How much should a DME tech know?

[sam1234]

Just picked up my Resmed Autoset II today. I had to drive almost 30 miles to the DME. The tech started with, "I don't know anything about this machine." He proceded to show me how to turn it on and how to adjust the humidifier heat. He didn't even show me how the humidifier attaches to the machine (not that I couldn't figure it out). Then he had me sign a rental agreement because the insurance company has to see that I am compliant first. I have over 18,600 hours on my current machine and had over 8700 hours on the Healthdyne machine (my first).

Maybe I should look for another DME? For all that he showed me, I would have been about as knowledgeable having received the machine directly in the mail.

I also had inquired about a converter (giving them part numbers as well), so that I could use a battery with this device, last week. The DME told me that ResMed charged $90 for a couple of cables that connect the machine directly to the battery. Not really a converter but just cables. I read the material from ReMed to the DME representative regarding the converter. We'll see if they figured it out.

[grandmma]

Guess the key word there is "should" as opposed to "would". Because what DMEs (and our sleep centre techs in Australia) should know bears little on what the vast majority do know! There's always exceptions to every rule, of course. I'm guessing training them costs money, which reduces overall profit. And that's presuming they are interested in the first place in being trained & becoming competent.

When someone supposedly knowledgeable gets out the user manual, they lose both me and my respect. I can check that out myself!

Think your responses here will be very ..... interesting. Spirited, even! The phrase "hornet's nest" springs to mind!

Good luck, sounds like you've the attitude & drive required to survive their incompetence.

[jnk]

I believe in the US that the DME has to have a respiratory therapist* (RT) on staff to read the scripts and punch in numbers. Everyone else who works there is likely a basic crutch-salesman droid, unless they choose to be otherwise. They seem to know less about the machines than your average Circuit City employee knows about how to set up a home theater.

The RT went to school and all. But the machines keep coming out with new features that few understand, and the manufacturers do a lousy job of educating their middle men. The whole system doesn't work very well, seems to me. The gaps between what a sleep doc knows and what a PSG tech knows and what an RT at a DME knows are cavernous. I believe that the gaps are actually larger than the knowledge, in most cases, from what I read here.

The good news is that we can educate ourselves with a little effort and basic research. Going back in this forum to read earlier threads is educational and entertaining. In a few short weeks, I think the average person can learn more practical knowledge reading old posts in cpaptalk.com than a whole barrel of DME flunkies picks up in five years handing out PAP equipment and checking compliance.

But then again, what do I know?

edit: changed "technician" to "therapist"

[Goofproof]

Should know not to cook the fries too long, and change the grease at least every three weeks. Jim

[SnoozeButton]

I'm sorry to say that my experience has been that they have more training in how to pawn the cheapest machine off on the patient and memorization of lines (lies) to try to get around handing out better equipment than they do in the basics of mask fitting (which is just one example of something they should know). If it were not for this board I would not have known how to go about getting a better machine or about mask fitting and adjustment. Without this knowledge I feel it's no wonder so many people give up on CPAP.

[sam1234]

+1 SnoozeButton

Reading your post reminded me that I also asked about a FF mask. He picked up a mask off the shelf and said that it was good. I asked him what model, he didn't know. Should have, would have been an indication that I should have asked for a different tech.

I guess that I raised this question because I had higher expectations..... I even brought a mask with me, so that he could set up the machine for the mask.

I entered the mask settings tonight. I expect that I will need to lower my expectations as the machines get more sophisticated.

When I received my Healthdyne CPAP machine, the tech spent time making sure that I understood the ramp feature, the passover humidifier (this was before heated units were available), how the mask fit, what to expect from the machine and how long it might take to get used to the machine. He also let me look at other models and gave me the benefits of each. He spent more than twice the time of the tech that I saw today.

Thankfully, this forum has given me enough knowledge to be dangerous.

[carbonman]

Should know not to cook the fries too long, and change the grease at least every three weeks. Jim

There may be more truth than humor in that statement,
and that is very scary.

Thankfully, this forum has given me enough knowledge to be dangerous.

Thankfully, this forum has given me enough knowledge to take my life back.

...if you haven't felt the fatigue,
...if you ain't strapp'n it on everynight,
...if you're not read'n the data every am,
and if you don't know the relief,
I don't know how you could possibly help someone that does.

[Slinky]

Hokay, I show them no pity! In the USA the local DME suppliers are REQUIRED to have an RRT (registered respiratory therapist) on staff. They will have the responsiblity for the 02 patients', as well as the OSA patients', equipment needs. I don't expect them to KNOW all the finer points of the devices they provide - BUT - I DO expect that when they provide a device they read the d*mn accompanying literature whether Clincians Manual or what so that they can answer my questions or find the answer!!! I don't expect them to fit my mask as well as I'll be able to w/a couple of nights' "living" w/it - BUT - I DO expect that they know the basics of mask fitting and find a likely mask and a comparatively comfortable fitting mask for me before shoving me out the door w/a 2 week time frame to try the mask and return for exchange if need be. I expect that the DME supplier provide their RT w/the proper facilties to do the mask fitting and an adequate supply of a variety of masks.

I can respect an honest "I don't know", I become infuriated when someone tries to deliberately pull a snow job on me. Less than the truth when they know the truth is also guaranteed to make me see red.

[DreamStalker]

It doesn't matter how much they know .... it will never be adequate for your best interest or health.

Do yourself a favor and become an active member of this forum ... a year from now, you will thank yourself as will many other newbies.

This therapy requires that you be in control of monitoring and managing your treatment. Treat it as one would treat diabetes.

[ChrisC]

As a DME fellow myself, I understand how some employees are just thrown on the floor with an overwhelming amount of equipment and an underwhelming amount of knowledge.. they're forced to "cope". Personally, I don't invest in any Home Healthcare equipment without doing my homework and knowing my business inside and out. I have the absolute luxury of having an employer who is very supportive of education, and gives me the time (and funding) to learn. I can tell you this for sure: I don't carry and sell equipment I don't A) understand or B) believe in. When it comes time for us to deal in respiratory devices, we'll have to have a licensed technician on staff to set up the equipment properly. After that, the customer will likely just be dealing with me, "the guy on the floor", and I make damn sure I know what I'm talking about before I'm in that position.

Also, I'm not shy about telling a customer "I don't know" when I sincerely don't know. I respect a salesperson who is up front and says "I don't know", instead of making up some BS on the spot. When it comes down to it, I sell and service a wide variety of products including ambulatory aids, bathroom safety items, aids for daily living, compression therapy products, orthotic devices, lift chairs, breast pumps and stair lifts. I attend regular tradeshows to learn about new products, accept all training opportunities from vendors, and regularly communicate with others in my field. As much as I strive to be the expert on all the products I carry, my customers sometimes still manage to surprise me with questions from left-field from time to time. That being said, when I tell a customer "I don't know", the next words out of my mouth are "but I'll find out for you!". Some delight and revel in the fact that they knew something that I didn't. I used to be offended that they were just trying to "get me", but now I'm happy that they're doing their homework and teaching me things: an educated patient is more likely to be a compliant patient.

That being said, as someone who may potentially have sleep apnea myself (been through my consult/sleep study: awaiting results), I'm definitely using this experience as a learning one. Carbonman: you've raised a very good point. It's so nice to walk into a business and have someone be able to completely emphasize and say "Hey, I've tried X product and can really recommend it". True, It'd be nice if more DME salespeople had diagnosed sleep apena and had been through the process.. but wishing for it is a bit of a double-edged sword .

[S-Dubya]

Just playing devil's advocate here...

Maybe the DME rep was not familiar with just THAT machine? Was the machine a special request? The DME's I have worked with seem to have certain manufacturers and models that they like to stick to. That may be because they are already familiar with them, customers request them often or they have a better relationship with with that manufacturer's sales rep.

A few years back I decided to try the Oracle interface. When I asked for it the DME rep readily admitted that I was the first person that had asked them for it. He and I both tinkered for a few minutes when he brought out the mask. Frankly, I appreciated his honesty. Too many times I have had reps (for CPAP and other goods) pretend to know even though they don't and create much bigger problems.

...then again he may be a moron.

[clancy2]

When I was switching from my sleep easy machine to my M series and told the DME what i wanted he didn't even know there was Cflex or A flex available with them said he'd have to email them and get back to me he thought I didn't know what I was talking about.

[jnk]

VERY nice post ChrisC. Thanks for that.

To my mind, there are three kinds of people working in "the industry": (1) people who know more than me about how the body works, (2) people who know more than me about how equipment works, and (3) people who know more than me about how money works [in other words, sales people]. I admit that I tend to prejudge and categorize people that way. But as long as all three groups are cooperating with me, I'm happy, because I think a large part of the responsibility for having enough practical knowledge to choose what equipment I should spend my money on to help my body falls squarely on my shoulders.

Threre are a plenty of people in the industry who have amazing knowledge in all three areas. But I doubt those people are going to be working on the floor at a DME or driving a truck delivering machines. So I don't expect that from them. It wouldn't be fair to, in my opinion. And the people on the floor and driving the trucks do still know more than me about plenty of things, I'm sure.

All I know is that out of everyone I have dealt with, it took the people posting in this forum to help me to piece together enough information for my life to be changed by this therapy.

[Wulfman]

As a DME fellow myself, I understand how some employees are just thrown on the floor with an overwhelming amount of equipment and an underwhelming amount of knowledge.. they're forced to "cope". Personally, I don't invest in any Home Healthcare equipment without doing my homework and knowing my business inside and out. I have the absolute luxury of having an employer who is very supportive of education, and gives me the time (and funding) to learn. I can tell you this for sure: I don't carry and sell equipment I don't A) understand or B) believe in. When it comes time for us to deal in respiratory devices, we'll have to have a licensed technician on staff to set up the equipment properly. After that, the customer will likely just be dealing with me, "the guy on the floor", and I make damn sure I know what I'm talking about before I'm in that position.

Also, I'm not shy about telling a customer "I don't know" when I sincerely don't know. I respect a salesperson who is up front and says "I don't know", instead of making up some BS on the spot. When it comes down to it, I sell and service a wide variety of products including ambulatory aids, bathroom safety items, aids for daily living, compression therapy products, orthotic devices, lift chairs, breast pumps and stair lifts. I attend regular tradeshows to learn about new products, accept all training opportunities from vendors, and regularly communicate with others in my field. As much as I strive to be the expert on all the products I carry, my customers sometimes still manage to surprise me with questions from left-field from time to time. That being said, when I tell a customer "I don't know", the next words out of my mouth are "but I'll find out for you!". Some delight and revel in the fact that they knew something that I didn't. I used to be offended that they were just trying to "get me", but now I'm happy that they're doing their homework and teaching me things: an educated patient is more likely to be a compliant patient.

That being said, as someone who may potentially have sleep apnea myself (been through my consult/sleep study: awaiting results), I'm definitely using this experience as a learning one. Carbonman: you've raised a very good point. It's so nice to walk into a business and have someone be able to completely emphasize and say "Hey, I've tried X product and can really recommend it". True, It'd be nice if more DME salespeople had diagnosed sleep apena and had been through the process.. but wishing for it is a bit of a double-edged sword .

As much as DMEs get "bashed" on the forums, I'm actually somewhat sympathetic to the situation they're in. They DO handle LOTS of different equipment and supplies. XPAP equipment is just one (probably small) part of it. I'm sure that the oxygen business is more significant.
I've likened it to my situation with computers.......there are so many variations, options, operating systems, etc., etc. that it's very difficult to keep up with because they're changing so fast. I DO appreciate a person who will honestly say "I don't know......but I'll find out for you". I've been in that situation many, many times, myself.
There are also the circumstances that you may walk into a DME shop and get the brand new employee who's just getting their feet wet......everybody has to start SOMEWHERE.......(maybe they WERE flipping burgers and dipping fries the week before) .......but hopefully, they'll be upfront with you when you ask questions, and/or get help from someone more knowledgeable.

Den

[rested gal]

I loved your post, ChrisC, as well as jnk's and wulfman's thoughtful comments about it.

And yours too, Slinky!

I kept thinking, "yes, yes, yes, yes....!!" while reading everyone's posts in this thread.

Chris, you (and your clients) are fortunate that...

"I have the absolute luxury of having an employer who is very supportive of education, and gives me the time (and funding) to learn."

A luxury, indeed. But the main thing is that you're obviously extremely intelligent, Chris. And you don't have an ego problem. You care. You're a "good'un."