Friends and other providers frequently ask me about the future of our industry as if I were some kind of soothsayer with a crystal ball. The fact of the
by David T. Williams

Friends and other providers frequently ask me about “the future of our industry” as if I were some kind of soothsayer with a crystal ball. The fact of the matter is, when asked this question, my thoughts always turn to two things: demographics and consumer opinion.

Americans are getting older. I know that because my beard is gray, my sons are both over 30 years old and my grandson will soon celebrate his second birthday. These personal indicators are supported by irrefutable statistics. Within 30 years, for example, the number of people paying into Social Security will be lower than the number of people receiving Social Security benefits. The leading edge of the baby boomer generation becomes eligible for Social Security and Medicare by the end of this year. And, the average lifespan in America grows two to three months longer every year.

In addition to an aging society is the fact that modern medicine now enables people to live longer, although many will be dependent on some form of home care and home medical equipment for several years. Further, technology is entering the world at a dizzying pace, and much of this technology is enabling people with chronic illness and disability to be more active and more productive. Consumer demand for HME products is on the increase, and there is no end in sight to this growth.

While many traditional HME providers bemoan the fact that television advertising and Internet sales are taking away some customers, this kind of marketing is also increasing consumer awareness of what products are available. Many people are not comfortable calling an 800-number, and they are even more unwilling to conduct business over the Internet. This bodes well for the traditional provider who can give consumers the kind of personal touch and hands-on experience they need to make a purchasing decision.

I am sure that a lot of people will want to argue with me on this point, but I believe television advertising and Internet sales are increasing demand for HME. Much of that increased demand ends up in the traditional provider's store.

Attitude Adjustment

Another phenomenon brightening the future for HME providers is a significant change in America's attitude toward people with disabilities. Many citizens who once had no option but to live in a long-term care facility or other institution are now being directed (many under court orders such as Olmsted v. Georgia) toward programs and opportunities designed to provide the support that enables them to live semi-independently in their communities. This new population will be looking for businesses to provide the HME once provided by the operator of the institution in which they resided.

Finally, as people with disabilities and chronic illnesses are integrated into the fabric of society, they have more opportunities to earn disposable income, which they are willing to spend on HME products that may not be medically necessary in the traditional interpretation, but are purchased because they improve quality of life.

I just paid a rehab provider $1,400 to install an automatic door opener that makes it possible for me to enter and leave my home by myself. Does anyone reading this column think for a minute Medicare or any other insurance plan would cover this? The point is that providers who become aware of who these customers are — and develop effective marketing programs to reach them — can grow and prosper.

The challenge to the HME services industry is to learn how to market effectively in this new world. Referral sources will remain an important source of new customers. But an emerging paradigm is for creating other opportunities to reach consumers.

In the past, the industry has looked to consumers for support in its battle for appropriate reimbursement. However, the industry seems to have ignored the fact that consumer support comes with a responsibility to become supportive of consumer issues and, indeed, a part of the consumer community.

Consumer Interaction

Smart HME providers seek opportunities to interact with consumer organizations on a regular basis. They understand that genuine support is more than buying a ticket to a fundraiser, although that certainly can be part of the mix. True interaction comes when a provider either seeks out or creates an opportunity that is centered around and actively involves the HME consumer, and not only on the organizations that serve them.

Let me give you an example of what I mean. A local rehab provider has made it possible for several members of his staff to attend the training necessary to assist in winter sports activities for wheelchair users. In addition, this provider sponsors several weekend winter sports programs that revolve around consumers but require constant interaction between the provider's staff and the consumer participants. The end result is personal relationships that lead to business relationships and consumer loyalty that can't be bought with straight advertising dollars.

We live in a world of constant change. HME providers must discipline themselves to evaluate on a regular basis how they reach, serve and interact with the customers upon whom they rely for success. This is a critical concept. I know many providers who firmly believe that what they do is a service for which their customers should be grateful. This attitude is as antiquated as institutionalization. Providers must begin to see consumers as customers they need — more than the consumers need them.

As a consumer of high-end rehab equipment, consumable supplies, products considered to be general DME, and now certain respiratory and sleep products, I feel that I have a right to respect from the providers with whom I do business. This is no different than what I expect from the vendors who sell me my lift-equipped van, a piece of furniture or my lawn care service.

I think the future is bright for HME providers who see consumers as the hub around which their entire business rotates. If the hub is happy, things run smoothly; if there's friction in the hub, there is a rough ride ahead.

David T. Williams is a retired executive (formerly director of government relations for Invacare) who now works as a freelance journalist and who recently celebrated the release of his first book, Battling the Beast Within. Williams can be reached at davidtwilliams@comcast.net.

Battling the Beast Within

When David T. Williams was 26 years old, everything seemed to be going his way. He was department director at a growing hospital, president of his professional association and father of two sons. He stayed in shape by riding his bicycle more than 150 miles a week.

But then something went terribly wrong. Williams' legs started to weaken, and his vision deteriorated to the point where he was afraid to drive. After testing, doctors gave him a diagnosis that would change his life forever — he had multiple sclerosis (MS).

Battling the Beast Within: Success in Living with Adversity (The Cleveland Clinic Press, 2004) details Williams' courageous fight with the disease for the past 28 years.

“David Williams' book is a poignant first-person account of one man's struggle with multiple sclerosis,” says Richard A. Rudick, M.D., chairman of the Division of Clinical Research and director of the Mellen Center for Multiple Sclerosis Treatment and Research at The Cleveland Clinic. “His story is an inspiration for those with chronic disease, their friends and families, and those who strive for better treatments.”

In writing the book, “I learned a lot about myself in the process that has better prepared me for future encounters with my companion, the beast within,” says Williams, a recipient of HomeCare's 2003 HomeCaring Award, given in recognition of distinguished service to the HME industry. As former director of government relations for Invacare, Williams served as a lobbyist and analyst specializing in health care issues and helping to shape public policy to benefit home medical equipment providers, manufacturers and consumers.

His inspiring account helps readers look for the positive in every experience and recognize the opportunities in every challenge. Look for Williams at Medtrade 2004, where he will share his personal story during a presentation scheduled for Oct. 26 at 11 a.m.

Battling the Beast Within is available through The Cleveland Clinic Press. All proceeds will benefit the Mellen Center's Patient Education Program. For more information, call 216/444-2315 or e-mail dunaskk@ccf.org.