Learning to say no: The evolution of an ATP

Among the moments at the National CRT Leadership & Advocacy Conference that drew the loudest round of applause was a story told by Michele Gunn.

Gunn, who participated in a panel on “Running a CRT company in a DME world,” is an ATP/CRTS for Browning's Health Care and an at-large director at NRRTS.

Here's an edited version of her story:

There's this perception that providers suck, that we don't know what we're doing, that we're incompetent, that it takes forever to get something done.I think the opposite is true: If you're still in business, you've figured out a way to survive.

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I was working with a pediatric client on a chair and the dad says he'd also like a stroller. In Florida, they'll pay for one mobility device every five years. He says, we have a trust fund that will pay for the stroller; we just need a denial.

Our office does their magic—all the steps needed to get this done. We get an approval for the chair and a denial for the stroller. He gives me the caseworker's name for the trust fund and asks me to send the stroller quote and denial. I call her (to follow up) and she says the dad has the check for the stroller and to give him a call.

I call the dad and he says, you guys charge a lot more for the stroller than what I see online. I say, well yeah, I met you at a clinic; I spent a lot of time with you. He says, thanks but no thanks, I'll go out on my own.

Later, I deliver the chair; it looks great, he's happy. I'm picking up my bags to leave and he says, since you're here can you set up the stroller, (which is still in a box).

The me 10 years ago would have put down my bag and dug into that box; the me now said, sir, I'm not going to open that box. (But) if you need help with the chair, I'm happy to help you. It took a lot to do that and I didn't feel good about it. I don't like to burn bridges or make people unhappy. He never contacted us once about the chair.

One day, I was at the children's pediatric hospital, and I was called on to help with seating for a patient, and there was the dad. He said, you left my house two years ago and never came back.

I tried to play it off with humor, saying I would have been happy to provide service for the chair, but I don't do drive-bys; that's illegal and creepy. He didn't smile.

His daughter's surgery went great. There was a lot of correction—it added four inches of length to her torso.

There was a flurry of activity (to adjust her chair and seating, as a result of the surgey) and it was all done in front of the client, the dad.

I was on my way out the door and I heard him say, wait a minute. He held out his hand and shook it.

I thought then, we're all good.