What do you want in a DME?

[ErnieH]

I don't want GREED! I went for a sleep test and they acknowledged I had sleep apnea. I then had to go back for another sleep test for the settings. I fell asleep right away the first time and they had plenty of time to analyze my settings, which are 13.6.

[oldnslow]

I want honesty, integrity, and knowledge. I understand and support the profit motive, but only to an extent. Those of us without insurance, or cash flow need to be treated, without the big sword hanging over us. I am appalled that the exact same machine (Devilbiss autopap) is $250 more in Canada from an "online" DME compared to the usual online DMEs.

[Madalot]

I agree with all the points made so far and want to add one more.

I want my DME & RT to admit that they may not know everything and be willing to learn, even from me as a patient. Just because I am a patient does NOT mean I am stupid. My first RT was an arrogant "know-it-all" that refused to acknowledge anything she did could be wrong or harmful. Even when faced with the facts, she got defensive and nasty about anything I tried to bring to her attention, no matter how politely or nicely I tried to do it.

When I was having such a hard time early on and brought my cpap & mask to her (the machine was blowing full force) she messed with settings here and there, changing things that made no sense, ultimately sending me home with NOTHING fixed because she didn't know what to do. When it turned out that my mask wasn't put back together properly (the seal wasn't in right and it was leaking like a sieve) and I told her -- she refused to accept it as a learning moment for the future and just got all nasty over it.

[DaveL]

I want to find a cpap supplier that has OSA and uses cpap and has the experience I need to be compliant.

When cpap works, it's life improving. When it doesn't work, it's terrible. It's hard to be compliant.

[jnk]

I want cpap.com as my DME supplier.

I would like suppliers to supply, and supply only.

I would prefer that sleep doctors all be required to have a staff made up of RRTs to help their patients make a success of PAP therapy, regardless of where the patients purchased their equipment. I would trust an RT who worked for a doc over an RT who worked for a crutch salesman. Just sayin'.

In my opinion, expecting equipment suppliers (and people they hire) to help with a medical therapy as important as CPAP is folly.

Move the RTs out of the supply business and into a medical office, where they belong. Let insurance hold the doc responsible for compliance and helpfulness.

Allow suppliers to compete on price, in a truly free market, with no manufacturers' price controls allowed. Then let the doc offices compete on being helpful to patients.

How's THAT for pie in the sky?

[SleepyT]

I want cpap.com as my DME supplier.

I would like suppliers to supply, and supply only.

I would prefer that sleep doctors all be required to have a staff made up of RRTs to help their patients make a success of PAP therapy, regardless of where the patients purchased their equipment. I would trust an RT who worked for a doc over an RT who worked for a crutch salesman. Just sayin'.

In my opinion, expecting equipment suppliers (and people they hire) to help with a medical therapy as important as CPAP is folly.

Move the RTs out of the supply business and into a medical office, where they belong. Let insurance hold the doc responsible for compliance and helpfulness.

Allow suppliers to compete on price, in a truly free market, with no manufacturers' price controls allowed. Then let the doc offices compete on being helpful to patients.

How's THAT for pie in the sky?

I like the way you think!

[Vader]

Move the RTs out of the supply business and into a medical office, where they belong.

A big AMEN to that!

[Slinky]

Y E S S SSSSSSSSSS!

[Slinky]

That's one area jnk and I have disagreed on. I blame the sleep DOCTORS for the mess sleep medicine is in. To me it is the SLEEP DOCTOR's responsibility to see to it that the patient gets the necessary education, support, advice and direction. This would best be served by that doctor having knowledgeable, experienced, emphathetic staff from RRTs down to office staff to provide the educating, training, assistance and support for their patients.

[chunkyfrog]

Make the RRT's medical providers--not effIng SALESMEN!
Yes!--get them AWAY from the 'store'.
Pay them for services, not, as I suspect, commissions on profit earned for their bosses.
The knowledgeable, helpful ones should be professionals--the rest should STARVE, dammit!
The DME should be replaced with your usual pharmacy--filling orders--end of story.

[howkim]

I want cpap.com as my DME supplier.

I would like suppliers to supply, and supply only.

I would prefer that sleep doctors all be required to have a staff made up of RRTs to help their patients make a success of PAP therapy, regardless of where the patients purchased their equipment. I would trust an RT who worked for a doc over an RT who worked for a crutch salesman. Just sayin'.

In my opinion, expecting equipment suppliers (and people they hire) to help with a medical therapy as important as CPAP is folly.

Move the RTs out of the supply business and into a medical office, where they belong. Let insurance hold the doc responsible for compliance and helpfulness.

Allow suppliers to compete on price, in a truly free market, with no manufacturers' price controls allowed. Then let the doc offices compete on being helpful to patients.

How's THAT for pie in the sky?

[Looking for the "Like" button ....]

[Otter]

Patient education.

Patient education.

Patient education. I'm talking about the real deal here, not minimal instruction with the mask and vague warnings about the "dangers of CPAP". Patients should get full support to understand OSA and manage their own therapy. Will this a little cost more? Yes, of course. But given that the consequences of untreated of OSA are life threatening and that CPAP therapy has a 50% failure rate, I think the cost is justified.

And it will be good for your bottom line. A noncompliant patient ceases to be a customer. And the DME with programs that produce the best compliance will get more referrals from doctors than the DME whose patients drop like flies. Hence, moderate investment in training can substantially increase long-term profits.

Of course, to fulfill the first three criteria, someone at the DME needs to do some studying too.

An experienced RT who actively researches the field, is a must. It seems to me that many are many RTs working from training that doesn't have much to do with real science or actual therapy, and what's worse is they don't read enough to realize this. The training programs for certification need to be cleaned up, but a good DME won't wait for that to happen. Insist on practical education based on relevant science and clinical experience.

Chanting "cpap is vewy dangewous" does not count. It probably makes the lawyers happy, but "educating" RTs in dangers for which there is little or no empirical evidence begins a chain of failure that leads to noncompliance. The dangers of noncompliance, OTOH, are well documented. An RT with an unrealistic notion of the risks involved introduces a mythical boogeyman into a therapy that should be grounded in medical science.

I agree that RTs should be medical professionals rather than salesmen, though I'm not sure it's practical to move them out of the DME store. User, RT, and a variety of equipment all need to be in the same place at the same time. But I would like to see RTs be better educated and more independent -- like an optometrist working in a eyeglass shop.

I want to find a cpap supplier that has OSA and uses cpap and has the experience I need to be compliant.

Yes! An RT who actually uses cpap will have much more insight than one who does not. And yes, that RT will probably be slightly more expensive because he'll be older and have more health problems on average than a 20-something without OSA. But would you hire a driving instructor who had never driven a car?

Ridiculous policies that overrule doctors are a deal breaker. A doctor's prescription should be filled without modification for any reason. Your lawyer and accountant did not go to medical school, and they should not be dictating any aspect of diagnosis or treatment.

Of course I want a DME to have wide variety of equipment and a good exchange policy. I do understand that costs must be balanced, but the cost of filling out the paperwork to get a refund from the manufacturer when a mask doesn't fit should not be that hard to balance.

Testing for flow generators.

Patient education.

[Guest]

Ditto to all of the above!

I would also like my DME to have a one evening each month meeting for education/support group.
This would not only set him apart from other DME's but actually besides providing a great service it would attract new business to him.

[Guest]

Ditto to all of the above!

I would also like my DME to have a one evening each month meeting for education/support group.
This would not only set him apart from other DME's but actually besides providing a great service it would attract new business to him.