Who is Andy Hoar?
Andy Hoar is a sixth-generation custom shoemaker and well-known certified pedorthist in the greater Halifax area who has recently started offering his services from Arthritis & Injury Care Centre in the brand new Advanced Orthotic & Pedorthist Lab.
A Glimpse at Andy’s History
Andy Hoar’s family has been providing custom-made footwear and foot appliances in Halifax since 1842. After graduating from George Brown College in Toronto in 1983 with a diploma in Orthotic and Prosthetic Technology, Andy went on to complete his training as a Prosthetic Technician in 1985. He then began his internship in Pedorthics, working under his father, and received his certification as a Pedorthist in 1988 through the American Board for Certification. Andy received his Canadian Certification as a Pedorthist in 2006.
Andy’s Work History
For many years, Andy worked as the senior Pedorthist at the NS Rehabilitation Centre. He assisted in the training of physicians as well as many other clinicians affiliated with Dalhousie University including Physiotherapists, Occupational Therapists, Orthotists and Prosthetists. In 2001, Andy joined the Multidisciplinary Leg Ulcer Clinic at the Halifax Infirmary specializing in neuropathic foot conditions and working with orthopedic, vascular, plastic surgeons, infectious disease specialists and clinical nurse specialists.
As a member of the Canadian Wound Care Association, Andy spent 5 years as an instructor for The Institute of Wound Management and Prevention, lecturing on wound prevention and treatment of neuropathic feet. Andy also co-authored the Best Practice Recommendations for the Prevention and Treatment of Diabetic Foot Ulcers: Update (2010) Wound Care Canada; Volume 8 (4): 6-40.
Helping People Live Better Lives
A variety of medical conditions including, but not limited to, rheumatoid arthritis, diabetes, polio and spina bifida can cause problems with the feet. For individuals suffering from these conditions, wearing ill-fitting shoes can cause serious problems. According to Andy[i], 15% of diabetes patients will develop a foot ulcer, and 80% of the amputations he sees done are done on diabetics that start out with a foot ulcer.
Andy assesses various foot deformities on patients and then makes them a custom orthotic or shoe, or modifies an existing shoe to fit their needs. This helps patients walk normally, and pain free.
Our Interview with Andy
We recently sat down with Andy to learn more about his family footwear history and professional life. See the entire interview below!
Tell us a little bit about your “family” footwear history.
My family has been doing this for six generations. My family originally came from Ireland in the 1840’s and worked as cobblers. I grew up in Nova Scotia as one of seven kids. My father was called the “guru of shoe,” and I have a brother who lives in Charlottetown, PEI who is an orthotic and prosthetic technician who has amazing hands for making shoes.
What was the company called in 1900?
The company was called John A Hoar & Sons Orthopedic and Custom Shoes. It was located on Bedford Road – the building is no longer there.
What made you decide to follow in your family’s footsteps?
I knew from the beginning that this was what I wanted to do – it came naturally to me and no other occupation even came to mind. I have the ability to visually finish a product before I start making or crafting it. I can see it all in my head before starting to build shoes. I’ve made everything from skates, shoes, boots, sneakers, and more. No high heels or dress shoes though! Laughs.
What do you think you would have done if not pedorthics?
I never thought about it!
How has coming from a family with a long history of shoemaking benefited your career as a pedorthist?
(Coming from my family) is immensely beneficial. I was taught how to hand sew shoes with linen, threads, and pig whiskers, which is a dead art now. (Throughout my professional career) I have gone from hand making (shoes), to using computer technology with digital scanning features. My father looked for people with good hands because you can’t teach that, and I was trained to be a craftsman.
What brought you back to Halifax?
I’m from Nova Scotia and always planned on coming back. I was only away to receive my education.
Having spent several years at the NS Rehabilitation Centre working in the Amputee Clinic and the Muscular Skeletal Clinic, how important (in terms of patient outcomes) is having a specialized center for areas like pedorthics (such as our new lab at Arthritis & Injury Care Centre).
A specialized center allows a professional to assess various foot conditions in order to make patients a custom orthotic or shoe that will help them walk normally, and pain free. I am looking forward to focusing on care versus administration. I’m also excited about teaching (mentoring) and caring for patients. Our plan is to bring on Pedorthic Interns so I may train them and help to ensure this valuable knowledge does not die.
You also spent quite a bit of time working at the QEII as the Staff Pedorthist at the Multidisciplinary Leg Ulcer Clinic. Why is a multi-disciplinary approach to care so important? And how are you implementing these important concepts at Arthritis & Injury Care Centre?
The physicians at Arthritis & Injury Care Centre use a collaborative practice and can reach out to me at any time – so we can work together to meet the patient’s needs. As diabetes is a multifactorial disease, multiple specialists need to work with the patient, including vascular specialists, neurological specialists, orthopedic specialists, and more.
You co-authored the Canadian Association of Wound Care resource “Best Practice Recommendations for the Prevention and Treatment of Diabetic Foot Ulcers”. What did you find most difficult about putting together such an important document?
There are a wide variety of different approaches and appliances (for treating diabetic foot ulcers). (An evidence-based best practice) approach has to address each patient. We needed to have guidelines that would create a foundation for patient care.
You spent 5 years as an instructor with the Institute of Wound Management and Prevention, teaching wound prevention and the treatment of neuropathic feet. How did getting out of the hospital and into the classroom help you become a better pedorthist?
We traveled around eastern Canada as a team and taught courses. I worked with a team of doctors, nurses and occupational therapists.
What have been the biggest changes/advancements in diabetic wound care treatment over the past 30 odd years?
Understanding the disease and what the patient is going through. The sheer numbers are scary – hundreds of thousands of people are going to go through this and it’s hard to ensure they have access to proper treatment. There are more pedorthists in Nova Scotia, which helps, but the new clinic will help to focus on the proactive side of treatment – including avoidance of diabetic ulcers, etc.
What new innovations and technologies are you excited about?
(There are) huge advancements coming including 3D laser scanning – what I used to do by hand can be done in moments on a computer, and the computerization of cast modeling – I position a patient’s foot in a neutral position (I hold it in place) and it scans their foot.
While completing your internship in the late 80s, did you ever imagine that you would be at the forefront of pedorthics in Canada?
No, I didn’t see it!
What made you decide to specialize in neuropathic conditions?
It happened out of necessity. There are so many patients with these conditions. I could not discover a “how to” book, so I worked with others to create guidelines.
Why do you do what you do?
I am passionate about providing education to patients, as the processes and treatments can be complicated. I strive to help each patient use the proper tools they have, or have access to, to keep them healthy and to be proactive with their treatment.
Questions about the Foot Lab:
What is your vision for the Advanced Orthotic & Pedorthist Lab at Arthritis & Injury Care Centre?
(My vision is to) provide a full pedorthic service – including repair of footwear, custom-made footwear, modified footwear, and footwear adjustments. As an example, custom modification could be needed after a patient undergoes hip surgery, foot surgery or experiences traumatic injury.
What are the benefits of the Advanced Orthotic & Pedorthist Lab?
The Advanced Orthotic & Pedorthist lab will use an experienced staff to provide a full suite of pedorthic services – including repair of footwear, custom-made footwear, modified footwear, footwear adjustments as well as orthotic repairs. This will all be done directly in house, which allows us to control the quality of the product.
Do you want to learn more about Andy Hoar? Check out these additional resources:
Arthritis & Injury Care – http://www.arthritisandinjurycare.com/blog/arthritis-injury-care-centre-welcomes-andy-hoar-to-the-team/