Member Spotlight

JON HESS, CPO, LPO, has been an O&P practitioner for 21 years—but that role follows a career as recreation therapist at Helen Hayes Hospital in West Haverstraw, New York. It was in that previous role that Hess was first introduced to patients with limb loss; he felt an immediate attraction to the hands-on nature of O&P work. Hess decided to go back to school at Northwestern University to study O&P, becoming certified in orthotics in 2000 and prosthetics in 2003.

Hess worked for several facilities until 2018, when he decided to open his own practice. “It was a leap of faith,” he says, “but my instincts told me it was the right thing to do.” He never looked back. “I would not trade this experience for the world. I love making my own decisions, and I appreciate the financial benefits of owning my own practice.”

Prosthetic and Orthotic Designs is located in Middletown, New York, not far from where Hess grew up. He is the sole practitioner, with another dedicated staff member—Iveliz Franceschi—managing the company’s finance, accounting, billing, and HR functions, as well as the company’s administrative staff.

Hess and his team are in the process of moving from a snug 1,300-square-foot office, where bumping elbows is an occupational hazard, to a facility that’s double the size—and right next door. “The only change to our address will be our suite number,” Hess says. The new space will better accommodate P&O Designs’ fabrication lab, where Hess and an independent technician build devices. While Hess has worked with computer-aided design, he prefers taking measurements and building sockets by hand. “In my experience, nothing is better than getting hands on the cast and making and relieving pressures,” he says. “In my opinion, when you create a relief or a pressure on a socket on CAD/CAM, you lose some of the intimacy of the shape. When I physically put plaster on a bony landmark, I know exactly how much pressure is going on.”

Hess sees an even split of orthotic and prosthetic patients, providing head-to-toe orthotic treatments and primarily lowerextremity prostheses. Many of his patients have diabetes or arthritis.

Hess works in the facility’s fabrication lab. John Hess, CPO, LPO, works with a lower-limb patient.

Prosthetic and Orthotic Designs

Jon Hess, CPO, LPO

Middletown, New York

HISTORY: Three years

Jon Hess, CPO, LPO

Hess responded vigorously to the COVID-19 pandemic, encouraging Franceschi and office staff to work from home. He took advantage of both the Payroll Protection Program and a loan from the Coronavirus Aid, Relief, and Economic Security Act, which “absolutely helped us,” he says.

Hess benefits from a solid cadre of referral sources and a network of therapists and former patients who knew his work from past positions. Aside from a company website and social media presence, Hess has not needed to market his services to create the volume he wants. Even so, he has retained someone to call new referral sources and plans to strengthen his internet marketing efforts. Before the pandemic, P&O Designs sponsored a local arthritis walk, and Hess has presented programs to a nearby amputee support group.

Hess recognizes the ebb and flow of his business. “I am very busy right now,” he says, “and when I am that busy every single day, I’ll know it’s time to hire another practitioner and more office staff. That would be a good problem!”

Meanwhile, Hess, Franceschi, and the administrative staff enjoy their work and have a genuine interest in the wellbeing of their patients. “Our commitment to providing the best care and being honest with our patients is why we’re succeeding,” says Hess. “We treat our patients like family, and we back up what we say. That goes a long way.”

Deborah Conn is a contributing writer to O&P Almanac. Reach her at deborahconn@verizon.net.

NAKED PROSTHETICS, a maker of functional, customized, body-driven prosthetic fingers, has developed several innovative devices over the years, all designed to restore function after finger amputation.

The company’s original prosthesis, the PIP Driver, is designed for amputations just above the proximal interphalangeal joint (or PIP). The prosthesis is controlled by movement in the PIP joint and both restores function and protects the sensitive residual digit.

In 2017, Naked Prosthetics released the MCP Driver (Gen 1), created for those with amputations through the proximal phalanx, the bone closest to the metacarpophalangeal joint, or knuckle, which drives the device. “The MCP Driver restores pinch, key, cylindrical, and power grasps,” says Bob Thompson, the company’s CEO.

Next came the Thumb Driver, introduced in 2018, which enables users to make opposition grasps. The prosthesis is driven by the carpometacarpal (or CMC) joint, along with the MCP joint in the thumb.

Naked Prosthetics’ most recent innovation is a grip lock device to address amputations through or just below the knuckles. Users can position the digit using a surface, such as their thigh or opposing hand, and then release it with a quick tap or by moving it to the full flexion release point.

“These have totally changed the lives of people with finger amputations,” says Thompson. “Most digital amputations are the result of construction and industrial accidents, and we can get people back to work, making a living and supporting their families.”

All Naked Prosthetics devices are 3D-printed and customized to each user. They can be worn in any combination, making it easy to address the individual needs of each patient. The devices are designed to act like fingers, not look like them, says Dulcey Lamotte, chief marketing officer. Their open design allows the hand to breathe, and they can be cleaned with soap and water. All styles are available in a variety of color options.

According to Lamotte, finger amputations receive far too little attention in the prosthetics arena. “Myoelectric arms and hands are big newsmakers, but 94 percent of upper-limb amputations happen at the digital and metacarpal level,” she says. “The degree of impairment in performing ADLs [activities of daily living] after finger amputation is high. According to the American Medical Association, losing the index and middle fingers

A patient wears his Naked Prosthetics device to work with plants.

Naked Prosthetics

Privately held

Olympia, Washington

10 years

Bob Thompson, CEO

Dulcey Lamotte, chief marketing officer midmetacarpal creates a 40 percent impairment of the hand, 36 percent impairment of the upper extremity, and 22 percent impairment of the whole body. If you’re missing four fingers, it’s equivalent to a leg amputation or the loss of an eye in total impairment.”

Naked Prosthetics occupies a former lumber storage facility in Olympia, Washington, built in 1920. The 20,000-squarefoot building features areas for production, engineering, administration, marketing, customer care, and clinical activities.

The company sells only to prosthetists, but works to educate all members of the hand community: surgeons, rehabilitation centers, hand therapists, physical and occupational therapists, and emergency room doctors. “We want these professionals to reassure amputees that there is something out there to help them,” says Lamotte. “Losing part of a hand can be devastating to people who think they can never return to work. Just knowing we can help them regain function is sometimes literally a lifesaver.”

Naked Prosthetics’ clinical team works closely with prosthetists in both evaluating and fitting patients, primarily through Zoom since the pandemic began. “We are here to support them throughout the process,” says Thompson. The company also serves as a billing resource for practitioners. Thompson is confident that the market will grow for digital prosthetics. “This won’t be a niche; there are more finger amputations than below-knee, and I believe that upper-limb prosthetics will approach lowerlimb in dollars spent within 20 years,” he says. “Prosthetists can add an enormous amount to their bottom line just treating a few patients a month.”

Deborah Conn is a contributing writer to O&P Almanac. Reach her at deborahconn@verizon.net.