Tuesday, August 28, 2012

The Great Enabler

This post is coming to you live from 3:30am.  I'm pulling a night shift at the hospital and have some rare downtime.  Instead of sleeping (which I desparately need), I have chosen to blog.  Why?  I don't know.  It makes no sense for me to blog when I could be sleeping.  But I am.

I've chosen to share my thoughts on perhaps one of the most misunderstood and, in my opinion, one of the most abused pieces of medical equipment currently available.  

They say a picture is worth a thousand words, so here you go:

I recently had an experience that made wonder about these beloved pieces of expensive medical equipment. 

A few months back I peered out into the waiting room of the clinic and noticed a woman similar to the one above, who also happened to be sitting in a scooter nearly identical to this one.  Joining her at her visit was her husband, equally as large and with an equally nice scooter that even matched hers!  How nice.  They blissfully held hands as they waited.

I've never really had an issue with these things until I saw this couple.  What started out as a mere curiosity soon turned into a bit of an anger provoking moment as the husband pulled out a large bag of Lays potato chips and handed them to his wife.  As she began to chow down, he produced an extra large Snickers bar and wasted no time polishing it off.  Of course these yummy treats tend to make you thirsty as we all know.  But this couple got an A+ for preparation - each had a jug of soda in their basket that was less than half an arms length away!

I couldn't believe my eyes.

I bet these folks are loving their scooters.  They hit the jackpot.  They no longer have to exert themselves at all.  I'm sure whoever prescribed these is a hero in their eyes.  They love him to death.  It wasn't me, by the way.

In medicine, things tend to come in bunches.  You'll go a few months without seeing something, and then in one week you'll see it three times.  Not more than a few days after seeing that hideous sight in the waiting room, I had a patient come and visit me to request a scooter.  He was middle-aged and had no real health problems.  

This is gonna be good.  Can't wait to see what he says.

Turns out he has pain in his feet from a rash.  Does he have pain when he walks around his house?  No.  But when he goes to the store and has to walk around a lot, the rash starts to hurt. Why can't he use the ones at the store?  Because he just wants his own, and saw on TV that Medicare would cover it.

It turns out that Medicare has been paying for too many of these little gems lately.  Check out this quote from an article in USA Today from 2011:

  • A report released last week by Medicare's inspector general also showed that 61% of the motorized wheelchairs provided to Medicare recipients in the first half of 2007 went to people who didn't qualify for them. The inspector general found that Medicare is billed an average of $4,018 for a motorized wheelchair that normally sells for $1,048.
I love it when I can find objective data to back up my opinions.  It's quite validating.

My gut instinct was correct - the majority of people who use these things have no freaking reason to be using them.  They are abusing a wonderful piece of technology (at the taxpayer's expense) that actually does help a lot of people who actually need them.

If we keep this crap up, it won't be long before the movie WALL-E becomes a reality.  Get used to seeing this!

And thus on a macro level, scooters are doing our nation more harm than good.  They are, perhaps, the greatest enabling piece of equipment out there on the market.  

Since 61% of people are using them when they really shouldn't, perhaps someone should make a list of reasons NOT to ask your doctor for one.  I couldn't find such a list on the web, so I've taken the liberty to publish my own list.  Let there be no more confusion!

The Doctor's List of Unacceptable Reasons to Request a Medical Scooter
  1. Obesity.  No exceptions.
  2. Complications related to obesity.
  3. Laziness.
  4. Fibromyalgia.
  5. Rashes (any location).
  6. Chronic fatigue syndrome.
  7. Inability to hold all of your junk food.
  8. Lack of automobile.
  9. Dislike of public transport.
  10. Because Medicare will pay for one.
There, I feel better now.  Will anything change?  Probably not.  But at least I feel better.

Stay tuned.