HQAA Blog

We’ve talked about retail showrooms before, but in the several years since we’ve covered the topic, retail has made a triumphant resurgence. The DME retail showroom’s amazing comeback is a product of a perfect storm of factors in the industry. Certainly, declining reimbursement and limitations to coverage for DME products and services is at least partially responsible. The fact that Baby Boomers are retiring and becoming eligible for Medicare is also a factor. Retirees today –compared to retirees of a decade or so ago—are tech savvy computer users who are comfortable shopping on line and also somewhat conditioned to paying for larger portions of their healthcare out of pocket. The bad news for local DME’s is that they are tech savvy and capable of shopping on Amazon-like platforms. The good news for local DME’s is that they are willing to pay more out of pocket for healthcare. Retail provides a “hedge” for your organization. If someone wants the traditional “deliver it and bill my insurance” DME model, you can do it. But you also have a showroom and are prepared to deal in cash.

There is a restaurateur in Columbus Ohio, let’s call him “Aaron,” who has opened and operates dozens of high-end, upscale restaurants in and around the Columbus area. There are several steakhouses, seafood, Italian, and other “concept” restaurants that bear his name. His name on a place guarantees a following and customers flock back for the good food and the good experience. I’ve been to many of his places and they never disappoint. The food is sometimes outstanding, sometimes just pretty good, but the service is consistently the best in the industry. I’ve never eaten in one of his places—in fact, I’ve never talked to anyone who’s eaten in one of his places—where the service was anything less than impeccable.

Because of the nature of our work, the durable medical equipment industry did not close our doors, shelter in place, or shut down for the Covid-19 Pandemic. We did, however, change the way we do business in many ways. Some of these changes will undoubtedly get back to normal as our nation and the world climb out of the pandemic. And of course, many of these changes will become the “new normal” and are destined to remain changed forever. At the time this blog article is being written, HQAA is carefully monitoring the industry as well as law and regulation and CMS policy to determine how accreditation surveys will be performed in both the short and long term. More on that in the weeks to come.

A phrase we’re hearing a lot through this crisis and pandemic is “new normal”.  As in, there’s a new normal out there that involves social distancing, wearing masks, working from home, restaurants and non-essential businesses closed or working limited hours, and on and on and on.  Every person has had some aspect of their life changed in sometimes small, sometimes profound ways.  Of course, this applies to medical equipment providers as much as anyone else. 

The DME industry has been hit with significant challenges that leave most owners and managers, well, not in a partying mood.  Those of us in the industry for decades remember the days of big Christmas bonuses and lavish holiday parties.  Profit margins aren’t what they used to be.  As the year winds down and the holiday season approaches, it’s important to reflect on the positive and what we DO have rather than what we don’t. 

Nobody wants to have a customer complain about any aspect of their business.  Complaints are negative feedback, indicative of an unhappy customer, and generally a bad thing.  They can be harsh or mild, constructive or destructive, fair or unfair, deserved or not deserved.  But at the core of any customer complaint, there is feedback about a customer experience, or at least their perception of that experience.  And this information and feedback can be a treasure trove of information to use to improve the customer experience, your internal processes, and how your organization does business. 

Think about this: In many/most cases, a patient’s first experience with -- and impression of -- your organization happens when they are set up on equipment and admitted to service.  Thus, when your organization delivers equipment or supplies for the first time, or when your respiratory therapist sets up your respiratory device, or when a pedorthist “fits” someone for diabetic shoes, they are forming an impression that will be with them for a long time.  It’s certainly possible they will talk to their friends and family about that experience. 

A few years back, at 5:00am Saturday during the coldest February Northern Minnesota had seen in decades, a longtime home care patient’s oxygen concentrator failed.  The patient’s wife retrieved an E cylinder that was for back up from the guest bedroom and proceeded to try to open the gauge.  Her husband—the patient—tried as well but neither could get the tank to open.  The couple was a little panicky because the patient had been using oxygen continuously for over a year with only a few moments here and there off oxygen.  Regular delivery for portable cylinders was Monday, and they were down to two small portable cylinders with a total of about one hour of oxygen combined. 

Memorial Day Weekend, the end of the kid’s school year, or the first day of June all mark the beginning of summer for most of us.  Sure, scientists will tell you that summer begins with Summer Solstice, around June 21^st, the day the Sun is the farthest north; but we all start our summer season based on man-made demarcations and arbitrary dates and times.  For many of us, summer means swimming pools, picnics, a long break from school, and of course, summer vacations. 

The holiday season is a time for merriment, good food and drink, decorating home and workplace, holiday parties, gift-giving, and cheer. It’s also a time for giving. When I visit home medical equipment companies in November and December--whether for consulting purposes or accreditation surveys—I sometimes ask about the holidays and what an organization does to celebrate the holiday season. The replies offer insight into the corporate culture and speak to the character of the companies.

I notice with great interest and growing optimism about the future of our industry that the trend seems to be increasingly about giving, sharing, and community service and moving away from the stereotypical office party of days past (think Mad Men).

I’ve heard a wide variety of customs and practices including gift exchanges, taking turns working at Salvation Army kettle drive locations, pot lucks that include inviting the patient/customers, volunteering at a soup kitchen, or simply getting together outside of work for a nice dinner together. These parties and other shared experiences serve several useful purposes. They promote a culture of togetherness and “family”—a sense that the organization you work for is more than a job, it’s a group of people working together for a common goal. They also give team members an opportunity to get to know their co-workers better by sharing a meal or a conversation at a deeper level than possible during work hours. The holiday service projects give employees a chance to work on shared projects which promotes team building. Hopefully, they are also a fun way to spend time together with co-workers to build deeper and friendlier relationships.

One of my consulting customers specializes in mobility: basic wheelchairs all the way up to custom rehabilitation equipment. They also do home modifications such as chair glide systems and building accessible ramps. They are a quality company that was accredited long before it was a requirement because they wanted the community to know their commitment to doing things right. They told me a story about their Christmas “project” last year. The Christmas project was something they elected to do in lieu of a party. The company gave them time off to do it and supported the project financially. Every employee from top to bottom, including the owners, had skin in the game and participated.

It seems that a family in their small town needed medical equipment. The driver delivered the equipment and supplies and identified several hazards around the house as he assessed their environment. He documented his findings and discussed them with the family, who said they could not afford to make many of the changes that were suggested. On a return visit, he noted that they had made some of the changes that were not particularly costly including removing area rugs and moving furniture around so that the family members with mobility problems could navigate the household.

Three generations were living in the house: a couple along with several children, and also a grandchild. The couple both had serious medical problems that made mobility challenging. They needed a ramp to get in and out of the house, and would also benefit from scooters. The husband had COPD and heart problems, which limited his ability to get out and walk; and his wife was a diabetic and an amputee, who got around in the house okay, but could not go out without a wheelchair (or scooter).

The driver mentioned the family again at an organization-wide meeting and discussion ensued. Eventually, the company decided to help the family by building an accessible ramp on their front porch/entrance to the house. They discussed plans with their home modification department and of course, the family. They got consent from the family and an estimate of material costs. The owner donated the material with the stipulation that staff would pitch in and “donate” their labor. The team effort kicked in and the ramp was built in a few days in October 2017.

In the course of working at their house, the owner was talking to the family about accessibility and decided to also make a few minor modifications in their bathroom for enhanced safety. These included grab bars in several places. The owner recounted how “making these small, seemingly insignificant improvements was easy for us—it’s what we do”. He also noted that these improvements were no big deal for his staff, but meant the world to the family.

When the project was finished, the team was so inspired by the good feeling they got and the appreciation the family exhibited that they decided to work together to get the couple scooters. The warehouse manager reminded the team that they had a “trade in” scooter in the obsolete area that could be fixed up easily. The owner bought parts, authorized repair/refurbishing, and considered getting another scooter for the couple. When he called his vendor/sales rep to ask for pricing and explained what they were wanting to do, the rep actually donated a scooter from his demo inventory!

The day before Thanksgiving, 2017, DME staff stopped back at the home to deliver two shiny scooters to a family in need. Along with the scooters, they brought a 20 lb. turkey and several pumpkin pies from a local bakery.

In the DME storefront, hanging on a wall above their license, a copy of the Supplier Standards, and a picture of the store on the day it opened hangs a Christmas card with a beautiful note from the family and a picture of the couple with their children and grandchild visiting a huge outdoor Christmas light display. The card reads, “Made possible by the generosity of a company made up of some of the most caring people we are blessed to have in our lives." 

Incorporate and emphasize giving in your holiday traditions, and you’ll be richly rewarded with a great feeling of satisfaction that is better than any gift exchange or party. And keep your eye on the ball: despite the tough reimbursement climate and the many challenges that face our industry today, most of us got into this line of business and work because it was a caring profession. Keep caring no matter what!

HAPPY HOLIDAYS everybody.