

Stanford Whizzes Develop an Astoundingly Cheap Fix for Clubfoot - replicatorblog
http://www.wired.com/design/2014/01/curing-kids-style-design-thinking/

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unwind
This passage:

> Before this brace becomes the standard of care, it will face challenges. In
> parts of Brazil, doctors often stay faithful to less effective solutions
> because they make more money delivering them.

Struck me as mildly derogatory; my impression (I'm not from the US, but I
parse Wired as speaking from a US perspective) is that it's not ... completely
rare to make that accusation for US doctors, too. :|

Of course, saying "this is a problem in Brazil" is not the same as saying
"unlike in the US, this is problem in Brazil", but that's how I read it, for
some reason.

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replicatorblog
Thanks for the note. Just FYI, I'm the writer and there was no malice intended
in my description. The sense I got in the interview was that the medical
system in Brazil is fragmented to a much greater degree than in the US/EU
where national healthcare establishes a more uniform standard of care. Of
course there are cases of this same behavior in the US, but I'd wager they're
far more rare.

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azernik
There is no national healthcare system in the USA.

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replicatorblog
About 1/6th of the country is covered by Medicare. Medicaid covers another
20%+ and increasingly being nationalized. All told, we're looking at 1/3 of
the US population's healthcare being paid for by the Government. The prices
set by the government tend to drive the price levels adopted by the private
payers. So while there is no NHS equivalent, the US government is critically
important in the set up of the reimbursement structure.

~~~
azernik
Heh. Point. Let me amend that to - the majority of Americans are not covered
by a national health care system.

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falsestprophet
University of Iowa Hospitals and Clinics "whiz" Dr. Ignacio V. Ponseti
developed this astoundingly cheap fix for clubfoot in the 1950s:
[http://en.wikipedia.org/wiki/Ponseti_Method](http://en.wikipedia.org/wiki/Ponseti_Method)

Of course, these guys are doing good work and don't claim to have cured
clubfoot. But the Wired coverage is, unsurprisingly, sensationalized and
misleading.

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mkolodny
> Adding insult to injury, these thoroughly low-tech braces cost more than
> iPads, generally coming with a $300-700 price tag.

I think "astoundingly cheap" is the important part here. While the title might
lead you to believe that these students came up with the idea for using a
brace to fix clubfoot, the article itself doesn't give that impression. These
students came up with a low cost implementation of the Denis Browne bar. This
means that the Ponsetti method will be available to the masses. Since the
brace they developed is more comfortable than other braces, and more like a
toy, it will also lead to more effective treatment of clubfoot through better
compliance.

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wmeredith
It said elsewhere in the article that many braces were not well made with a
doctor bending a metal bar over a chair as he gave the diagnosis. Does not
compute.

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VladRussian2
just googling "club foot brace" seems that there are similar solutions already
out there and some look better at first look (not a specialist, so may be
missing the point of Wired's excitement). Nothing in all these other braces
looks like it costs much (i.e. BOM and manufacturing-wise). With regard to
price to end-user, especially in US, - it doesn't matter whether your device
costs $20 or $200 - it will be sold for the same $700, and thus expandable
braces may be more cost effective because they minimize the occurrence of that
$700 charge. Though, again, i'm not a specialist and may be really wrong - the
guys most probably did improve the situation, just hard to see it behind the
hype.

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yetanotherphd
Excellent point, often when people talk about disrupting the medical industry,
it looks like what they are really doing is making a similar product to what
exists, but choosing not to collect the monopoly rent like other players.

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tempodox
Can we PLEASE stop posting sponsored ads from wired.com?

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Eye_of_Mordor
Surprised they didn't use 3D printing.

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sp332
If you already have a form for the shape, casting is faster and easier.

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Groxx
And way, _way_ cheaper for mass production.

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sp332
True, but I don't think these are mass-produced (yet). One of the advantages
cited was precise calibration of the angles for each user.

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minimax
This is totally off topic, but the woman in the video, Chesca Colloredo-
Mansfeld, has a really distinctive accent that I can't place at all. Does
anyone recognize it?

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IvyMike
Her facebook page says she attended college in Australia. But she has lived in
the US ever since, so... a well-sanded Australian accent?

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grifpete
v cool

