If the physician marked the prescription for “generic ok” or if the orthotist called the physician and had the prescription modified there should be no legal problem. That the orthotist is able to provide a cheaper, but equal, device is good for all concerned. It is my understanding that devices are billed according to their function, not a brand name, so substituting a less expensive device with the same function should pose no legal or ethical problem.
What should be of greater concern then protecting a sales rep’s commission is what Mr. Nudelman has described occurred in the orthotist’s office. Medical information is privlaged and should never be disclosed or discussed with anyone other then the patient or someone with a proper release. If this breach actually occurred then the orthotist may be facing a more severe problem then having the sales rep mad.
It amazes me that Mr. Nudelman has such intimate knowledge of the goings on between orthotists and sales reps. His previous postings have also usually been highly critical of “Orthotists” and full of alleged information about orthopedic technologists and sales reps. I have previously corresponded with Mr. Nudelman on the orthopedic tech issue relative to Florida law. Since there is no one licensed in Florida by the name of Nudelman I asked my son-in-law who is this Nudelman. He tells me the general belief is that Mr. Nudelman is really a C. Boracas, an orthotist from the Tampa/St. Pete area who is also an orthopedic tech and sales rep. If this is true, the information posted should be viewed with healthy skepticism, as he may have ulterior motives for creating dissension and turmoil.
Dr. Jerry Levitt
—
On Sun, 20 Jan 2002 11:16:34
Jacob Nudelman wrote:
>Warning!!! Warning!!!
>
>Sales Reps from major brace companies are being told to be on the lookout
>for O&P shops who change scripts from Doc’s who order specific
>brands for their patients. The companies don’t like putting all that effort
>and money into detailing Doc’s offices and then some Orthotist changes the
>RX without the Doc’s knowledge to a cheaper generic brace but still bills
>for the one originally authorized. And in some cases the authorization
>paperwork was done with the help of the sales rep and the sales rep
>actually gave the script to the O&P shop.
>
>Imagine the sales rep’s suprise when he dropped by the O&P shop to find out
>how the patient was doing in “his” brace and was told by the secretary that
>the patient was fitted with a different brace. (not a better brace for this
>injury, just a cheaper one) She tried to retrack after she realized who the
>rep was.
>
>Two Orthotists in Pinellas County will be the first Orthotists to have a
>complaint filed against them. This type of Rx switch might force
>manufacturers to market direct to OrthoDocs (a mini stock & bill) and bypass
>O&P shops if they feel this is widespread and impacting on their bottom
>line.
>
>This particular company has made it a policy to market mostly to O&P and in
>fact some of their braces are limited to fittings by only a certified
>orthotist. This might change if they find evidence of Rx switch is common.
>
>This list will be kept informed of the complaint filing and the names of the
>Orthotists if they are reprimanded by the Fla O&P Board.
>
>
>
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