By Patrick K. Lynch CBET, CCE, CHTM
We are at a sensitive place in our profession: Our future existence is being threatened. Various entities would rather have us not be able to maintain our own hospital’s medical equipment—instead preferring to lock us out through various means. Although many of their tactics are legal today, I consider them greedy and underhanded.
Patrick Lynch
We are at a sensitive place in our profession: Our future existence is being threatened. Various entities would rather have us not be able to maintain our own hospital’s medical equipment—instead preferring to lock us out through various means. Although many of their tactics are legal today, I consider them greedy and underhanded.
These entities, as you all know, include password protections, restrict service materials, offer limited or no access to meaningful service schools, restrict the sales of repair parts, refuse to sell parts unless a service contract is in place, levy a $6,000 (or more) minimum zone charge if you don’t have a service contract, and do many more restrictive practices.
The Current State of Affairs
Hospitals are on their own. Each must do the best they can to negotiate for future rights to service their own equipment. If they fail to negotiate the proper clauses and protections, the equipment manufacturer will exercise every legal means to force the hospital to use only their services—at a cost that is exponentially more than the true cost.
This only serves to add millions of dollars to the manufacturer’s profits while adding many millions of dollars to the cost of healthcare in the United States—healthcare that we are all paying for. And because of current laws, and the lack of any centralized negotiating body, hospitals are totally at the mercy of these companies—who, in my opinion, often provide poorer-quality service to the customer than a good in-house program.
For one thing, in-house programs are always at the main hospital. They do not have to schedule a visit or travel from another hospital. They can respond to the troublesome equipment in a matter of minutes, often while the patient is still being treated, and resolve the problem without needing to cancel or reschedule procedures. Secondly, in-house teams know the hospital, the departments, the personnel, the routines, and the equipment intimately.
When a call comes in, it is not an anonymous “hospital J; model XYZ; serial number 87654” machine,” but it is “room 7 in main radiology, where they do the fractures of the little kids from the ER,” and it is Mary calling.” The call, the people, the problem, the urgency, the response, and the passion to restore operations are all personal. This is a crucial difference between in-house and outside, contracted service.
Looking to the Future
The situation today? Lackadaisical laws, as well as efforts by manufacturers, lobbyists, and trade organizations to introduce new laws in an attempt to restrict or stop anyone but the original manufacturer from servicing medical equipment. In some places, these individuals are almost succeeding.
They have been convincing lawmakers that allowing anyone but the original manufacturer to service medical equipment would cause many deaths to innocent people since only the manufacturer knows how to do it correctly. If these laws pass, our roles may become unnecessary. We may be out of jobs. And hospitals around the nation may lose billions of dollars due to high equipment maintenance costs.
I’ve had conversations with leaders of many local and national HTM associations. We have all agreed that no local biomedical association has ever achieved the goal of significantly changing a single major problem that is plaguing the biomedical profession.
The large goals are just too big for them. Even the largest associations are not prepared to take on a multi-state, multi-year battle to change laws that will guarantee open access to whatever we need to maintain our own medical devices.
Several problems cause this:
- There’s not enough money in any single state association to fund such a fight.
- There’s not enough people to do the necessary work on all fronts to engage in such a battle as this.
- An entirely volunteer-based organization simply does not have the continuity of leadership, personnel, and activity to engage in any long-term, intense campaign. With volunteers (I have been one for more than 37 years continuously), life, family, work, and health all get in the way. Activity levels rise and ebb. There is no torchbearer who can carry the fight and message forward year after year.
But this can happen in an organization with paid staff. When you have people whose paycheck is dependent upon accomplishing certain milestones, performing certain tasks, and contacting a certain number of people, the mission carries on regardless of outside pressures and events.
A Proposition for the Industry
Join the American Hospital Association (AHA). I am speaking with them about creating a special personal membership group (PMG) specifically for the HTM community. It would operate and be structured like the American Society for Hospital Engineers (ASHE) and would be for HTM.
Here is the vision: Every local biomedical association in the U.S. would become a chapter of this AHA association. All of your members would join the AHA association.
I believe that since it is part of the AHA, hospitals administration would be more likely to allow membership to be paid with hospital funds. In return, the AHA association would provide a wealth of benefits for us—the greatest of which would be constant monitoring of bills introduced into every state legislature across the United States. If a threatening, or unfavorable bill is introduced, we would have the time and resources (through AHA leadership and name recognition) to wage a battle to defeat it.
They could bring our message about manufacturer restrictions directly to the hospitals and get action at a national level. No longer would only the systems with big purchasing leverage and the foresight to negotiate well have an advantage. Every hospital could have the freedom to manage its medical equipment as it sees fit.
By being part of a central organization, we could centrally produce marketing materials, member educational videos, as well as presentations. AHA membership would also give HTM professionals access to other types of healthcare professionals who are in the AHA.
What About AAMI?
I have been in contact with AAMI leadership, who have suggested that the AHA is a better place for this sort of relationship. AAMI does not wish to change their support of the HTM community, nor are they threatened by a proposed AHA association. This sort of advocacy is not something that they are prepared to undertake.
Summing It Up
Everyone I’ve shared this plan with—including society leaders and members—agree that the current situation is getting us nowhere. And when faced with all the options, they believe that the AHA is the place that will give HTM the greatest clout and stature going forward.
On June 22, I spoke with the executive director of ASHE , P.J. Andrus, as well as their 2017 president, Russell Harbaugh. They are preparing to take this request to the AHA board within the month. As a business entity, part of the board’s main concern is financial viability. Especially important is that they have a good estimate of how many people will join this new association. If it is 50, they won’t even consider it. If it is 10,000, it’s a different ballgame.
How You Can Help
Please write a letter to:
PJ Andrus, CAE, Executive Director, American Society for Healthcare Engineering: 155 N. Wacker Chicago, IL 60606; email: [email protected] cc: [email protected]
In this letter, please convey your interest in being affiliated with a new society supporting the HTM community. If you are a member of a local association, please mention that association, as well as how many members it has. This is all about numbers and how many potential members a new association can bring to the AHA. If you are an officer of board member, mention that, also, as well as how you support this move on behalf of your association.
And get your coworkers to write letters—all of which should be sent before July 7. If there was ever anything that our career futures depended upon, this is it. Your letter or email could mean the difference between having a biomed future and not having one. Please do not procrastinate.
Mr. Lynch, as I read your words what comes to mind is the fact that medical equipment is increasingly becoming a disposable commodity. Cheaper, faster manufacturing methods and low cost overseas labor combined with nano technological compact hardware assemblies have made it virtually impossible for technicians to administer effective onsite repair solutions. In most cases the manufacturer would rather send you another one. Also, modern Technicians are trained and educated to be IT professionals and many lack the desire to “take the lid off the pickle barrel to see whats inside” as we of the more seasoned generation were accustomed to. Also, let’s face it, the volume of work left to understaffed CE departments drive HTM’s to turn to manufacturer service agreements and exchange programs. People no longer have faith in the Technicians ability to approach ANY piece of medical technology and effectively resolve maintenance issues that present themselves. How do we resolve these issues?
Here is my suggestion:
I’m Matthew Du Vall and a member of the Intermountain Biomedical Society 159 strong. http://www.icis-biomed.org.
I am interested in supporting saving HTM careers
Feel free to contact me for further information and action
I have been reading on how the lobbyist and some legislators are trying to enforce who works on hospital equipment. What I am seeing in the field, when looking at vendor service is that, at least in my area, there is a lack of field service personel and jobs are not being filled to cover the service load. If it is considered that this field started in late 70’s early 80’s and was fed from the military personel most of the field has retired. So to put legislation in to restrict non-vendor service is only a way to combat lack of available vendor personel.
What is really concerning is that AAMI is not planning on assisting in this cause. What does AAMI stand for? If there are no in-house programs where does that leave AAMI?
Pat, your ideas and zeal to solve the problems mentioned are greatly appreciated! As a Board member of my association I have some reservations about your request. Without having a “discussion” within our Board & perhaps even the membership, I would hesitate sending a letter to the AHA saying we “support” this concept. I believe we DO support the idea of having discussions with the AHA. I also think that we would need to have further discussions about what it means to be part of the AHA. Impact on our members (some of whom are vendors/manufacturers). Cost to members. Value the AHA brings to our association. Expectations of AHA towards our association and so forth. I do believe it is worth having these discussions, and I will write a personal letter to say this. This is my personal view, not that of my association since we have not had adequate time to fit this into our agenda. Probably will discuss next week. Chris Walton, WSBA.
Here is a copy of my letter in place of a comment. Dear Mr. Andrus,
After reading Mr. Lynch’s column, I would like to convey my interest in being affiliated with a new society supporting the HTM community. At the ripe old age of 54, I am new to HTM (graduated college, and started working in HTM in 2014) but I have been working in and managing vehicle maintenance operations since 1978. Without national representation the HTM field may go the same way vehicle fleet maintenance went. Most fleets no longer have in house mechanics, due to the same reasons Mr. Lynch raised in his column. As far as AAMI is concerned they fulfill the same role as the National Institute for Automotive Service Excellence, and have to represent all groups equally to retain public confidence in their neutrality. I believe there are enough potential members in our community to justify a special personal membership group. In the words of Mr. Benjamin Franklin “If we do not hang together, we shall surely hang separately.”
Hi Pat:
Great thought but what about HIMSS? Today, everything we do in Biomed has an IT connection. Aligning with them might not be so bad.
I have believed for more than a decade that a national organization that exists to support our field is the only way for the in-house or independent HTM professional to survive. This post is a great example of why we need such an organization. I received the email on July 6th requesting a response by July 7th. Not to mention that this is a very popular vacation time. I am not sure how many other people received this email after the requested deadline. Has this limited the responses? I am not sure. Pat, can you reach out to the AHA to extend the deadline into August so we might get the word out to more people? I will send a letter as you requested, but would like to forward your article on to my co-workers if the deadline is extended. And Pat, thank you for all your efforts to improve the HTM profession.