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YOUR WELL-BEING: Taking Quality Care and Innovation to Rural Amputees

By Laura Canfield

According to the Amputee Coalition, an estimated 507 people experience limb loss every day. In November 2020, one of those people was Jenny Urivez, a breast cancer survivor whose severe blood clots required her to have above‑knee amputation surgery.

Thankfully, Jenny had the support of Bay City-based Oakland Orthopedic Appliances Inc., where owner‑prosthetist Corey Smith, CP, had crafted her care plan. Within weeks of her surgery, Jenny was up and walking on her prosthesis, making good on her vow to walk through the town of Lake Huron, Michigan.

Smith, who owns Oakland, is a second-generation prosthetist who was inspired to join the field by his father, an amputee and orthotist/prosthetist who established the practice 51 years ago. Today, the Oakland team marshals everyone — from surgeons to therapists and prosthetics professionals — in a coordinated approach that prioritizes patients’ mobility goals and ensures they have access to the right care and technologies.

You might expect to see such innovative, coordinated patient care in massive healthcare centers in major metropolitan cities… not necessarily in a small town like Bay City, Michigan — population approximately 33,000 — where Oakland is headquartered.

“My dad wanted to bring a high level of care into a smaller community where they didn’t have those services, to become a part of the community so he could take good care of its members.”

But in fact, rural residents tend to be among the highest risk for amputation. Due to the combined impact of low income, poor diet, sparse healthcare resources and remote geography, many rural residents develop chronic conditions like Diabetes, which can lead to infections and ultimately limb amputation. Helping rural patients offset those risk factors is what initially attracted the Smith family to settle in Bay City.

“Our family has been committed to this area for over 50 years,” Smith says. “My dad wanted to bring a high level of care into a smaller community where they didn’t have those services, to become a part of the community so he could take good care of its members,” Smith says. “And we continue to live those values today, because the rural community often gets left to the wayside even though they’re a vulnerable population.”

Importantly, just because people live in rural areas doesn’t mean their healthcare quality must suffer. As Smith says, “People may think they need to look for a university center or large population area to find high quality care, but wherever they are, quality care can be available to them.”

One important benefit to rural care is relationship-building between patient and prosthetist. “In my opinion,” Smith says, “we can offer more personalized care in rural settings, because we’re not in a volume-based practice focusing on how many people must be treated in a day. We’re able to spend more time with patients, to really get to know and connect with them, and to understand their goals.”

The Treatment Center: A Unique Patient Solution Arising From Relationships

One result of the close relationships between Oakland and its patients is the team’s ability to address patients’ unmet clinical needs. “Over the past 20 years, insurance has been reducing physical therapy visits, so patients may have access to great prosthetics technology, but outcomes don’t improve if they don’t get comfortable with their prostheses,” Smith says. “We needed something better, so we built a Treatment Center with the sole purpose of giving amputees the extra care they needed.”

Oakland’s innovative Treatment Center is the only one of its kind in Michigan. The uniquely designed, 4,000-sq. ft. facility, which Smith funded out of his own pocket, features a bright, open walking track that allows anyone with limb loss or limb difference to walk, socialize, and enjoy the physical, mental, and emotional benefits of mobility and interacting with their community.

Each day, as many as 25 people use the facility to improve their mobility and maintain physical fitness. The Treatment Center helps people stay mobile despite the long, hard Michigan winters, offering a place to safely participate in daily, supervised walking no matter the weather conditions. Smith says one patient has been consistently coming to the Center for over two years.

We’re able to spend more time with patients, to really get to know and connect with them, and to understand their goals.

“We try to bring in fun and interesting opportunities, which people enjoy,” Smith says, recalling that for one bilateral transfemoral amputee who wanted to push mow his lawn again, Oakland’s clinicians created a lawnmower simulation.

“Whatever the patient aspires to do in their lives, we want to find a way to make that work for them,” Smith says. The Treatment Center unites two critical concepts — providing a freely available space for people to experience the benefits of regular physical activity, and the power of a community of peers supporting one another. As Smith notes, “It’s so important for people to see others who are dealing with challenges similar to theirs, and to encourage each other.”

This is echoed by Oakland patient Jenny Urivez, who recently became one of the first people in the world to be fit with a new POWER KNEE. “You have to have a good attitude or you’re not going to walk,” Jenny says. “If I can help anybody else learn to walk, I definitely want to help them.”

The Treatment Center also provides a source of clinical outcomes data, including critical metrics on patients’ overall mobility and walking speeds. As Smith says, “As we age, our walking speed decreases and our chances of falling increase. So, we encourage patients to keep walking at a certain pace to decrease their risk of falling, which can be especially dangerous for an amputee.” Overall, patients’ response to the Center has been so positive, Smith added, that plans to further expand the Treatment Center are already underway.

Finding the Life-Long Patient‑Provider Relationship

Wherever someone is geographically based, and wherever they are in their limb loss or limb difference journey, Smith encourages patients to advocate for themselves. “Patients have choices and a say in their care,” he says. “It’s important to do your own research because you need to find the prosthetists and medical care team you can ‘click’ with.”

Patients can read online reviews, ask questions, and talk to other amputees to better understand their experience with their prosthetist. “The relationship between the patient and the prosthetist can be life-long,” Smith says. “You need to work with someone who understands you and wants to help you achieve your goals, whatever they are.”

As a testament to the Smith family’s commitment to serving its community and building relationships, the practice still has several patients today who were there when Oakland first started over five decades ago. “These patients were once treated by my dad, and now by me,” Smith says.