Conceive-Ability: A New Model for an Old Practice

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By Karen Henry

When Jeffrey M. Brandt, CPO, founded Ability Prosthetics and Orthotics Inc., he vowed that his company would be different from the rest.

Jeffrey T. Quelet, CPO, and Jeffrey M. Brandt, CPO. Photographs and images courtesy of Ability Prosthetics and Orthotics.
Jeffrey T. Quelet, CPO, and Jeffrey M. Brandt, CPO. Photographs and images courtesy of Ability Prosthetics and Orthotics.

Jeffrey Brandt, CPO, was first exposed to O&P as a child through his grandfather, Joseph Mazur, a POW in World War II who lost a limb. Although Brandt had a close relationship with his grandfather, he says he didn't consider working in the field until years later, when his uncle, Harry Brandt, CO, sparked his interest in O&P. "My uncle provided guidance by speaking highly of the field and encouraged me to build my credentials through education," says Brandt. "He never pushed me into the profession."

After formal training as a technician and practitioner from 1995 through 1999 followed by experience working at several O&P facilities, Brandt grew frustrated by the lack of structure and vision he experienced. "There seemed to be a lack of efficiency in terms of basic procedures such as ordering, insurance authorization, and billing, despite the redundancy of those tasks," says Brandt. "Business owners tend not to have a plan for reinvestment in their company-no planned marketing focus, and no plan for growth." He aspired to create an orthotic and prosthetic company that would break the traditional, fabrication-centered practice mold by offering a strong commitment to patient and physician satisfaction through education, compassion, and top-notch care along with an infrastructure designed with growth in mind.

Joseph Mazur
Joseph Mazur

While working at an O&P facility in 1996, Brandt met Jeffrey T. Quelet, CPO, whose background was engineering. They formed a relationship at the bench, and after working together for nearly a year, they moved on to pursue their careers. The two stayed in close contact, however, through their respective jobs and educational pursuits and had frequent conversations about the O&P profession. "Quelet challenged me to question things about our field," recalls Brandt. "We started wondering why certain processes and standards in other professions were not widely implemented in ours." As they parted in 1997, Quelet handed Brandt a dollar bill and explained that this was to be the first dollar to start his company.

Brandt tucked the dollar away, and in 2004, he decided it was time. He spent two weeks creating a detailed business plan, making it his goal to address frustrations he encountered as well as incorporating the strengths each practice had, such as a "patient-comes-first" ideology and the idea that O&P is a service, not a product. He says he made a conscious decision to secure capital from a bank rather than from a family member. "Many other O&P facilities seemed to be family owned, operated, and funded," Brandt says. "This was something I was doing on my own, and I did not want to have any conflicts of interest."

In 2004, Brandt's dream became reality with the opening of his first office in Gettysburg, Pennsylvania. In 2005, Quelet joined Brandt to open Ability's second office in Hagerstown, Maryland. Quelet is now the vice president of Ability Prosthetics and Orthotics.

The Ability Model

Final design plan and exterior construction of Ability's newest facility.
Final design plan and exterior construction of Ability's newest facility.

If you ask Brandt, he'll tell you that the Ability model is simple. The company doesn't make its own devices. While on the surface, that decision may seem to be a simple matter of operational logistics, it reveals a driving theme behind many of Brandt's business decisions-empowering people to focus on their core strengths and abilities to positively impact patient care and Ability's bottom line. And that starts with Brandt himself. "I once read an article about a dry cleaner who couldn't grow his business because he was always hovering over the clothes himself," says Brandt. "As practitioners, we don't need to be in at 6 AM to modify molds. This time is better spent on marketing or treating more patients."

Because Ability has no onsite fabrication laboratory, Brandt was able to focus Ability's facility design and practitioner approach around patient evaluation, device design, and patient education. "Our practitioners are provided with a Class A medical office in which to practice," says Brandt. "The office space is not lavish, but it is highly functional and meets the needs of the disabled-our primary population."

Quelet shares Brandt's strategy of allowing people to do what they do best and not trying to be all things to all people. "We work with more than 50 manufacturers to bring the highest levels of solutions to our patients," says Quelet. "Why not send the mold or image to the company who makes 50 of those particular orthoses or prostheses a week, rather than be tied to one office onsite that does our fabrication?"

Another recurring theme in Brandt's business approach is his insistence on open communication and relationship building. Ability practitioners are encouraged to establish strong relationships with their manufacturers," he says. "We provide a high level of detail and guidance to our manufacturers. We don't rely on them to make clinical decisions for us. We are very proactive in deciding what we want for our patients."

Smart People

Brandt is committed to staffing his offices with an educated workforce. All of Ability's practitioners must have a bachelor's degree, they must be trained by a National Commission on Orthotic and Prosthetic Education (NCOPE)-accredited O&P program, and they must be certified by the American Board for Certification in Orthotics and Prosthetics (ABC). All Ability practitioners are encouraged to take the time to share their knowledge with physicians, therapists, and patients.

Brandt says his appreciation for the value of education developed during the summer of 1994, when he volunteered at an Orthotics and Prosthetics department in a HealthSouth facility located just outside State College, Pennsylvania. It was there that he met James Devier, CPO. "Jim was one of the first people I met in the profession," he says. "Jim was very much an advocate of elevating the profession through formal education."

Ability's commitment to education continues long past certification. In order to maximize the patient, physician, and payer experience, in-service/educational presentations are provided weekly. Topics addressed include device education, specific pathologies, materials updates, and O&P patient care and services.

Smart Locations

Ability Prosthetics and Orthotics reception area.
Ability Prosthetics and Orthotics reception area.

Having the right intellectual capital in place is essential to the success of any business, but it isn't enough. Placing an office in the wrong location can destroy a business before it ever has a chance to get off the ground. Brandt says that all of Ability's locations are strategically positioned. "We based our office locations on demographics research, not because of a single physician or therapist contact," he says. The company made calculated decisions to open patient care facilities in areas serviced by other companies' satellite offices. "These regions have increased in population over the past ten to 15 years," says Brandt. "In the 'traditional' model, other companies rarely planned' office openings. Competitors might go to a given location a couple of days a week or month to address the needs of a specific referral source. Then they must funnel all their work through the 'main office' or fabrication-centered office. Ability's theory is just the opposite. Practitioners in each office provide full-time, comprehensive care, and they market their services to all local referral sources. Devices are shipped directly to the office where the patient is to be treated. We have grand opening celebrations to announce the opening to the entire community," Brandt says.

Smart Systems

Brandt also takes advantage of available technology and productivity tools. Ability offices are run almost entirely electronically and use the OPIE software system to help streamline office practices. Brandt says Ability encourages all of its employees to use the system every day to find answers to questions that arise. "All data is available at all offices. I can discuss a patient's case with another practitioner in another office while we view the same data," he says. Not only does the system allow Ability to standardize the data collected on patients, the system decreases the number of L-Codes missed, eliminates potential handwriting misinterpretation, and increases HIPAA security, privacy, and supplier compliance. "OPIE also allows our staff to identify where a device stands with respect to insurance authorization, fabrication, shipping, and scheduling without having to contact the practitioner or owner."

In addition, Ability has improved its payer relationships by implementing a clearinghouse to interface with its office software. "Claims are now 'clean' the first time and are paid in fewer than 20 days, resulting in very few outstanding claims," explains Brandt. He attributes this to implementing processes that have removed him from having to be a part of this process, again allowing him to focus on his core strengths. "I can't concentrate on treating patients and growing the company if I have to be watching over coding, billing, and collections."

Giving Back

Also rooted in Brandt's business approach is a deep sense of social responsibility. "We have to give back to our profession," says Brandt. "You have to make a commitment to giving despite profit goals." Over the past three years, Ability has supported numerous functions and causes. Brandt has supported the Orthotic and Prosthetic Assistance Fund (OPAF) Dale Yasukawa Memorial Fund Scholarship Program. The fund was established in November 2001 to honor Yasukawa, who died at the age of 43 and served as the director of prosthetics at the Rehabilitation Institute of Chicago (RIC), Chicago, Illinois, in the department of prosthetic-orthotic clinical services. Brandt and Yasukawa had been colleagues at RIC.

Brandt has also established a housing scholarship for Northwestern University students in his grandfather's name. This spring, Brandt will award the scholarship during a presentation held at the International Museum of Surgical Science, where he has loaned his grandfather's original WWII prosthesis to the "Beyond Broken Bones: Orthopedics and Prosthetics" exhibit.

The Ability Difference

Since opening its first locations in 2004 and 2005, Brandt and Quelet have been proving their vision works. They opened a third office in Frederick, Maryland, in 2006 and will open a fourth this year. Brandt always knew that he wanted his company to be more than just a "local" operation. "The company has grown because we have established quality standards and procedures from within before we needed them," Brandt explains. "Our investment in intelligent people and systems has allowed us to take advantage of opportunities as they arise. We went to great lengths to create brand recognition from day one. We have trained and engaged our employees. We have cultivated relationships based on patient care and results. We have created a website and newsletter. We have made quick decisions to offload human resource and payroll responsibilities. Ability has been run as if it were a larger company, even when it was only one office."

"With the number of patients who will need our services so strongly in our favor, there is no reason not to lay out your practice exactly how you envision it," says Brandt. "I am so appreciative of the work opportunities I had in other O&P facilities," he adds. "I drew from each experience to form Ability."

While an ending point for Ability's growth may not yet be established, Brandt says he will continue to grow Ability within the confines of the mission statement by partnering with qualified practitioners who share his vision and possess the skills necessary to operate an office. "For now, we will continue to strengthen our core operations. We have done quite a bit in just three years."

Karen Henry is the editor of The O&P EDGE. She can be reached at karen@opedge.com