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Tippie MBA Students Help Spread the Word about Ponseti Clubfoot Treatment

A group of Tippie MBA marketing students has spent the last year looking for ways to market the Ponseti method of treating children with clubfoot. They found that good news doesn't always travel fast.

Despite 50 years of success, many physicians in the United States are still not fully aware of, or even practicing, the revolutionary nonsurgical treatment developed by University of Iowa Health Care's Dr. Ignacio Ponseti. A marketing report compiled by the Tippie students over the past year said this lack of awareness comes despite the fact that the Ponseti method has been declared the standard of care for clubfoot by major U.S. health care professional organizations.

"There's still such a low rate of occurrence of clubfoot, with only about 5,000 children born each year in the United States with the condition, that doctors don't see patients very often," said Amber Fourcault, a second-year full-time MBA student and a member of the group. "Quite often, we heard from doctors that they see only two or three clubfoot cases every five years."

The report was commissioned by the University of Iowa-based Ponseti International Association as part of its effort to increase awareness and usage of the Ponseti method, first developed more than 50 years ago by the professor of orthopaedics at the UI Carver College of Medicine. His method involves gentle, manual manipulation of the child's foot and application of toe-to-groin plaster casts. The casts are changed weekly after a clinician manipulates softened foot ligaments to gradually achieve near-normal muscle and bone alignment.

Five Tippie MBA students -- Fourcault, Adnan Fazal, Emily Gander, Brandi Gibbs and Su Zhang -- worked on the marketing plan during the past year as part of a marketing class taught by John Murry, professor of marketing in the Tippie College of Business. The students came to their recommendations after talking with hundreds of orthopedists, obstetricians-gynecologists and family practice physicians across the United States, as well as in India and China.

In their report, the students suggested the Ponseti International Association take steps to better manage the information flow regarding the method to improve awareness and reduce confusion.

"We suggest they make Ponseti a brand, to manage it and control it and establish a presence that would make them the authority on the Ponseti method," said Fourcault.

One easy and inexpensive step would be to establish a comprehensive Web site about Ponseti, and market it is as the authoritative source of information about the method. The Web site would eventually replace pamphlets and other printed materials that the students discovered don't always get to the doctors or the patients.

"Print materials are an ineffective use of resources," said Fourcault. "Electronic material is easy to send and update, and it doesn't cost much money."

During their research, the students found physicians who said they used the Ponseti method, but in fact were not, or were using modified versions. Fourcault said the doctors weren't maliciously trying to trade on the Ponseti name, but simply didn't realize they weren't doing the Ponseti method as it was developed by Dr. Ponseti.

"Many of these doctors treat so few patients that they've forgotten some of the details, or they added steps that aren't a part of Dr. Ponseti's method," Fourcault said. "The problem is that if they say they're using the Ponseti method but they're not, and it doesn't work, then that reflects badly on Ponseti."

The students recommended that once the brand is established, the association should publicize it at national medical conferences, publish a Ponseti newsletter, and create a network of Ponseti-qualified physicians to promote the method.

The Ponseti International Associate has already taken steps to build the Ponseti brand. A Web presence was established in 2007 at www.ponseti.info, and the first-ever international conference of Ponseti practitioners was held in Iowa City. A second international conference is planned for 2009.

Jose Morcuende, M.D., associate professor of orthopaedics in the UI Carver College of Medicine and president of the Ponseti Association, said board members appreciated the group's work and ideas.

"They did a great job of looking at things from the perspective of the business side, not physicians, and they identified areas we have to work on to make the Ponseti name more widespread," said Morcuende. "They also identified that we have to use different programs and different messages in different countries."

He said the report shows the association must do more to correct misconceptions about the Ponseti method (for instance, that the treatment lasts for years; in fact, it is usually only three to six weeks for the correction of the foot by casting, followed by a simple, comfortable nightbrace for two to three years to prevent relapses). The report also suggested the association look for new ways to introduce the method to China and India, where clubfoot patients are seen as social pariahs and little is done to help them lead a normal life.

"Clubfoot can be eradicated around the world in 10 years if we had the resources to implement the programs," he said. "This report will help us find new ways to get the word out."


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