A few months ago, a patient said she saw a service advertised at Costco, which provided custom foot orthotics to customers for a price of $89 per pair. She asked if I was concerned about this “competition” from a mass retailer. I replied that this type of commercial offering of custom foot orthotics would only help drive more patients into the offices of podiatric physicians.

Recently, my prediction was validated when a gentleman brought his 12-year-old son into my office for an initial consultation. The father had been shopping with his son at Costco several weeks earlier and saw the display for a custom pair of foot orthotics. He made a spontaneous decision to buy a pair for his son, who had symptomatic flat feet all his life. The father had procrastinated in taking his son to the doctor for an evaluation and this simple system of purchasing the foot orthotics at Costco seemed like an easy way out.

The Costco foot orthotics are fabricated from a weightbearing computer scan image of the feet. Many of these weightbearing scanners are now being marketed in podiatry. Unfortunately, the foot orthotics manufactured from such an image are not truly custom molded to a three-dimensional model of the foot. There is no intrinsic balancing of forefoot to rearfoot deformities with these devices. Therefore, true correction of alignment is not possible.

With the Costco purchase, the father ultimately wound up buying an $89 pair of arch supports. The devices did not fit his son and were uncomfortable to wear despite a three-week “break in” period. There was no technician or qualified sales staff at Costco to modify or change the orthotic devices.

The father now realized that a better solution would be available from a qualified podiatric physician. The negative experience at Costco had actually raised awareness about the possibilities of using foot orthotics to treat foot pain and had finally motivated this parent to make an appointment for his son.

My evaluation confirmed a congenital flexible pes planus deformity in this patient and I determined that legitimate custom foot orthotics could be effective. Better yet, my office staff confirmed that the patient was a beneficiary of a medical insurance plan, which covered custom foot orthotics. The out-of-pocket expense for my custom devices was actually less than that of the Costco orthotics.