Can the machine companies dictiate to dialysis corps/units how many patients they must train at a time in order to be permitted to enter into a contract with them?
Companies that make dialysis machines can establish their prices for machines based on the numbers of anticipated patients a clinic will have. If you think about it, in many situations in our economy you can get price breaks if you buy more than if you buy only a few. For example, if you go to a printer to have 5 copies made, you’ll pay more for each copy than if you go to the same printer and have 500 copies made.
At the same time, individual clinics and corporations have the right to talk with sale personnel from multiple companies, to test machines, to ask for proposals, and to choose to do business with the company or companies that they believe will best suit the clinic’s needs. Hopefully clinics will also consider patient’s needs in their decision-making.
What I am asking is, can a machine co. say they will only agree to contract with a unit if the unit agrees to have x number of patients in a home program? For ex. say the unit only has 2 patients that want to do home txs., but the machine co. says they must have 5. There is nothing the unit can do about it if they don’t have more patients who are interested yet. What if the machine co. has been negotiating with the unit for months and patients have been promised a program and then the machine co. tells the unit at the last minute we need more patients. Is this ethical and do they have the right to require it?
I have heard of companies doing this and I think the company is probably trying to find out how committed the clinic is to home hemo. I’m sure it’s not illegal, although it’s frustrating for patients and may not be the best PR for the company. However, you have to think about it from the company’s perspective. When a company provides machines to a clinic, it’s not just providing machines, it’s providing training to nurses, manuals, customer service, and machine maintenance. It’s a significant financial commitment on the part of the machine company.
Maybe your clinic is not thinking outside the box. Is there any way your clinic could market a home hemo program enough that patients from other clinics would choose to transfer and start home hemo at your clinic? Are there other patients in your clinic who with more education about the advantages of home hemo might choose to do home hemo? How many patients does your clinic treat in in-center hemo?
Does your clinic offer a PD program? We’ve always said that if someone has to go off PD to HD, home hemo should be the first option offered. Depending on the machine, it might not take that long to train a PD patient to do HHD since PD patients already know most everything about doing dialysis at home except how to run the dialysis machine and do needle sticks.
I hope that your clinic will find more patients to do home hemo, but in the meantime, if you want a specific machine, I’d suggest you call the company and find out the closest place that offers it. Later if your clinic builds a program, you can always transfer back.
I’m not being disagreeable here but I don’t understand something.
Take Fresenius- Fresenius furnishes the machine- it’s paid for. I would think customer service would be included in the machine price as with almost anything you buy you expect some customer service.
Fresenius furnishes the machine maintenace. This is paid extra for.
Manuals for their machine have been done along time, I can’t see where this can be a big expense. Trainining nurses - 1 week? and wouldn’t they also include this in the price.
I can understand Fresenius not wanting to go into an area where there were only 2 patients and contracting for the maintenance because 1 serviceman couldn’t do multiple calls in 1 day. But our center doesn’t even use Fresenius for our machines they have an outside contractor so I can’t see them not willing to sell the machines because of significant financial commitment.
Fresenius also charges for the parts our center buys to fix the machines.
I don’t know about NxStage but on the surface it doesn’t seem as machine maintenance would be an issue as they are shipped via UPS or something anyway. They spent 1 week at our center training a nurse.
I’m sure it happens and I am sure there is a logical reason but I think it would depend on the machine co. as to what the reasons are.
The PHD would sell to our home center but wouldn’t service the machines, however they would allow our center to get someone else to provide the service. I can understand this because the PHD isn’t popular in our area and it would have been expensive to fly in service personnel to do machine maintenance with only a couple of patients.
Heather did you have any particular machine co. in mind when you posted?