RTS, RRTS®, NRRTS, conflict of interest? … cripples be damned
I am fed up with this entire wheelchair nightmare. As I get into it more, it gets scarier. I will hold for another post the fact that one of the most important safety issues, the tie down securement points for transportation, are messed up (it appears). The parts on the wheelchair are entirely different from what the owner’s manual shows and says must be used and have been tested. And the manufacturer has still not simply said, “you have a new version” or “what you have has been safety tested.” No, they say nothing, silence is golden. They sold me a chair with undocumented and different safety items (different from the ones they say you must use) and so far have not explained. But I digress.
What has me fired up now is learning exactly who is it that sells you the chair? Do they have any special training or certification? They seem so confident and tell you what you need. Well, so does an experienced heart surgeon as well as a used car salesman on his first day on the job.
Please answer the poll of the day on the right!
When you buy a wheelchair, the salesperson is probably an “RTS” … Rehabilitation Technology Supplier. RTS is a description, NOT a title. With enough friends and experience, the RTS may become “registered” with the NRRTS, the National Registry of Rehabilitation Technology Suppliers. At that point they can use the title RRTS®. Impressed? Don’t be. They are offered continuing education classes such as: “Wheelchair Use in Everyday Life … The use of wheelchairs and seating systems by users throughout their day is largely unknown. …”
You may remember the problem I had with Pearlsky’s wheelchair, described in part (from this post):
In March of 2008 one of the tilt-and-space pistons on my daughter’s wheelchair froze. Her chair was positioned all the way back and could not be changed. I was called to school and walked her home since we felt it was unsafe for transport. I called your company and told S the problem. She told me it would be at least 3 – 4 weeks to repair. I explained that my daughter could not be transported, could not go to school or the doctor, nor fed and she said there was nothing she could do.
During that incident, I called multiple DME companies in my area. This is important: each and every one said they would not sell me a part, nor repair the chair if they did not sell the chair to me originally (wait for the punch line at the end of this post as to who one of them was). I explained the importance, offered to pay any amount in cash, and again, each one declined to help me. Period. Beware, if you move, you will never get your chair repaired.
Well, now with all the problems with the new chair, I am learning about these companies and people. I find the NRRTS and they have a directory of all their members. Guess what, the ones who would not sell me a part, for any price, for my daughter’s wheelchair when she was bedridden for lack of a $125 part, they are registered with the NRRTS! So, you are saying, “Single Dad, what the hell is your point?” Well … their code of ethics includes (emphasis mine):
1. Provide competent, timely, high-quality equipment and services to meet the physiological and functional needs, as well as the goals, of the consumer.
4. Explain fully the consumer’s rights and responsibilities, including the right to work with a supplier of his/her choice.
Maybe I don’t understand English. If I have the right to work with the supplier of my choice, why won’t any supplier work with me? This is an emergency, I will pay cash for a simple part, but no, they won’t work with me.
So last week I asked the Associate Executive Director of the NRRTS, Judy Dexter, why no one will sell me a part to a wheelchair when my daughter was to be bedridden for 3 – 4 weeks for lack of an off the shelf part. Her response?
We do appreciate your situation and understand your frustration. Unfortunately, the changes being made on reimbursement for wheeled mobility and seating have forced many business owners to make some hard choices about the way they do business.
The “reimbursement” bit is a red herring, I told her I offered to pay cash. The point is, ethics are important unless, of course, there is a business decision that overrides our ethics. Note that just about all of the staff, the directors, the chairs of this organization all work for DME companies. What a crock. We will proclaim our ethics if it does not cost us money, but when there is a business decision, well, cripple be damned.
So, will they toss the RTS’s that did not live up to the code of ethics out of the registry? No. Well, maybe, but that would be a business decision ..
Silly me, I thought they cared about the disabled.
Study before you buy that wheelchair. Ask questions. Demand answers. Read the manual. Talk to friends, talk to me! Make sure your PT, OT or physician approves of EVERYTHING because that wheelchair sales person is just that, a sales person. I wonder if any are on commission or have quotas. His or her application of the code of ethics, well, apparently can be fleeting … And of course, make sure you will not move during the life of the chair, because DME’s will not repair a chair unless you bought it from them.
Remember, I really and truly like my RTS, he is a great guy, and he has lots of experience. But, he also delivered me an untested, scratched, non-working wheelchair and he did not know all the parts available, such as a washable seat cover. I have no doubt that the vast majority of RTS’s are good people, well meaning, hard working, and do the best job they can. But, and this is a major “but” … this device is everything to my daughter, without it her quality of life is horrendous. It is invaluable.
As for the hoity toity organization … ask them to respond to this post, I dare them (or you!) …
Simon Executive, director NRRTS (was president of a DME) firstname.lastname@example.org
John Zona, president (works for Lakeview Medical, a DME who TURNED ME DOWN for that wheelchair part), email@example.com
[UPDATE: Mr. Zona says that his company will sell parts to anyone, but no comment on anything else said here]
And you can see here, everyone who gives the fancy-shmancy RRTS® title to your sales person works for a DME, hence they make money if you are impressed with your salesperson and his or her title!
And remember, you can’t spell “conflict of interest” without r-t-s.
“The “reimbursement” bit is a red herring” You got that right.
Don’t realtors and financial planners do that serial credentialing stuff, too?
I expect the DME personnel to, at the very least, be technically competent and know the equipment. I rely on them to know everything that is on the market, how to get it, and what just came-out.
I do not expect them to know how to fit the chair….well, my expectations are modified by the locals who I have worked with for years. I suspect they eye me with a bit of trepidation as my opinions on seating for children are bit edgy, different.
In your poll, SD, you mention PT. No mention of the PT in your saga. Usually a PT or OT has to sign-off on a wheelchair order. I realize the PT cannot prevent the technical failures recently experienced, but therapists are part of the DME retailers marketing network. Getting a bad reputation with a group of therapists can cut into referrals and sales. Just a thought.
Like your last sentence.
That is crazy that they would not sell you a part to fix her chair. How can they justify that?
Everyone should write to those guys and ask!
I would be happy to sell you a part for your wheelchair. I have talked to all our customer service people here. Noone here told you they would not sell a part to someone for cash. We do it every day.
Because we only bill private insurances and not medicare or medicaid could have been the problem. I wish you would have called or emailed me before making many unfounded accusations. How can you say I will not sell you a part when you have never spoken to me.?
It was not you personally, it was whoever answered the phone when I called the company you work for, along with several other area DME companies. I was clearly told that if I did not buy the chair from said company, they would not sell me the part. I did not contact you personally because back then I was innocent and did not know from NRRTS or anything else, all I knew was my daughter was bed ridden and I needed a part.
What are my “many unfounded accusations”? Maybe you dispute the one statement that the DME company you work for would not sell me a part, but what else is an unfounded accusation?
It is interesting that your only point of contention is if your company would sell me the part, and nothing about the organization you are president of. I can only assume you agree with all my statements about NRRTS … and it appears business does come first.
Thank you for responding. I have noted your comment in the original post.
All I can say is wow… I’m glad I’m not dealing with those people, and I’m sorry you are. Thanks for bringing it to the attention of anyone who may have dealt with them in the future. I hope Pearlsky is cruising around in a new and/or improved wheelchair soon.
We recently picked out our first wheelchair and to say that my experience was less than stellar would be an understatement. Like yours, he was nice, but his knowledge was out-dated, his opinions conflicted with what I’d been told my professionals. In short, I ordered a chair with bad information and am not sure what I’m going to get. I find that unsatisfactory. I’ve started brainstorming with another special needs mom to think of ways to put the power back in the hands of the consumers and give parents move options. Wish us luck!
Let me get this straight, you explain why this organization is actually a farce, their ethics policy is moot if there is business involved, they offer dumb-ass classes for credits for a meaningless title, and the president of said organization has one thing to say? And that is to dispute that he personally did not do something you did not accuse him of anyway? The PRESIDENT says NOTHING to defend his own organization. Wow.
Just shows to go you that these guys are just salesmen with a meaningless title. I dealt with a clueless woman last time and still regret some of the issues with our son’s chair.
Unfortunately I was running out the door and didn’t have time to address concerns about NRRTS. I am in my office at 6:30 in the morning and don’t get home until after 5. I have countless children and adults that seek out my help. I recently had a patient with CP graduate from college with honors. I have been doing his chairs since he was in the first grade. That is a sign of a good RTS. Good RTS’s have long relationships with consumers.
NRRTS is a wonderful organization that does have a strong code of ethics. It is run by individuals like myself who do not get paid for their time and are constantly striving to make this industry better.
Waynes comments and others are unfounded and ignorant. NRRTS and RESNA certifications are not meaningless. CMS (centers for medicare and medicaid) has come out with new rules for people doing “complex rehab” . They have determined that NRRTS and RESNA certified RTS’s are by far the best. They now require these certifications before you can bill for services. When CMS requires something all the private insurers follow that lead and also now require the same. I could go on but I’m off seeing patients this morning and have a clinic this afternoon.
It appears the letter “I” is stuck on your keyboard. This post was never about you. I feel sorry for you as you describe your oh so difficult life. My owning a company, being single, and having two severely disabled kids is nothing compared to your busy schedule. As for your CP client, it is nice you take credit for his college degree with honors, I am sure his chair helped. Or at least, it didn’t kill him.
In many instances, people get the same RTS year after year. For valid or invalid reasons, calling a company and saying you don’t like that person and want someone else is a difficult thing to do. It should not be, but many people are intimidated and don’t do it. Staying with a patient for 15 or 20 years may be because one is great or because the consumer does not know they can or should change, or just accepts it.
You have chosen not to back up your claim of my “many unfounded accusations” because it is your statement that is unfounded. Wayne appears to be commenting on the topics, and apparent need, for the continuing education classes you offer which seem rather basic, especially since you only admit well qualified and experienced RTS’s.
Again, Mr. Zona, this was never about you nor your abilities. I can only assume you are a fantastic RTS since you hold an important post. But do look at the poll of the day on the right, read the blogs, many people are very disappointed with their RTS and their wheelchair purchases.
As far as I am concerned, this comment trail is over.