Michael Schäfer, CPO
Chief executive officer of Pohlig GmbH explains O&P care and reimbursement in Germany
O&P ALMANAC: Describe a typical work day for you.
MICHAEL SCHÄFER, CPO: A typical work day for me starts between 6:30 and 7 am. and ends between 8 and 9 p.m. ar Pohlig GmbH, a facility that engages in the research, design, and creation of health care and rehabilitative aids for children and seniors. My daily work belongs to typical chief executive officer´s duties and strategic human resources, as weil as interactive communication with our specialized units of O&P.
Part of my day involves working together with our experienced CPOs during patient examinations with recommendations and discussions for the best O&P treatment – in these cases, my expertise helps me serve as a „firefighter“ in difficult O&P cases. That´s what my heart beats for.
Additionally, I travel a lot between our different workshops all over Germany, with similar expertise as mentioned above, and I spend some time working on national O&P, research, and political boards.
O&P ALMANAC: Describe the location where you provide services.
SCHÄFER: In addition to our headquarters in Traunstein, Bavaria, we run seven highly specialized orthopedic workshops all over Germany – in Hamburg, Berlin, Cologne, Heidelberg, Nuremberg, Munich and Aschau, and one outside Germany in Vienna.
Because of the high specialization in the fields of individual O&P, patients from all over Europe visit our workshops.
O&P ALMANAC: What types of patients do you typically see, and what types of devices do you fit for theses patients?
SCHÄFER: We specialize in highly individualized custom-mad prostheses for upper and lower extremities, orthoses for trunk and head, orthoprostheses for people with congenital malformations and syndromes, and individual seatings. Approximately 70 percent of our clients are children. Adults are treated in specialized O&P teams, where our CPOs, physiotherapists, and doctors focus on the best outcome with our devices.
Our rehab offers special wheelchairs, beds, rehabilitation devices, home care, and wound management. We also have a division for shoe technology, with approximately 20 staff members offering individualized shoe production, insoles, diabetic footcare, and more. So there are approximately 540 dedicated people who run our daily business.
O&P ALMANAC: How are the devices you provide paid for?
SCHÄFER: Our devices for national patients are paid for by insurances from the German health-care system; most of them are public bodies, but some of them are private insurances. Of course, we also have additional social insurances and a worker´s compensation insurance, which is organized centrally in a concern-like structure and traditionally with a high scope of services. Devices for European and international patients are often paid privately, by international or European services or from national insurance departments that are ruled by agreements from the European community.
Most of the devices are described in a register called „Hilfsmittelverzeichnis“. As technological advances are protected by German law, most of the upcoming new devices – which support and significantly improve the people´s daily living – are paid for by the health-care system. Therefore we have to sign contracts, where the codes and the prices for the products are ruled in a pricelist. Most of the products in O&P are covered by the health-care system except a small amount (between 1 and 75 euros) that patients have to pay as a statutory co-payment. Additional extras and specialties, for instance design characters or high-end cosmetic devices and enhancements, often have to be paid on top by the patients themselves.
O&P ALMANAC: If the payor is other than the patient, do nonpatient payors have an audit process? lf there is an audit process, do you consider it to be fair?
SCHÄFER: Of course, there are audit processes in Germany. Often nonpatient payors, like insurers, are trying to reduce the costs of an evaluated prosthetic or orthotic treatment by accepting cheaper devices than submitted. The patient here in Germany is protected by law, so he or she can place an official protest, where allsides (representatives from insurance, medicine, therapy, and CPOs) have to argue the pros and cons of the recommended treatment. If the payor does not accept the argument, the patient still has the opportunity to go before the law, where a chief judge will render a judgment. The whole process can take a lot of time but at least will be absolutely fair.
O&P ALMANAC: Describe your educational background and any certifications you have. How do you keep your skills sharp?
SCHÄFER: Before I started in the profession, I did my university entrance diploma in a German secondary school. The professional education for O&P certificates lasts three years and runs in a dual system, where I worked in a company workshop, learning all the basics of practical O&P, and additionally in a specialized medical school, where all of the theoretical concepts were taught.
After doing my certificate as a CPO, I worked in a specialized O&P workshop for another four years, improving my performances of patient treatments, and then visited the O&P Bundesfachschule in Germany, where I focused on the German Meister Degree education and the ISPO CAT 2-certification in an additional one-year full-time study. It was certainly a lot of school and practice, but it was all intended to improve daily practice and allowed me to receive a deep background for my work.
In the 30 years of my business practice, I completed nearly 200 courses, including specialized certifications for O&P techniques, and I took all of the required refresher courses and visited a lot of conferences and colleagues. I also worked on the Meister Certifications Board for 10 years.
I have given many lectures at national and international O&P conferences, workshop, and courses, and a lot of presentations. To be honest, every new presentation keeps me deeply up to date on the topic.
O&P ALMANAC: What´s the biggest challenge you face as a practitioner, and how do you deal with it?
SCHÄFER: The biggest challenge as a practitioner in O&P is providing the best for our patients. Best performances in O&P will only be possible if you can offer understanding and empathy to the patients and, on the other side, the knowledge and the complete horizon of O&P methods and markets. Therefore, continuous search, research work, and developments of new technologies, materials, and procedures for improving our quality of services in individual patient care are essential.
Every patient is different and most of our paitents require individually adapted treatments. Out of our internal network of colleagues, quality circles, and research and development groups, there are so many good and new ideas coming up daily – and that is what my colleagues at Pohlig and myself are burning for.
O&P ALMANAC: Describe any charitable work you or your organization does.
SCHÄFER: As we treat a lot of children with O&P devices in our company, every year a special amount of orthotic and prosthetic treatments for children will be donated to nonprofit organizations or poor children/families visiting us from developing countries.
We also have founded a registered society called „Pohlig hilft“, which means „Pohlig helps“, where we support disabled people here in Germany with fundraising efforts to improve their performances of daily living.
Source: O&P ALMANAC | APRIL 2017