Anyone else heard about ResMed stopping Internet sales?

[drj130]

Yeah, like I want to go to my doctor and watch him going down a checklist created by a government regulator while he talks to and examines me.

Be glad that you're not in the military. They have a book that they do just that when you go in if you're sick or hurt.

[Guest]

I read with great interest the comments about your CPAP therapy problems. My goals are many but the main goals are these:

Improving the reputation of DME providers as most are trying to do a good job.
Educating the user of sleep therapy equipment and supplies as my experience was not much different than what I am reading.

First, I am a "brick and mortar" DME but am not adverse to buying off the internet. However, it has been my experience that there are things that cannot be accomplished using the internet. One is getting a good mask fit. One person commented that an RT fitted the mask and it was still done poorly. I have hired RTs that never achieved good mask fitting skills as it is as much an art as a science. Another comment was being an RT does not necessarily give them the proper skill set to fit masks. This is absolutely true, so to clarify, we TRAIN our RTs and this is all they do so they have the opportunity to get very good at it. All studies show that the a poor mask fit is the PRIMARY reason people fail to comply with therapy. If you get one off the internet and it works great but the odds, according to all studies, are against this. My philosophy is the mask that is best is the one you will wear. So, to increase your odds of getting past the first hurdle of compliance get a good mask fit. Someone commented that compliance gets the DME provider paid. While this is true it is not the primary nor sole reason that motivates a good DME provider. If a person is non-compliant then this person is not getting treated properly and will have a negative clinical outcome. Accredited providers have to track these negative outcomes and develop processes to improve these outcomes or they can lose their accreditation. Medicare has instituted some draconian rules regarding compliance that in essence eliminates people from having their equipment paid for even though they are trying hard to use the equipment. I am close to making the decision not to accept Medicare sleep therapy patients as I cannot participate in a system that allows patients with a known diagnosis (OSA) to go untreated. I could just treat these patients as three month rental patients but ethically I cannot do it.

Second, I was surprised at the negativity towards DME providers but not internet providers. Maybe the people that would use this site are the most internet savvy but we get an enormous number of people who come to us after having a bad experience from an internet provider. That being said, I know there are internet providers that do a good job given the constraints of not being local nor having a face to face relationship with the patient and physician.

Finally, I had comments saying take control of your own education, do not rely on your provider. I need to clarify my position on this. PLEASE educate yourselves about this and all treatments from physicians or providers. I am big on personal responsibility. Why would you rely on any one source for something as important as your health? I have asthma which complicated my ability to adjust to CPAP therapy. I worked hard to educate myself about every issue I had. I came to the conclusion that my staff needed to do a better job with professional as well as patient training based on my own experience. I visit these sites in hopes of learning a better way to accomplish greater compliance. Any tricks of the trade are greatly appreciated.

[Muse-Inc]

...You are an idealist...

I think you are too Rooster, it just expresses differently.

..."If we can just get the right policies written down everything will work great." History shows that does not work.

I agree but we can criminalize violation of the mandates. Those who violate them can be stopped, arrested, tried in court, sued in civil court; while this is unlikely to stop the problem, it will reduce it. I see some in the sleep industry as acting like Madoff. Yes, it's buyer beware but Rooster most of us at diagnosis can't think straight, we're dependent on these healthcare providers to help us get better, being taken advangtage of while in that state is wrong...yes? Legistation might not improve it, a Patient's Bill of Rights might not be used...but these might deter some from preying on us and give us grounds for compenstation from those who violated those laws. We used law to stop many polluters; our air is cleaner than it was 30 yrs ago and in some places so is the water. It did not stop determined polluters but it stopped many and gave us grounds to go after those we can identify as polluters.

...Democracy is messy. Freedom is scary. But that is what my country has been about and that is the way I want to continue to live.

Absolutely! But absolute power absolutely corrupts and that's the situation we find ourselves in now.

[roster]

Yeah, like I want to go to my doctor and watch him going down a checklist created by a government regulator while he talks to and examines me.

Be glad that you're not in the military. They have a book that they do just that when you go in if you're sick or hurt.

Sorry about that. I pray you don't get sick or injured.

But aren't there some good guys who practice medicine in the military?

[drj130]

Yeah, like I want to go to my doctor and watch him going down a checklist created by a government regulator while he talks to and examines me.

Be glad that you're not in the military. They have a book that they do just that when you go in if you're sick or hurt.

Sorry about that. I pray you don't get sick or injured.

But aren't there some good guys who practice medicine in the military?

If there is, I've not run into them yet. Good example, tomorrow is the first time I'll get to speak to the lung doctor who put me on XPAP. I was suppose to see him the morning of the study, but got a call the day prior saying he had to go to Iraq. I can understand that, but why not set up someone else to see me that same day?

The other example I have, is that I had the chance back in June to start my treatment, but the PA who is assigned to my unit decided that I could wait until I could get an appointment at the Army hospital. Which is over 3 1/2 hours away. I didn't get in there until the 10 of Jul, where I could have had my treatment started around the 15th of Jun. Not bad I know, but still.

The wonder drug of the military, Motrin.

Tis life.

[Guest]

Black Spinner,

I completely understand your point, I guess I didn’t really expand on what I meant by education. I provide my patients with a folder which includes a copy of their Rx, sleep study (or studies), various articles about OSA, and a list of internet support forums. There are currently no local support groups, the hospital ran one for about a year but it was discontinued due to lack of participation. The director of the local private sleep lab and myself than decided to start up an AWAKE meeting, she spent around $6,000 on advertising in local newspapers and on the radio and TV. The largest turnout in the 9 months that we ran the meetings was 2 people. For the first 3 months it was just her and I and a local doctor at the meetings, than we got a people for a couple of months, and than 0 for the next 4 months until we stopped holding the meetings.

You are right, one on one is never going to solve the problem for everyone, however I can’t make people seek help with support groups or on internet forums. When it comes down to it, like many here on the forums say all the time, YOU have to take control of YOUR therapy. That statement means different things to people, for some it simply means becoming educated about OSA and to other it means going it completely on their own from diagnosis all the way thru to therapy. Bottom line is, whatever it takes to get your therapy working for you is what you need to do. There is never going to be one magic system that works for everyone, that’s not to say that I think the current system is working as intended, but I don’t believe it should be completely done away with either.


AKCPAPGUY

[BlackSpinner]

Yeah, like I want to go to my doctor and watch him going down a checklist created by a government regulator while he talks to and examines me. .

He/She already does that - that is what medical practice is about. If they want to get paid from an insurance company or here the government then they will fill in the blanks.
Getting a diagnosis is basically going down a check list - only you don't see the list.

I will continue to choose doctors who love helping patients in order to make a very good income. Those are the ones I trust (but verify).

Yeah well check out the incredible number of ceasarian sections that American doctors do compared with the rest of the world.

You are an idealist who thinks just like Obama: "If we can just get the right policies written down everything will work great." History shows that does not work.

I suggest you read some real history - all of your industry standards and safety rules come from history - Check out the Triangle Factory fire, Check the thalidomide scandals, Read some Dickens.
Most government regulations come about because people have died for the profits of big business. Without regulation you will never know whether the drug that pharmacist sells you is tested (Thalidomide) or meets quality standards or actually contains the drug you are buying. You will never know if your lawyer actually studied law, if your car will stop when you hit the brakes(Unsafe at any speed)

Democracy is messy. Freedom is scary. But that is what my country has been about and that is the way I want to continue to live.

That is not democracy, it is anarchy. Democracy is about voting for your leaders - that's it. Regulation is about not tolerating bullies, fraudulent practices and money buying you different standards.

[roster]

.......I suggest you read some real history - all of your industry standards and safety rules come from history - Check out the Triangle Factory fire, Check the thalidomide scandals, Read some Dickens.
Most government regulations come about because people have died for the profits of big business. Without regulation you will never know whether the drug that pharmacist sells you is tested (Thalidomide) or meets quality standards or actually contains the drug you are buying. You will never know if your lawyer actually studied law, if your car will stop when you hit the brakes(Unsafe at any speed)

........

Go read this "real" history: Source List and Detailed Death Tolls for the Man-made Megadeaths of the Twentieth Century, http://users.erols.com/mwhite28/warstats.htm

These are all what powerful governments did to the human race. Not one business is accused.

Read the list and if you still want to give the government more power, don't bother telling me.

[jnk]

In this thread, I'm more interested in the history of PAP-related Internet sales, myself. But, hey that's just me.

So, I apologize for my part in helping this thread to veer off course.

I like ordering stuff off the Internet from CPAP.com. That does NOT mean I think all Internet sellers (or are they resellers? I don't know) are good.

[roster]

......So, I apologize for my part in helping this thread to veer off course.

......

Well now that I stunk up the entire thread, I may as well throw this in before quiting.

Evolution of Government Education of Math Students

1. Teaching Math In 1950s A logger sells a truckload of lumber for $100. His cost of production is 4/5 of the price. What is his profit ?

2. Teaching Math In 1960s A logger sells a truckload of lumber for $100. His cost of production is 4/5 of the price, or $80. What is his profit?

3. Teaching Math In 1970s A logger sells a truckload of lumber for $100. His cost of production is $80. Did he make a profit?

4. Teaching Math In 1980s A logger sells a truckload of lumber for $100. His cost of production is $80 and his profit is $20. Your assignment: Underline the number 20.

5. Teaching Math In 1990s A logger cuts down a beautiful forest because he is selfish and inconsiderate and cares nothing for the habitat of animals or the preservation of our woodlands. He does this so he can make a profit of $20. What do you think of this way of making a living? Topic for class participation after answering the question: How did the birds and squirrels feel as the logger cut down their homes? (There are no wrong answers, and if you feel like crying , it's ok.)

6. Teaching Math In 2009 Un hachero vende una carretada de maderapara $100. El costo de la producciones es $80. Cuanto dinero ha hecho?

[jnk]

I didn't smell any stink, rooster. I think everyone agrees that gov't regulation is a core issue with Internet-sales issues.

But I think the specifics of how it relates to manufacturers and Internet sales directly (not just the overall contoversial concept of what extent of regulation would be ideal), and how it has all affected Internet sales over the years and why, may be largely unexplored in this thread. And it is a history I am completely unaware of, since I only started using PAP within the last two years.

Does the possiblity exist, even remotely, that Internet sales of CPAP machines and supplies could be shut down one day because of manufacturers' desires, or regulators' issues? Or can we rest easy on that question of that possibility in the foreseeable future?

[BlackSpinner]

Go read this "real" history: Source List and Detailed Death Tolls for the Man-made Megadeaths of the Twentieth Century, http://users.erols.com/mwhite28/warstats.htm

And just what do wars have to do with regulating the medical industry? You are comparing apples to poison ivy.

[s8user29]

If this would happen other manufacturers would just step up and make the type of machines that RESMED makes. They would never do this though. That would be like McDonalds saying too many people are getting fat we have to take the BIg Mac off the menu. Never will happen.

[roster]

If this would happen other manufacturers would just step up and make the type of machines that RESMED makes. They would never do this though. That would be like McDonalds saying too many people are getting fat we have to take the BIg Mac off the menu. Never will happen.

You have no idea what "the regulators" ("poison ivy") will do.

[roster]

If this would happen other manufacturers would just step up and make the type of machines that RESMED makes. They would never do this though. That would be like McDonalds saying too many people are getting fat we have to take the BIg Mac off the menu. Never will happen.

Oh, now I see you are a slimy spammer. Looks like the good members are deleting your spam quickly.