Before I began working for a start-up publication named Mobility Management in 2002, I was managing editor at Dealernews, an industry publication for motorcycle and powersports dealers. Instead of writing for seating and wheeled mobility clinicians and suppliers, I was writing for people who sold and repaired motorcycles, ATVs, personal watercraft, etc.
There are more similarities between those two jobs than initially appears… and not just that I had ROHO in my Rolodex at both jobs.
Both industries designed, built, sold, and maintained/repaired complicated, high-tech vehicles and devices, though motorcycles and ATVs aren’t medically necessary equipment, of course. Motorcycle dealers were mostly small business owners, which was true of Complex Rehab Technology (CRT) suppliers 20-plus years ago.
At the motorcycle magazine, repairs and service were a big editorial focus. We had a columnist, Paul Wünsch, who specialized in service and wrote, in his inimitable and occasionally profane way, about why he believed service and repairs were integral to any dealership’s success.
Before Dealernews, I worked for an automotive publisher, where I copy edited high-performance niche publications: Mustang Illustrated, All Chevy, 4-Wheel Drive & Sport Utility, Hot Bike. I spent my days editing stories about rebuilding motors, and my weekends hanging out with pit crews at racetracks.
Professionally, I grew up believing that outstanding service and repair work was essential. Dealerships and manufacturers distinguished themselves not just with their OEM quality, but on the service they provided afterward.
Therefore, the repair and service dilemma in CRT puzzles me.
For example: Wheelchairs are generally expected to have a lifespan of five years — but insurance payors don’t routinely pay for preventive maintenance.
Imagine going five years without taking your car in for an oil change. Imagine how unsympathetic your mechanic would be when your engine seized up.
While automotive and motorcycle manufacturers are cutthroat competitors, I don’t recall them showing embarrassment when providing service and maintenance recommendations. To the contrary: They knew that for vehicles to run well, they needed regular service by professional technicians.
I don’t know why routine service hasn’t been normalized in CRT. Wheelchairs have become more complex over the years, but it’s as if a step in their evolution — service — has been skipped.
When a wheelchair breaks down — not surprising, as they’re used for many more hours a day than a typical car is — manufacturers and/or suppliers often get blamed. Why? Do drivers blame automotive manufacturers because their cars need oil changes?
Repair is a huge topic in CRT right now. I hope that as policies are reconsidered, payors will look to precedents in other industries… or even to best practices in dental insurance, which routinely pays for six-month dental cleanings in the hopes of preventing larger problems down the line.
Service and performance are very closely connected. Neglect the first at the peril of the second.
(As an aside, Medicare’s in-the-home coverage rule and corresponding funding means wheelchairs aren’t necessarily designed to be used outside the home, such as on asphalt and grass and gravel that can lead to more frequent breakdowns… but that’s another rant for another column.)
