A wrong wheelchair or an inappropriate wheelchair is often not just luck of the draw. Wrong wheelchairs can be made to happen or can be forced to happen.

A wheelchair that disappointments, creates more problems than it solves, and in general moves the user backwards instead of forwards in their quest for mobility and independence is a bad investment for everyone.

Most wheelchair users, regardless of how they get their wheelchair, purchased out-of-pocket or funded (Medicare, Medicaid, insurance), have very limited opportunities to get a new wheelchair or to swap out a bummer. Most self funded wheelchair users can’t afford to flip for a new wheelchair if the one their butt is in is wrong, and sure as hell the funders don’t want to hear it. So if it is wrong, it is going to stay wrong and do some serious damage for quite some time.

There are many ways that this situation can come about but there is one way it should never come about. The top decision maker in the process, the clinical last word, the physician, should never be the one turning the independence table over on a patient.

The following excerpts below are from a recent discussion regarding such a case. The wheelchair user and family were steered in the right direction- They went to rehab specialists to get an evaluation for a new wheelchair. A thorough evaluation was done, specific recommendations were made for a Medicare funded powered wheelchair, the doctors approval was needed to frost the cake, and then…

Here are some excerpts from comments by the therapist, “Jodie” Kitty J. Stogner, PT, ATP, (an ATP credentialed rehab specialist) who is involved in this situation. You can decide for yourself on the ethics and outcome of this:

“Received a call regarding an evaluation I performed for a CVA pt. via referral from the pt’s home health agency. I had recommended a chair with tilt and some seating components. Custom vendor sends it to the doctor for signature….doctor will not sign saying he only uses vendor XYZ…XYZ not credentialed to do rehab.”

“I’ve informed the family that their doctor will not sign to allow the rehab vendor to proceed with the chair that she was recommended after the eval and that if they choose to accept the lesser chair delivered that there was nothing more I could do.”

“There is another doc, but if they sign for the low end chair when it’s delivered tomorrow then what’s the use- sweet family that just doesn’t want to go against their doc and cause waves . What gets me THE most is most pts when asked about a vendor choice say they don’t have a preference…this lady specifically asked for this vendor (the rehab vendor) then was instructed by their doctor to”hang up” on them if they tried to contact her to allow the vendor that, in the doctor’s own words, “he has a personal relationship with” to deliver a lesser chair”

Form your own opinion, but in any event you are going to hear mine.

I have been involved with dozens of wheelchair evaluation clinics and have been a player in thousands of evaluations. From these experiences there is one thing I can tell you with complete certainty- Wheelchair users who undergo an evaluation by experienced, trained, and credentialed therapists and suppliers are much more likely to end up as winners! Obtaining a thorough evaluation is the best investment one can make in the new wheelchair process.

To think that a doctor would jeopardize a patient by insisting that a patient deal only with a lesser qualified supplier that the doctor has a “relationship” with, and to accept a lesser and ill configured wheelchair, is an outrage. It reeks of ethical impropriety and personal monetary gain. Ya, you know, kick-back, payola, pay-off.

But what of the patient, and what of the cost, not only in dollars but in lost function, lost mobility, lost independence, and the potential loss to society by marginalizing it’s players?

You know what they say- If it smells like fish it probably is fish. And this deal smells about as fishy as a wharf in August.

Ziggi Landsman
The TechGuide
VP Assistive Technology
United Spinal Association