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Orthotist and Prosthetist

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Bob Pacini is a certified orthotist in Worcester, Massachusetts. He says he loves his job because he has always loved working with his hands.

"As a kid, I was always making models," says Pacini. He also enjoys the daily patient contact. "This job is extremely diverse. I have no idea what's coming in the next day. It is a challenge. The hands-on part makes it fun."

Notty Bumbo is a pedorthist, specializing in only the foot and ankle. An orthotist can treat everything from the neck, the hands and the arms to the legs and the spine.

Bumbo started out making shoes by hand for people with foot problems. He predicts a rosy future for orthotists. "There will be a demand for orthotists, as well as good shoemakers, who are dedicated to helping people. There are and always will be people with foot problems. It's very satisfying to put a pair of shoes on a person's feet and have them start crying because they feel so good."

Yvonne Jeffreys is a certified orthotist at a rehabilitation center. "We assess what's wrong with them, how they run their lifestyle, what they want to do, why they need something from their point of view," she says. "I like to work with the people, to make a difference in their lives."

"I see small success stories each day. If I put a body jacket on a child and that gives them the support to sit up and be able to use their hands, well, that's success to me," says Pacini.

Jeffreys says her favorite part of the job is helping people and being creative. "My least favorite part of being an orthotist is talking about money, and telling people that I can't do any more to help them."

Pacini agrees with that point. "There is a lot of sadness. We deal with sick patients, people who are not always in good health."

Although he would love to be able to fix them all and make them all better, he can't -- and that frustrates him. "That, and dealing with the insurance companies who want to limit the money they spend, can produce barricades. It prevents us from providing the best quality orthoses that we can," he explains.

Pacini was interested in the field even as a child. "When I was a child, my mom and my sister were in the hospital quite a bit. Just being a typical kid, I would wander around the hospital and end up checking out where they made the braces," he says.

Jeffreys earned her engineering degree, then got her orthotics certification.

"I took a course at university pertaining to the biomechanics of prosthetics," she says. "I knew I didn't want to do hard core engineering. I thought P and O [prosthetics and orthotics] would include both aspects of what I was looking for in a job -- working with people and, at the same time, still allowing for problem solving."

Bumbo was born with club feet. "I was personally motivated to try and solve my own problem. I had limited success with solving my own problems, and I saw a great need to help other people."

Looking back over the years, he sees the changes in the profession. "Now it's technical manufacturing, but you still get to help people and focus on the patient."

Pacini says that students interested in these professions should study science, math and English. He recommends going to a facility and seeing what the field entails. "You will learn by talking to people involved in the field, including doctors, therapists, patients and orthotists," he says.

Jeffreys recommends math and science, and concentrating on developing real problem-solving skills. "Although it's not rocket science, there are forces here deforming the body. Something is happening, and you may need to use applied physics to figure out the problem and apply it to the solution to make it work," she says.

Edward Lemaire works at a rehabilitation center. He explains that the trend in orthotics is going high-tech. "Some orthotists use a CAD-CAM computer system, and use computers to eliminate the step of filling the plaster cast to make a positive model of the limb. Using a CAD system makes the process more consistent and, in many instances, faster."

Guy Martel is the director of a prosthetics and orthotics department. He agrees with Lemaire. "The advantages of the CAD-CAM system are great in a learning environment, where the teacher and the student can work on a model on the screen and compare where the differences in decision making lie."

Jeffreys reflects how her work affects clients. "My work changes the world by allowing people to get on with their life," she says.