Amputees rely on clinics to fit them with prostheses. What happens when a manufacturer owns the clinic? – WHY

Jeffrey Brandt, founder and president of Ability Prosthetics and Orthotics, said there were “only patient benefits”.

He said being manufacturer-owned gives the company access to more resources and a larger network of clinics across the United States and around the world. He said this means his employees can provide better service by learning from more clinics. He can talk about setting up a residency program for students learning to become prosthetists, and he can give his employees more options to progress if they want to get out of clinical work to be more of an administrator or a manager.

I contacted Ottobock, the manufacturer who purchased Ability Prosthetics, several times. After our first conversation, they didn’t call me back for an interview.

In the United States, clinics agree to such agreements for commercial reasons, explained Eve Lee, executive director of the American Orthotic and Prosthetic Association, which represents clinics and prosthetic manufacturers.

“What’s driving this is more of a business function…a growth in the industry, the profession and the patients we serve.” said Lee. “To continue to be a viable profession, growth must occur.”

Prosthetists used to make custom appliances in their own little full-service shops – make the new limb, fit it, and service it.

But nowadays, prosthetic appliances are more sophisticated. Clinics have to order many different parts that require clinical trials and research before a patient can get them. This sophistication also makes it more expensive and complex to run a clinic today compared to a few decades ago.

It’s harder for a clinic to stay in business today than it used to be, even compared to a few years ago, said Wendy Beattie, assistant professor of physical medicine and rehabilitation at Northwestern University. During her career, she has both worked with prosthetic manufacturers on design and practiced in a clinic for over two decades.

“It’s not enough to provide fabulous patient care if you can’t keep the doors open and the lights on,” Beattie said. “Reimbursements have gone down … which means the money we get from insurance companies, mainly Medicare, and our costs have only gone up.”

“Manufacturing costs have skyrocketed because the cost of shipping, the cost of workers have all skyrocketed over the past few years. I think it’s much more difficult for an individual private practice to be financially stable.

So on the one hand, Beattie said, a clinic that’s part of a much larger network has a lot more power to negotiate better deals for patients, when it comes to buying parts or insurance payments. However, she also said that if patients and clinicians are “going to have fewer options in terms of what they can adapt to patients, I see that as a concern.”

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