Repetative Strain Injury

This type of injury is becoming more and more prevalent in our society, from carpal tunnel syndrome to shoulder injuries suffered by a growing number of aging individuals in manual wheelchairs. It has always been the stance of medical professionals and insurance carriers to limit the ability of walking impaired to manual wheelchairs as their principle means of mobility. It makes sense that if you are walking impaired, that your calorie burn to intake ration is less, and using a manual wheelchair will help burn more calories, and help keep the user physically fit.

As these clients who were prescribed only manual wheelchairs for their mobility are aging, many are finding themselves having severe pain in the shoulders, which is being diagnosed as repetitive strain injuries. In addition to propelling their wheelchair throughout the day, within their homes, into the community and workplaces; medical professionals are realizing that the human shoulder has limited capacity for these functions.

The movements of pushing a wheelchair, compounded with independent transfers, and daily routines it generally too much for the human shoulder to handle.

It has always been my belief that there is a balance between manual and powered mobility for individuals who are confined to a wheelchair, and dependent for their mobility. From a mobility stance, having the ability to use manual mobility within the home and work place, as the chairs are smaller and more maneuverable is certainly an advantage. Manual wheelchair burn more calories, reducing the potential for excess weight gain; and increases strength allowing for independent transfers. Powered wheelchairs allow a user to travel across greater distances, which put users at risk for repetitive strain injuries.

Repetitive strain injuries can cost funding sources tens of thousands of dollars, not to mention loss of employment to the wheelchair user. This loss could be simply reduced by providing both a manual wheelchair, and powered system to long term users of mobility aids. It would make sense (and reduce costs) by providing this equipment to specific diagnosis; that generally develop these types of injuries.

A possible solution to save money and benefit the wheelchair population, would be to provide both types of equipment; and prompt an education program for potential injury groups to explain the benefits of using both types of equipment; thereby reducing medical care costs, and risk of obesity from inactivity.

This article was provided by Carey Britton, ATP/SMS, CRTS from Active Mobility Center, located in Pompano Beach, FL. He can be reached at 954-946-5793 or cbritton@wheelchairguys.com

Is Medical Equipment too Expensive?

I have seen many posts lately on Face Book and in Blogs about the high prices for DME and Medical Equipment. I have seen comparisons to Sport Aid and other online pricing compared to the brick and mortar companies. 

As a tax payer, and after taking an Ethic course and discussing the outside perception of the costs of Medical Equipment; I understand the concerns.  It is hard to fathom that a powered wheelchair may cost as much as a car, that an ultra light weight wheelchair may cost $3000. 

That being said, have you seen how much a refrigerator, furniture or a racing bicycle may cost?  I have a friend that has a bicycle that costs $5K.  I understand that the racing bicycle may be considered a luxury and where a wheelchair is not; but there are a lot more bicycles sold yearly than the same custom wheelchairs. Bicycles do not have the same requirements and liabilities as do wheelchairs.

As a Complex Rehab,  DME supplier and Board Member of NRRTS, I see the other side of the equation.  Generally Medical Equipment is funded through Insurance and all insurance companies follow Medicare guidelines. Unlike the Sport Aid type companies, we are forced to comply with all Federal, State, Local, Accreditation, and Insurance guidelines.  Unlike Sport Aid, we have to follow the clinical model and have to provide a report that builds a case for medical necessity, we have to chase all the paperwork, submit the request to funding, help with any appeals, order, assemble, deliver, fit and then submit the claim for billing; which can take up to one year to be reimbursed. 

Retail companies, advertise their products, take a deposit or the entire amount up front, and ship the equipment to the customer.  There is little cost and risk in this process. Catalog and On-line companies can be anywhere, allowing them to reduce costs, they do not have to have the insurance coverage, they do not need to be accredited, inspected, or follow the same standards as Insurance providers.

There are costs associated with playing the game. In retail, it is all about price and value. When providing equipment through insurance, you have to have a location that is certified, inspected, accredited, bonded and insured. The costs above the rent, staff, trucks, equipment, parts; etc. is the Professional and Liability Insurance ($10-$20K / year), Accreditation ($3-$5,000/year), Medicare and Medicaid Licensing ($1K/year), Bonding ($1K/year). There are regular audits by the insurance carriers, which cost much time, and expense in fulfilling the requirements and ensuring payment for services.

DME companies offer and provide knowledge, education, and their experience to improve the quality and successful outcomes. I am the first to agree that there are not enough safe guards in the DME world, which is why NRRTS is aggressively promoting trying to carve out Complex Rehab Equipment from DME.

There are studies that have been conducted, showing that in Complex Rehab that the net profit for most DME's are under 7% which is very low in comparing to other industries. This offers very little room for growth, pay increases to staff, or any additional benefits to workers. 

Competitive Bidding was introduced, reducing payments for many DME products. After the first year 33% of the winning providers went out of business as they could not afford to stay in business.
It is important to remember, that DME companies purchase the equipment they are providing, and help with all the insurance paperwork and do not receive any compensation until the equipment is delivered.  All of the labor costs from the intake, evaluation, quoting, requesting medical documentation, submission for approval, ordering, assembly, and ensuring there is a service staff to help with concerns is all funded through the sale of the product.  It is a semi-flawed system, however if insurance companies paid a lower rates, and considered labor hours for the entire process; the price of the equipment would be higher than it is now.

This article was written by Carey Britton, Seating Specialist for Active Mobility Center. He can be reached at 954-946-5793 or at cbritton@wheelchairguys.com.

Tis the Season for Gratitude

A morning ritual for me is to take a few minutes and write something that I am thankful for.  At each staff meeting, I go around the table and ask not for what problems we face, but what Positives we want to share with each other.

If you are involved in the Health Care field than you already know that generally we have thankless jobs. Nobody gets up and says I want to go and see a physician, therapist or wheelchair specialist. We glory in our outcomes and success stories whether told or seen through our own eyes. 

This brings me to my point....Life is not perfect or fair, and if we dwell on the negative, and there certainly is a lot of that in the world, then our projection/signal to the world will be reflected in the same light and we will miss the most valuable thing in life.....TIME.

I would encourage you, during this time of year, to reflect on the good in you and your family/friends lives.  Stop judging yourself on what you have not achieved and Celebrate and Appreciate what you have.

Happy Holidays from the Staff at Active Mobility Center.  Carey can be reached at (954) 946-5793 or at cbritton@wheelchairguys.com .

Understanding A Small Moment in the Life of a Wheelchair User

I was watching behind the scenes of Jamie Fox playing Ray Charles, and he didn't become the character until the director had his eyes sealed with a prosthetic.  Until he was able to experience life without vision, he didn't understand what it was truly like.

Similarly, the public has not realization on what a wheelchair user goes through both physically and emotionally. I will not pretend to understand or know everything; but do have each staff member working with us spend quite a lot of time sitting in and using the equipment we provide and try to perform daily tasks.  This is an eye opening process, and even though they can get out of the equipment; they learn a valuable lesson.

A few years ago the PVAF held a bowling event where everyone had to bowl from a wheelchair or scooter device.  It was a great opportunity not only to raise money; but awareness. 

Any time we as a group can glimpse at the lives of others it builds a understanding and brings down barriers.

This article was written by Carey J Britton, Seating and Mobility Specialist at Active Mobility Center. He can be reached at 954-946-5793 or cbritton@wheelchairguys.com.