Fasten your virtual seatbelts as we zoom with our guest, Lee Dockstader. Lee navigates us through the transformative landscape of 3D printing, from its revolutionary impact on Formula 1 racing to its impressive scale in producing Invisalign parts. We'll also tackle the intriguing subject of 3D printing in the hearing aid industry, and the powerful role of automation in manufacturing medical products like foot orthoses, helmets, AFOs, and prosthetics.
The road gets a bit bumpier as we examine the challenges and opportunities in the orthotics and prosthetics market. From the success of trailblazers like UNYQ and Prosfit, to the potential for premium products serving our aging population - it's evident that ingenuity and innovation are the fuels driving this industry. But don't just take our word for it, Lee shares his invaluable insights on scaling 3D printing and the crucial role of 3D geometry in successful manufacturing.
We'll get a sneak peek into the future of 3D printing in the medical field. Is there potential for prescription orthoses in your local Walgreens? Will custom earbuds and prescription glasses join the ranks of 3D printed items?. Trust us, you don't want to miss this ride!
Special thanks to our sponsor: Vorum
Fasten your virtual seatbelts as we zoom with our guest, Lee Dockstader. Lee navigates us through the transformative landscape of 3D printing, from its revolutionary impact on Formula 1 racing to its impressive scale in producing Invisalign parts. We'll also tackle the intriguing subject of 3D printing in the hearing aid industry, and the powerful role of automation in manufacturing medical products like foot orthoses, helmets, AFOs, and prosthetics.
The road gets a bit bumpier as we examine the challenges and opportunities in the orthotics and prosthetics market. From the success of trailblazers like UNYQ and Prosfit, to the potential for premium products serving our aging population - it's evident that ingenuity and innovation are the fuels driving this industry. But don't just take our word for it, Lee shares his invaluable insights on scaling 3D printing and the crucial role of 3D geometry in successful manufacturing.
We'll get a sneak peek into the future of 3D printing in the medical field. Is there potential for prescription orthoses in your local Walgreens? Will custom earbuds and prescription glasses join the ranks of 3D printed items?. Trust us, you don't want to miss this ride!
Special thanks to our sponsor: Vorum
Welcome to season seven of the prosthetics and orthotics podcast. This is where we chat with experts in the field, patients who use these devices, physical therapists and the vendors who make it all happen. Our goal To share stories, tips and insights that ultimately help our patients get the best possible outcomes. Tune in and join the conversation. We are thrilled you are here and hope it is the highlight of your day.
Speaker 2:Hi everyone, this is Joris Pules, and this is another episode of the prosthetics and orthotics podcast with Brent.
Speaker 1:Wright how you doing Brent. Hey, joris, do it. Well, you kicked that little hamster to make sure you get good cell service for your Wi-Fi.
Speaker 2:Oh, my goodness, I am a little bit cursed on the internet the last couple of days. I hope this works. I hope this works. I am kind of very nervous, actually, because the internet has been very, very iffy the last couple of days here. So, brent, I think we've got a sponsor for this episode, right? Who are they?
Speaker 1:Oh yes, man, it's so great when people just reach out and say hey, you know what, we really like the show, we like the education and we want to keep on providing support for it. And that's exactly what happened. Gene from VORM actually reached out to me and said hey, you know what? I'm newer into the O&P space and I want to know a little bit more about it. And I started listening to all the episodes of the Orthotics and Prosthetics podcast and she was like I think VORM would love to just be a part of that information. It's been so helpful for us. We'd love to sponsor a few episodes.
Speaker 2:Okay, that's super cool, that's really nice. That's really nice and I like that people are doing it not just like a pure commercial thing, but also because they're kind of like what we're doing in the mission and VORM, of course, is well, there are a bunch of stuff right. They've got software, they've got through use scanners, they've got carving equipment, all sorts of stuff right. So how would you describe them? Like kind of like a end-to-end supplier to O&P or how would you call them at some time.
Speaker 1:Well, you know, they've been a mainstay in the prosthetic and orthotic industry for so long I mean over 30 years, so I think that's been really neat and they've been able to. You know, on the last podcast we talked about how to be successful with software in 3D printing and I think it was you that said you need to sit down right next to the clinicians doing the work and find out what they're doing and they'll be successful. And I mean it's obviously worked for them over the last 30 years. You know over 800 facilities in many, many countries and what they focused on on the end-to-end stuff is really neat. So not only from scanning but then to modification, and then, you know, carving, potentially 3D printing, and I think that's an interesting take. But you know we've talked about scanning so much and how things can go sideways with scale and that sort of thing. It does make a lot of sense.
Speaker 2:Yeah, that's super good and also, but just on, yeah, and then not like this is just like a thing for news, but also like just on an ongoing thing in your business. You want stuff that just works. You know day-in-doubt works, get the job done. You know, no crazy new stuff, no crazy crashes, no crazy. Just you know, get the job done.
Speaker 1:Oh, absolutely, and that's what it's all about is getting the job done. I mean, you're always going to have the people that want to fiddle in the O&P side of things, but having something that just works right out of the box, I think, is the way to go.
Speaker 2:All right, cool. Well, thank you so much for for sponsoring us. That means a lot to us and check them out. If you don't know who they are already, or if you do know who they are already, check out what they're offering right now and know what they could offer to you. Thank you.
Speaker 1:Cool. Well, I am super excited about today's podcast. Lee Doxtetter has really been an inspiration in many ways, at least during my time as far as anything, multi-jet fusion and specifically on the color side of things, been a big fan of the color stuff and then the some of the prosthetic stuff. He's had his fingers in a lot of developments in the multi-jet fusion stuff. He's been retired a little bit of time now. He loves to fly fish, but he still likes to shoot debris regarding 3D printing stuff and is still staying up to date on some of that stuff. So I think we're going to have a pretty fun conversation today.
Speaker 2:All right, lee, welcome to the podcast, welcome to the show. So you, of course, you've all started 3D printing a while back. And so, first off, like you know, when did you first start with, like 3D printing? Because you were 3D printing first and then prosthetics later, right, or you were around.
Speaker 3:You know I was in 3D CAD first with HP and they had sent me out to Asia and then HP sold off that division and a few years later 3D systems said hey, you know Asia, you know 3D, you want to go back out there for 3D printing. So I went out there in 97, right before the handover in Hong Kong.
Speaker 2:Okay, that was cool and that was also a really interesting time to work for 3D systems Because of course that was, like you know, stereolithography, vat, polymerization relatively new technology for five years old. And you know that must have been like true kind of evangelism stuff, like truly trying to explain how it works, what it can do, that kind of stuff right.
Speaker 3:Yeah, it was still at the big companies and pretty much in the prototyping shop. Remember the time they had CO2 gas lasers? You know it would take a power 100 amp, three phase, 220 circuit to run it, you know, for a whopping 250 milliwatts. There's a half a million dollar machine and today you can get that from a form labs, you know on your countertop for 2,500, 3,000, it's just. And then the resident at the time wasn't very suitable for human things and I go well, wait a minute, I'm out in Asia. The parts would get soft, you know, within days. But that all changed in the next year or two with the introduction of solid state lasers and a new generation of humidity resistant resin.
Speaker 2:Okay, and in that time I mean you said a while through the system. I think, like what was the biggest thing that changed for users? Was it really like tougher materials, faster processing times, better computers? A lot of it was going on in the time that was getting a lot, a lot better right.
Speaker 3:Yeah, it was kind of the transition for the materials and then specialty materials like materials for investment casting. Not many people know it but all the big investment casting companies in the world use large share of the photography systems to print the master patterns for the production or the tools. But they have rooms full of half a million dollar machines punching out patterns that they burn up and patterns I mean, you know, engine fan covers that are eight foot diameter. You know they take a few days for a few parts to build. Then they invest them in ceramic and then burn them up. It's a very good consumer of lots of parts and they're still using that today and it's a very little known niche but it's been in production since probably the mid 90s.
Speaker 2:Yeah, that's one of the biggest like things that we don't really talk about because the machine is boring but it does, like day in, day out actually works, which is a benefit of all these other things. And what are some other applications from back then that you kind of maybe were really involved in? And besides prototyping, obviously also maybe wind tunnel testing, maybe what's other stuff that you were involved in in time?
Speaker 3:Yeah, so that was F1 racing. Not many people know it, but all the F1 teams have large half million dollar started the fargafing machines to print not only prototypes but actually wind tunnel patterns because every racetrack is different. And then they change the rules and they have to recheck out all the aerodynamics and so they'll make scale model F1 parts for the wind tunnel and all the variations of them. So a tenth of a degree of flair, you know, on a wingtip or something, and they burn up a lot of parts. I don't know if you've ever seen some of the F1 presentations on 3D printing. It's just amazing. Some of these teams have 81012 large format 3D printers and they print thousands of parts, big parts, per year. And it was funny.
Speaker 3:There was a presentation I listened to a number of years ago and he showed a picture of all the slow parts and it was like a 20 foot dumpster and all the slow parts go in the dumpster and the fast parts, you know, get to be master patterns. It was. And then when Toyota came in way late in the game, they built two wind tunnels and they bought a whole bunch of large format start of the firefarin machines at half a million bucks a piece just to catch up. And there was a specialty resin called Bluestone that was made just for Renault's wind tunnel and it was stiff in it and it had a high temperature resistance Not very good for anything else you drop it and the part would break, but it was perfect for wind tunnels.
Speaker 1:So with that, was it mostly like aerodynamic stuff that they're printing, or was there some other stuff that they were printing as far as big parts?
Speaker 3:At the time it was mostly wind tunnel stuff because that was the highest value. But then because they had them, they were able to make master patterns for polyurethane castings to be actually production and use parts. And then, when selective lasers entering improved enough, they were starting to use some of those parts for actually on the car parts, or neck braces or custom seats or you know all the different applications that they developed.
Speaker 1:Now were you in. So how long were you in Asia during this time? I mean, were you actually living there or was it kind of a part-time thing or flying? I'm sure you racked up some miles that way. What was that situation like?
Speaker 3:Yeah. So HP sent me out there in 89, and I was interviewing during Tiananmen Square. That was kind of interesting in Hong Kong. And so I went out there for three years with HP and then came back a few years later in 97. I was out there for another seven years. I was out in Hong Kong for 10 years and I looked after the Pacific Rim. That was pretty interesting. I met my wife, a tall, good-looking partner in a law firm, tall, blonde. She kind of stood out in Hong Kong. We got married there, raised our kids there. It was very, very interesting times.
Speaker 1:Okay, so then when did you start really focusing well, not even focusing on the medical side of things, but when did that start coming into be? Can you just take us on a little bit of a history of what you saw and then maybe what your journey was into some of that stuff?
Speaker 3:So my grandmother was a dentist, my father had a dental lab and he focused on orthodontics. He had an ortho lab and so when a line you know Invisalign came up, I jumped on that line and actually I had some pre-IPO stock that I bought for $12, and 10 years later I sold it for $20. And it briefly hit 700 here this last year. But I thought I doubled it in 10 years was a good deal, but I could have held onto that.
Speaker 1:Yeah, you want to hold onto that one right.
Speaker 3:Yeah. And so in the early days Invisalign or Align Technologies was trying to develop the build modes themselves for accuracy and speed and didn't tell 3D systems what they were doing. And they finally came back and they get hey, we need some help. And they charged them some donor current engineering and they agreed to buy 50 machines 50 machines. But I think 3D systems are about $90 million that year and you can imagine 50 times half a million dollars a piece. You know what kind of attention that got at that 3D systems.
Speaker 3:And so they worked on the build mode for a little while and, lo and behold, it became production enabled. Because at the time they were making plaster, they were doing impressions and they making plaster molds of that. And they were putting the plaster molds in a pan and then they would pour black epoxy around it and then they would machine off a layer and it would have the white plaster inside and then the black epoxy on the outside and they would capture. They would take a picture and capture that layer profile. Then they would stack up all those profiles and create a 3D part from it. And that's how Align Technologies started making the molds for the aligners. So obviously that was pretty cumbersome, so when the 3D printing came online so not many people know it Align probably makes more parts than all the rest of the industry combined per day.
Speaker 2:Yeah Well, a line does a million a day and its competitors do another million, so it's two million a day. So that's like you know that's huge. But also it's been going on for now, for you know, for decades now, so it's also like it's. The longevity of this application is insane really.
Speaker 3:Yeah, and it's growing and it had copycats. You know the Smile Direct Club. They jumped on board with Direct to Consumer, which the timing wasn't the timing is unfortunate, but yeah. So those production applications I've been attracted to since kind of the very beginning. So out in Asia it was jewelry, and in Italy they did a seminar on jewelry master patterns using stereophography and they sold two machines at the seminar and I go nobody sells machines at seminars. Yeah, we did make them. Well, send me all your stuff. And they did. And I went out to Thailand and I sold one machine on the first visit and these are $200,000 3D printers and at the time I just didn't understand the value of a machine made master patterns and it became a pretty big thing and most of the world's master patterns are for jewelry, are 3D printed now and not again. Not too many people know it. Same thing with hearing aids. Virtually 100% of all the world's hearing aids are made with 3D printing and has been for 15 years, maybe longer.
Speaker 2:And in the beginning did it because it's like looking back, like something like a visual line. The hearing aids looks kind of like really obvious, kind of. But was it maybe where a lot of skeptical people like, oh, a hearing edge, why are we doing that? Is that really going to be a big application for us?
Speaker 3:Yeah, so it was. Yeah. So once somebody buys half a dozen machines, you go, oh crap, well, let's go talk to the other people that, the, the, the carriers, and it turns out the top five companies make 80 or 90% of the world's hearing aids. So did you need a big Salesforce? No, we need one person to go talk to those five companies. But they need to know what they're doing in the value chain and all kind of fun stuff.
Speaker 3:But once you get the first one to to, to buy into the process, it was a lot easier to get the second, third, fourth and fifth and within three years I think pretty much all five of those companies had converted, at least started doing three printed hearing aids, because the reject rate was so much better, the fit was so much better, the modifications, customer satisfaction it was, it was so compelling. If you didn't have it, it was a big drawback. And it takes a year or two to get to train somebody to make hearing aids with some acceptable sort of return rate, because if they're not comfortable, the, the doctor has to replace them for free and that's that's. That can get kind of pricey. So, yeah, so, tens of thousands a day for hearing aids, jewelry, master patterns, investment casting, so been through a lot of those and it's it's fun.
Speaker 1:I'd love to talk about the hearing aids side of things. What do you think is that was the tipping point? I mean, did, did hear the hearing aid. People come and seek you out for that, or the technology out, or was it more? There was somebody that had kind of an entrepreneurial, you know spirit from that and they're like, hey, why don't we try 3D printing this? And then, and then they kind of get the eye of a manufacturer and say, hey, can you help me out with this? And then and then what becomes the tipping point? Where that starts snowballing.
Speaker 3:So it was kind of a three things converging and making it possible. There was a resin supplier in Germany called Drewe, and 3D systems had just launched the solid state laser version of their 250 millimeter star photography machine. And there's this little company called three shape that had just come online with the scanning and an app to create the shells, and all three of those things kind of came online at the same time, and a couple of the large hearing aid companies I think Widex might have been the first. I might be wrong on that one, but actually rumor has it is they helped fund the master's thesis that these two guys in Belgium or a Denmark University and that was the founders of three shape and their first and so their first customer was was Widex.
Speaker 3:And those three things materials, the printer and the software and the scanner all kind of came online and so, like I said once one company pushed for it, if you didn't have it you were at a severe disadvantage. And then the big the, I think which is going to be the next big breakthrough is the in ear scanning and then translate that to the over the counter hearing aids that you can get now and the the introduction of the AirPod Pros. Just think if you had a custom tip instead of that silicon one that doesn't fit everybody, or doesn't fit hardly anybody. If you're running and your your headphones are always falling out. What if you had a custom tip that would go on your over the counter hearing aids or your $300 pair of AirPod Pros and they would never fall out. They would seal better, it would cancel the noise better and it would sound better.
Speaker 2:Yeah, I love that. I think it's a really wonderful vision. The other thing, of course, that you know what we see with these things is that you know we'd have to add a wall green to something, train someone to do it, you'd have to buy the scanner. So there is some effort required. But if a company did implement this, I think it's wonderful. But we've seen the ultimate ears uses 3d printing in its hearing or its headphones. Phonak tried to make headphones with 3d printing and for it's the most confounding thing in the world to me why, with all these hundreds of thousands of dollars people spend on headphones, that no one has made headphones and 3d printing work.
Speaker 3:They do. I mean, I've got I did some work for ultimate ears a number of years ago I've got a couple of pairs of their thousand dollar headphones. They're awesome, they just they're stunning. That's what the musicians use on stage. But just think if you've got the over the counter hearing aids today are basically AirPod Pros with an equalizer. I mean, that's really all they are. I'm probably oversimplifying that a huge amount, but it's like it's $600 instead of $2,000 per ear. So it's $600 for a pair of headphones instead of $2,000 an ear. So I think the over the counter and the custom is going to work and but not with the traditional scanning. You have to go to an audiologist and get scanned where you have to buy a $10,000 in ear scanner.
Speaker 3:There's some new technology. There's a company down in Australia called Hearables 3D. There was a master's thesis person down in Monash University and he came up with AI to be able to use a Apple scanner in the iPhone and it would scan the outside of the ear, you know, in in the canal, as far as it could have line of sight. But then they had thousands of scanned ears data and then say, ok, if the outside looks like this, then the inside is probably going to be like that, and they could then model down deep enough. Now is it. Is it good enough for severe hearing aids? No, because those have to go right down next to the to the eardrum. But are they good enough for some AirPod pros? Yes, yeah, so that's. That was only my second ever investment in a company with. I made a small investment into those guys Because I think that's going to blow up.
Speaker 2:Yeah, I think that's really exciting because, like I think, if you look at also, we know for cone scan, for example, we tried that out, played with that for for for orthotics and stuff about it and just the idea of empowering someone to have the iPhone they already have and use that to personalize is, of course, like incredibly powerful because, like, how many people have an iPhone? That is like hundreds of millions of people. So so that that really extends that ability really very drastically.
Speaker 3:Yeah, the iPhone 10, 11 and 12 had really really good 3D scanners at it. It's that I think it was the sense chip and there was a company called Bellis 3D that took advantage of that scanner and they had an API that they would OEM to different people and then a few years later they got bought by Facebook, so that API is off market. But I actually made a clip on scanner for androids as well and I've got one of those and dang, it is a good scanner built in your iPhone. The sense three camera scanner is really really good. I mean, I had my face scanned around probably 20, 25 years ago. It was a good scan. It was a hundred thousand dollar laser scanner, you know you can now get it built in your darn phone and it's just as good, if not better.
Speaker 2:And color, I think, and, yeah, I think the screen amazing. If they keep doing it, then I love this idea also for aesthetics, and aesthetics to, you know, keep people, you know, getting that custom geometry and easier and more direct wise and for you. So so, hearing as you talked about a bit, I love that you pointed out that you needed all these three different elements. There was the same with the visual line. I mean, was that just a time? Or these guys, like you said, these are visual and guys are just completely in this really contrived, ridiculous, expensive process and they do anything to get out of it. So they'd invest in you guys as well.
Speaker 3:Yeah, it was two grad students at Stanford University that were chatting and they weren't from the dental industry and they had this idea and credit to them. They stuck with it and saw it through. Now it probably took 10 years for a line to be profitable. I mean it was. It was heavy lifting because the infrastructure wasn't there. They tried getting the orthodontists to do it and the orthodontists are so great, Thank you, and they get up.
Speaker 3:They went public, raised like 100 million or something, spent a bunch of it on advertising. And the advertising is telling people to go to their orthodontist and, you know, ask for an visa line, and so they get they would do that and the orthodontist of committing so wait a minute, and visa line is going to charge me 1000, 2000, whatever it is. For the aligners I, if I do braces, I got $100 in cost materials and I charge $5000 for teeth straightening. You know I make 4900 if I, if I use and visa line, I make 3000. So a lot of that advertising went to the orthodontist, driving people into this to see the orthodontist.
Speaker 3:But it really didn't drive business. And then they made the break and went to dentist and the dentist go, wait a minute. All that things taking impression and align does all the work for the planning and the models and I can make $5000 instead of you know, $150 for a filling. Yeah, sign me up. And so that's where they made a big turn is when they went to the general purpose dentist instead of just orthodontists. And then now it's so ubiquitous that if the orthodontist doesn't carry it, they're going to lose customers. So it's it's that prevalent in the US now and they're they're expanding the type of cases that they can do, they're expanding the geography in the different countries and it's it's heavy lifting, but heck, they do. I think they're over a billion dollars in revenue now. It's at 70% gross margins Plus.
Speaker 1:Yeah, that's amazing. I mean, joris and I talk a lot about the design side of things. A lot of that design is done offshore, right, so it's not done in the US.
Speaker 3:They have a very large building in Costa Rica that does the dental planning.
Speaker 1:Okay, and so there's some dentists that are hanging out at Scuba Diving, having a good time and also doing some dental planning too. It sounds pretty awesome, so okay, so that's on the dental side of things. Do you ever see that? I'd love to just talk a little bit about some of your experience in the orthotic and prosthetic market. Do you ever see that kind of design sort of thing centralized and off-shored out of the US, or is the prosthetic and orthotic market just a completely different animal?
Speaker 3:It's probably a little bit of both, just because in the O&P market there's a custom orthotic for your feet, completely different workflow than a scoliosis brace. The workflows are so different and so specialized and other than our footer orthotics, the market isn't really that big. My big thing in production 3D printing is the geometry has to be created automatically or virtually automatically, with the user interface appropriate for whatever the application is. I mean, you never see CAD kind of stuff within Visalign. All you see is your teeth and then a little animation of the teeth being straightened and then a before and after what they're going to look like. And then I think recently they started doing a face smile thing as well, so you can see what your teeth are going to look on your face before and after. And so it's software that automatically creates production-ready geometry is the key.
Speaker 3:Nothing has made it to market that isn't hasn't made the market in large scale. That isn't like that. Same thing for hearing aids and I think same thing is going to happen with orthotics, and orthotics is getting there. If you guys looked at Invent Medicals.
Speaker 1:Yeah, yeah, they're foot orthoses, and then they have the helmet, as well as the AFOs and that new, the AUGO, the prosthesis, yeah, and I know those guys and I really like what they're doing.
Speaker 3:Yeah, like the Cainiosinitosis helmet, the baby helmet. It's awesome. I've actually been to their clinic in the Czech Republic and they've. You know, it's all pink and blue, it's centered for babies and they go in, they put a little sock on their head and then they scan it and then the software automatically I mean you just kind of control how far you want the temple things to come down. There's just a couple of handles and a couple of sliders and the rest is, you know the regular prescription and where the dent is, and it identifies where the dent is and it suggests a correction. But their software is meant for the doctor to prescribe the baby helmet and it doesn't look like CAD. It doesn't look like you use the freeform stuff. Brett, there aren't many people with your skills and your talent for O and P. I mean, how many icons does that software have?
Speaker 1:It's a bunch, but I only you know I probably only use 10% of them, but there's definitely it's a lot. Yeah, for sure.
Speaker 3:But yeah. So I think the key to all of this is the software to automatically create the geometry. And then that's kind of the front end, the back end. None of this would have made it to the market unless there was a manufacturing shop floor. Shipping labels, you know UPS things. Can you imagine a line at a million parts a day, each unique, each have to go in the right bag with the right label, and then 98 of those have to be combined in the right box. I mean, just think about the workflow of tracking all of that stuff. And if you lose one out of that 98, it's like the ultimate lost sock syndrome. You have to put the 97 on a shelf somewhere until you remake the 98 and put it back in there.
Speaker 3:So the shop floor and the automation is incredible and even automating some of the factory floor stuff. So they worked for years to go from a CNC trimming tool. So first everybody starts by hand cutting those aligners off of the molds by hand and then manually polishing them. Well, if you guys have ever tried taking apart anti theft packaging, you know for a consumer good with a clear cover, you know the liner stuff is worse. It's really tough stuff. And so they automated the five acts of CNC, and then they they would still have to polish it, and then they worked for years on a laser base that would actually cut it and the right amount of heat would polish it in the same step. But if you're doing a million a day, you can save 10 seconds per amount of labor. Wow, things add up really fast when you times a million. So it's the automation of the geometry capture, the prescription, and then it gets to be workflow, especially when you get into high volumes.
Speaker 2:But I think it's also interesting. A friend of mine, matt Griffin, at one point said he thought a lot of the consumer product startups failed because they started doing automation too early, because before they actually stabilized the product, before they actually had the volumes, before they actually knew what the problems were, they started to come up with like this really cool end to end automation solution that I'm not working.
Speaker 3:Yeah, the automation. I mean automation only makes sense if you're, if the volume is high enough to pay for it. Then you and some of the software companies were really trying to get into the. You know they want a piece of the action, so we'll charge you very much for the software but you're going to give us 5% of your revenue. It's like that's yeah, that's, that's hard to escape if you get sucked into that Good business model for startup because they don't have the cash but mature companies are hesitant to do that.
Speaker 3:But the the invent medical type of ease of access for the prescribing own P person or the actual doctor is fantastic and the craniosynoptosis helmets is just a perfect example of that. And I think in the England they already have 80% of the market or something and they just launched it in the US. It would be curious, you know, as they find the doctors that prescribe that kind of helmet, how fast that's going to go, because you guys have all seen the traditional one. It looks like a basically an igloo ice chest on the kid's head. It's basically a fiberglass filled styrofoam and it's, you know, on a hot day there's no vents, it's anyway. So it's a better product, it's more comfortable, looks better. Yeah, it's just awesome.
Speaker 3:And scoliosis breaks. The other big thing I saw years ago from bespoke innovations. You guys remember those guys in the Bay Area yeah, scott Summit and the orthopedic surgeon from Kaiser, I can't remember his name. I saw a picture from them and they'd come up with a scoliosis brace and I had no idea that 80% of all scoliosis patients are females, you know, from 13 to 18. And if they don't, and the Scolius who braces?
Speaker 3:At the time they worked fine. But again, it's like wearing an ice chest around you. And if you're a teenage girl and you're sweating because you've got this brace on and you smell, you know you're in high school. Ah, that's not a good combo. So they would, mom would drop them off at school, they'd take the brace off, they'd stick it in the locker, they'd put it on when they went home and guess what, when they're 18, they have to have $100,000 in super invasive surgery to straighten their back. And if you wear the brace, it works. And then they found with the 3D printed brace, they did some studies I think it was Stanford Medical Center, I can't remember with 50 girls and they found the compliance of just wearing the 3D printed brace was 50% better than the standard brace and 50% in medical. That's astonishing and so.
Speaker 3:But unfortunately at the time they didn't have the laser centering that was making them and the software to create them was all manual and the machines big enough to make them were like three quarters of a million bucks and they could only make one every day and it just didn't make any economic sense to make them. But with the new software that breaks them into pieces so they can make more per build and some of the software for the automatic geometry creation, I think it's gonna come back. But again it's kind of a volume versus a price. And the other thing that killed when 3D systems bought the spoke innovations, the other thing that killed them was the reimbursement. Code only paid a certain amount. Just say it was 2000. Well, if it cost you 3000 to build it and they thought they could get a higher reimbursement and they couldn't because the code is the code and they'd only allow us for a certain amount of reimbursement and so it just didn't make any economic sense.
Speaker 1:Yeah, I love the Scolius.
Speaker 1:I do think that there's a lot there, and I think there's a lot there on the kind of the hybrid side of things, where you're using different materials, maybe some from either SLS or multi-jet fusion and then also some FDM.
Speaker 1:We're involved in a study right now. That is just that and it is amazing. And just like what you said with the females and such, the compliance is through the roof with the 3D printed and actually the correction is better as well. So not only are they doing the comfort side of things, but they're also looking at the overall correction in the X-rays and it's better in the 3D printed brace. So I'm really excited about where some of that stuff is going, because the Scoliosis stuff, a lot of that is either very, very quick or can be automated as well, because there's only a few different curves and then if you have an oddball curve or whatever, okay, say, it takes a skilled person another 30 minutes to modify that one, but that doesn't really, you know, hold you up too much on the other 95% of them. So I really like that.
Speaker 3:The software and the regulatory stuff was a big barrier as well, because all they were doing was they would have a regular O&P clinician do a thermoformed brace, first with the manual pressure and then heating up the plastic part that they put around the body, and then they would scan that and then turn that into a 3D printed brace that kind of looked like Wonder Woman's armor, not a igloo ice chest. And they did that because it was a custom device prescribed by a doctor. It wasn't designed by software. The only thing they did was scan the manually created form. And I think the big breakthrough is gonna be the people that go through the regulatory and go from the body scan and the X-rays to, but then that's gonna have to go through clinical trials and tests, and so it's gotta be a pretty good size company or somebody with quite a bit of financial backing to go through all that stuff before they actually can market it, and that takes years.
Speaker 2:Yeah, I think I can already guess who's gonna do this. I should be.
Speaker 3:But it's gotta be one of the big guys because they one, they can afford the investment and two, they have access to the market. And that's the other big killer is what's the cost of customer acquisition. So there's a lot of really good 3D printed orthotics on the market, but unless you have access to the hundreds or thousands of O&P clinics or, even better, if you provide, just say you're doing photorethotics and you can get it to your GP doctor. Can you teach a GP doctor how to do a photorethotic for the most common applications and have the software take care of the rest? Yeah, it's like teaching a dentist and taking an impression for teeth straightening If the software detects and prescribes and the doctor's trained what to prescribe and what not to prescribe. Yes, you can, and so access to market is the other killer expensive thing. If you don't have it, it's really expensive and slow to obtain it.
Speaker 1:So I mean it sounds like when we're talking about all these applications and then, specifically with you, what you're talking about is and this ties in a little bit with yours, your article that went nuts this week but about finding the right applications for 3D printing. So from what it sounds like with what you're saying is like okay, photorethosis makes a lot of sense, there's volume there. It's small, it can be automated. The helmet side of things makes sense. It's small, automated Spinal stuff can be. I mean, even though it's larger, it can be automated. So that friction from the data acquisition to actually getting the device, that's when it starts making sense for 3D printing. But I mean, what do you say to those that like, like the prostheses? You know we do a lot of prostheses. Maybe that is not the right thing to look at with 3D printing, or what are your thoughts around that? So many of those are so unique different weights, different sizes, different bony structures, different styles of amputations it is more difficult to automate that side of things.
Speaker 3:It is and in my opinion, if you can figure it out it's all that much more valuable. And it's like the crinocenitosis. There's a lot of complicated stuff going on there. You've got the kid's head doubling in size between three months and one year. You've got the dent, you've got the location the skull plate seems that you got to worry about. So it can be done, but you have to have enough.
Speaker 3:Is there the value there in the part that is 3D printed or you know it's just the vacuum forming of a person's stump and the O&P person feeling the skin and how close the bone is to the skin, all those little nuances and stuff. Can that be prescribed and can the software kind of figure all that out and then fine-tuned and fine-tuned with lots of good feedback? I think it can. But Sox is another good example that I mean you've got somebody with your skills, with the Freeform software and your experience as an O&P clinician. If that can be automated, I think you end up with a better socket. It's more comfortable, you can replace it much more easier, all that kind of fun stuff. And I think Invent Medical is working on that lattice work with a 3D printed liner. That's part of the socket, if I believe, if I remember that correctly.
Speaker 3:So if they can do it. But then there's a small self-funded company and they're making great strides but you need a hanger or an autobock or somebody to actually bring it to market, in my opinion, to make it economically successful, and that's going to be at scale and the cost of customer acquisition. I mean, if you're trying to go call on all the O&P clinics in the US and you've only got a five-person sales force, and that's hard, ok, and it's just not going economically and speed wise can be very effective. So it's access to market, automatically creating the geometry and then have an automated supply chain Figured out, I think, and hardly anything has gone true production unless all three of those things Exist, plus you have access to the darn market.
Speaker 2:I think I think that's a really amazing point. It's an amazing point, I think a lot of people look so naively at these, these things and say, oh it's, we get a slightly better result. Okay, cool, let's charge your head. This is it. But you know, without those three things, I don't see it happening.
Speaker 3:Yeah, yeah, and it Try to think of. There aren't very many times it has happened. Invisalign was, was Was one of the exceptions that they created it from scratch. But, like you said again, it took him 10 years to be to be profitable.
Speaker 2:And I think that's also the good point. An extra point I'm putting is that the product has to make sense without kind of this mass customization software and magic right. So you know you have to have something to sell when it's just you or some guy somewhere doing it, and it has to be so valuable that people are willing to put in that kind of time for it to be validated enough for you to build this, this software, because you're talking about the automation, it has to be able to carry the cost. But it's the same for the software. I've seen a lot of startups build the software first and then end up having something that either doesn't work for the people to use it or is way too ever complicated or, as you know, it's just it's not the right solution. And I think just building in tandem with the solution, I think really really really makes sense as well.
Speaker 3:Yeah, the last group I worked with it at HP was the footer thought it group and it was a really, really good interface scanner workflow automated. But does HP have access to the footer thought it business? No, no. So they had to hire some folks from the industry and they have a team of, you know, maybe half a dozen sales folks but, and they're making great inroads, but there's only so many people you can call on per week and you know the success factor. So it's it's really hard for somebody to enter the market, even if they have a Reputation like HP.
Speaker 3:You know, I can imagine how the sales call would go. They knock on the front door. Hey, no, we're fine with PCs and printers today, you know. Thank you very much, and I know our footer thoughts. What, yeah, it's, it's it's got to be a uphill battle for, but it, like I said, it's a, it's a good application. I've you guys have seen it's called a rise, it's my rise and it I think it's very intuitive. They designed it around a prescribing doctor and it kind of looks like a prescription tab.
Speaker 1:Yeah, and they've done a, they've done an amazing job. I mean it's like it's. It's almost like the cheesecake factory where there's too many options, but they've, they've made it. So all the the standard options that any doctor may want, can, can, can get, whereas you know some of these, the smaller, smaller groups, I mean it's like, no, you're gonna get. You know, the only top cover is this, the only met pad is this, and you know these are the things that you get. But whereas arise and you know a larger company a little bit, you know a lot deeper pockets, I guess Can start offering more of these options to to gather the bigger, you know population. So so that so an excuse can't be oh no, we don't offer that. No, it's in there. So I think that that's. That was what struck me when I saw the arise stuff was wow, there is, this is comprehensive.
Speaker 3:Yeah, well, they hired people from this what are thought like business and then interviewed I don't know how many doctors About you know. How do they want the scan, what do they want to see, how do they do prescriptions, and they basically it's an online prescription pad with, you know, with graphics, and it's quite and they did. They work really hard. They had a user interface person from HP helped join them and interpret what the doctor said and and what the foot people wanted, and then worked on the software to deliver it and it's it's, you know. But then access to markets the is is difficult because they're they're going after podiatrists.
Speaker 2:No, I think that's all that's also. The interesting thing is about this the visual line thing. You said nothing. That's something I didn't realize, but I knew this, but I didn't know this right, the fact that I thought a visual line was Invisalign because they went there labeled dentist to play on the orthodox market, the idea that they first went to orthodox or or or, or to what are they called? The dent, the brain? Yeah, that is, of course. You do that first, right, of course. But then you're telling this person Well, you study for this and I'm gonna replace you, right, and that's not gonna work. We know that already, right?
Speaker 3:Well, you're, you're, you're gonna charge him $1,600 instead of $100 for the cost of goods and at the time it was kind of unknown and the the orthodontist, he was $5,000 in profit, you know. And then you can get that if you, if he has wire and brackets, so you'd have to charge $6,600 if he was charging, you know, for Invisalign. And it turns out, if you kind of go to your orthodontist, now it is they charge about $1,500 more for clearer liners, because they can, because they've got some market awareness now after what? 25 years in the market, but it was, it was tough going. They spent massive amounts on advertising to send them to the orthodontist and they say, yes, that invisible and stuff is fantastic for certain cases, but you, my friend, you need braces.
Speaker 1:When you're starting to see that some in the orthotic not in the prosthetic market, but in the orthotic market, as far as not only the foot orthoses of you know Going outside of O&P because of podiatrists and such do it, but even some of the arm braces, you know, some of it, like the, the twickets and the spentes of the world, are going straight to physical therapists and occupational therapists For very much the same same reason. Now, it's a value add for the physical therapists or occupational therapists To provide this sort of device that's automated and such whereas it's. It's. You know, upper extremity orthoses isn't, isn't a super profitable niche for the orthotic and prosthetic market, even though a lot of times they're the best suited to provide it. It's not something they want. And so, you know, kudos to those companies of like hey, if the O&P market isn't gonna, you know, help us, we're gonna go and find a place that does help it so we get to take care of the most amount of patients.
Speaker 3:Yeah, it's act for them. It's also access to market. It's the. You know, if you need to risk brace because you've got carpal tunnel, you know the over-the-counter stuff versus a custom one. I am, I'm not that versed in that market. I mean, I I had one for a little while and the damn brace hurt worse than the my thumb to. Yes, I don't know. And then what's the value of a break? And for fractures or injuries you have to wait for the swelling to go down anyway. So you have to put a plaster cast on to begin with and anyway. So it's the deep when she died in the details for any particular orthotic device. Wow, it's complicated in a hurry, yeah.
Speaker 3:And the socket, I think, is another one that can be automated and I think if you go the invent medical route you can really do a lot better. Or Unique, the, the US and Spanish company that makes prosthetic, or they make covers for limbs. It's not the device itself, but it gives the person more confidence about their, their missing limb because they've got it looks like shin guards for soccer and or it looks like Wonder Woman's armor instead of you know, just a pole in a shoe. So the, the unique, did a really good job on their software making those easy to order you know what kind of device you have, the length, the sizes, and then you pick, know your style, and they, they 3d print all of those covers and and making it easier to access the market increases demand.
Speaker 1:Yeah, and what they did I mean going a lot of times direct to the consumer was good too, because, you know, even even in a shop like ours, there's no way that I would ever Use any of those covers, and not because they're not great, it's because I was a little bit more confident in my Great, it's because I will literally lose money. I will. I'm better off giving that patient a hundred dollar bill and say and go here, take this and go, you know, spend it on a cover, than it is for me to Provide it. So I mean, I think that is that's excellent. And you know, the other part of that is it's essentially a no risk type of deal because that thing, even if it, if it fails or breaks or what have you, it's not going to cause the patient to fall or you know what have you. So it's a Extremely low risk Product to bring to market, which, which I like, and I think going straight to consumer is is Okay on some of that stuff.
Speaker 1:But I think one of the other things that Many people underestimate and I forget what the latest numbers are right now, but in in the American household, you know, most people don't even have a thousand dollars to spend on something. They cannot write a check for a thousand dollars. I forget what the what the thing is. So this idea of hey, we're gonna provide this, this you know process or or something extra and we believe that the patients will pay for it I think people get the cart before the horse a lot of times on that and not really look at the economics of that. Because the economics is if the insurance is going to pay for it, ain't nobody gonna pay for it, and that's just the way it is.
Speaker 2:Okay, okay, counterpoint. I think it's a really good point. The counterpoint of this is that Bill Gates and I will have the same wheelchair and and there's no super premium wheelchair I still think that there is an opportunity there to do something at the top of the market to say, look, there's like a there's a huge generation is getting older. There's a lot of these people have wealth. I Will, I'll make us, yeah, two thousand dollar pair of crutches and you know what. It's not gonna be a volume product but it's gonna be very profitable if you just sell 10 of them.
Speaker 3:Yeah, again, it's access to market on on that one it's. It's kind of like sockets. Like you guys know, crossfit, they they have a hand scanner. They can send a clinician into an area that doesn't have any O&P shops. They can scan somebody and have a socket made and Remotely and shipped in and Again the software is super easy. My understanding is the sockets are really good. You pick what kind of attachment you want. It's all designed offshore and you pick your your manufacturing thing. And and again, they've just made it easier for access to the countries that don't have In country shops. Unfortunately a lot of its war-torn Areas that don't the don't have any 3d printing, don't have any shops. So if they have somebody that sets up a Shop which is really just a scanner and a laptop, it's it makes it easier to access for the market and that increases demand. But that's that's. It's heavy lifting working on world countries.
Speaker 1:Yeah, yeah, well, and yours, yours and I actually just recorded a podcast about that that will be released, and very soon, just about we. We love this idea of the entrepreneurial spirit and and such like hey, if you, if you have an inkling towards providing a prosthesis, or what have you, and you have a scanner and a laptop, and then you know, and then you use a third party to create a prosthesis in what? In whatever ways possible, how cool is it to be able to provide, say, a premium product like a multi-jet fusion socket, I mean the, I think the then the reality then becomes. It does put it out of reach in the multi-jet fusion side of things for a lot of people, unless you have Investor money or donors or or or what have you. That's supporting some of that side of things. So, but I love that idea of the entrepreneurial spirit in some of these places where the only thing that you need is a scanner and a computer, that's, and access to a PO box, right.
Speaker 3:Yeah, yeah and it's, it's. I think all this stuff is percolating. Well, I I Don't believe it's gonna go widespread until one of the big OMP companies makes it Pervasive. You know, it's got to be an Otterbock or an Ocer or a company or hanger that's got hundreds of shops already and then Deliver the platform for the for those shops. It's man doing it for the ground up. This is heavy lifting, yeah. So I mean.
Speaker 1:I know you're, you know, a few years removed now from the HP side of things and you're looking into the orthotic and prosthetic industry and I know some of the 3d printing side is on the road maps of some of these bigger companies and even some of the. So you've got the Otterbock, the hangers, the Ocers, and then you've got a company like equal that's coming in and then that's coming in and that's been heavily investing into digital side of things. What do you think is the tipping point? Or, you know, even a different question is why, why hasn't anybody taken that kind of first stab at it to commercialize it on a big scale? Some of those big companies?
Speaker 3:Yeah, that's probably a good question for the big companies. So one's in Iceland, one's in Germany. I've been told that both countries are very conservative in their business practices. I don't know. Good question for another podcast.
Speaker 1:Yeah, I mean, I think the biggest thing for what I see on some of this stuff is really the aversion to risk. And then I think, the other side of things, just kind of like what you mentioned with the Aligner a lot of these big companies actually have contract manufacturing in-house already where their cost of goods is so low and it's a cash cow for them to send to something else. So that's where I see one of the more difficult areas of adoption like a global adoption. But it might start off as some sort of niche adoption, say, like an upper extremity, or we starting to see things like partial fingers come into the market and things of that nature. Where 3D printing is making sense, the risk is low. I think that makes a lot of sense for big companies to leverage that, Whereas they've already got the wheels greased on some of the traditional fabrication. So why change that?
Speaker 3:Or it could be like HP was doing with plantar fasciitis. Give the scanner to a GP doctor. I mean, can you teach a GP doctor how to prescribe plantar fasciitis? Brent, you probably do it in a couple of hours. And then having a GP doctor do it, rather than having to go see your GP, than having to go see a podiatrist. I just saw a podiatrist for a sokeely thing. It was 450 bucks 20 minutes and I'm on a high deductible plan, so that's out of pocket. It's like crap.
Speaker 1:Yeah, yeah, yeah, okay, yeah. I mean I think that's an interesting point and for a lot of these high volume things and like what Invent has done, I've talked to many clinicians that have provided Invent medical for orthoses and they're like man, they're great. You slide them in the shoes and they fit great. Patients love them, they last and all that. So when you have something like that that's dialed in, yeah, why wouldn't a doctor offer something like that? You know, the biggest thing comes is okay, what if something fails or needs to be modified and it's like okay, do we really want to a doctor or does the doctor really want to spend their time to evaluate that? But I would say, for the most part, they're not going to have to when you have a solution like the foot orthoses from Invent, yeah, I've got another follow up visit with my podiatrist.
Speaker 3:After I do all my stretching for six weeks, I think I'll bring some foot orthotics back in with me and say why wouldn't you have a scanner? Because there's several podiatrists and sports medicine people in this practice, so why wouldn't you have a scanner and just send the person over? Yeah, it was interesting.
Speaker 2:And so we were kind of dancing around this. We were talking about the Visibleign, we talked. Lee mentioned like we need to automate the software. We talked about automating the production. So the obvious thing to do would be to put, like this HP gear, this you know footbed scanner, and the 3D scanner in like a Walgreens right, and then the Walgreens just like starts prescribing these things, and then the podiatrist maybe sits somewhere in Boulder, colorado or Costa Rica and just every once in a while, just like you know, signs off on the thing, and then we automate it completely. You know, Do you think and that to me I think, I think you know we're talking about like at one point we maybe feel comfortable with that and all of a sudden we get start feeling very uncomfortable because how far would Walgreens go? Do you guys think a future like that is a possibility?
Speaker 3:Well, in the US, dr Scholes did that quite successfully in the drug stores. They had an end of aisle stand and you basically stood on this thing and it's, and asked you a couple of questions and then it says you need green, size 10. And there's, you know, red, blue, green, and it was. It was just marketing, it was just helping you pick and it was a little bit of automated suggestions, but nothing was custom. It was just helping you pick the right Dr Scholes insole end of aisle. I thought I thought that was quite clever. I don't know how financially successful it was, because the vendor has to pay. You know, walgreens is not going to say oh, yes, dr Scholes, we're going to sell more insole, we'll gladly give you eight square feet of an end of aisle. No, it's like no, you need to pay us for that end of aisle location and give us a good cut on the insole. Yeah, once you're retail man, it's that's.
Speaker 1:That's really interesting. But I think you know yours and I talk about it all the time you know with with some of the FDM stuff and the food orthosis coming out of the market and being able to do some of that stuff live right there. Man, you know it would take somebody with some deep pockets but that's super attractive.
Speaker 3:There was a small company that tried it at Costco and they were making a flexible FDM thing in the Costco store and they had like half a dozen printers going. The amount of labor, the amount of failures, bad builds, broken machines, they, they. But they were doing it live, you know. Good for them. They give it a horrible failure, but it was a good, it was a good effort. I think I wear is the next big one. Well, custom earbuds for over the counter hearing aids is a big one. And then prescription I might.
Speaker 3:I had my eyes lasered years ago and my distance has always been good, but my my ended up having readers now that I'm over 60. In finding the right size frame with the right kind of frame that would hold a progressive lens, it was ridiculously hard. I mean, you go, oh, here's what's covered under your insurance, but you, my friend, you know if you want progressive lenses, well, that's another 150 bucks. And these frames, oh they're, they're not included in insurance. They're another $250. And everybody knows frames cost like 10 bucks to make. How can they be $450? It's ridiculous. And so even at Costco there was only a couple of frames that they had that fit me and it's like, oh man, unfortunately, I like the looks of one of them and it wasn't covered under insurance, but it was still less out of pocket than I wear, that I would have gotten on my insurance and it's like, yeah, and I had, you know, very little choice in frames, whereas the workflow is, if you go in, you have your face scanned Okay, you need this temple with you need this nose bridge, you need this, this ear length and you can have any of these designs you want and will make them to fit your face and you can do a virtual try on.
Speaker 3:Before you know, you order your $400 glasses and that it's. The technology is there. There's a Northern Europe. There's a lot of companies that actually have 3d printed eyewear, but right now it's more of a fashion thing as opposed to a fit thing. And a fit thing with progressive lenses is super important, because I've got an astigmatism and progressive lenses and where those sit on your face is super important. So, and again, that's access to market. Oh, you know 50,000 independent optical shops and trying to call on them.
Speaker 1:So on the on the lens side of things, I've always been curious are there like standard lenses or are the lenses cut to the frames?
Speaker 3:They're cut to the frames. So all lenses start, as you know, spheres. And then you there's, you cut the prescription into the frame or, I'm sorry, into the lens, and then you trim the lens to meet the frame.
Speaker 1:Is there a standard way that the lens goes in a frame, Because I know like I've had lenses pop out right, so is there like a? Is that a standard thing?
Speaker 3:Yeah, yeah, it most of them. So if you have a plastic frame, you usually it's nylon, it's a TR 90, I think it's called it's. Anyway, you heat, you heat it up, put it in hot water, you have a ultrasound type thing, and then you pop the lens in from the Is it like tapered or is there like a, like a routed edge? There's a route, there's a routed edge and it's like a V groove Male part on the lens and a female part on the frame and then the metal frames just have a little screw that types it up.
Speaker 3:But yeah, they have to have to be done pretty darn accurately, but that that's. There's tons of machines that do that. They've got machines that you actually just run a probe over your opening and it programs a lens cutter. I mean it's, it's that it's really automated. Now you can, you can go in and have lens cut it what's it called lens crafters or something you can. They can make it while you wait. And that's not progressive lenses, that's regular lenses, but cut to the whatever frame you pick.
Speaker 1:Very cool.
Speaker 3:Yeah, but getting frames with the right nose bridge and the right temple width and then the right angle for where the top of your ears are an arm length, and all that kind of stuff, there's, there's only five or six variables. But just imagine if you've got a popular Frame. You know the tool. A tool could cost anywhere from 10,000 to 60,000 for frames, for eyeglass frames. Well, what if you have to make 20 different sizes? Crap. But you know you've got an awful lot invested before you even know if the things are going to sell. Yeah, so the dirty secret in the eyewear thing is what percentage of frames are actually ground up and recycle? It's, it's, it's a large percentage, it's, it's a ridiculous percent. And I would I was doing treatment patients, I would show this is what happens to all the frames that don't sell. And I took a picture of a street vendor in Barcelona. You know, all the frames are out on a blanket on the sidewalk.
Speaker 2:That's what happens to no, but it's like about it could be as much as a quarter to a third of them. So it's crazy. I've heard.
Speaker 1:So there's heavy.
Speaker 2:There's dumped like as in, like they'll take anything for them, and then there's destroyed, and destroyed is about a third or something. But that's also going to change, because the EU doesn't allow you to do that anymore for increasing categories of things. So hopefully that'll happen for our work, because I just think it's just you know, yeah.
Speaker 3:So 3D printed frames that fit you and your progressive lens prescription and virtually any design that you, you like and you know with, with MJF, you can probably make them for 20 bucks. Well, what's wrong? Well, we can get regular frames for 10 bucks. Well, so what? You're charging 450. But what if it's better for the customer? And anyway, so it's, it's going to happen. But I think more than 50 percent of the market is controlled by one Italian company. So you know, unless it looks on, it does it. Or a company like VSP. Have you guys ever heard of VSP?
Speaker 1:I'm not familiar with that one.
Speaker 3:Yeah, it's a five billion dollar private company based in outside of Sacramento and it was founded dozens of years ago by five ophthalmologists. And it's a five billion dollar private company and they're the largest provider of eye health insurance, the second largest frame manufacturer. That's the largest practice management software for all the optician shops. If it's a company like that introduces it and, under their insurance, if their 3D printed frames are covered, it'll change the market in months.
Speaker 1:I love it.
Speaker 3:Yeah, it's automatically. Creating geometry to be 3D printed is the key to the first step for anything to actually go to manufacturing. Then the next is the logistics and the supply chain. All that stuff has to be automated or it's not. It's, it's not, it'll be less economically attractive than it should be.
Speaker 2:And what do you think the impact would be if we're looking forward to a couple of years? What do you think the impact of 3D printed being orthotics and prosthetics so that's essentially. That's a whole idea of a whole podcast here, you know, is this going to be a niche tool? Are we going to have a couple of people like Brent who love it and everybody else is going to go on doing what they're doing? Or are we going to, like you know, like see more, like dental brand, like every practice that has a 3D printed? What do you think?
Speaker 3:Yeah, it kind of depends on more companies like Invent Medical creating a product that's actually better, you know, like the craniocinatosis helmet, or changing the business model so that you're getting GP doctors prescribing plantar fasciitis stuff like the Arise medical stuff from HP. So you've just cop, just copying something that's manually made. It's doubtful, brent, what do you think? I don't think you can make it cheaper.
Speaker 1:Right, yeah, so I think you definitely have to make a different product, and what's cool, though, is some of these, you know, like the TPUs and things of that nature are really, and end up helping patients with comfort sorts of things and, you know, and also being able to create braces that you weren't able to make before, or a combination of a TPU or a PA 11 or 12, or even the color stuff. I mean, the color stuff is. There's always a wow factor with that, and so, like I think the pediatric orthotic side of things also makes a lot of sense with the 580s, you know, for as long as we have service, right.
Speaker 3:Yeah Well, you got another five years at least to go. I still have your butterfly socket that, the first one we made for you.
Speaker 1:Yeah yeah, I see a couple of those things behind you.
Speaker 3:Yeah, so it's. It's. Don't print it just because you can, but print it because it's either a lot more economically viable or it provides something that manually created ones don't. And I think sockets could be there. I'm not an expert, but if you have a built in socket liner that adapts to your limb throughout the day when the size changes, you know that's instead of stuffing a pair of socks down your your socket, If it's more comfortable and it fits better.
Speaker 2:You know that there's a good value there. I think that's a very helpful message and I think that's really wonderful that if you could make things better than we should print them. I think it's a wonderful idea of like you're seeing that this is a real value add, not a threat, but just a tool to make everything better in this orthodox and prosthetics world. Hey Lee, thank you so much. It's been ages since I speak to spoke to you, and so it's really nice to kind of find you again in the podcast. So it's super nice and and I really enjoyed this is really wonderful.
Speaker 1:This is. This is a good one. I know I'm not supposed to have favorites, but this might be one of my favorites and it's on the side of things. As far as stretching me to, as far as you know, I think Lee was the first one to say Brent, you know, I think you're doing some real cool stuff and all that stuff, but, yeah, you're not able to scale nothing of what you're doing, and so you know, that's what I've been working on over the last three, three, four years actually going on five years now on on one specific product that we're we're hoping to launch in Q1. That, I believe, is going to be a difference maker for, for you know, 3d printing in prostheses and so in the prosthetic field. So so thank you, lee, for enlightening me, even though it was a tough truth at the time.
Speaker 3:Yeah, how many people that you know that can do free form and have your own peace skills? There's not hard, is there anybody else?
Speaker 1:I mean, what's neat is there? There's, yes, there's, there's some really great I mean, but it's still less than 10. Right, so I think the biggest thing is, how do you get this, these modified things, into a workflow that is specific, so you still have the clinical base knowledge, but then the magic black box, so to speak, which is essentially what invent medical has done. And so you know, my hope is to it's not going to be of that scale, but it's.
Speaker 3:it's a difference maker product, I believe cool and you've got your own 580 now.
Speaker 1:Yes, and we're going to be adding to potentially three more, and we have a, and we have a 42, 10 and the amt post pro.
Speaker 3:Awesome, yeah, the amt stuff. I, I did a whole, a whole bunch of studies on post processing, different tumbling, different coats, automotive catalyzed spray, I mean, and the amt stuff be them all very cool.
Speaker 2:Thank you for coming on and thank you for listening to the prosthetics and orthotics podcast. Have a great day.