Don’t Be a Fossil

You're sitting through a demo. The rep is sharp, the product looks sleek, and about four minutes in you hear it: "The old way of doing that is legacy." Said with a little curl of the lip, like the word smells bad. And you catch yourself nodding — because who wants to be the practice still doing things the old way? 

Hold on a second. 

I've recently read a blog by Javvad Malik at KnowBe4: "What Security Can Learn From Dinosaurs". While he wrote about cybersecurity, he landed on something that runs straight through our world too. We treat "legacy" like an insult. They say dinosaurs ran the planet for years and then evolved into every bird outside your window. They didn’t win by being new. They won by being proven and by adapting. 

That's the part we usually skip. The dinosaurs that made it didn't make it by staying exactly the same. They adapted, generation after generation, until they could do something the old body plan never could — fly. So the real question for your practice isn't "are we legacy or are we modern?" It's a harder one: are we still evolving, or have we quietly turned into a fossil? 

Legacy is a compliment. Fossilized is the warning. 

Strip the sneer off the word and "legacy" just means something lasted long enough to leave one. In a small O&P practice, that's not a liability — it's your balance sheet of hard-won knowledge. The clinician who's fit a thousand sockets and reads a residual limb before the patient finishes the sentence. The intake checklist you bled on for six years until it finally stopped letting sloppy documentation slip through to billing. None of that showed up in a pitch deck. All of it is why you're still standing. 

A fossil is different. A fossil is that same proven thing — after it stopped changing. It's the checklist nobody has questioned since 2019, running on autopilot while the payer rules underneath it quietly moved. It's the "we've always done it this way" that used to be wisdom and is now just habit wearing a nice coat. Proven and frozen are not the same thing, and the gap between them is where practices get hurt. 

The two ways to lose 

There are really two failure modes, and it helps to name them both. 

The first is the mayfly — chasing whatever's newest because it's newest. A vendor who's been around eighteen months with a gorgeous interface hasn't lived through a single Medicare fee schedule change, a DME MAC audit wave, or an LCD rewrite that redefined what "medically necessary" means for a knee. The mayfly gets one brilliant day and then it's gone, and if you built on it, you're gone with it. 

The second is the fossil — clinging to the proven thing long after it stopped keeping up. This one's sneakier, because it feels responsible. Stable. Loyal to what got you here. But loyalty to a process that's fallen behind the rules isn't prudence. It's exposure with a good story attached. 

The winner is neither. The winner is the bird: a proven lineage that kept adapting. In practice terms, that means honoring what's earned its keep and being honest about where it needs to grow. 

How to tell if you're evolving or fossilizing 

You don't need a consultant for this. You need a couple of honest questions, asked out loud, on a regular schedule: 

• When did we last change this on purpose? Pick any core process — intake, scheduling, documentation, denials follow-up. If the honest answer is "I can't remember," that's not stability. That's drift. 

• Does it still match the rules as they are today? Not as they were when you wrote the process. Payer policies and coverage determinations move quietly; a workflow that was airtight three years ago can spring a leak without anyone noticing. 

• Are our proven people still learning, or just repeating? Your veterans are your greatest asset — and the most likely to be running on knowledge that was current a while ago. Evolution includes them. Retraining the expert isn't an insult; it's how the expert stays the expert. 

• Would I defend this to an auditor, or just explain it? "This is how we've always done it" is an explanation. "Here's why this still holds up" is a defense. If you can only manage the first one, the fossil is showing. 

None of these requires a big transformation project. Pick one process this month, ask when you last changed it on purpose, and if the answer is "never," schedule thirty minutes to look at it against today's reality. That's evolution — small, deliberate, repeatable. It's how the proven thing stays proven. 

The long game 

Malik reclaimed "legacy" for the security world, and I think it's worth reclaiming for ours — but with the second half attached. Lasting a long time is only an achievement if you're still growing. The mayfly burns out because it never had roots. The fossil breaks because it stopped bending. The bird is still here, still airborne, because it did the harder thing: it kept what worked and let the rest evolve. 

Your practice has legacy instincts in it — real, proven, hard-won. The question is whether you're using them to fly, or to hold still. 

The proven thing only stays proven if it keeps growing. 

Idea credit where it's due: this one was sparked by Javvad Malik's "What Security Can Learn From Dinosaurs" at the KnowBe4 blog. The dinosaur framing is his — the O&P detours are on me. And I have to throw in an OPIE plug here…if you haven’t seen OPIE 2.0, check it out. It’s about to take flight!