Japan: The pathway from retail footwear to pedorthics

The Gozovation team with Clemens Hagen (left) and Kosuke Fukushi (right).

The pathway to his own workshop was a long one for Kosuke Fukushi. After many years in footwear retail and innumerable continuing education courses in pedorthics, Kosuke braved the waters last year and added on a fully equipped pedorthic workshop to his shoe business in Tokyo. This new workshop isn’t just where all orthopedic and pedorthic work is now carried out; it’s also where he produces all of his hand-made custom footwear. By Clemens Hagen

On the side of the blue behemoth “16t” is written in big letters. Its tamer is sitting securely in his glass box, demonstrating his absolute mastery of the joysticks and pedals. Both ends of the little street are punctuated with warning signs and security personnel blocking every entrance. Many pairs of eyes are staring up at the precarious load hanging high above the electrical and telephone cables. Crane acrobatics were needed to get the ­machines into the workshop.
The opening to the building is not all that big, more like a window swung wide open. In its upright position, the machine will not fit through the opening, which means it had to be tilted even before it was suspended from the hoist line. Two helpers are waiting in the window frame to accept the incoming delivery. Then the metal box simply drifts into the building that will form the workshop's heart and core.
It would have been a lot more work if they had taken the stairs, but a lot less costly. Unfortunately, the entrance to the former yoga studio was too narrow. That’s why bridging the over ten-meter height difference between the truck and the workshop cost just as much as the entire transport from the manufacturing plant in Wuppertal, Germany, to the front door of the building.

The new workshop, centered around the big working tableMeanwhile, the workshop — which is located in Hachioji on the western perimeter of Japan's capital city — has already been operating successfully for over a year now. Indeed, the path to one of the first genuine pedorthic workshops in Japan was not only a long one in terms of kilometers. Although this healthcare craft is not really something new here in the Far East, in the last 20 years, hardly anyone has managed to set up a technically and economically viable workshop.
Such projects were either affiliated with wholesalers who wanted to make their products known or they were merely departments of a P&O company.
Previously, only shoe retailers specialized in comfortable-style shoes additionally fabricated orthopedic custom-made products like foot orthoses and shoes, although they only manufactured custom orthotic shoes in low volumes. Besides the companies run by the pedorthists from foreign countries, you could count on one hand the number of companies that run technically substantive and economically independent operations as pedorthics companies on the Japanese market. Unfortunately, and despite a considerable number of graduates, the one single technical college and other educational opportunities have hardly contributed to the founding of independent companies.

Given this perspective, a certain amount of courage is required to undertake an adventure such as this. Access to statutory health insurance patients as customers is subject to a state orthopedic technician's license. The orders are issued exclusively to such license holders by physicians at hospitals. The orthopedic technology taught in school touches on pedorthics, but it can hardly be said that a sound education is provided in this field.
This means that the only avenue left open to anyone who has focused their training on pedorthics is the private market. Of course, that can also have its advantages. Order transaction and processing are much more efficient and contact to patients is much more direct. There is more leeway in terms of pricing as well. Nevertheless, large sales volumes should not be expected.
This was the path Kosuke Fukushi chose to take. With a nearly thirty-year track-record in the shoe sector, he’s nothing if not an old hand. His first contact with footwear as a commercial product, however, was selling super-cheap shoes from crammed-full shelves to customers who he asked for their shoe sizes, if anything. At some point, he switched to a shop with a foot measuring device.
His boss at the time was riding the wave set in motion over 30 years ago by a woman from Germany, living in Japan who started importing high-quality comfortable-style shoes from Germany. Along with these shoes, she brought Japan a raised awareness for foot health and technology for the personalized treatment of problem feet.
Fukushi-San was finally able to see a deeper meaning in his work besides just earning money. Since then, he's kept his eye on the ball. Unlike many of his peers, he has continually honed his skills and demonstrated unparalleled commitment to continuing education.
He became self-employed twelve years ago. The first location was a bit off the beaten path, but with an affordable rent, on the outskirts of Tokyo. Even back then, he already had a small workshop for carrying out simple orthopedic work.

Individual solutions for patients with foot problems.Five years later, he made the move to where he knew he’d have access to more customers. Despite the larger investment entailed by purchasing the storefront shop, it was a necessary step that paid off immediately by increasing his customer base. I supported him during these years as a consultant, visiting each month for two days to help him manage the more complicated customers with technical craftsmanship.
As the store grew, more employees were hired; however, the number of "difficult" customers with foot problems increased as well. We spent several years exploring the possibility of establishing a specialized workshop to satisfy the particular customers needs. We singled out a student at the technical college in Sanda and offered her the opportunity to do an internship at my workshop in Nagano. After completing school, she first worked in the Fkushisans store to gain experience and learn how best to interact with customers. Despite all of these preparations, it took some effort to finally decide on the "big solution" – setting up a new, proper workshop separate from the main store.

From yoga studio to pedorthic workshop
An abandoned yoga studio in the neighborhood was soon found and deemed practicable for precisely this purpose. True, it was located on the third story and only accessible via an outdoor stairway. The patients, however, did not need to ascend to these heights, because taking measurements and handing out wares took place in the shoe store itself.
In addition, the pre-existing sanitary facilities, the beautiful parquet floor and the high ceilings were unequivocally positive aspects in favor of the selection. Despite all this, the space was indeed tiny compared to European workshops or those out in more rural areas. In our planning, we accepted this fact as a challenge.
Back in my own workshop in Nagano, a centrally located table had proven it merits: A large open work surface covered with a cutting mat, underneath which the entire gamut of hand tools, small devices and materials were always within reach. The large machines were grouped according to the work step involved all along the walls surrounding this table.
Frequently used material was stacked on special shelves. Plastic boxes, on hand for the individual orders, were arranged systematically in the racks of a grid wire shelf.
This arrangement allowed for quick access to everything needed, ensured extremely short distances and made things as manageable as was necessary. Of course, the big compromise ought not to be kept secret either: Noise and dust emissions affect all employees in this workshop.
At the 2015 IVO World Congress in Paris, Fukushi-San found out a great deal about what's new on the market. Nor did it take long to reach an agreement with Peter Mebus from AFT, from whom we had already been sourcing one thing or another.
Parallel to drafting order lists for machinery manufacturers in Germany, we began diligently drawing up construction plans. In order to stay within the tight budget but also meet certain functional and aesthetic demands, Fukushisan and I decided that he should add his own finishing touches. So the two of us ventured out to scour the nearby hardware stores and procure the materials required.

The Gozovation shoe store, where also patients are examined and ­orthotics are fitted.The workbench with its many mysteries as well as the leather shelves were all our own, in-house productions. A workbench especially and individually fabricated for the customized shoemaker belongs as much to the do-it-yourself construction mentality as to the sundry incidentals tucked into every nook and cranny and yet always in sight — all characteristics of optimal space utilization. There were many little details we were very proud we came up with solutions for.
Meanwhile, the machinery ordered — ready and packed in boxes — was on the ship to Japan. An electrician was commissioned. New wiring, new outlets and new air-conditioning systems all had to be installed.
We were already able to begin positioning the delivered devices around the room on "big crane day". If the electrical plug issue hadn’t come up, the guys and gals could have taken to their tasks lickety-split. Of course, meanwhile all of this is history and the workshop has been fully functional ever since.

Well trained and motivated employees
There were plenty of orders on the books from Day One — some from the orthopedics sector, some for custom-made shoes. In this part of the world, that deserves huge recognition. The customers had to accept delivery dates extending up to six months or more in the future. This was partly, but not entirely, due to the large number of orders.
In contrast to dual systems, where the apprentice gets involved right from the beginning in an operation that has to be economically well-functioning, the educational curricula at technical colleges have a different orientation. It took a while before the freshly graduated staff members with their academic knowledge and basic craftsman's techniques had adapted to the efficiency-oriented workstyle prevailing in the workshop.
To make everybody's lives easier, we followed a multi-pronged approach. First, the work itself had to be organized. The chain of communication between the retail shop where customer contact took place — located just two minutes away — and the production facilities proved to have a few weak links, despite the fact that there was constant back-and-forth between the staff members. Not until every employee is able to access all relevant data instantly is it possible to interact responsibly with customers. These days, all work progress is documented and every interaction with customers forwarded. This makes it much easier to stick to deadlines, because every employee also carries a certain degree of co- accountability.
We have defined time reference targets as general guidelines for each individual step in the fabrication process. It is the task and responsibility of each individual employee to be aware of these and, at some point, to start achieving them. In addition, we devised our own training program. The curriculum featured short seminars where, under my tutelage, the employees were given intensive instruction in examination techniques and more in-depth production solutions. We also succeeded in getting Master Pedorthist Daniel Wiendl to hold a three-day seminar; Daniel comes to visit us from Australia now and again and gives courses here in Japan. Over these three days, he showed the employees at Gozovation how to finish a complete set of orthopedic shoes in the time allotted.

Fine custom made shoes – handsewnOur last coup was an excursion to Europe. A continuing edu-vacation, if you will. To employees who only get two weeks’ holiday a year, it was a pretty big deal. First, we spent three days visiting various companies, like the material suppliers Orme/Vogt or semi-industrial manufacturers like Thanner, or even custom shoemakers like Haderer. Subsequent to this, our colleague Andreas Ober in Lindau offered to take on the eager learners for a week-long practical internship. As it would appear, our efforts have borne fruit. Both the pace of production as well as general motivational levels have risen dramatically.
We are all very proud of this project. There will no doubt still be all kinds of hurdles to surmount. The Japanese market has its own peculiar stumbling blocks. It will take a few years before we can say for sure whether we have built a model for success or not. But I have a good feeling.

Clemens Hagen did his pedorthist training in Austria. He has been living in Japan for 20 years and runs his own business there.