I agree the potential for abuse exists in the sale of orthotics. As usual "caveat emptor" is good advice. However, I found it ridiculous that you would expect a company (the orthotic manufacturer) to NOT run ads that show the business benefit of reselling their product. Also, I thought the attack on the "ethical" chiropractor to be unnecessary as well - You sent a spy in (let's discuss ethics here) with good feet who did complain of a sore back. After he was examined, the chiropractor recommended orthotics as another method of assisting with back pain, which seems logical. No crime transpired and who knows, maybe the guy with good feet will have improved function with his back - or was that also a lie? Posted by: Jacqueline | Feb 20, 08 07:53 PM

I agree that abuse in the orthotic industry is rampant. However, I think the real question is when is the prescription of orthotics warranted and who is qualified to prescribe them? No profession can agree on medical indications for orthotics, therefore the insurance companies side with the professions that prescribe less and do not dent their bottom line. Posted by: Andy | Feb 20, 08 08:40 PM

Where can I buy the $ 12.00 cables? Posted by: John Boorsma | Feb 20, 08 08:53 PM

My chiropractor explained the benefits of orthotics and was very happy to perform the mold procedure. However, MOST extended health care plans in Canada DO NOT cover orthotics UNLESS the diagnosis, assessment and mold procedure are done by a registered foot doctor. I had to fight to get my $300.00 back. Chiropractors should not be recommending this procedure to be done by themselves, but to make a referral to a registered foot doctor. Posted by: Kari Boult | Feb 20, 08 09:55 PM

The program was a gentle warning to consumers about the financial pitfalls of orthotics . I would like to see a follow up with the physical damage that can be done as a result of incorrectly fitting orthotics. It would also be beneficial to understand the different functions of podiatrists vs. other foot experts and where to go for help to undo the damage. I have permanently deformed feet because of this. Muscle spasm, toe, foot, hip and knee pain, back pain. I spent close to $900 with my original podiatrist and easily another $1000 with physiotherapy, consultations with other podiatrists, chiropractors, over the counter aids, etc. The Quebec podiatrist association's solution is to take the podiatrist to court. Posted by: Sharon Rundle | Feb 20, 08 09:58 PM

The abuse of orthotic prescription and dispensing has been a common problem for years in all healthcare disciplines. The truth of the matter (and this has been argued among all foot care specialists including, podiatrists, chiropodists, pedorthists, orthopedic specialists, sports MDs and doctors of chiropractic) is that there is no current "gold standard" for the examination, assessment, prescription and manufacture of orthotics. All studies to date suggest there is no difference in effectiveness of orthotics produced by casting by foam or plaster in the traditional "subtalar neutral position" vs that of gaitscan technology which includes a thorough examination and foam casting in subtalar neutral position (which in itself is debatable if it even exists). The gaitscan is not a diagnostic device but a tool to be used as part of the entire examination to pick-up discrepancies that the eye does not see. Unfortunately this chiropractor has been highlighted in this segment but there are just as bad examples that occur at the hands of other specialists prescribing, and selling comparable orthotic devices for more than a $1000.00 dollars. Now that is truly a crime. I am a healthcare professional who has experienced these techniques and devices and none are any good unless the professional does a complete and competent examination. What it boils down to is that all healthcare disciplines need to monitor the behaviors of its members and adequately police the individuals perpetuating unethical behavior. Posted by: Annonymous | Feb 20, 08 10:03 PM

While your segment seemed to be a "passive attack" on chiropractors who use Gait Scan in their practice, what I believe you failed to address was that many practitioners actually utilize a combination of visual gait analysis, orthopedic physical testing, functional movement screens, plaster casts, AND Gait Scan when assessing the need for the use of orthotic devices as a clinical management tool. However, in my opinion the problem does NOT lie in the medical professionals themselves but in those who prescribe orthotics that ARE NOT medical or allied health professionals. As a health care practitioner who has the privilege and 11 years of relevant post-secondary education to prescribe these orthotics, I am disappointed in the orthotic manufacturer(s) who allow business people who have little to no training in any health care field (other than a weekend seminar) to have equal rights to dispensing these products. In a future segment, I highly suggest you investigate this sub-population of privileged orthotic dispensers. Posted by: Anonymous | Feb 20, 08 10:04 PM

Thank you so much for your expose of the orthotics industry. Seeing people who have been ripped off by shady "practitioners" is part of my daily life as an orthotist. This field is truly buyer beware. There are no laws preventing anyone from providing the service, regardless of their lack of knowledge and training in anatomy, biomechanics and pathology (let alone fabrication). Until 3rd party payers understand that there IS a difference in service, we will not see any dramatic changes. Anyone who can write a prescription for an orthopedic device, as well as provide them, I would be wary of. It would be like visiting your family doctor, and having to pick up your tylenol 3's from his receptionist! Your story is a step in the right direction. I found it especially comical that the gentleman from the Orthotic Group mentions 4 types of practitioners who they encourage to use their product (chiropractors, physical therapists, podiatrists, chiropodists), and fails to mention the TWO fields who ARE nationally recognized as the specialists in foot orthotic design (pedorthists, orthotists) I suppose this is because anyone who truly knows about the foot and the mechanics of the foot would not affiliate themselves with companies such as the Orthotic Group. Thanks again for this story. Jen Halliday BSc CO(C) Posted by: Jennifer Halliday BSc CO(C) | Feb 20, 08 10:08 PM

Regarding the use of foot orthoses as a treatment for low back pain. This notion is often stated as "fact" by some health care practitioners. In reality, there is currently little, if any, evidence in the peer-reviewed medical literature to directly support this association. Accordingly, ethical (and well-read) practitioners would not likely make such a claim. Posted by: Leslie | Feb 20, 08 10:36 PM

Several years ago I saw a podiatrist about a small blister-like cyst on toe. The cyst got drained. My walk was observed and I was ‘prescribed’ orthotic inserts. As added incentive I was told that they would probably help my lower back pain. I felt uneasy when I saw that more than half a dozen impressions had already been made that day. How could so many clients' problems be solved by inserts? And at $350. per client. Wow. The cyst returned a few times. I self-treated. Daily yoga has practically cured my sciatic pain. Should I sell the inserts through the Bargain Finder? Or will the Sally Ann sell these in their thrift store? Money lures ‘experts;’ experts lie to their clients for the money, then lie to themselves to ease their consciences. Posted by: jane | Feb 20, 08 10:49 PM

It's unethical to send it an undercover camera to a doctor's office. I hope the person you illegally taped sues CBC. This show was probably put on by the Pedorthic Association who is trying to corner the market. Doctors of Chiropractic are well qualified to prescribe orthotics. They spend 4 years in professional school and most DC have a bachelor degree. This adds up to 8 years of post-secondary education. This show is nothing put an attack on the profession. Why doesn't CBC show the side of the industry where anyone can open up an orthotic store and sell orthotics. This includes all the franchises or individuals such as Happy Feet. These non health care professionals dispense orthotics and their customers have MD prescriptions. You tell me who is abusing the industry. What about the people who sell orthotics at malls and fairs. In fact the Pedorthic Association can't even control their own profession. There are people in Canada pretending to be Certified Pedorthists and the association doesn't even do anything about them. How can the Pedorthic Assocation make comments about the chiropractic association. Lastly most of the labs manufacturing orthotics are owned by Podiatrists. Posted by: Kevin | Feb 20, 08 11:34 PM

I am overweight, and I was offered orthodics by my chiropractor. I think that they specifically target larger people, claiming that it will "prevent back pain in the future". I would have loved to actually seen the identical orthodics, if they are all truly the same. Posted by: Reginald Phibbs | Feb 21, 08 12:00 AM

I am a chiropractor. We DO have advanced training in biomechanics....with emphasis on the spine, and to a lesser degree of the feet. Orthotics CAN help with chronic low back and hip problems. What would you think of a proctologist if he/she wanted to listen to your heart and lungs? Surely he has had the training to do this....it just isn't his specialty. In my opinion, we should specialize in what we work on - protecting the spinal cord and restoring joint function to the spine and let the pedorthist or orthotist specialize in the feet. Posted by: Paul | Feb 21, 08 09:39 AM

I rarely watch CBC, and this illustrated exactly why. This was nothing but a pre-meditated attack on orthotics dispensers. While there is potential for the system to be abused (and I'm pretty sure it happens), there were a few flaws with the documentary. Not one orthotics user was interviewed, and asked whether it actually helped them or not. The chief at the Ontario Chiropractic Association was interviewed, and although he specifically said that HE WAS NOT AN EXPERT in orthotics personally, words were being put into his mouth in an argumentative fashion. What nonsense. Is this what journalism is about, really? I was told by my chiropractor that orthotics "MIGHT HELP" - I was never told I'd become Superman after wearing them. I use them, and they've helped. They were gone through the GaitScan, and they may not be "perfect", but they're close. I'm challenging Wendy to wear my orthotics for a few days, then come back and tell me that she wasn't uncomfortable WEARING MY ORTHOTICS CREATED THROUGH THE GAITSCAN, SINCE THEY ARE DESIGNED FOR ME. Posted by: Sanjay | Feb 21, 08 10:07 AM

The only experts in foot care are Podiatrists NOT Orthotists or Pedorthists. Neither of them are Doctorate degrees. Family docs have no rights to prescribe them as they are not trained in them. Besides insurance companies are wasting provincial health care dollars by requiring an MD prescription. Posted by: Bob | Feb 21, 08 10:29 AM

Ok, enough already! How many more grainy "hidden camera" ambush interviews must viewers sit through? Perhaps when 60 Minutes was pioneering this tactic, decades ago, it made for fresh, compelling tv. Sadly, this tired premise used today is little more than a cheap stunt, leaving viewers with empathy for the show's intended 'targets' and contempt for the show's once venerable host. Perhaps there's merit in the show's message, but as viewers are forced to peer through peepholes, out from open gym bag zippers, or from beneath a CBC intern's 'hat cam', Marketplace's focus is irredemably blurred! Not even hdtv can clear up a moral compass this fuzzy. Posted by: Danny | Feb 21, 08 10:36 AM

I was very disappointed with this program. In my opinion, a negative predisposition set the tone for the entire piece. The "experiement" was based on one "foot expert's" opinion that the subject did not require orthotics. That "expert" does assessments on behalf of an insurance company!! Electronic scanners are the only method of accurately measuring DYNAMIC gait patterns, as the foot moves faster than can be measured with the human eye. My gaitscan orthotics are far superior to others I had made through casting. I believe that your "foot experts" fear becoming obsolete, as "full-body expert" chiropractors can prescribe orthotics that better benefit their overall health. Posted by: Mike | Feb 21, 08 10:39 AM

In 2001, I began experiencing pain in my left foot which got progressively worse. I used anti-inflammatory drugs, underwent extensive physiotherapy, tried an insert which I bought from the Shopping Channel - nothing helped. My physician referred me to an orthopedic specialist who diagnosed the problem. Essentially it is a deteriorating tendon on the inside of the foot between the ankle and the heel. He prescribed orthotics. I purchased them from a health store which sells prosthetics and other devices. The fitting for them involved a process similar to the Gaitstride machine. When they arrived, at a price of $225, I was not very impressed. They were very similar to the Orthotics Group inserts - not in any way a "custom fitted" insert. I wore them for period of time with some slight initial improvement, then worsening. After 3 years of treatments, including being in a cast for 6 weeks, undergoing bone scan and MRI, and with surgery the next option, I found a qualified pedorthist. He fitted me with the actual custom fit inserts, using a static foot molding process The difference is amazing- I am now pain free most of the time and able to walk normally. Interestingly enough, I do see a chiropractor sporadically for back problems, but he never once suggested orthotics. He avoids any potential conflict of interest by not selling any products from his office. He will suggest and recommend, but does not sell. I am a firm believer in you get what you paid for, except in this case, where I vastly overpaid for an inferior, essentially useless product. Posted by: DENISE | Feb 21, 08 12:05 PM

I was disappointed to see what could have been a very good segment on the need for orthotics and as in all industry, the potential for abuse, seemed to be nothing but an attack on chiropractors. In Ottawa, the largest medical chain uses the exact same technology and yet there was no mention of this apparent abuse by MDs even though it is in fact rarely the MD who does the actual fitting. The testing, diagnosis and fitting of orthotics DOES fall within the scope of chiropractors by law given their training and education and when related to the rest of the body goes beyond your so called expert. In fact, I have personally fitted people who were extremely dissatisfied with the orthotics received from their podiatrist and pedorthist. There IS scientific evidence on the use of custom orthotics and had you bothered to look (or ask a professional who is familiar with it) your agenda may have changed. Given that you are CBC "MarketPlace", it should be no surprise that there is a business side to ALL healthcare. There are good and bad orthotics, good and bad orthotic labs and good and bad health professionals in all fields. The past prime ministers and gold medal sprinters I have fitted are thrilled with their custom orthotics which were prescribed after thorough examination and only if they were necessary as is the case with the vast majority of chiropractors. Next time may I suggest an honest, more open look into the facts. Posted by: Dr. John Zielonka | Feb 21, 08 12:51 PM

I watched your program tonight, and feel that you have done a disservice to a superb Toronto chiropractor. As with all shows of this nature, you look for someone to be painted in a light of your choosing, and then turn it on bright. This was very underhanded; ethics anyone? Why single out chiropractors from a group of health care professionals who provide orthotics. You could have easily found a physiotherapist or podiatrist to flog. The very nature of orthotic prescription is not a hard science, there is no one specific test that will conclusively determine if someone is a candidate for orthotics, but rather an amalgamation of pertinent clinical information; subjective, objective, orthopedic, and a sound clinical knowledge of anatomy and mechanics, all of which orthotics providers should possess. Once gathered, this information will assist the provider to determine whether or not the patient would benefit from orthotics. The chiropractor was using the tools available to him, and determined that this individual needed orthotics, just as your professional determined that the patient did not. The argument here is over opinions, and ultimately, who pays the bill. You asked the Orthotic Group representative what orthotics cost wholesale. When was the last time you went shopping and DEMANDED to know what the seller pays wholesale? That’s not how it works. When you purchase a product like an orthotic, you are also purchasing the accumulated knowledge of the individual, and trust that they are providing you with a service that does have a price. Your dentist cleans your teeth and charges you $100, why not demand your dentists wholesale cost? At the end of the day, they are just little pieces of plastic and cloth that thousands of Canadians greatly benefit from. Did you really have to pick on one chiropractor to show us that they cost too much? Posted by: John | Feb 21, 08 12:57 PM

Can we assume that all journalists are dishonest given that Wendy sent a "patient" into a health care provider's office and had the "patient" lie to the health care provider about low back pain? In this situation the provider is expected to do something that may assist the "patient". Unfortunately, the practitioner assumed the patient was telling the truth. Given that the patient likely was a pronator (many of us pronate to some degree), this may have been a reasonable prescription on the part of the practitioner Posted by: anonymous | Feb 21, 08 01:35 PM

"Anyone who can write a prescription for an orthopedic device, as well as provide them, I would be wary of." Be would be wary of anyone who recommends a pair of Custom Foot Orthotic devices to every person who is sent to them. Be wary of anyone who only provides one type of orthotic device to everyone they see. Ask to see samples. Be wary of anyone whose idea of a dispense visit is passing you the devices over the counter in the reception area. Ask around and get feedback from someone who went to the same place you are considering. The analogy to medications is faulty. I believe only the prescribing professional can design and dispense. There is much more to an orthotic than a scribble on a page. The fit of the orthosis must be checked. It has to be evaluated to decide if it meets the patient’s needs. If I made an error on the order form or sent someone out with the wrong orthotic, it could cause injury. This would be my fault for neglecting to check final fit. I would not send someone to an alternate provider for assessment, design, manufacture/dispense service; it is my reputation on the line when I prescribe. I would use a good local pedorthist to manufacture orthotics to my specification for a fee for labor/material; some pedorthists do work in this capacity but I dispense what I prescribe. I am qualified to prescribe and provide custom foot orthoses in Ontario. I do not recommend them to all of my patients. I rarely cast at the first visit. I place padding in shoes to mimic the desired correction, and ask clients with mild problems to try an over-the-counter arch support if the felt padding is helpful. If their shoes are too worn or inappropriate, they will also get footwear advice. If mild cases do not achieve desired results with an OTC, then I will go ahead with a custom device. I prescribe different devices for active/runners, rigid arthritic feet, sensitive feet, hypermobile feet, and have samples in my office. Posted by: anonymous | Feb 21, 08 05:39 PM

Am I supposed to feel sorry for the insurance companies despite their record breaking profits? So what if I spend $400 a year on my feet. I work hard for my benefits and I'm on my feet all day and they hurt without orthotics. I've tried orthotics from cast and from the gaitscanner and both methods performed well. Posted by: GREG | Feb 21, 08 06:24 PM

The segment on orthotics was confusing. One professional's conjecture against another is hardly high grade journalism. What exactly is the research? The show did little to explain the intended purpose of orthotics. If I wanted to watch hidden cameras and biased editing I would have watched Jerry Springer. Posted by: ted | Feb 21, 08 07:26 PM

I have been watching Wendy for many years and I must say that this particular "expose" on orthotics and Chiropractor-bashing sincerely disappointed me. As a government funded, people-funded television station, I think that you owe your viewers researched and professional journalism rather than a witch hunt! You failed to show a proper history and physical examination on the "perfect foot" patient with the initial "foot doctor". Perhaps her examination was flawed on the "perfect-foot" patient. Do you not think that it would have been wise to get more than one opinion as to whether or not this patient had a "perfect foot". As it stands right now, it is the word of one healthcare professional versus another. This has completely discredited your documentary. Tax dollars well spent CBC! Posted by: Sony | Feb 21, 08 08:32 PM

Kevin states: "Chiropractic are well qualified to prescribe orthotics. They spend 4 years in professional school and most DC have a bachelor degree." Tell me this Kevin: How much of that 4 years is spent focusing on the mechanics of gait and the foot? I was informed by a Chiropractor that they focus less than 1 day of education in Orthotic design. Amazing! Chiropractors can learn in 1 day what a Pedorthist spends years to learn. The president of your professional organization even states that your members are highly qualified....you're kidding yourselves. Posted by: Anonymous | Feb 21, 08 08:42 PM

Sanjay: I'm challenging Wendy to wear my orthotics for a few days, then come back and tell me that she wasn't uncomfortable WEARING MY ORTHOTICS CREATED THROUGH THE GAITSCAN, SINCE THEY ARE DESIGNED FOR ME. Huh? Your "gaitscan" insoles could be given to 20 people with your shoe size, and they'd fit everyone about the same. People who have a relatively normal foot get along quite well with a generic design. People who actually have biomechanical issues with their feet will NOT do well with a generic design. I would say Sanjay, that you could go to Shoppers Drug Mart and be happy with a pair of 25 dollar insoles...they'd probably not be perfect, but they'd be pretty close too! Posted by: Anonymous | Feb 21, 08 08:56 PM

Thank you for running this program. I almost felt like crying watching it due to the frustration. I'm constantly being ripped off when it comes to orthotics. Over the years (I'm only 29) I've walked seen countless orthopedists and chiropractors who were so quick to offer me results, always with the same mould or scan. After they got my money and I had new pain from ill fitting orthotics, they could do nothing more for me. I realized that the mechanics of my feet involve the rest of my body and muscles and just want them to look at the problem. Instead they get can make a quick $400 for having me step in styrofoam and are gone to the next patient in 5 minutes which anyone off the street could do! I'm afraid to get older because I can't run anymore without pain, and after getting about 7-8 different orthotics that caused more harm over the years with all doctors being as arrogant and oblivous to doing any real work instead of making a mold, I really cant afford to throw away money to just anyone anymore. Posted by: Aaron | Feb 21, 08 08:59 PM

Yes, the patient was a pronator, but his pain was only while sitting, not while standing. Pronation is a normal motion, as long as it is not excessive and is present in the proper part of the stance phase. To the Podiatrist who feels an MD is required to dispense an insole, do you require an MD to supply physiotherapy or occupational therapy to an individual? Orthotists and Pedorthists are allied health professionals. A Certified Orthotist and Certified Pedorthist focus only on orthotic design, and manufacture. THEY are the specialists. Posted by: J | Feb 21, 08 09:09 PM

Competent Podiatrists will never promise custom made orthotic devices will solve any back problems. Back pain is a very generic term and may have many many different causes. Custom made orthotic devices are employed to correct biomechanical abnormalities of the feet and legs. It is all about angles and proper measurements. Most people who have limb length differences will experience back pain. Orthotics or heel lifts will solve that problem. Orthotics will not solve back pain from herniated discs, degenerate vertebral arthritis or nerve impingements. Computerized gait scan is an old technology which measures pressure points. It is flat and two dimensional. It can not measure the height and contour of the arch. Plaster casting is the most common, effective and accurate method to properly cast for orthotics. Currently, three dimenional LASER scanning technique is being developed and standardize. The words of advice are SECOND OPINION. If you don't understand your professional advice, get a 2nd opinion. If you have questions, ASK. If you are still not sure, get a 2nd opinion before you commit. Posted by: Ed (Podiatrist) | Feb 21, 08 10:15 PM

Speaking as a Biomechanics undergraduate, and a current Chiropractic Student, I have been in the most advanced labs in the country, and am privy to the best technology and research in the field. I have seen hard data on the kinetic benefits of Orthotics before my eyes and become published in medical journals. Orthotics can offer many benefits including; improved proprioception, reduced pressure and improved mechanics for the foot as well as alignment and force transmission throughout the body. All the benefits of orthotics were not just ignored, but these devices were downright defamed! Orthotic companies (and professionals who offer them) are business, and as with any other business, do need to make money. I honestly believe business’ primary goal is to help the population, not to take them for all they’re worth. As with absolutely every profession, there are those who are not at the utmost of integrity, but it is unreasonable to make a case from outliers. In my humble opinion this is uneducated, unscientific, erroneous, sensationalist based reporting. Posted by: Edward | Feb 22, 08 12:52 AM

Chiropractors have been trying to find respectability in the healthcare industry for years and now I feel they are making a very bad impression. I bought orthotics from a chiropractor for my daughter who is suffering with knee problems. They do seem to be helping but I wish I had seen this show first. We may not have the correct fit or maybe this isn't the best solution. My insurance company paid and did not question anything but they will only pay for one pair in a lifetime. This seems to be an example of private practice at its worst. If there is an easy way to make money my health is put at risk. Posted by: Merna | Feb 22, 08 04:52 AM

I find it interesting that people have to argue back and forth as to who is the most qualified provider of foot orthotics. If you want to have you feet properly assessed, go see a foot doctor. As to who is qualified to fabricate the device....I'm willing to say that the orthotist is, as this is what they are trained exclusively to do. Let's not make this issue too complicated. If you wanted you Car fixed would you bring it to a Carpenter?! These Chiropractors are doing orthotics to make the bottom line bigger, no if's and's or but's about it. These professionals are supposed to be the holistic approach to general medicine. You would never see a medical doctor doing orthotics. But then again, they never have a problem filling their schedule with patients!! Posted by: Geoff | Feb 22, 08 07:06 AM

I would like to question how one determines in 3 minutes that orthotics will help someone who has “tension in his shoulders from sitting at his computer”. How does the structure and posture of the foot transfer up through the butt to affect the shoulders while sitting? And even if Robert did have poor foot mechanics and experienced discomfort on standing or walking, the first line of treatment for shoulder tension would NEVER be orthotics. I would also like to know how this “tool”, the gait scan which is basically a 2 dimensional pressure mat, “said that Robert was a mild case” leading to the decision that orthotics were needed. If this professional is truly as honest and ethical as he claims, then the only other explanation for his recommendation that orthotics will address “tension in the shoulders while sitting at a desk” points to a lack of training and incompetence in assessing the need for them. This is why assessment and provision of foot orthotics should be left to those specifically trained in the field. I can only speak for myself but if I had a heart problem I certainly wouldn’t see a brain surgeon. Specialization in any field helps to ensure expertise, and those with expertise in their field have no reason to practice beyond their scope. As an individual with 22 years experience in the profession of pedorthics, I think you will agree that I am qualified to make this observation. Posted by: Kim | Feb 22, 08 09:45 AM

I have purchased orthotics from my local chiropractor and I paid a nice sum of money for them. That being said I have never felt better on my feet and my doctor knew exactly what I needed. Your show did not paint a positive picture whatsoever. The show didn't mention from the onset that the two ladies who were the negative forces against chiros worked for insurance companies. I think that was a pretty important piece of information that you guys did a nice job of scrubbing out. As well I think it was completely unethical with respect to sending a faux patient into that doctor's office with a spytech camera. What kind of operation do you guys run? Paying a hefty sum for your health is what life is all about. Why would someone pay exorbitant amounts of money for prescription glasses? Orthotics work the same way. And to pick on a chiropractor the way you guys did does not depict the way all professionals practice. Posted by: annonymous | Feb 22, 08 10:00 AM

Many people do not understand that a Gait Scan cannot make a custom orthotic. I think the general public who bought these orthotics are to put it mildly STUPID if they are still defending their purchase through a Gait Scan. The expose shows conclusively that anyone getting an orthotic from a GAIT SCAN has been fraudulently sold a "custom" orthotic! Chiropractors are peddling a device they have no idea is a prefab because they themselves have no idea how they are made; even though the science of making an orthotic is not by 2-Dimensional plane! That's why a cast is important. It is also for that reason Chirpractors should not be selling these unless they truly understand what a custom orthotic is. It is 3-Dimensional! Not just pressure points! Posted by: Allan | Feb 22, 08 10:01 AM

Would you do a story on how awful the automobile is, how unreliable, poorly designed, and dangerous it is, if you were really only talking about the Yugo? I am an orthotist (advanced degrees, certifications and all that) and I design and make orthoses (the plural of orthotic) so that children with CP can walk and run; For babies with spina bifida so that they can grow straight and protected; young men with spinal cord injuries who need to stand and walk to support their families; old ladies with hip replacements to reduce their pain and maintain alignment; and for many many other conditions. To paint all ORTHOSES (the plural of orthotic) with the same brush by calling FOOT orthoses 'orthotics' is not only painful to my profession, it doesn't make yours look too bright either. Being an Orthotist is a fantastic and very satisfying branch of the medical field. When you call those shoe inserts 'orthotics' and try to show what a rip off they are (I don't agree) that is all your audience hears of orthotic, orthoses or Orthotists. Should we judge all TV persons by Geraldo Rivera? Who is and who isn't qualified?, how much are they worth? Does anyone have the appropriate training? All of that is fine to discuss BUT please, please, please call those things "FOOT orthoses", even "shoe inserts". Thank you. Posted by: Sam | Feb 22, 08 01:31 PM

What was not addressed in this otherwise revealing program was that there needs to be a prescriber gatekeeper in all of this. this should be the family doctor. They can prescribe, but not manufacture an appliance. This for the most part makes the doctor a less biased prescription source, and less prone to financial conflict of interest, as so clearly seems to be the case with chiropractors and other prescriber/manufacturers. The doctor is in a good position by virtue of their medical training to assess and refer a patient with a prescription to a certified orthotist or pedorthist (and perhaps chiropodist) for further assessment of the patient's feet, and manufacture (using evidence based mehtods) appropriate custom foot orthoses, that I am sure any insurance company would be happy to pay for. It has been my professional experience that these practitioners are the only ones who have historically, upon seeing my patients, assessed them, provided custom devices, and sent me a thorough consult note back, explaining exactly what was found on exam, and what device was provided. this creates a professional collegial relationship that benefits the patient, and allows the lines of communication to be open, especially if there are pre-existing, relevant medical issues. I cannot say that this has been my experience with other para health professionals, especially as it pertains to orthotics. Posted by: brenda | Feb 22, 08 02:28 PM

As chief podiatrist at Mt. Sinai Hospital I really appreciated your segment on orthotics. Your information on the show was excellent. It's about time somebody exposed the overprescription of orthotics by chiropractors. As a podiatrist I see their mistakes often. Chiropractors have little formal training in footcare yet their college allows them to advertise themselves as foot specialists. You often see foot logos on their storefront offices and some even sell shoes, because orthotics are profitable. In my own podiatry practice I prescribe very few orthotics. Often, the problem is with the footware and proper shoes can resolve many foot problems. it was apparent that the chiropractor you featured has little knowledge of feet. He recommended orthotics for a little bit of foot pronation when, it fact, some pronation is normal for shock absorption by the feet. So you can just imagine how many would be honest chiropractors are unknowingly prescribing orthotics based on the foot scan because they have very little understanding of the biomechanics of the foot.Thanks again for a great show. Posted by: Alan Silverstein, DPM | Feb 22, 08 03:57 PM

this was my first time being exposed to CBC Marketplace - to be honest I don't plan to watch again. I watched this expose on orthotics and chiropractors and saw one sided journalism. You are insulting the intelligence of your viewers. Provide well balanced, well researched information and let the viewer make up their mind. I have no bias toward or against orthotics and chiropractic but I do stand up for quality journalism. On a related note, scroll down the page of past shows - you'll realize that every show is bashing one profession/supplier/company or another. In this case chiropractors just pulled the 'short stick'. No big deal, only lay people who already have it out for chiropractors or orthotic providers will take this interview to heart - I, on the other hand, will do my own research and discount that of Marketplace. Thank you for your time. Posted by: first and last time viewer. | Feb 22, 08 08:22 PM

As a concerned viewer I must add it is a HUGE conflict of interest that a health care practitioner both prescribe and distribute a product (IE chiropractors with orthotics). It seems this point has been lost in all the arguments. The second issue I have is with Gaitscan. Where is the evidence that a 2-dimensional image of the foot is superior to a 3-dimensional mould of the foot? So for all those people with the "evidence" proving 2 dimensions are better then three, I am still waiting for your sources. Somehow I think I will be waiting forever. Posted by: Greg Stewart | Feb 22, 08 08:41 PM

The fraud perpetrated upon the public by unscrupulous providers of various orthotic devices is wrong, but the public bears some level of responsibility. We want instant fixes to what ails us and technology has progressed to allow almost anyone to "fabricate" a quick fix to "satisfy" our need. Add to this the fact that we eagerly overeat, get very little exercise and wear stylish but terribly unsupportive footwear and you have a charlatan's dream. Custom orthotics are appropriate and necessary for individuals that have documented (read "diagnosed") structural, neurologic and traumatic disorders of their feet. Notice I said diagnosed. Don't treat yourself! If your feet hurt, visit a podiatrist, orthopedist or orthopedic foot and ankle specialist to determine what is wrong AND the correct solution. Then see a qualified provider; either a Certified Pedorthist or Certified Orthotist to be measured and fit for the appropriate orthotic. These professionals make their living providing relief in the form of custom orthoses and their reputation and livlihood depend upon the outcomes. It's not a cash cow, but a profession. Some physicians and podiatrists provide orthotics in their offices, and in some cases this may be fine. But beware of providers who diagnose you and have a readily available solution that comes out of a box. They may be simply augmenting their income with a convenient, quick fix. For sure, some disorders are easily relieved with off-the-shelf orthotics found at a variety of venues, but don't buy a solution off the internet, from a television ad or magazine. Often though, the appropriate "treatment" is a few stretching exercises and/or temporary cessation of the offending physical activity. Don't judge the science and profession of providing appropriate orthotic care on the basis of a small number of unscrupulous vendors. Be smart with your health and with your feet as well! Posted by: Jim Rogers, CPO, FAAOP | Feb 23, 08 12:02 AM

I'm disappointed by the approach the Ms. Mesley and the CBC took about the orthortic story. The heavy and unnecessary piece on chiropractic doctors could have also included physiotherapists, medical doctors, and any other health care professional that prescribes orhotics. First, GPs have no real training in neuromusculoskeletal assessment, diagnosis and management and should not be the gatekeepers for the prescription of ergonomic devices. DCs, PTs, physiatrists and other physical medicine specialities have more than adequate training to make a judgment call as to whether or not the patient's function in general will improve. Also, this piece completely neglects that the gait scan forms but ONE component of the clinical exam; orthopaedic testing, kinetic chain functional evaluations, muscle testing, joint play and many others forms the basis for the diagnosis and subsequent plan of management. To posters here who take a harsh tone on DCs and their ability to accurately diagnose and treat neuromusculoskeletal dysfunctions, your opinions are not valid based on current research. Chiropractic care is as effective and at times exceeds conventional medical management for various mechanical back disorders, joint pain, headache treatment and there is promising research suggestion it may be effective for non-musculoskeletal conditions as well. Contemporary, evidence-based chiropractors in trained in Canada are solid clinicians, diagnosticians and manual therapists and hopefully readers do not get swayed by this poorly done "investigation". I won't even comment on the ethical breaches the CBC did on this one. Posted by: Marc | Feb 23, 08 02:04 AM

I have been a practicing chiropractor for over 15 years...8 of those as a locum chiropractor taking over chiropractic practices for vacation and emergency relief. In that time I never came across a chiropractor that has a policy to put everyone into orthotics for monetary gain exclusively. While I do think there is abuse that goes on, I think it is perpetrated by practioners of questionable ethics, not all chiropractors. I only hope that people have the ability to think critically when watching a program like marketplace and question the sensationalistic motives of this 'news program'. Further, I feel that the approach employed by the marketplace producers was ignorant toward the chiropractic profession. This approach by the media is partly responsible for the 8-10% utilization rate by the public of the chiropractic profession.....what a shame. On the other hand, a message to those in my profession that are perpetrating orthotic and practice standards that are questionable....smarten up! You are also responsible for the public's poor utilization rate of our profession. Also, the average person who pronates bilaterally can improve their biomechanics by utilizing generic $30.00 inserts and doing foot exercises like the 'short foot' position. Posted by: Ron | Feb 23, 08 10:02 AM

It is about time that there was more public education done with respect to orthotics. This is a good start; however it seemed like the documentary was a little biased against Chiropractors. Note that I am not a chiropractor, nor do I use one. However, having been in the orthopaedic devices health care service for about 25 years now, I can say that there are always bad apples in any basket - meaning that there are bad professionals in any group of professionals. What did disappoint me was the comments by the Chiropractor Colleges director - that really did NOT come across well at all. I do feel very STRONGLY on the issue of conflict of interest that needs to be addressed very seriously. This is where abuse has the most potential to occur. Just as physicians are disallowed to fill their own prescriptions by "selling" the drugs out of their offices; orthopaedic devices should not be allowed to go through a similar process - no health care provider should be allowed to prescribe as well. AS professionals in the various different disciplines, we should be confident in our "specialization", while respecting the other professional in his/her specialization. If we could design services that complement what we do and cross refer accordingly; the patient would benefit most. At the end of the day, this should be the uppermost interest in our mind and our ethic of practice. Professional associations and colleges should work on screening individuals on this ethic to the best of their abilities; as well as monitoring those in practice accordingly. Overall; good start, but more work needs to be done as this kind of abuse is also prevalent in some of the physicians' practices, as it is in all the allied health professionals. All health professional associations need to be wary of this and uphold their true virtues. Posted by: Minaz | Feb 23, 08 12:04 PM