Portable O2: Tell referral sources about patient benefits

Monday, March 31, 2003

Portable oxygen equipment is now lighter, easier to operate, more cost effective and is as therapeutically sound as stationary systems, respiratory manufacturers say. As a result, the referral source community sorely needs to be brought up to speed on the new systems’ attributes, vendors contend.

But before providers can spread the word, they need a doctor’s appointment. That in itself is proving to be challenge. And even those lucky enough to get a face-to-face meeting aren’t guaranteed success - there are still a number of skeptical clinicians who remain unconvinced that flow rates and oxygenation levels are on a par with stationary systems.

Even so, by emphasizing how the new breed of oxygen systems can improve a patient’s quality of life, manufacturers believe providers can successfully build physicians’ knowledge and confidence in the technology.

“It’s about letting referral sources know that oxygen patients can now have a life,” said Stuart Bassine, president of Asheville, NC-based OxLife.

Specifically, patient ambulation is the most significant benefit, added Tim Clark, executive director of global sales and marketing for Northampton, Pa.-based Precision Medical.

“If someone with COPD is stuck at home, they will die much quicker,” he said. “Quality of life makes a difference and physicians are starting to realize this.”

The reason why oxygen technology has advanced so far in just a couple of years is simple, Clark said - necessity is the mother of invention.

“With all the reimbursement cuts in Medicare, the government forced it,” he said. “When you take away income, people find a way to replace it. The cuts spurred innovation.”

Barry Schwartz, president of Portland, Maine-based Contemporary Products says that with all the competitive pressures weighing on the health care continuum, the new technology’s cost effectiveness is an attractive selling point. More importantly, the new systems save money without compromising quality patient care, he said.

“In virtually every case the patient is benefited - a lighter package to ambulate with and fewer cylinders to keep track of,” Schwartz said. “But the main thing is portability. They are capable of being used in cars on a battery. It’s certainly an improvement over a 40- to 50-lb. unit.”

Still, manufacturers concede that just getting in to see the physician is a formidable challenge nowadays.

“Therein lies the rub,” said John Goodman, vice president of technical and professional services for Denver-based Transtracheal Systems. “It used to be about bringing in doughnuts and Chinese, but that doesn’t cut it anymore.”

Clark agrees that stringent time constraints have made the medical establishment much more aloof.

“The doctors’ time has become so precious that some clinics are charging pharmaceutical reps an office visit fee for a sales call,” he said.

While many physicians are still unenlightened about the wonders of the new oxygen technology, others remain unconvinced of its value, Bassine said.

“There are certain clinicians who won’t change their patients’ prescriptions unless they absolutely have to,” he said. “The provider just has to keep working on them.”

One way to sway physicians about portable conservers’ therapeutic value is to present clinical data that shows strong oxygenation rates.

Even physicians familiar with the new systems are still on the incline of the learning curve, said Rem Siekmann, global product manager for Sunrise Medical’s Devilbiss oxygen products, Somerset, Pa.

“They tend to guess [on prescriptions],” he said. “They hope the patient feels good on two liters per minute.”

Still, today’s technology is designed to eliminate guesswork, Siekmann said, adding that physicians need more training on the finer points of the equipment.

It is especially important for physicians to understand which of the oxygen alternatives are best suited for their patients, said Tom Tucker, vice president of DME sales for Mundelein, Ill.-based Medline.

“Physicians may be aware of the new options out there, but not all of the alternatives have gotten equal time,” Tucker said.

Goodman maintains that the best way to market a new generation of oxygen products is to introduce them to the new generation of medical students.

“We’ve got to get to the young warriors while they’re young and impressionable,” he said. “Get them to develop compassion for patients.”

Young doctors might be more receptive to demonstrative techniques like wearing a cannula for a period of time, Goodman said.

“It generates empathy, which is important in making the point that oxygen is medicine and if patients don’t take it, they get sick,” Goodman said. “It’s easy for a physician to write a prescription and walk away. They spend 12 minutes with a patient and we spend a lifetime with them. They need to walk a mile in our moccasins.”

Ultimately though, the most coveted referral source is the patient, manufacturers say. Direct-to-consumer advertising is yielding huge dividends for the pharmaceutical industry. Word of mouth among patients is what energized Puritan Bennett’s successful Helios system. Quality of life issues, while important to clinicians, resonate strongest with the patients themselves.

“Conservers are becoming more mainstream because the public is more educated,” Clark said. “Patients are calling each other and talking about the products. Providers need to be telling this to referral sources.”

Mass media has helped parade some of the new products in front of the public as well. Irvine, Calif.-based Cramer & Decker had its backpack cylinder system featured on The American Medical Review, a public television show hosted by legendary news reporter Morley Safer. But even after getting valuable TV exposure, General Manager Scott Decker says the company needs to be more proactive in getting the product in front of end-users.

“As a manufacturer, we need to do a better job of reaching them - there’s a gap,” Decker said. “We’ve simplified the systems, but we still aren’t reaching our customers the way we want to. We need to get out there and sell.”

As someone who has worked on the provider side, Rochelle Thuener knows that getting out there and selling is easier said than done.

“Providers are in a tough spot right now - money is tight and people are looking to do the most with what they have,” said Thuener, a former Lincare employee who is now president of Strongsville, Ohio-based Roscoe Medical. HME