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We explore how pricing, policy, and 3D printing are reshaping orthotics and prosthetics from the UK to the Gulf and across Africa. Hugh Sheridan shares hard truths about aid that bypasses clinics and a road map for sustainable, locally led care.

• roots in shoe materials evolving into O&P supply chains
• UK reimbursement pressures and the pivot to prefabs and 3D printing
• UAE as a hub versus Saudi growth and privatisation
• pediatric disability needs and cultural barriers to access
• why direct aid can starve local clinics of patients and revenue
• franchise-style partnerships as a sustainable aid model
• China and Turkey’s rising role in components and materials
• open materials, SLS/MJF economics, and avoiding lock-in
• central fabrication versus in-clinic making and clinician psychology
• direct scanning, hybrid workflows, and protecting clinical value

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We trace how affordable, reliable material extrusion is changing prosthetics and orthotics—from student labs to jungle clinics—and why toolpaths, not just materials, will drive the next gains in comfort, strength and cost. Real patient stories show the economics and ethics of access at scale.

• season launch and mission to improve patient outcomes
• shift from tinkering to reliable, prosumer 3D printers
• material extrusion vs FDM and why terminology matters
• nonplanar layers, multimaterial potential, pellet economics
• toward truly digital extrusion with better sensing and AI
• application focus over generalization in O&P innovation
• case study on low-cost pediatric prosthesis with reuse of CAD data
• orthoses workflows moving toward “toaster-like” simplicity
• education pathways as students learn on clinic-grade printers
• materials outlook: TPU, TPE, silicone prospects, polycarbonate tradeoffs
• variable density, air pockets, and hybrid fill strategies for comfort
• polar kinematics and toolpath planning as the next frontier
• print farms, software orchestration, and scaling production

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We talk with Molly McCoy about turning dense policy into practical tools, writing notes that get covered, and why advocating coverage can improve outcomes. The focus stays on patient stories, shared decisions, and using the whole medical record to support care.

• how clinician notes function as medical records and drive coverage
• writing people-first justifications that explain medical necessity
• using therapists’ and nurses’ notes to support decisions
• drafting notes in real time to capture shared decision-making
• where AI helps as a writing partner and where it harms
• working with payers while advocating for policy change
• why two devices enable both ADLs and true physical activity
• reducing burnout through smarter workflows and legislation
• telehealth access gains and state-level advocacy
• flexible roles, job sharing, and retaining clinicians in O&P

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Is this the lost episode? No, but there is some "old news".

We dig into how O&P is changing fast: major acquisitions, new L codes, and a fresh vision for education that blends clinical reality with digital tools. Adrienne Hill shares a grounded path for students and clinicians to build skills without burning out.

• Hanger’s acquisition of Point Designs and upper limb strategy
• Medicare L codes momentum for partial hand coverage
• Three education models and how to choose
• Why residencies still define clinical growth
• Embedding scanning, CAD, and 3D printing in coursework
• Practical literacy vs making the "sausage" in-house
• Shifts from plaster to digital and what’s realistic
• Workflows that prevent burnout and improve retention
• Ownership dreams, debt realities, and timing
• The modified seven-year rule for career moves
• How to pick residencies that fit your EQ and IQ
• Going rural or high volume to accelerate learning
• Broadening applicant pipelines and faculty needs

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We break down how L code pricing is set, why crosswalk and gap-fill can fail innovators, and how appeals drain time and cash. Two case studies—Point Designs’ digits and Ethnocare’s volume system—expose how “divide by five” logic and invoice anchoring distort value, while 3D printing and hybrid workflows offer a path forward.

• crosswalk vs gap-fill pricing methods and trade-offs
• pitfalls of 99 miscellaneous codes and ALJ appeals
• point designs digits priced against a mechanical hand
• Ethnocare’s volume management tied to sock costs
• framing comfort as adherence, safety and savings
• click medical as a data-backed reimbursement win
• Medicare recognizing 3D printing as manufacturing
• desktop tpu print farms and reliability advances
• hybrid workflows using load-bearing capture and automation
• fragmentation in O&P advocacy and need for alignment

Thank you for listening. We’re in 118 countries and nearing 35,000 listeners—keep learning with us and share the show.

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We explore how foaming TPU, belt printers, and clinician-led automation can bring custom foot orthoses in-house, cut costs, and reduce lead times from weeks to hours. Fredrik from CADmed shares what actually works, what doesn’t, and how remote design plus per-pair pricing changes the game.

• why automation increases clinician control rather than removes it
• carving versus printing tradeoffs on speed, finish, and cost
• foaming TPU benefits including smoother surfaces and less waste
• belt printers for continuous TPU production and better surface feel
• FDM advantages over powder bed fusion for insoles
• practical lattices and gradients without overengineering
• decentralizing production to clinics for faster delivery
• remote design, slicing, and printer control with per-pair pricing
• scaling systems for reliability, repeatability, and low friction

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We trade trade-show gloss for real-world tactics, then lay out a three-step plan to bring 3D printing into O&P without risking patient care or cash flow. From Bambu-level starters to automated check sockets, we show how to start lean, learn fast, and scale what works.

• Formnext’s shift from machines to applications
• Materialise Bricks for modular workflows and costing
• Multi-material metal, gradient parts, and smarter tooling
• Affordable LPBF and the desktop print farm surge
• Start with a low-cost printer and print clinic tools
• Outsource complex adjustable sockets to free capacity
• Automate transtibial check sockets for speed and margin
• Scanner choices from budget to pro with trade-offs
• A three-tier roadmap to adopt and scale digital O&P

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We record on the road to the mothership to fit a 3D-printed adjustable suction socket using AirFit casting and compare loaded scans to raw scans. David shares his crash-to-career journey, why adjustability matters for neuromas and daily volume, and what makes the Americus foot feel lighter and livelier than it looks.

• AirFit casting under load versus direct scanning
• Four-scan workflow and remote 3D fabrication
• Suction plus adjustability for volume and hotspots
• Flexible inner swaps for quick tuning
• David’s neuroma history and fit lessons
• Merecus foot layup, split keel, and energy return
• Social media as connector, career builder, and patient support
• Choosing a prosthetist who listens and offers trials
• Safety, waste, and smarter ovens in the lab
• Why 3D printing speeds care and improves revenue cycle

Find David: YouTube The Adventurous Amputee • LinkedIn David Slider • Instagram Pirate Peg Leg and The Adventurous Amputee

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