Cooler Heads

I recently spent a few days on St. George Island, nine beautiful miles of barrier beachfront — with the requisite enclave of vacation homes, of course — off the Gulf Coast of Florida. Actually, the tourist brochures call it Florida’s “Forgotten Coast,” and I guess it must be, because my cell phone didn’t work there and the only place with Internet access was a tiny coffee shop in nearby Apalachicola.

I have to admit being cut off from phone calls and e-mails was relaxing, and breakfast at the Cafe Con Leche, run by a Venezuelan proprietress, was outstanding. (Try the pan de jamon, a scrumptious concoction of ham, black olives and raisins.)

Aficionados also claim Apalachicola Bay oysters are the best in the world, but exploring the eccentric old town led to discovery of another distinction: Apalachicola is the home of air conditioning.

According to the city history chronicled at the John Gorrie Museum, when the young physician moved to Apalachicola in the early 1800s, it was a bustling port filled with commerce and shipping — and mosquitoes and tropical disease. To make his yellow fever patients more comfortable, Gorrie came up with a way to cool their rooms using a fan-like device that swept over suspended ice to create cold air.

The real trick, however, was producing the ice. In 1851, Gorrie received the first U.S. patent for mechanical refrigeration, and a replica of the ice-making machine he invented is on display at the museum.

We’ve come a long way since then. I thought about Gorrie and his machine as I walked the aisles last month at Medtrade, more than a million square feet of home medical products that all have been invented to help patients. Much of today’s equipment is downright amazing: products that make it easier for people to walk, to breathe, to recuperate or live at home instead of in a hospital or institution. Advanced electronics that help rehab patients accomplish what heretofore have been arduous tasks, simple things to the rest of us like turning on the television or adjusting the lights. New technology that keeps oxygen users active.

As show attendees awaited news of power wheelchair pricing and fended off further cuts to oxygen, they made it clear that HME is at a crossroads in its history. Providers’ traditional business models are under assault. Radical reimbursement cuts and com-petitive bidding are imminent, while electronic health initiatives and managed care expansion point the way to new opportunities in home care. And the emphasis for the government and other payers seems at last to be turning toward prevention and outcomes.

Keeping your own head cool through the changes may become your arduous task. But just as Dr. Gorrie’s concern for his patients spurred his invention, I hope your commitment to your company and its patients will lead you forward.

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