Re: continuation on cost of parts and business
Donnie Priest
Description
Collection
Title:
Re: continuation on cost of parts and business
Creator:
Donnie Priest
Date:
1/16/2003
Text:
Dear Justin and List,
I learned a long time ago that one cannot fault someone for something that
he or she honestly does not know. This is life and hopefully living through
life one will always learn until the day he or she dies. We all make
mistakes, and hopefully we can pull ourselves up and learn from
them...however, often life lessons are painful.
Prosthetics and orthotics is a very complicated field in which I do not
know some, but I know some and am learning more every day. The more I
learn, the more I realize just how much I do not know. My belief is to keep
an open mind, continue research, bring in outside knowledge and experience
from other fields, and continue with further education (among other things).
Prosthetics involves many fields including psychology, physical therapy,
engineering, business, biology, biomechanics, and hand-fabrication. One
cannot expect a school to teach everything, and one cannot expect someone to
know everything either.
With regard to the proposal of a used or demo foot to cut cost, this
brings up an interesting ethical question. Is one willing to break the laws
in order to save the patient money. Secondly, is it penny-wise and pound
foolish. While everyone would like to save a patient and themselves money
and lower costs, many times it is impractical unless one works for specific
non-profit institutions or has other avenues of obtaining parts or labor
very cheaply or for free.
With the used or demo foot, I would suggest that one checks to see if it
is legal to bill for an already used item. I personally would not be
willing to pay for a 5 year old used car at the same price tag as a new car,
expecially since someone else already puchased the item and the prosthetist
or shop does not own the item being sold. I believe the patient owns the
item once it is paid for, either by the patient or the insurance company on
the patient's behalf.
Feet are also mechanical items...which mean they break and fatigue. A
used foot does not have the same spring characteristics as a new foot. What
happens with the liability when you put a used foot on a patient, it fails,
and the patient gets hurt. Thus, in trying to save the patient some money,
one forgets the important aspects of fit and safety.
On the new technology feet, where does one find a used example of these?
On the Demo items, one cannot expect a supplier to provide two feet for
the price of one. Just because a supplier charges a lot of money for an
item and sells a lot of this item does not allow one to think that the item
is profitable or the company is. There is a lot of research and
development, marketing, and logistic costs in getting a product to
market...How many products get left on the floor when trying to develop
something.
In running a business, one firsts needs to understand what the highest
costs are in order to adequately cut costs. I believe that the highest cost
is labor and not parts. Besides one's physical salary, do not forget the
social security the employer matches, benefits, sick-time, insurance, etc.
In trying to cut part costs, you hypothetically caused a need for increasing
your labor costs. Which one went up more?
In cutting your labor costs, be very careful that patient care is not
neglected. This causes patients to get hurt or not do as well as they
could...a quality of life issue (that is our main goal). Built into the
cost of every prosthetic device is the necessary and needed follow-up care
that is all so important and the true necessity.
For my belief, a good fit at the beginning is the most important thing.
Following this, maintaining this fit is next. Then comes having the patient
understand how to use the prosthesis and incorporating it into his or her
body image.
I could add more, as well as others, so if anyone else would like to add,
please feel free to do so.
Sincerely,
Donnie Priest
>From: Justin Foster < <Email Address Redacted> >
>Reply-To: Justin Foster < <Email Address Redacted> >
>To: <Email Address Redacted>
>Subject: [OANDP-L] continuation:
>Date: Wed, 15 Jan 2003 20:46:08 -0800
>
>OK, one more try...
>
>This is not about hurting our own pocketbooks, or taking money away from
>our
>families, or being a poor businessman. I think that reducing overhead, and
>subsequently reducing O&P payments is a good goal...
>
>If, as so many have pointed out to me, the reason we have to charge $3500
>is
>to keep the $1500 item on the shelf while we make the prosthesis, and so
>the
>user can wear it for 90 more days until we get paid... then how about
>having
>the person wear a demo or used foot until we get paid, then order the foot
>and fit it. We can then reduce the reimbursement because we haven't had to
>prepay by 90-120 days on the foot.... even saving a few hundred dollars is
>GREAT!!! That money only went to pay for the foot in advance, and served no
>other purpose but to cover us on the next guy's foot. That is the waste I
>am
>talking about, and trying to find a way to eliminate. Additionally, that is
>just the foot of the iceberg if you will... repeating this process on all
>modular componentry might save us and our patients (through the
>corresponding copay reduction) even a little bit of money, while still
>providing the manufacturers with the incentive to develop new technologies
>(as their prices would remain similar).
>
>We are going to have to cut costs at some point, shouldn't we at least
>attempt to be proactive and dictate our own future?
>
>Don't tell me I am stupid, or childish, or that this is not a
>chat-room...
>tell me I am wrong, and why, and give us all your ideas so we can run them
>through. It is time to brainstorm, not to browbeat each other into
>silence.
>Idealism is what keeps me going in a strange world.
>
>Justin Foster
>Prosthetic Resident
>Unemployed?!?
>
>
>
>_________________________________________________________________
>Protect your PC - get McAfee.com VirusScan Online
> <URL Redacted>
>
>
I learned a long time ago that one cannot fault someone for something that
he or she honestly does not know. This is life and hopefully living through
life one will always learn until the day he or she dies. We all make
mistakes, and hopefully we can pull ourselves up and learn from
them...however, often life lessons are painful.
Prosthetics and orthotics is a very complicated field in which I do not
know some, but I know some and am learning more every day. The more I
learn, the more I realize just how much I do not know. My belief is to keep
an open mind, continue research, bring in outside knowledge and experience
from other fields, and continue with further education (among other things).
Prosthetics involves many fields including psychology, physical therapy,
engineering, business, biology, biomechanics, and hand-fabrication. One
cannot expect a school to teach everything, and one cannot expect someone to
know everything either.
With regard to the proposal of a used or demo foot to cut cost, this
brings up an interesting ethical question. Is one willing to break the laws
in order to save the patient money. Secondly, is it penny-wise and pound
foolish. While everyone would like to save a patient and themselves money
and lower costs, many times it is impractical unless one works for specific
non-profit institutions or has other avenues of obtaining parts or labor
very cheaply or for free.
With the used or demo foot, I would suggest that one checks to see if it
is legal to bill for an already used item. I personally would not be
willing to pay for a 5 year old used car at the same price tag as a new car,
expecially since someone else already puchased the item and the prosthetist
or shop does not own the item being sold. I believe the patient owns the
item once it is paid for, either by the patient or the insurance company on
the patient's behalf.
Feet are also mechanical items...which mean they break and fatigue. A
used foot does not have the same spring characteristics as a new foot. What
happens with the liability when you put a used foot on a patient, it fails,
and the patient gets hurt. Thus, in trying to save the patient some money,
one forgets the important aspects of fit and safety.
On the new technology feet, where does one find a used example of these?
On the Demo items, one cannot expect a supplier to provide two feet for
the price of one. Just because a supplier charges a lot of money for an
item and sells a lot of this item does not allow one to think that the item
is profitable or the company is. There is a lot of research and
development, marketing, and logistic costs in getting a product to
market...How many products get left on the floor when trying to develop
something.
In running a business, one firsts needs to understand what the highest
costs are in order to adequately cut costs. I believe that the highest cost
is labor and not parts. Besides one's physical salary, do not forget the
social security the employer matches, benefits, sick-time, insurance, etc.
In trying to cut part costs, you hypothetically caused a need for increasing
your labor costs. Which one went up more?
In cutting your labor costs, be very careful that patient care is not
neglected. This causes patients to get hurt or not do as well as they
could...a quality of life issue (that is our main goal). Built into the
cost of every prosthetic device is the necessary and needed follow-up care
that is all so important and the true necessity.
For my belief, a good fit at the beginning is the most important thing.
Following this, maintaining this fit is next. Then comes having the patient
understand how to use the prosthesis and incorporating it into his or her
body image.
I could add more, as well as others, so if anyone else would like to add,
please feel free to do so.
Sincerely,
Donnie Priest
>From: Justin Foster < <Email Address Redacted> >
>Reply-To: Justin Foster < <Email Address Redacted> >
>To: <Email Address Redacted>
>Subject: [OANDP-L] continuation:
>Date: Wed, 15 Jan 2003 20:46:08 -0800
>
>OK, one more try...
>
>This is not about hurting our own pocketbooks, or taking money away from
>our
>families, or being a poor businessman. I think that reducing overhead, and
>subsequently reducing O&P payments is a good goal...
>
>If, as so many have pointed out to me, the reason we have to charge $3500
>is
>to keep the $1500 item on the shelf while we make the prosthesis, and so
>the
>user can wear it for 90 more days until we get paid... then how about
>having
>the person wear a demo or used foot until we get paid, then order the foot
>and fit it. We can then reduce the reimbursement because we haven't had to
>prepay by 90-120 days on the foot.... even saving a few hundred dollars is
>GREAT!!! That money only went to pay for the foot in advance, and served no
>other purpose but to cover us on the next guy's foot. That is the waste I
>am
>talking about, and trying to find a way to eliminate. Additionally, that is
>just the foot of the iceberg if you will... repeating this process on all
>modular componentry might save us and our patients (through the
>corresponding copay reduction) even a little bit of money, while still
>providing the manufacturers with the incentive to develop new technologies
>(as their prices would remain similar).
>
>We are going to have to cut costs at some point, shouldn't we at least
>attempt to be proactive and dictate our own future?
>
>Don't tell me I am stupid, or childish, or that this is not a
>chat-room...
>tell me I am wrong, and why, and give us all your ideas so we can run them
>through. It is time to brainstorm, not to browbeat each other into
>silence.
>Idealism is what keeps me going in a strange world.
>
>Justin Foster
>Prosthetic Resident
>Unemployed?!?
>
>
>
>_________________________________________________________________
>Protect your PC - get McAfee.com VirusScan Online
> <URL Redacted>
>
>
Citation
Donnie Priest, “Re: continuation on cost of parts and business,” Digital Resource Foundation for Orthotics and Prosthetics, accessed May 19, 2024, https://library.drfop.org/items/show/220319.
