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Who offers a money back guarrantee on foot orthotics?

Discussion in 'Practice Management' started by pgcarter, Dec 13, 2007.

  1. pgcarter

    pgcarter Well-Known Member


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    Just curious to know if anybody out there apart from Craig and myself offer a money back guarranty on orthoses?
     
  2. Daniel Bagnall

    Daniel Bagnall Well-Known Member

    Re: Who offers a money back guarranty?

    Yes I do. Terms and conditions apply though. I take full responsibility for prescribing orthotics, and if something abnormal happens, why should that be the pts fault? If such cases arise, I offer my pt the oppurtunity to have a re-cast or money back.

    Regards,
    Dan
     
  3. Boots n all

    Boots n all Well-Known Member

    Re: Who offers a money back guarranty?

    l thought that was standard for everyone, we do as Daniel does, the same said for custom made footwear also
     
  4. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    Re: Who offers a money back guarranty?

    Hmmm...why should you offer a money back guarantee?

    1. If your dentist does a filling and it doesnt take, do you get your money back?
    2. If a physio treats your sore anterior knee pain with massage, electrotherapy, exercises etc, and it doesnt resolve, do you get the fees back?
    3. If a GP prescribes an anitbiotic for a urinary tract infection and it doesnt resolve, do you get the money back on the drug and the consults?
    4. If a neurosurgeon excises a brain tumour and it redevelops, do you get the surgical fee back?
    5. If a dietitian consults you about weight loss and you dont shed pounds is it there fault?

    This seems a wierd concept to me - and very unique to podiatree/orthodics.

    As a professional, you treat things that can be treated according to best available evidence and professional standards/best practice amongst your peer group.

    If a specified treatment doesnt 'work' - and you have followed acceptable standards compared with your peers - then that particular form of conservative care has failed, and the patient requires either;

    1. a different form of conservative care, or,
    2. surgical treatment, or
    3. additional investigations and referral elsewhere

    Complications, adverse outcomes and less than perfect results can always occur. A 'failure' of conservative care is just that - and it generally means you need to refer on for an opinion on definitive surgical treatment. That is the whole point of non-surgical interventions.

    If there has been a breach of professional standards then the patient has every right to complain to the registration board or relevant authorities.

    Otherwise, if you try your best and it doesnt work, why should the clinician have to "pay". It just means its time to move on to the next treatment option up the ladder.

    LL
     
  5. Ian Linane

    Ian Linane Well-Known Member

    Re: Who offers a money back guarranty?

    I have only ever had to refund three times in the last 12 years. When this happens my rule is that a refund only covers the charge to pts for the devices but not the fees for their consultation. Rarely has it been the orthotic that is at fault. It may be patient tolerance of the devices (could therefore be my prescription, although some folks are very impatient in getting used to things) but is the hassle of refusing to refund, go through the protracted process of lots of letter writing worth and the miss understandings that go with it worth not refunding. When I have refunded it is dealt with and off my back. Worth its weight in polyprop'!
    Ian
     
  6. Daniel Bagnall

    Daniel Bagnall Well-Known Member

    Re: Who offers a money back guarranty?

    To date, I have never had to give a refund. However, I did mention in my last post that, "terms and conditions apply". I will say again though, if I prescribe a device and something severely abnormal happens, I consider that to be my responsibility, therefore, I have to rectify it. If that means I have to dispense a new device then so be it, or in "exceptional" circumstances, a refund is given.

    Dan
     
  7. pgcarter

    pgcarter Well-Known Member

    Re: Who offers a money back guarranty?

    I agree that there are lots of situations where you probably should get a refund and don't ask and would not get it if you did. I agree that you don't need to refund all the money...they can't give you back your time. Under Victorian consumer law if an item is not suitable for the purpose for which it is intended then you would be due for money back. This should apply to fillings, drugs footwear that does not fit etc...and orthoses that don't work due to inability to tolerate them or are not a suitable solution for the problem. Just curious to know what others do.
     
  8. Scorpio622

    Scorpio622 Well-Known Member

    Re: Who offers a money back guarranty?

    We do not have a refund policy, but we have given a few refunds to unhappy patients. They are usually the type that expect a quick fix and are not willing to work with the doc to make things better. I consider it a payoff to get them out of the practice.

    I agree with LL. Refund guarantees, coupons, give-aways, free consultations, jugglers in the waiting room, and any other marketing ploy demeans the profession. Anything that costs nothing is worth nothing.

    All treatments carry the risk of not working. Why should a doctor carry the risk for 1000's of patients? The individual should carry the risk. I've spent thousands on treatments that did not work- such is life.

    I compensate dissatisfied patients with extra time, communication, and understanding. If that's not good enough, they can go down the street and watch the juggler.

    Nick
     
  9. zaffie

    zaffie Well-Known Member

    Re: Who offers a money back guarranty?

    We too do not have a refund policy. As a practice i think we have refunded twice. I always take great care in talking options through with patients. I always talk through contra indications and the possibility that the orthosis may not be tolerated etc etc. Does any one use some form of informed signed consent?
     
  10. DTT

    DTT Well-Known Member

    Re: Who offers a money back guarranty?

    Hi All

    Yes I do have a refund policy ( sorry):eek:

    There are patients that whatever you do for them there will always be something wrong (whether there is or not):(

    Once they pass a certain stage ,I cannot be bothered to argue with them ( after having tried all alternatives) and refund the cost of the orthotics ( 3 times in 20 years).

    But the consultation / scanning fee etc remains mine so I break even on that one:)

    I think that has enhanced my reputation that I am completely fair with all patients and as a reminder to me, there is "always" the one patient we cannot help for whatever their reason :rolleyes:

    But if it is within 12 months he has to re-fill it free of charge !

    Cheers
    Derek;)
     
    Last edited: Dec 13, 2007
  11. javier

    javier Senior Member

    Re: Who offers a money back guarranty?

    Dear all,

    From a consumer behavior point of view. Health business is related to confidence and health perception improvement. If you offer money back guarantee as an argument for dispensing ( I do not dare to say selling) a health product, it introduces an uncertainty thought about outcomes on the patient mind. It can have negative effects on the health professional-patient relationship.

    But, if you prefer to avoid disputes with unhappy patients offering a refund it is an easy way to deal with them. Sometimes it can be the best option, but if you use it frequently it can affect your reputation. It is better to try to solve the patient unsatisfaction by different ways (like the ones Nick proposed)

    Regards,
     
  12. Daniel Bagnall

    Daniel Bagnall Well-Known Member

    Re: Who offers a money back guarranty?

    Yes I think it is paramount to go through an informed consent criteria, so that there are no surprises. I have learn't the hard way from this, which is why I go through the "do's and dont's" pretty thoroughly. If I have covered this basis and something unusual happens, often, it's not the devices, but rather more to do with pt complience. In addition, my rule is that if I've put in my 50% and the pt isn't willing to put in their 50%, then I dont necessarily think it should fall back on the practitioner.

    Regards,

    Dan
     
  13. jos

    jos Well-Known Member

    Re: Who offers a money back guarranty?

    No, I have never given a refund in 10yrs of practice. I just make sure the patient really understands every aspect of having orthoses. IMHO the main challenge is footwear - if they won't change their attitude to footwear then they are not going to comply with their orthoses. Those "know it all- I've read it on the internet- I need orthotics" patients who come in demanding them ( i actually had one wander in yesterday, not that they have a hope in hell of an appt before Feb 08) I will often send somewhere else......I don't need the hassle.
    If ,of course ,the orthotics require modification/recovering within 12 months, then I do that at no cost to them. I guess it means we just have to get our diagnosis/prescrption right the first time and be aware of those demanding type A patients!!.
     
  14. DTT

    DTT Well-Known Member

    Re: Who offers a money back guarranty?

    Hi Javier

    I totally agree on that one.

    On the rare occasions I have given a refund it has been at my discretion ( see above) not as a condition of treatment

    And to quote Daniel


    Then you eventually come to a stalemate :bang:

    That's the point I give them a refund, I don't need the aggro either :hammer:

    Cheers
    Derek;)
     
  15. Paulo Silva

    Paulo Silva Well-Known Member

    Re: Who offers a money back guarranty?

    Hi all

    We don't sell health services or goods, only footwear fitting and accordingly to the company's long tradition and policy we offer money back guaranty.

    Apart for general costumers I use this specially with technical costumers

    At the initial sale, I always point to my costumers that I don't want to give them their money back but I do want them to be satisfied, so I encourage them to bring their shoes/ insoles back even used to find out what possible went wrong, we also call costumers 3 to 4 week later the initial operation and encourage them to come back if they report any complain.

    with this we do have to receive back a few pair of shoes / insoles but usually costumers buy a replacement, so it is clear (at least to me) that in the end its a win win situation: happy costumers good reputation to the store and finally more business to the store, and the few pairs I receive back I send them to manufacturer as defects.;)
     
  16. pgcarter

    pgcarter Well-Known Member

    Interesting to see the range of views and perspective here. I don't agree that having a refund policy is a "sales tool" like jugglers.....the very fact that you open the door for an income gives you an ethics issue right from the start, I don't think having a refund policy changes that one bit. One of the criticisms levelled at Pods is that they prescribe and dispense.....orthopaedic surgeons just tell you to go to the prosthetist/orthotist....which is supposed to be more ethical....but the fact that the surgeon did the surgery in the first place, for money, places the self interest question in the same place as it is for every business. Having the courage to back your own judgement financially is in fact quite ethical in my opinion. I am not suggesting that this be used up front as a sales tool as a way of "inducing" people to "buy" orthoses.

    regards Phill
     
  17. davidh

    davidh Podiatry Arena Veteran

    Hi all,

    I don't give a money-back guarantee on orthoses, although I'm happy to refund a patient the cost of their devices if they are really not getting on with them.

    I routinely operate a fixed cost policy. After the orthoses have been fitted and the pt has returned for their first check-up I stop charging. Pts are instructed that I will be seeing them again - as often as I need to to obtain the agreed-upon result. If everything is going to plan this will involve at least one more visit (usually at three months to ensure whatever improvement has been notoiced is actually maintained). Some pts wil require several follow-up visits, and ocassionally I have a pt who requires many follow-ups before we are both happy.

    The patient knows at their first consultation exactly how much everything is going to cost them, and I take great care not to raise unrealistic expectations (as I suppose we all do).

    I take the view that orthoses, like eye-glasses, should do the job they have been prescribed for.
     
  18. Scorpio622

    Scorpio622 Well-Known Member

    David,

    Would you give a refund for a pair of glasses that correct to 20/20 but fail to eleviate the patient's headache with reading? The problem with orthoses is that the desired effect is typically objective from the doctor's perspective and subjective from the patient's perspective.

    Nick
     
  19. Dr_Shibu

    Dr_Shibu Member

    Re: Who offers a money back guarranty?

    I agree with the above. That being said I have never seen a patient in the last 8 years who was so dissatisfied with an orthotic that they asked me for a refund. I do spend time with my patients prior to casting them & show them an example of what the orthotic will look like so they are not surprised when they see the device & its dimensions. I don't know of any podiatrist or cped in New York that offers a money back guarantee on orthotics or bracing.

    This is a slippery slope to go down. I have a friend who is a dermatologist who told me that he recently received a bill from a patient who was not dissatisfied with the care but felt that he was waiting too long for the doctor. The patient has sent him two letters so far threatening to sue hime if the doctor does not submit to his demands. I'm not trying to dissuade anyone with regards to their current policy but be careful how much you are willing to pay people just to go away.
     
  20. Dr_Shibu

    Dr_Shibu Member

    Re: Who offers a money back guarranty?

    I agree with the above. That being said I have never seen a patient in the last 8 years who was so dissatisfied with an orthotic that they asked me for a refund. I do spend time with my patients prior to casting them & show them an example of what the orthotic will look like so they are not surprised when they see the device & its dimensions. I don't know of any podiatrist or cped in New York that offers a money back guarantee on orthotics or bracing.

    This is a slippery slope to go down. I have a friend who is a dermatologist who told me that he recently received a bill from a patient who was not dissatisfied with the care but felt that he spent too much time in the waiting room. The patient has sent him two letters so far threatening to sue him if the doctor does not submit to his demands. I'm not trying to dissuade anyone with regards to their current policy but be careful how much you are willing to pay people just to go away.
     
  21. pgcarter

    pgcarter Well-Known Member

    It's not about paying people to go away.....My view of Australian law is that if someone sits in your waiting room so long that it causes them other damage then they have not mitigated their own damages, which they have an obligation to do, and cannot look to you to make that up to them.
    On the other hand if anybody keeps me waiting that long I tell them I won't come back, if they don't avoid that problem in future, a phone call can help a lot.......
     
  22. Heather J Bassett

    Heather J Bassett Well-Known Member

    Hi Philll think there may be a link to this previously.
    this topic comes up now and then?
    What if they help the foot function but not the Sx?
    I have never been offered a refund with a/biotics that did not work?
    Other meds that do not work?
    surgery that has not helped?
    Dental work that needs to be repeated.
    Must admit it is an interesting debate?

    Hope the break did you well.

    Cheers
     
  23. Kevinl

    Kevinl Member

    Do orthotic labs offer a money back guarrantee??. If so then theres your answer....
     
  24. Graham

    Graham RIP

    i don't offer a money back guarantee. I do guarantee that I will do what it takes to make every effort to resolve the patients complaint. I will sometimes replace the device with an alternative Rx, if adjustments haven't worked. Sometimes I will issue and OTC Vasily Howard Dananberg device ( No I don't work for the company). These devices are softer and more accommodative but also incorporate Sagittal Plane principals.

    In some cases referrals to other health care professions are required and are made.

    The Custom Lab I use (PARIS Orthotics) will do a re-make/adjustment at no charge if there is obviously a lab error.

    Regards
     
  25. bpod

    bpod Active Member

    Hi Graham,
    Just wondering where you order the OTC Danenberg devices here in Canada?
    From the east coast
    Sue Hall Davidge
     
  26. Kevin Kirby

    Kevin Kirby Well-Known Member

    Graham:

    Don't they have an OTC Vasily Graham Curryer device yet? I can just see your black and white photo now, with your chin resting in your hand, looking very solemn, in the advertisement for your own Vasily orthosis. This should really be a blockbuster of a product for Vasily.....what's the hold up??:rolleyes:
     
  27. Graham

    Graham RIP

    Kevin,

    No point in re-inventing the wheel. I apply saggital plane facilitation principals in my biomechanical application of choice. Vasily and Howard have done a nice job with this device. I use it for clients without insurance and for test devices.

    Anyway, my bald head wouldn't make for a great black and white shot.;)

    regards
     
  28. Alank

    Alank Member

    We do provide a money back guarantee also. Our group understands that there are many arguments to be made for not doing so. The bottom line for us is that the price of an unhappy patient may be much higher than the price of a patient who, though not cured, is at least not ticked off. It is hard to complain about a doctor that gives you your money back. It happens only occasionally and I think, on balance, has brought us much more in good will, new patients and an intact reputation.
     
  29. stirto

    stirto Member

    Yes. The Active Foot Clinic takes pride in the prescription of customised orthoses, so we do offer a three month (six months for heel pain) orthotic guarantee. This provides the patient with the confidence in the product that they will be receiving to reduce their foot pain.
     
  30. Kevinl

    Kevinl Member

    Howard Dananberg device????, I never heard of it. Please explain.....
     
  31. Graham

    Graham RIP

  32. pkt_diamonds

    pkt_diamonds Member

    Re: Who offers a money back guarranty?


    Excellent point.

    Offering money back guarantees and such only 'cheapens' our reputation as a profession.

    A client comes to us hoping that we can help them with a problem.
    I never guarentee that I will be able to provide the help that they need.

    The only time I would give someone their money back is if I guaranteed them that my orthoses would be 100% successful and I never do that.
     
  33. MrBen

    MrBen Active Member

    Re: Who offers a money back guarranty?

    Agreed. No medical procedure is 100%. You give patients the information and choice to go ahead with a procedure.
    Cant refund a lottery ticket because your numbers didnt come up
     
  34. Heather J Bassett

    Heather J Bassett Well-Known Member

    Ouch Howard would be so hurt ::--))
    WOW december 2007 and still going, long term thread Phil.(hi)kevin (hi)
    Sure there are some other threads with the same topic KevinL.
    Sure i have said the same things or maybe "ally is setting in" I have not had guarantees for synthetic ligs stuck in the knees, the screws in the knees, and jaw or many other choperations etc, just thoughts

    Cheers
     
  35. eddavisdpm

    eddavisdpm Active Member

    I believe that it is important that patients understand that we are not providing a commodity but rather a service. The orthotic device is a component of a biomechanical exam and treatment which, in turn, may be part of a larger treatment plan. The professional service is what differentiates the treatment we provide as podiatrists from a non-professional dispenser of medical equipment and devices. Additionally, orthotic therapy is dynamic in that the device may required modification over time based on the needs of the patient. For example, when providing foot orthotics for a patient with functional equinus, I may initially lower the medial longitudinal arch and avoid a forefoot post. Once the equinus has been mitigated the orthotic is modified accordingly.

    Larry Huppin, DPM of Seattle states that he guarantees orthotic comfort and fit but not a clinical end result such as pain relief.

    Ed Davis, DPM

    BUT... if one really insists, I will guarantee that the orthotics I provide....:dizzy:
    1) will never rust
    2) are HIPAA compliant
    3) are made in the USA
    4) contain no GMO (genetically modified) materials
    5) have a minimal carbon footprint (except for the carbon-graphite devices)
    6) have no impact on global warming...
     
  36. Paul Bowles

    Paul Bowles Well-Known Member

    Ed do you use thermoplastic devices? Aren't they a petro-chemical? Might want to retract gurantee's on 5 and 6!!!

    :)

    Also I note that Ed states Larry Huppin, DPM provides a guarantee on orthotic comfort and fit but not a clinical end result such as pain relief. It is important to remember that although pain may not reduce, function may improve.
     
  37. Pod on sea

    Pod on sea Well-Known Member

    I'm interested in excatly how you inform patients about your guarantee, what do you say?Are you guaranteeing they will be pain free/reduced symptoms etc. Do you refund your consultation fees?
    Many thanks.
     
  38. Alank

    Alank Member

    We guarantee that the devices themselves will be comfortable. One cannot guarantee that we will resolve their problem. that would not be legal. We do not refund consultation fees. In short, while we could rationalize away NOT refunding money for orthotics that are not comfortable (you don't get your money back for antibiotics that cause GI upset and antihypertensive agents that make you dizzy) we try to do what we would want done if we were in the patient's shoes (pun intended). On the other hand, today I had a patient that wanted me to pay to have her orthotics recovered because she decided she wanted black instead of the blue they were made in. We declined to do it for free. That was not reasonable.
     
  39. Re: Who offers a money back guarranty?


    Well put Lucky!

    I agree....if you want a guarantee, go buy a toaster! True, offering a "money back guarantee" implies....hmmmmm...do they know what they are doing? Think about this: I recall 2 twin sisters going for several months to the same Physiotherapist ( who has a great reputation and certainly knows what she is doing after 20 years of practice ) for almost the same identical left knee problem.

    After 9 months of treatment, the 1 sister had symptoms alleviated about 98% while her sister received only 10 % relief. Take a guess what they both said about the "profession of physiotherapy?!" Correct! 1 said it was "awesome" while the other said that "Physiotherapy doesn't work!!" See how rediculous that statement sounds?! Now, the same "goo" went on and into the same people but obviously the results were different. Welcome to medicine. So, when physiotherapists start refunding for therapy care ( I will be purple skinned and 30 feet tall when that happens) that "doesn't work", then , and only then will I offer this strange notion of an orthotic refund.

    I don't know about others, but if someone asked that patient (requesting the refund) to go and work for "free" at their job that day because their results were so-so, do you think they would do it?!! NOT!!

    1 thing does not work 100% of the time for 100% of your pateints. The orthotic is only a treatment option. We are not Gods and can predict and guarantee that it will "work 100". Health care doesn't work that way. Besides, the ONLY patients I have ever encountered over the last 25 plus years of practice that hinted at a refund were those NOT covered at all with a 3rd party insurance plan. Most of my patients have had anywhere from 60% 70 to 100% coverage; thus the only thing they have to lose is pain.
    Insurance companies make millions of dollars per year and they make more than Iand all colleagues in here combined and I don't plan to make them any richer. Also, IF and IF you were to refund, you would have to send it back to the 3rd party insurance Company and not the patient ( who already were rimbursed their $) as patient's could play that game all year long as they are double-dipping in the till.

    Nuff said!

    Later gator!
    :deadhorse:
     
  40. Rainer Maier

    Rainer Maier Well-Known Member

    :good:

    Yes we offer a 3 month 200% Comfort and Care Guarantee which is a guarantee on the comfort of the devices, not any results for treatment. At the end of 3 consults in 3 months they can get recast at no cost. If the devices still are not suitable they get a refund minus the initial consult fee.
    This has worked really well and the referrers love it. You can read more at www.completefeet.com.au
     
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