Thank you to everyones responses and time in responding. Many people
requested the repsonses and are hoping to get a conversation going on this
more openly and nationally.
The Original Question: “I was just wanting to see what people’s thoughts,
opinions, and take on the manufacturers investing in practices and in
purchasing suppliers. After now hearing Ottobock invested in ability o and
p and also purchased cascade orthopedic supply I am just curious in
people’s opinions and the rapidly changing scenery in o and p.”
Responses:
1) I see no issue here at all. It’s positive change that increases
patient choice, drives quality and will progress us further down the line
of a patient centric model where quality care and outcome measures will
remain the means of staying in business and thriving. Some folks may see
it as another big player in the market but the reality is manufacturers
engage in clinical care all around the world, the US is playing a little
catchup. There will always be room for smaller providers to remain
competitive.Please remember, with any change comes great opportunity.
2) Definitely interested in what people have to say about this one. Don’t
forget that Ossur is doing the same thing. Both Ossur and OB have very
successful patient care clinics around the globe. North America just has a
different medical system and barriers set in place that makes it a
sensitive realm.
3)I hadn’t heard about OttoBock’s movements, not surprised! I’m not a fan
of manufacturers moving into patient care or the consolidation within our
industry as a whole. Independent clinic owners like us are getting rarer
but I’m a firm believer that it’s better for patients. I don’t blame folks
selling when it comes time to retire but I’d like to see more folks selling
to other clinicians and not the big name groups. Competing against large
corporations is hard enough with their manpower, purchasing power, and
marketing budgets. Competing against the manufacturers is a whole new
level. I think the more publicity this kind of activity gets, the more it
helps independents. I’ve had great success with referrals and patients by
marketing my independence. If it all stays behind the scenes it’s hard to
use that to our advantage. I’d love to hear your thoughts!
4) The previous administration dealt a severe blow to small O & P
practices, and consequentially patient care, with the draconian OIG report
and audits in 2011-12. When excessive government imposes, capitalism
retaliates, vis-Ã -vis big business swallowing small. Capitalism usually
wins (at least for those involved in the transaction at hand). Government
imposition rarely ends well. The industry is growing and changing, just
differently than it did a couple of decades ago. Leadership must
concentrate on balancing positive and negative forces within the
professional body. Let the history of pharmacists be a cogent lesson.
5) IT SEEMS LIKE THERE SOON WONT BE A NEED FOR INDEPENDENT SMALL CLINICS.
PROSTHETICS IS NOW MONEY DRIVEN. THESE COMPANIES EXPECT LARGE RETURN, AND
PATIENTS ARE THE ONLY ONES THAT ARE GOING TO SUFFER IN THE INTERIM.
6) I do have lots of opinions on this we currently use empire but empire is
party owned by the Evergreen orthotic and prosthetic group. I recommend
going direct with your biggest manufacturers. Also Amazon is a great way to
go Amazon prime if you’ve never looked into this- blue diamond orthopedic
is a great source for TLSO’s – Aryse is a great direct manufacture for
other soft goods. Try to go direct lump things together control your
shipping costs. Be very aware of who you are purchasing through they can
see everything you purchase in your business and learn from that they can
work against you. You obviously know SPS is owned by the hanger group or
vice versa. Work with your technical companies lump products together
-bulldog is a great company to go through direct For prosthetic components
for prosthetic components. Freedom was purchased by Otto Bock as well.
Try to use local smaller independent companies instead of all the big guys
if you can develop relationships and deals. Prepared shoes we use
exclusively one type of shoe that’s it -it works great if you have any
further questions feel free to give me a call .
7) Great question! Please post your responses..
8) It appears to be a case of minnows eating guppies, not sure where that
leaves us, are we the worms?? Vertical integration and O and P world
dominance.
9) Unfortunately, or fortunately, its how the field will go. I also
believe it’ll come back and splinter out again way down the line. I guess
its a matter of “who are you going to align with?” or “Who shares my
values?” Join large companies (Bock, Ossur, Hanger), stay independent or
band together as groups of private companies to create a larger company.
Good luck out there.
10) Thanks for your recent post. The international O &P organizations like
Ottobock, Ossur and Hanger included are definitely changing the landscape
in our industry. I’m curious about the Ability Acquisition/ investment, as
this is first I’ve heard of Ottoock‘s interest in patient care in the US.
There seems to be great advantages with Cascade. Access to all
vendor/manufacturer’s business dealings for distribution. Sales numbers
and commissions allows Ottobock to replicate “copy†successful products
like Tamarack joint and capture those markets with ease. For that matter,
they can take unprotected products that have good sales numbers, knock them
off and redirect the customer to purchase their own brand. Significant
advantage as they also have direct access to the purchasing history of any
O&P company, which give insight to the geographical location of your
practice, sales assumptions in both Orthotics and prosthetics.
Time will tell but I expected in 10 years there will be 5-7 large players
in patient care. In the same way we have Target, Walmart, Costco and Sams
Club. Happy New Year!
11)I find it deeply problematic and a conflict of interest.
12) I am a cpo. I work for a company that I do not own or have a stake in.
I have chosen to not work / or as little as possible with companies that
may become competitors. I am willing to work with suppliers but not those
that want to eat the entire pie.
13) Your inquiry is thought provoking. I think people organizing
themselves one way or another to maximize market interaction is in itself
usually an effective strategy if not a good idea. If and when you can find
it convenient, could you paint a picture of contemporary extracorporeal OPR
scenery so I can have a better view of possible change being discussed?
14) Frankly, I have heard & believe that the gov’t & big insurances Want
only 2 or 3 O&P providers Nationally. Somehow this would “simplify”
billings, recoupment efforts & communications btwn providers & insurance
carriers.The big 3 would be: Hanger, Otto Bock & Ossur. I believe, like the
rest of “healthcare”….it is no longer about caring for patients, but what
is the cheapest way to address their health issue. Somehow, 3 large
companies competing for O&P business will lower the fees insurances pay for
products & services.
15) Cascade also bought Ortoped in Canada. Ortoped is Canada’s biggest
supplier other than the International companies like Otto Bock or Ossur.
As far as whether I like this – definitely not. American medical costs are
what is driving up costs across the board – These large companies having
such a huge control of the market is going to drive up costs even more. The
service is suffering as well – I had a great relationship with the folks at
Ortoped, now there is someone new every time I call it seems. They always
say the amalgamation is going to make things cheaper – and it never does.
16) Thanks for bringing this up. I’ve been concerned about this for quite a
while. Otto Bock did the same thing a while back with Sabolich. But it goes
much deeper. It was 1975 when CMS came to our profession about how we were
to get paid. It was Kingsley Feet and USMC and others who suggested that we
get paid only for what we provide. There is no vehicle for us getting paid
for our knowledge, thus our clinicians tend to not be involved in research,
and it increases the influence of manufacturers. Is there anything we can
do? I’d invite you to get Malcolm Gladwell’s book “David and Goliath:
Underdogs, Misfits, and the art of battling giantsâ€. You see, when we have
an opportunity to change something, people like Hanger and Otto Bock would
prefer that we didn’t. {personal story that was removed for posting this
reply to maintain anonymity} My point is that if I wanted to sell out and
just make money on a patent, I could have done it already. I’m trying to do
something more… I’m trying to save our profession with the leverage I have
from something that is very embarrassing to the medical community. Example:
Just as we’re the scapegoat in rehab, the implant folks are the scapegoat
in the surgical suite. My hope is that as things come to light, O&P gets
credit for the discovery and we’re ready to harness that opportunity for
some real change. Way more fun that selling out just to sit on a beach and
get bored.
17) We were just starting to discuss this within our company (our
practitioner group text across multiple offices) yesterday. I think it’s
kind of scary, weird, and sketchy. Cascade distributes other companies’
products so what’s to keep them from giving a much better discount on Otto
Bock to sway customers? We are an OPS member with Ossur so we do order
direct from Ossur for their best pricing, but my boss was just saying how
this will definitely affect Ossur’s distribution. VERY interested in
hearing what other people have to say. I feel like it’s only a matter of
time before they buy or open up a practice here…
18) I think I made mine clear about a year ago! Get ready!
