[Responses] Ossur encroaching on your business?

[Responses] Ossur encroaching on your business?

Spencer Doty

9/27/2010

Thanks to everyone for sharing their thoughts regarding my last post, I received quite a few passionate responses within the 1st few hours of the post, so it's clearly an important issue for many practitioners out there. Here you go:
 
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Hi Spencer,

Your timing in quite interesting and coincidental... I have a similar
experience this morning.
 
A physician placed an order for a EMPI dynamic extension brace for a
pediatric inpatient. When I called to place an order for the brace I
was told we couldn't purchase it but they KINDLY offered to take it
off our hands and fit it for us. How nice of them. Of course, I'm
being sarcastic here.
 
I had a lengthy conversation with the sale rep and Clinical Services
who claim that they are very competent to fit an off the shelf knee
brace. But for those who actually provide patient care know there's a
difference between fitting a device and truly understanding the
indications and contra-indication for using it.
 
In this particular case, many alterations would have to be made to
accommodate an open wound laterally on the limb that I'm guessing the
rep would not be able to provide.
 
I must say, I find it infuriating to be undercut by a sales force that
has no other interest than to sell product and then prevent you from
even using there product. Come to find out that EMPI and Don Joy are
completely affiliated. Surprise, surprise...
 
To add to your story we actually caught the Don Joy rep fitting an ACL
brace in the lobby of our building. We now don't even give this
company the time of day as it is becoming so obvious that Don Joy,
Empi and Ossur are actually be competitors rather than partners in
providing care to our patients.
 
We must be causious as we order product from our competitors as they
then have direct insight to your market and usage trends based on
their sales to you. I'm starting to believe an O&P alliance needs to
be formed so that we too only support companies that sell to the O&P
industry.
 
Please post all responses.
 
Thanks for broadcasting your concerns as I share the same!!
 
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Spencer,
According to the 2009 Ossur annual report, they own 62% of Team Makena.

Do you know if Team Makena is providing services to:
private insurance
Medicare
VA/Tricare
Medicaid/Medi-CAL?

Thanks
_____________________________________________________________
 
This has been a concern of mine for years and has become a growing problem in my area. My biggest competitors have become the sales reps that don't darken the doors of my office but go directly to my referral sources and sell to them or teach them how to fit and bill themselves. I fault our own industry for not stopping this years ago. I was hopeful that when state licensure went into effect that this kind of thing would end. It only seems to have gotten worse in my area. And medicare's answer is to audit the o and p offices while the sales reps and pharmacies and therapists continue to provide the orthotic care. Hopefully the new stock and bill changed policy will put an end to it but it's only a matter of time before they figure out another route around the law. There has to be some way to convince our organization that if they're to keep increasing the educational requirements to become certified and increase the amount of money that we spend annually to keep our certification (and licensure) then we need to convince medicare to separate us from DME. I truly believe that the fraud that is talked so much about through CMS is outside of the o and p profession. I think that the fraud and waste is taking place through folks that are fitting and billing that have little idea what they are doing (besides making a buck). Are we alone in our concern?
________________________________________________________________
 
I hope you are aware Otto Bock has been doing the same thing for a long time now. Not a justification, just a fact.
_______________________________________________________________________
 
Its interesting Team Makena just lost a contract with a local Ortho
grp in my area. D.J. ortho is taking over and is meeting with my off.
Next week. As of today Medicare has stopped all stock and bill
arrangements. Apparently D.J. ortho will be only billing for non
Medicare pts.I don't see the benefit to the ortho grp to have any Team
Makena or D.J. type group in their off. Any ideas?
_________________________________________________________________________
 
We've had our practice in Arizona for 8 years and have been frustrated with
the same issues.
We have battled with Ossur, Townsend, Don Joy, Breg and others over the same
problems.
Most of the off the shelf manufacturers and suppliers are doing everything
they can to push their products directly to the
orthopedic doctors.
Try focusing your marketing and team work more with physical therapists vs.
physicians.
You will find a great collaboration can easily be developed by
communicating, and networking as a team member with the
PTs.
Best of all, you need to stop using these companies products.
Good luck with your practice and your competition.
Sell your skills, service, and warranty.
_____________________________________________________________
 
This is a ongoing issue with reps approaching physicians offices, etc.

I would make sure that your referring MD's know the difference between a
rep and an Orthotist. Be sure that they know the difference in the
level of care that they will receive. If yor referring physicians can't
tell the difference then shame on you.
You and I both know that there is a difference beetween evaluation and
fitting v. a delivery of various orthoses but, unfortunately your
local MD's may not know or even care.
Here in Texas, State Licensure helps with this problem but did not
totally eliminate the issues. There are still folks that provide OTS
Rental Dynamic Splinting that claim they are not a rep but rather a
neurologic consultant. The latter means nothing more than they went
thru a week of instruction from their company prior to being permitted
to sell something.
______________________________________________________________

Spencer,
I'm not familiar with the team makena format but certainly have noticed
an increase of Ossur products at local orthopedic practices. I watch
through my office window as the Ossur orthotic rep walks by to see them
and only occasionally stops by to say hi to us. This, even though we
were exclusively fitting CTI's for our largest group of local ortho
docs. Unfortunately the one-stop shop has bitten us as the ortho
groups keep as much in house as possible and have their cast-techs
working overtime to fit braces. What was once a wrist splint or lace up
ankle brace, has now moved to custom fit ACL and unloader braces as well
as many different back braces. Of course, we're called the rescue if the
patient is morbidly obese or has a lack of insurance coverage. Ossur is
just one of many groups marketing and fitting directly in the doctors
offices. They've joined the club with donjoy, breg, and Bledsoe to name
a few.

Personally, I've limited the amount of Ossur prosthetic components that
I use based on seeing this. Why should I continue to support a company
that is directly taking away business from my office. The only product I
use is the seal-in liner and only because their competitors have not
come out with a comparable product.

I don't think there is a real solution to this issue as doctors are
always going to be able to bill L-codes and supervise their cast techs
and other staff to fit braces. We are too small and will get
steam-rolled if we complain too much and it's tough to bite the hand
that feeds you referrals. When we broached the subject a few years ago
to one of the docs fitting a lot of his pt.'s with knee braces, he said
show me how sending you patients makes me money..... In my office
we've tried to re-direct our lost KO business into rehab bracing and
prosthetics.

I'd be interested to hear your other reponses, perhaps you could email a
summary.



 
 
Sincerely,
 
Spencer Doty, CPO, MBA
Certified Prosthetist & Orthotist
Verdugo Hills Hospital Med Staff
 
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