Five Questions for Nathan Keepers, CPO

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Nathan Keepers, CPO, is the owner and president of Barnhart Prosthetic & Orthotic Services Springfield, Oregon. The ambitious 32-year-old recently moved his practice into a new $1.3 million building, which covers 7,800 square feet and houses ten employees. The first floor of the new facility houses the 3,800-square foot clinic and workshop area, and Keepers plans to lease out its second story to another business or even expand it into a durable medical equipment (DME) business. Keepers is an active churchgoer, a husband and the father of four children with a fifth one on the way; his family's fourth child was adopted in China in September.

1. How did you become interested in 0&P?

When I was in high school, I saw a National Geographic special about a bilateral transtibial amputee who made his own prosthetic feet for rock climbing. [Editors note: That climber is Hugh Herr PhD, director of MIT's Biomechatronics Group]. I thought that was really interesting and decided I wanted to design prosthetic components as an engineer. I started in mechanical engineering, but I quickly tired of the impersonal nature of engineering. I found out more about working with patients as a practitioner and set out on that path.

2. What has motivated or inspired you in your professional pursuits?

My motivation for becoming an O&P business owner was to eliminate one boss from the getting-things-done equation. The other three bosses remain: the client, doctor, and insurer. At least I can get a little closer to doing things the way I feel they should be done.

3. How has your career progressed?

While getting my bachelor's degree in biology at Oregon State University, Corvallis, I volunteered at an O&P facility as a clean-up guy and technician. After graduation, I was hired on as the foot orthotic technician. Then I completed the orthotic certificate program at Northwestern University, Chicago, Illinois. My residency was in southern California; then I went back to Northwestern for prosthetics training. I spent four months with a large O&P company, and I realized that I would not always be allowed to do things the way I felt they should be done. I then hired on with Barnhart with the understanding that I would purchase the business, which I did six years ago.

4. What do you see in the future for O&P?

I already see a shift away from custom products and toward off-the-shelf products. This opens the market to new and nontraditional providers. We are seeing physical therapists fitting more devices, and facilities or manufacturers with only fitters. Although I am sure that they can fit the devices they are trained in fitting, that is the extent of their knowledge. Their world revolves around the few specific devices they are familiar with, but they lack the training or experience to know when another device would be more appropriate. Basically everyone they see will be fitted with the same device, regardless of its appropriateness.

5. Describe your approach to patient care.

I feel that it is important to listen to people to understand their goals and expectations. Frequently, the clinical solution to the biomechanical problem does not align with the patients goals or desires. By determining this up front, you can keep a lot of devices out of the closet and on the patient.

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