I use a thick orthotic and have only been able to wear Alden's Modified Last - the fit is acceptable but FAR from perfect. I've literally wasted thousands of dollars in the past 8 years trying to find good-fitting, business appropriate dress shoes. I am very happy with my orthotic (have had the device for 6 years) - sure wish it was thinner of course but it corrects the medical/pain issues I have with my feet.
Mr. Glasgow gave me two options after looking at my shoes, orthotic and feet - 1. Build a bespoke shoe that will better accomodate my foot and current orthotic; or 2. Build a bespoke shoe with added arch support and metatarsal padding added directly into the shoes.
Mr. Glasgow recommended option #1 - He thinks we can achieve a very good fit along with the comfort and correction that comes along with my existing medical orthotic. He was very honest - stated that he is not a Doctor and despite the fact that he does build custom adjustments into footbeds for his clients, given my situation, there is a chance that the final result could be disappointing.
George believes that he can build both an elegant and comfortable pair of shoes for me. I believe him so I took the plunge. I ordered a pair of Bespoke Black Calf Imitation Full-Brogued Oxfords (Cat No 51 on the website) - some might find them boring but I think they're beautiful. Now the long wait begins...