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When I first dipped my caster wheels into the mobility industry in the 1990s, I knew what the pervasive issue was in the industry, affecting all, from consumers to providers to manufacturers to insurers. In fact, I’d recognized it from as early as my childhood in dealing with mobility product providers and manufacturers. And, I always knew what the key was to solving it. However, looking back to when I entered the industry, I underestimated the depth of the issue, and on top of that, due to a number of circumstances (constant funding cuts being one), the industry’s biggest issue has become even more pervasive as the years have past. You might say that the experience has proved along the lines of where you set out to extinguish a brush fire, only to realize that it's not just bigger than you thought, but lightning strikes are creating more fires all of the time.

The issue I speak of is, trust – or, more aptly, rampant distrust. For decades, distrust has plagued the mobility industry, and the personal and economic tolls continue harming everyone. Think for a moment of just how prevalent distrust is in our industry: Many consumers don't trust providers or manufacturers; many providers don't trust consumers or manufacturers; many manufacturers don't trust the policy-makers on Capitol Hill; many policy-makers on Capitol Hill don't trust manufacturers; many consumers don't trust insurers; many insurers don't trust consumers; and, on and on and on it goes, where these are just a few examples of how we have to wonder, does anyone trust anyone in this world of wheelchairs?

Personally and professionally, I trust virtually everyone with whom I interact – which is why I see eradicating distrust in our industry as so vital to everyone's success. I know the rewards of trust and the harms of distrust, and we simply can't continue a climate of distrust, as, again, the personal and economic tolls are too high. Therefore, let's take this occasion to look at the nature of trust, and recognize how applying it can elevate not just our industry, but our lives.

Trust, of course, is the foundation of all healthy interactions, albeit personal or professional. Trust is fittingly described by experts as being exhibited by two foundations: character and competence. Put simply, when we get to the core of trust, it's believing that someone always follows through with integrity – they do what they say.

Unfortunately, there's very little trust exhibited in the mobility industry. It's as if people distrust each other as a default mode, where even when there's every reason to trust, they default to distrust. I'll give you some examples that you'll recognize: I placed an order with my provider, but I don't believe that he called it in.... My consumer says that his power wheelchair simply stopped working, but he must have abused it.... The provider says that he didn't receive the part, but I bet it really was in the box.... As the insurer, surely we're paying for wheelchairs that people don't need....

No matter what area of the mobility industry spectrum in which we function, we've all encountered such statements – sometimes daily! But, here's what's striking: If you critically consider such routine sentiments, you'll realize that they are truly baseless assumptions of “bad intent,” merely rooted in irrationally defaulting to distrust. Using my above examples, we can say without question that providers promptly place orders (it's how they earn a living); consumers don't purposely break their wheelchairs (their lives depend on them); providers don't lie about not receiving parts (the faster they fix a wheelchair, the faster they get paid); and, people don't file insurance claims for wheelchairs that they don't need (no one wants to be in a wheelchair). Does each party have a self-interest? Of course. However, through our various roles, we’re also contributing to a greater good – that is, the supplying of life-sustaining mobility technology, and it’s all derived from good intent.

Now, I know, you may be saying, But, I know of an instance when there was clearly deliberate bad intent.... Sure, you can always reference a bad experience. There are millions of wheelchair users, with thousands of mobility professionals, whom have interacted for decades – of course there have been horror stories. And, that's regretful (and, unfortunately, based on aspects like Internet forums, horror stories, hearsay, speculation, rumors, and malice spread unjustified distrust like wildfire, unnecessarily alarming those with no reason whatsoever to be suspicious of anyone in the mobility industry – it’s a gossip and rumor mill on steroids!).

However, in actuality, as one who works in as many facets as anyone in the mobility industry (I cover a lot of bases!), I can tell you that valid issues of bad intent warranting distrust are extremely rare. Through everyone’s actions that I interact with, I see every reason to trust on a daily basis, with any sort of bad intent by anyone so far and few between that it in no way warrants the universal distrust that’s exhibited. Truly, what I witness is many in our industry distrusting simply to distrust – not based in reality – and this default distrust reflects horribly on all of our characters. We have virtually everyone trying to do right, with the best intent; but, because of unjustified distrust, much of the good is tainted by poor perspectives. It's not that those in the industry aren't trustworthy, many simply choose not to trust them, often even before interacting with them. Therefore, bad intent isn't the issue; rather, the issue is unjustifiable distrust – that is, defaulting to distrust without valid reasons.

Since we’ve now looked at the prevalence of distrust in the mobility industry, let’s see what happens when we compare it to the default mode of trust that we should strive toward.

Let's review two real scenarios – one based on trust, the other based in distrust – in my professional roles, and see how they socially and economically impact all of us:

Trust: Mr. Jackson emailed me that he left his battery charger at a hotel, and when he called the hotel, they couldn't find it. I shipped Mr. Johnson a new battery charger complimentary, and it arrived exactly on the day that I said that it would. I trusted Mr. Johnson, and he trusted me – and his issue was solved with no anxiety and very little time.

Distrust: Mrs. Jones called me, concerned that her provider hadn't placed the order for her new power wheelchair – just a hunch – asking me to check on it for her. She didn't have an order number, so I had to work with my sales department to try to find the order, contacting the field rep and provider. Wanting to give Mrs. Jones meaningful customer service, I was glad to ultimately verify for her that the order was placed exactly as the provider said. However, it took me some time to clarify the situation, and the provider rightfully questioned why Mrs. Jones distrusted him? Therefore, based on unwarranted distrust, Mrs. Jones was upset, the provider was upset by her questioning him, and my team and I invested time in tracking an order that didn't need tracking.

Obviously, Mr. Jackson's charger situation, based on trust, resulted in no anxiety, and Mrs. Jones' order situation, based on distrust, resulted in tremendous anxiety. However, in real dollars, which situation cost more to address, the trust or distrust situation?

One might conclude that the complimentary charger (trust), cost me more than tracking the order (distrust), because it's a capital product with a literal dollar amount attached. However, tracking the order actually cost more because of the man-hour and resources used, all having costs attached. Therefore, through these very real examples, we see how distrust simply costs everyone, whereas trust benefits everyone.

Some might say, So, it costs Mark more to chase down an order than to ship a charger – why do I care? The reason why all of us should care is because we're all affected by the socio-economic costs of distrust versus trust in the mobility industry. When an insurer distrusts a claim and audits it, it costs more and eats up time. When a provider distrusts that a consumer's wheelchair broke on its own, and drags out the repair process, it costs the provider more and eats up time. When a manufacturer distrusts a provider noting a missing part, rather than promptly sending the part, it costs the manufacturer more and eats up time. Again, these baseless distrust scenarios go on and on, but here's what we know: they each add cost and time to mobility products and services – we all lose.

However, to the contrary, trust lowers costs and speeds up processes. Let's look at a very obvious example of what happens when we move from distrust to trust: Medicare exhibits very little trust to beneficiaries, providers, and manufacturers. When a beneficiary needs a power wheelchair, he or she has to provide a litany of proof that he or she needs a wheelchair (distrust that costs Medicare – read that, tax payers – money, and slows the process). The provider who sells the wheelchair is subject to Medicare paperwork, processes, and audits (again, distrust that costs both Medicare and the provider money, while slowing down the process for the beneficiary). Then, Medicare reimbursement rates are slashed (reducing what power wheelchair technology they’ll fund), forcing manufacturers to alter their products (all of which often places beneficiaries in lesser products, decreasing independence, potentially escalating long-term healthcare costs). The result is that Medicare’s distrust in our industry ushers in a snowball effect of escalated costs and delays that effect everyone, right down to your tax-paying neighbors.

Yet, if Medicare simply used rational, “wise trust,” everyone would win – including Medicare and your tax-paying neighbors. If Medicare used a trust model and simply said, Of course a quadriplegic needs a power wheelchair, supplied by a certified provider and quality manufacturer, so here’s the approval for whatever technology is needed, administrative costs would go down, and delivery times for life-sustaining power wheelchairs would be lightning fast. I’ll say it again – trust cuts costs and speeds processes, period. (I know, you’ve just thought, But, there’s no due-diligence in such a practical, trust-based funding model! That’s irrational distrust talking. Wise trust says, He’s a quadriplegic – there shouldn’t be doubt by anyone that he needs a wheelchair – fund it, deliver it, cut the cost and save time!)

In these ways, if we shift our industry from distrust to trust, we will see huge rewards. Consumers will get better products and services, faster. Insurers will save money. Providers and manufacturers will operate more efficiently. And, everyone wins. This isn’t rocket science; it’s simply rational, integrity-based economics.

Finally, the key question is, If it’s so obvious that “trust” better serves all, then how do we make the shift from the current distrust mode to a trust mode?

The answer is, it starts with each and every one of us as individuals. See, it’s best to diagnose the issue from the outside, in – which we’ve done here by analyzing the prevalence and consequences of distrust in the mobility industry. However, in order to resolve it, we must work from the inside, out. We have to individually be trustworthy and trust others. Fortunately, as I witness every day, our industry is full of trustworthy individuals. From consumers to providers to manufacturers to insurers, most individuals are remarkably trustworthy. The difficulty is in one trustworthy person not trusting another – and that’s the illogical equation that needs solving. Yet, it’s easy to solve: Let us simply start from the inside, striving to trust others.

I ask you to take time to consider your perspectives on the mobility industry, and to truly consider why you may be addressing it with a level of distrust? Maybe you’re a consumer – what real reasons do you have to distrust all in the industry? Maybe you’re a provider – what real reasons do you have to distrust all in the industry? Maybe you’re a manufacturer or an insurer or a caseworker – what real reasons do you have to distrust all in the industry? The great peacemaker, Anwar Sadat, said, “He who cannot change the very fabric of his thought will never be able to change reality, and will never, therefore, make any progress.”  We’ve been destroying our very fabric in the mobility industry with a community of baseless distrust for decades, and it’s time to strengthen it with a culture of warranted trust, creating progress.

What’s ultimately required is a shift in each of our thinking, from unnecessary defensiveness to that of humility, where trust connects us all in the noblest effort to set a higher level of belief in each other, not just for the sake of our industry, but also for the sake of ourselves. Distrust destroys, but trust builds. We’ve had enough destruction. Let us each use trust to build a better industry and life for all.

Published 2/2012, Copyright 2012,