Eric Neufeld of Agile Orthopedics: How Businesses Pivot and Stay Relevant In The Face of Disruptive Technologies

An Interview With Charlie Katz

Know your competitors: You can’t really truly disrupt or differentiate without completely understanding your who you are competing with and what they are doing. The whole basis of Agile Orthopedics’ creation was reversing the trend of the dangerously high patient no-show rate at typical prosthetic and orthotic appointments. Going mobile and caring for patients conveniently at their place of need separated us from the industry, and we continue to grow our patient base every day.

As part of my series about the “How Businesses Pivot and Stay Relevant In The Face of Disruptive Technologies”, I had the pleasure of interviewing Eric Neufeld, CPO, FAAOP, Chief Prosthetist and Medical Director at Agile Orthopedics, the only mobile prosthetic and orthotic provider in Colorado.

Eric has been a managing partner and lead clinician with several of the nation’s largest private orthotic/prosthetic practices. He earned a BA Degree from the University of Wisconsin, and then received his Orthotic education at the University of Connecticut and his Prosthetic education from Northwestern University. Eric is also a Fellow of the American Academy of Orthotists and Prosthetists.

Eric is also a founding member of the Range of Motion Project (ROMP), a 501(c)(3) non-profit organization dedicated to providing prosthetic care and education to developing nations where resources are limited for amputees in need.

Thank you so much for joining us in this interview series. Our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you got started?

I always loved building and making things. After college, I was kind of lost in terms of a career direction. I kept busy working in construction and home renovation, but I wasn’t really going anywhere. It was my mom who first encouraged me to reach out to a friend whose son was a prosthetist.

While I ignored this at the time, as most people do when presented with advice from their mother, I connected with him a few years later. He immediately introduced me to another prosthetist in New York City, where I was living at the time. I was invited to shadow this man, and within seconds of being exposed to the field of prosthetics and orthotics, I knew it was what I wanted to do. I fell in love with the idea of being able to make things that help people move and walk and pursue their physical potential. I went back to graduate school, and then sought out a great residency program in Chicago, where I ended up spending the first 10 years of my career.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lessons or ‘takeaways’ you learned from that?

When building my first mobile clinic, I was on a shoestring budget. I had just bought a van, but in order to turn it into a fully powered mobile clinic, I needed some specialty wiring to operate all the equipment and machinery used for on-site appointments. Having no experience with automotive electrical systems, I enlisted in YouTube videos to show me the way. I spent a day making connections and hooking up the battery to an inverter, thinking I was good to go. Instead, the mobile clinic van would die every single night, causing me to jump start it again every morning. After dealing with a very small — but concerning — fire in the battery compartment, I finally surrendered and took it to a professional who connected everything properly.

Looking back, I spent way too many hours researching how to power up my van, then many more hours dealing with the fallout from my failures. That time would have been better spent building my business rather than trying to save a few dollars. Although it’s in my nature to figure things out on my own, this experience taught me to outsource specialized tasks to professionals so I can stay in my lane and focus on my strengths.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story?

I am lucky enough to have had several mentors who not only spent time and energy supporting me through my early years in the field, but also continue to be incredible resources today. I am particularly grateful to Dave Rotter, a prosthetic guru and my first boss during my residency in Chicago. Dave always made the time to spend with me, whether it was shoulder-to-shoulder in the lab learning to fabricate devices or in the clinical setting managing patients. To this day, he is my first call for a particularly tricky case where I need advice on technique, or to discuss a business conflict or opportunity.

I try to emulate Dave as a mentor, making myself available for up-and-coming practitioners and students. I want to be there for them the same way so many people have been there for me along the way.

Extensive research suggests that “purpose driven businesses” are more successful in many areas. When your company started, what was its vision, what was its purpose?

The idea behind Agile Orthopedics was to be a truly patient-centric practice, meeting patients on their terms and providing care in the comfort of their homes. As the concept of concierge service emerged, my vision became even more necessary to provide highly personalized care to those that need it most.

When you think “concierge,” you think of patients who can afford it. This is not the Agile model. People in need of prosthetic and orthotic care may lack the resources to receive this care, whether it be a lack of insurance, stable housing or transportation. It is Agile Orthopedics’ purpose to not only ensure all people in need of prosthetic and orthotic treatment receive high-quality care, but that their experience is also a pleasurable and convenient one.

Thank you for all that. Let’s now turn to the main focus of our discussion. Can you tell our readers a bit about what your business does? How do you help people?

Agile Orthopedics is the only mobile prosthetic and orthotic care provider in Colorado, helping patients meet their mobility goals in the comfort of their own homes or place of need. Our innovative mobile model caters to amputee patients who struggle to attend traditional office appointments, ultimately lowering the risk of mobility-related injuries that could occur in transport to an office. The “service-on-the-go” approach uniquely positions Agile as a health leader amid the pandemic, allowing for concierge-style care that prevents high-risk patients from COVID-19 exposure.

Agile offers a full range of services from complex cases involving multiple limb loss to more straightforward orthotic management. Our six intentionally designed mobile clinics are equipped with cutting-edge technology and equipment accessible to skilled nursing facilities, physicians’ offices, and patients’ homes across the state.

Averaging 20 years of experience, Agile practitioners are prepared to manage every type of patient need.

Which technological innovation has encroached or disrupted your industry? Can you explain why this has been disruptive? What did you do to pivot as a result of this disruption?

Agile Orthopedics is the disruptor in the prosthetic and orthotic care industry. Prosthetic and orthotic patients face numerous barriers to health care access including physical limitations or lack of access to transportation and consistent care. According to the CDC, 1 in 3 adults with disabilities 18 to 44 years old do not have a usual health care provider, and 1 in 3 adults with disabilities 18 to 44 years have an unmet health care need because of cost in the past year. The result is a dangerous trend: nearly 50% of prosthetic and orthotic appointments are no-shows.

I broke away from the typical care model to reverse this high “no-show” trend, answering with a full-service mobile approach to prosthetic and orthotic care to meet patients where it’s most convenient for them. Agile Orthopedics was created as the first mobile care model for prosthetic and orthotic patients in Colorado, meeting an evolving health care need and breaking traditional barriers for mobility-impaired people.

The mobile clinic fleet is intentionally designed to leverage cutting-edge technology such as 3D scanning and iPad-based patient management systems to support on-site care. On a higher level, data support cost savings to the overall healthcare system, and a reduction in medical complications when care is provided in place. Specific to amputees, there’s a lower risk of falls and subsequent injuries when patients aren’t required to navigate transportation to traditional appointments.

This mobile model has grown even more important as healthcare practices drastically change to accommodate the COVID-19 pandemic. Agile Orthopedics is leading the way in concierge-style care and “service-on-the-go” to prevent high-risk patients from COVID-19 exposure. More than half of Agile’s patients is uninsured or rely on Medicaid coverage, which would normally compromise their ability to quarantine through transportation and longer wait times at typical health care office settings.

Was there a specific “Aha moment” that gave you the idea to start this new path? If yes, we’d love to hear the story.

Before I started Agile Orthopedics, I was a regional managing partner for a large prosthetic provider. Aside from being accountable for the financial performance of the business, I also had to generate and analyze reports on productivity and growth. One of the metrics I reported on was “no-show” rate. This metric is vital to the economics of a prosthetic practice since billing is based on devices provided. If patients don’t show up to their appointment, resulting in a “no-show,” devices cannot be provided, and revenue suffers. Ultimately, I found that no-show rates climbed up to 50 percent in some quarters.

Digging into this further, I began reaching out to patients to understand why, if a prosthetic leg was waiting for them, they did not show up to their appointment. Their answers made perfect sense. In many cases, patients’ physical disability prevented them from getting down a flight of stairs, driving a car, or simply getting to a bus stop. Additionally, many cases were financial: it cost too much to take a day off work, or to ask a friend or family member to do the same.

Determined to make a change, I found the only reasonable solution was to remove the barriers to receiving care, which would mean going to the patient rather than having them come to us. I presented this concept of mobile care to my former employer, who did not share the excitement behind this idea, so I created Agile Orthopedics to fulfill this need.

So, how are things going with this new direction?

Our mobile care model has helped us reverse the high no-show trend. Since launching Agile in 2017, we have achieved a less than 1 percent no-show rate. We’ve also been able to grow the number of patients treated by 50 percent annually.

Just this year, Agile Orthopedics has expanded from its Denver metro base to three new regions across the state of Colorado. By partnering with regional health care facilities and physicians’ offices, we now offer mobile care services across Northern Colorado based in Fort Collins, the High Country based in Vail and across Colorado Springs.

Can you share the most interesting story that happened to you since you started this pivot?

I received a call from a Colorado rancher who had a llama with a missing leg. She was unable to bring the llama anywhere to be treated but had heard of Agile Orthopedics’ on-site model. We rode one of our mobile clinics over to her ranch and were able to fit the llama with a custom prosthetic pastern, which is the lower part of the llama’s leg. This was a unique case since the llama’s weight fell outside of the limits of human components. We ended up partnering with a creative industrial design firm, who 3D printed a fully custom foot for him to walk on safely. It was so exciting and fulfilling to be able to collaborate on such an unusual project, and it’s led to a great relationship working on broader projects since then.

What would you say is the most critical role of a leader during a disruptive period?

Stay focused but remain flexible. It’s important to stay true to the spirit of the vision, but along the way, opportunities will present themselves, and they should be explored. This is especially applicable when the opportunities are presented internally.

Ideas generated by staff and stakeholders are critical throughout disruptive periods of growth, as they are people who genuinely believe in your mission and model. By being an open-minded and engaged listener, you’ll broaden your access to innovative ideas while showing your team how much you value their input.

When the future seems so uncertain, what is the best way to boost morale? What can a leader do to inspire, motivate and engage their team?

Staying calm and excited about the future is contagious to those around you. It allows your team to avoid fear, which can be destructive and ultimately lead to poor decision-making.

On a personal level, I also believe leaders should pay attention to the family lives of their team. During tough times, especially navigating the pandemic this year, it’s been extremely important to connect with each individual on a deeper level to ensure their families are safe and have the mental and physical health support they need. A true leader goes beyond the interests of the company, investing in their people.

Is there a “number one principle” that can help guide a company through the ups and downs of turbulent times?

Don’t be afraid of change. It’s what encourages innovation and growth.

In the early days of the COVID-19 pandemic, I became aware of the growing need for protective barriers made out of acrylic in all settings. Like the new protective barriers we see in coffee shops and retail stores, physicians and medical professionals were in need of these as well. Agile uses acrylic in manufacturing prototypes for prosthetic limbs, and after a quick discussion with an anesthesiologist friend, I realized I could pivot and work to serve a growing need for these plastic barriers in the medical field. It didn’t take much to go into production to provide hospitals and physician practices with this type of technology — not only throughout Denver but in many other cities across the country.

Although we have discontinued producing these products, innovating led to recognition and the development of relationships that continue to refer business today.

Can you share 3 or 4 of the most common mistakes you have seen other businesses make when faced with a disruptive technology? What should one keep in mind to avoid that?

1. Going all in on the shiny new object: We’ve gotten where we are because of quality training and adherence to principles that work. There’s certainly room for improvement and innovation in any situation, but we need to remain true to the vision and core of the business. We need to know everything we can before investing time, energy and money into new technologies.
2. Racking up debt: It’s enticing to own new equipment and technology, or to hire on a big supportive staff. But aside from affecting credit utilization, going into significant debt puts the business in a vulnerable position that can lead to significant stress and fear. Smart decisions are not made under these circumstances.
3. Close mindedness: Just because you or your company has been successful doesn’t mean it will always be, or that nobody can displace you. Arrogance can cause you to overlook a great idea that can be folded into your company and help you remain relevant when faced with disruptive technology.

Ok. Thank you. Here is the primary question of our discussion. Based on your experience and success, what are the five most important things a business leader should do to pivot and stay relevant in the face of disruptive technologies? Please share a story or an example for each.

1. Don’t operate with blind optimism: Preparing for the unexpected (COVID-19, anyone?) can leave you on top when everyone else is caught scrambling. This can be preparation for available capital to survive a cash shortage or a strategic plan to diversify your client base or offering. Our at-home care model, keeping patients away from typical medical office settings, placed us in a leading position to practice social distancing without interrupting care amid the pandemic. This allowed us to quickly adapt. However, I was extremely proud that our company went above and beyond through the creation of protective acrylic barriers we provided to medical professionals across the country. We were ready to create during this crucial time of need without sacrificing care to our existing and growing patient base.
2. Know your competitors: You can’t really truly disrupt or differentiate without completely understanding your who you are competing with and what they are doing. The whole basis of Agile Orthopedics’ creation was reversing the trend of the dangerously high patient no-show rate at typical prosthetic and orthotic appointments. Going mobile and caring for patients conveniently at their place of need separated us from the industry, and we continue to grow our patient base every day.
3. Don’t underestimate the importance of strategic planning and marketing… and don’t try and do it on your own: One of the best investments I made was to engage a strategic marketing firm. They do all the heavy lifting so I can focus on my team and our mission. I’m not embarrassed to discuss learning moments in my career. I was quick to learn from my first van, as I previously described, trying to correctly wire it into a full-service mobile clinic by myself when I clearly had no experience in automotive electronics. I’m so proud to bring on other people to help forward Agile’s mission while I focus on my team, patients and how to better serve them both.
4. Choose quality partners: Entering into a partnership is a huge risk. Trying to make 1+1=3 is certainly possible, but it’s not guaranteed to bring your business the highest quality result. I’ve had great partners and terrible partners. My keys for creating a successful business partnership are clearly delineating responsibilities, sharing the same vision, being generous with each other and, above all, trusting each other. Earlier in 2020, Agile Orthopedics expanded outside of its home base in Denver, Colorado, to Fort Collins in Northern Colorado. We made this initial leap with Prosthetic Orthotic Group (POG) because we were able to address the major keys to a successful partnership, and I trust them to follow through on Agile’s growing goals. I’m happy to share that, due to this first leap, Agile has been able to expand to numerous other locations in Colorado since then.
5. Never stop learning: For me, the ability to pivot and remain relevant as disruptive technology emerges requires knowledge of developing technology and concepts within both my field and adjacent fields. For example, as a healthcare provider, understanding trends in reimbursement is critical to successfully advancing ideas, disruptive technology and service models. For years, I tried to get insurance companies, Medicaid and Medicare to pay for a specific feature of a prosthesis I was providing. The feature allowed the prosthesis adjustable to accommodate the patient’s limb as it changed in size due to weight change or other factors. Many other practitioners actually stopped using this type of feature because they couldn’t get paid to provide it. I found out that Medicare offered a monthly series of continuing education courses, typically attended by compliance officers and billing administrators. Determined to find a solution, I began to attend this series and was able to understand how to bill — and get paid — for unique features. By taking the steps to learn this process, I’ve been able to increase our bottom line, and even more importantly, I’ve been able to further innovate and provide my patients with the personalized level of design they deserve.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

“Hustle is the cost of entry, grit is what takes you through to the end, and none of it would be possible without the countless hours of work one puts into themselves or their business.”

Being an entrepreneur isn’t always glamorous. I’ve felt the imbalance between work and life that comes with hustling, the fatigue of grit, and the slog that comes with hard work. I also know that it’s all worth it.

Even after thousands of prosthetic fittings, seeing someone walk for the first time since the trauma of their amputation never gets old. Having the opportunity to continually build upon a vision is exciting beyond comparison, and it sets an example for my kids. Building Agile Orthopedics has shown them what can happen through hard work and taking action in what you believe in.

How can our readers further follow your work?

Agile Orthopedics is very active on social media, sharing new projects, technology and stories of inspiring patients at @agileortho on Facebook, Instagram and on our LinkedIn page. Patients or interested partners should reach out on our website.

I am also a founding member and active Board Member of The Range of Motion Project (ROMP), which is a non-profit, for-impact healthcare organization dedicated to providing prosthetic and orthotic care to those without access to these services. Since 2005, ROMP has completed more than 10,000 patient visits and delivered nearly 4,000 devices across three countries.

Agile Orthopedics is a ROMP clinic partner, and through collaboration with Denver Health Medical Center, patients without resources are given the technology and support needed to improve their mobility.

You can follow along on social media as well at @ROMPglobal, and please reach out if you or someone you know are in need of these services.

Thank you so much for sharing these important insights. We wish you continued success and good health!

About The Interviewer: As Exec. Creative Director, Charlie Katz spearheads the full gamut of creative marketing for Bitbean Software Development in Lakewood, NJ. Charlie has over 20 years experience in major NY and west coast agencies, including Dancer-Fitzgerald-Sample, now Saatchi & Saatchi, D’Arcy-MacManus & Masius, and Wells, Rich Greene. Starting as a junior copywriter and moving up to Exec. Creative Director, he developed creative strategies and campaigns for such clients as Colgate, R.J. Reynolds, KFC, and Home Depot. Along the way he won numerous national and international awards including the NY Advertising Club ‘Andy’.