Letter from Don

Last week I was scheduled to measure/cast a 9-year-old boy for a DAFO 2. This patient had suffered an episode of static encephalopathy at 7 years of age that resulted in poor ankle and foot control on his right side. The extra stability provided by the DAFO had been very useful in restoring function since the initial incident.

At the appointment I watched the patient walk both with and without his DAFO 2 and came to the conclusion that the DAFO no longer seemed to be helping this child, at least that I could see in the narrow time frame of a clinic appointment. After a fairly lengthy discussion with the family, and later follow up with the supporting therapists, it was agreed to try a period of time with no brace being worn at all. This trial demonstrated the patient was not experiencing a loss of function or range over a two month time period of no brace wear.

So by spending at least two hours of time beyond what we had allocated for the initial casting, I had worked my way out of a pre-approved and funded brace project. As I drove home from the initial clinic visit I questioned my business sense. However, the feedback I received in the following weeks was very positive and at the heart of the messages was the fact that people trust me to do the right thing for the patient, not the bottom line. I think this is a very important value for all clinicians, and I do my best to honor this approach in my personal work as an Orthotist and in Cascade Dafo’s support of other clinicians. The careful nurturing of trust between me and people I work for is a slow and fragile process that becomes the most valuable thing I can be a part of.

-- Don Buethorn

Don Buethorn, CPO, is founder-owner of Cascade Dafo, Inc., and Cascade Prosthetics and Orthotics.