Amputees rely on clinics to provide them with prostheses. What if a manufacturer owns the clinic? – WHY

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Jeffrey Brandt, founder and chairman of Ability Prosthetics and Orthotics, said there are “only patient benefits.”

He said owning a manufacturer gives the company access to more resources and a larger network of clinics in the US and around the world. He said it means his staff can provide better service by learning from more clinics. He can talk about establishing a residency program for students who are going to be prosthodontists, and he can provide more advancement opportunities for his staff if they want to leave clinical work and be more like an administrator or manager.

I have contacted Ottobock, the manufacturer of Ability Prosthetics, several times. After our first exchange, they did not contact me for an interview.

Clinics in the US do these deals for business reasons, said Eve Lee, executive director of the American Orthotic and Prosthetic Association, which represents clinics and prosthesis manufacturers.

“What’s driving this is more of a business function…a growth in the industry, the profession and the patients we serve,” said Lee. “To continue to be a viable profession, growth must take place.”

Prosthetists used to create custom devices in their own small, full-service workshops—made, fitted, and serviced the new limbs.

But nowadays, prosthetic devices are more sophisticated. Clinics have to order many different parts that require clinical trials and research before a patient can receive them. This sophistication also makes it more expensive and complex to run a clinic today than it was a few decades ago.

It’s harder for a clinic to stay in business today than it used to be, even compared to a few years ago, said Wendy Beattie, an assistant professor of physical medicine and rehabilitation at Northwestern University. Throughout her career, she has both worked with prosthesis manufacturers on design and practiced in a clinic for more than two decades.

“It’s not enough to provide fabulous patient care if you can’t keep the doors open and the lights on,” Beattie said. “Reimbursements have gone down … which means the money we’re getting from the insurance companies, mostly Medicare, and our costs have only gone up.”

“Manufacturing costs have skyrocketed because transportation costs and labor costs have exploded in recent years. I think it’s much more difficult for an individual private practice to be financially stable.”

On the one hand, Beattie said, a clinic that’s part of a much larger network has much more power to negotiate better deals for patients when it comes to buying parts or paying insurance. However, she also said that if patients and clinicians “are going to have fewer options about what to confide in patients, I see that as worrying.”

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