Word to the Wise

Remember when mobile homes were “trailers?” And flight attendants were “stewardesses?”

If Lisa Getson has her druthers, home medical equipment “dealers” also will be a term of the past.

Several years ago, I had a conversation with Lisa, executive VP at Apria Healthcare, in which she explained she thought the word “dealer” was no longer appropriate when referring to HME providers because it leaves out so much of the service that goes along with the equipment. Plus — and this is no small matter — the word conjures up some negative images on its own.

“What’s the first thing you think about when you hear the word ‘dealer?’” she asked.

“A car dealer,” I replied.

“Exactly,” Lisa said.

Her point makes a lot of sense, because the overwhelming majority of HME companies are solid community citizens, supplying needed medical equipment and services for the nation’s sick, disabled and elderly in their homes. With apologies to the honest car dealers out there, that business is synonymous with shady deals and rip-offs. According to consumer guru Clark Howard, in my state you shouldn’t rely on anything a car salesman tells you during the sale because all that matters is what is in writing. In Oregon and Illinois, he points out, it’s even illegal to disclose information about accidents in which cars have been involved.

So, since that conversation with Lisa, I don’t know whether you have noticed, but HomeCare’s writers have not referred to HME providers strictly as “dealers.” It’s been the norm for so long in this industry, however, that many of those we quote directly in our articles use the word proudly.

Unfortunately, when the government uses the word it doesn’t sound so great. In September of 2003 when CMS and HHS’ Office of Inspector General rolled out their plan for curbing power wheelchair fraud and abuse, they called it “Operation Wheeler Dealer.” Not exactly flattering.

The sad thing is, of course, that some dishonest operators do exist. Three years later the Department of Justice is still going after them in Houston, where there turned out to be massive PWC fraud. It’s also unfortunate that these “bad actors,” as the government calls them, are the ones that Congress remembers when its members think about HME. They think about the fraud and abuse. They think about “Wheeler Dealer.”

They don’t think about the fact that you are on call 24/7. They don’t think about the fact that you may be the first one to arrive at your oxygen patient’s home when the power goes out. They don’t think about the fact that you or your employees may be the only people who are in contact with your patients — those homebound sick and elderly — on a regular basis.

As columnist Shelly Prial notes this month (page 58), “HME providers are, without a doubt, the most unappreciated members of the health care industry. Most providers are hardworking, honest individuals … who receive very little reimbursement for the services they perform.” Most providers would agree with him.

Changing the views of government officials and Congress may take awhile. But freshening HME’s image with a simple change in terms — certainly “provider” better reflects the true nature of the business — could help. Who knows? It seems to have worked for mobile homes and flight attendants.

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