  10. joejared

    joejared Active Member

    As to the merits of delrin vs carbon fiber, reported also was that it is not only heat moldable, but also unlike carbon fiber products, doesn't leave behind frills after grinding. Like other polymers, however, the pricing is at the mercy of oil prices.
  11. Phil Wells

    Phil Wells Active Member


    You are correct re the pressing issues having to be done with male/femal parts. This is not a major issue as any design software can do this and take into consideration ofsetts etc required to get you a good press. You would need to direct mill the models in a rigid material such as polyprop or similar.
    I don't know too much about the actually machinery needed as I have only tested it using a manually press - hard work and low volume. However they are quite cheap (second hand) and you could by multiples of them.

    Re posting, you can either directly mill the post into the shell or post them in EVA afterward (But we mill the EVA posts to save time so that it only needs to be glued on). The ideal is to mill them directly as you will have no issues with post avulsion.

    Again it comes down to what your potential customers want - new materiel, speed, low cost- as these will define your business.

  12. joejared

    joejared Active Member

    Is there a demand for a matched die set (negative and positive) for forming of orthotics? Not that it would be all too difficult to do, just wondering. Most materials will form with a single positive mold using a vaccuum press after preheating the material to be molded, but it would be a simple matter to add holes to a die press arrangement if there was such a demand for it.
  13. UA101

    UA101 Member

    The way I see it is that most lightweight materials can’t be milled, and even though you guys say that today 99% of all labs still use traditional plastics, it would be stupid to invest in machinery and then in one or two years a new material will come out on the market which can be manipulated very easy, and the machinery will collect dust. There are already thermo-formed composites on the market. If the direction of my lab is to be innovative and offer something different then most local labs, maybe CAD/CAM is not the best way to go.

  14. joejared

    joejared Active Member

    Most lightweight materials can actually be machined. In fact, just about any material can be machined, although some materials will cause more wear on tooling than others. Cutting materials is a simple matter of speeds (rpm of the spindle * number of flutes on the tool) and feeds (travel velocity from point A to point B). The actual machine by itself is not the complete answer, however. A cad/cam system will simply reduce some of the skills required to produce orthotics, but not all of them. A solid foundation of manufacturing orthotics by hand, however is probably the most important tool you'll need so that if and when you do automate, your transition will be that much easier.

    On a side note, the one thing I do respect about Pfola (or did if this is no longer the case) is that for membership in that group, you had to make orthotics the old way, using plaster and files. Starting with making orthotics the traditional way is generally a good idea anyway, in a karate kid wax on wax off sort of way. Automation merely eliminates the physical storage requirement for casts and attempts to emulate what is done by hand anyway, at least from my perspective.
  15. The Beaver

    The Beaver Welcome New Poster

    I was looking into opening a lab in Atlantic Canada .
    Carbon composite technology is our forte here - [not just lobster fishing or pogey] -
    Our local manufacturer a division of EADS http://www.compositesatlantic.com/
    Dynamic team probably could do anything you want including light weight
    carbon fibers
    They even have a testing facility in Dartmouth.
    Govt money is available for labs - ACOA is open to partnerships ..............
    http://www.acoa-apeca.gc.ca/English/Pages/Home.aspx -
    Last edited by a moderator: Apr 7, 2009
  16. UA101

    UA101 Member

    Well, if they'll finance you at a low rate then it's a different ball game. I have a feeling the program is only for larger businesses which can partner up with the local government so they get a piece of the action plus interest on the loan.

    Secondly the cost of having a custom made material for a special purpose like orthotics would be too great unless we buy huge volumes.

    Last edited by a moderator: Apr 8, 2009
  17. The Beaver

    The Beaver Welcome New Poster

    ACOA can provide capital for smaller projects with an R&D base

    EADS - Lunenburg - manufacture CC's for aerospace small projects

    I've a few patients that work there - I'll do a little more research
  18. UA101

    UA101 Member

    Check if they can finance an Ontario based location, we can open two labs under the same name, yours being the major location and mine the secondary so you would be the local guy as far as financing goes :)


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