Applegate/30/dp1st/mark2nd
JANE APPLEGATE
One of the best ways to learn all about a business before starting your own is by working in a similar business.
Susan Heard was working as an office manager in a local prosthetics company when she realized she had better ideas about running the business than the owner.
For example, she responded to a patient’s suggestion and set up a support group for amputees. She founded the UnLimbited Amputee Support Group as a separate, non-profit organization, independent from her employer’s practice, and then began reaching out to the community before going out on her own in 1997.
In November 1997, she left her job and joined one of her employer’s former partners to start a new practice. A friend who was a bank vice president was not enthusiastic.
“He told me that no bank would give me the money to start the business,” Heard said. “I had no assets, and I was going through a divorce.”
She finally secured the start-up money from a relative. But her obstacles to success were formidable.
First, Heard and her partner were forbidden from contacting any of the 150 patients from their previous practice. Then, her previous employer filed a lawsuit against her that was eventually dropped. She also had to wait six months for their Medicare billing number to be assigned by the government so they could be paid.
Heard said they persisted because they knew there was a market for a more personalized approach to serving amputees, and the market was strong and growing.
The orthotic and prosthetics business is a $1.6-billion industry in the United States. Although it accounts for only one-tenth of 1 percent of the entire Medicare budget, the industry is growing, according to Martha Rinker, director of government relations for the American Orthotic and Prosthetic Association in Alexandria, Va.
The AOPA’s 1,800 members include many small businesses that sell supplies as well as operate patient-care facilities. There are 1,100 facilities accredited by the industry’s board of certification, but Rinker said these figures are incomplete because many prostheticists operate legally without accreditation, certification or membership in a trade association.
“Amputations in this country will continue to increase,” Rinker said.
Rinker said diabetes and vascular disease are the leading causes of amputation. As the American population lives longer, the side effects of these ailments increase the need for artificial limbs.
Rinker said younger people also need limbs due to an increase in cases of diabetes type 2, which strikes mostly teenagers.
In a state like Florida, home to a huge population of retirees, there is no shortage of patients. In Volusia County alone, where Heard is based, there are 5,400 amputees. Vascular and orthopedic surgeons refer their patients to local centers like Unlimbited to be fitted for an artificial limb after surgery.
Heard has a prostheticist on staff and makes all but the most specialized artificial limbs and braces in-house. Unlimbited’s approach to patient care has been different from the start.
“We can fit you in your home, and not everyone does that,” she said. Unlimbited also provides in-service training for hospital physical-therapy staff members.
Heard said her toughest competitors aren’t the other small practices that service her area but rather huge companies like the Hanger Orthopedic Group based in Bethesda, Md. Hanger recently purchased its largest competitor, Nova Care, which has 365 locations in 37 states and generated $252 million in revenues last year. Big firms like Hanger usually win the large HMO contracts and continue to expand nationwide.
But Heard’s mix of patient advocacy, personal care, customer service and grassroots marketing has given Unlimbited a competitive edge. She now serves 300 patients. In 1998 (its first full year in business), revenues were $400,000.
“That’s unbelievable for us,” Heard said. “We started with nothing.”
Heard, who studied criminal justice in college, credits her success with making people feel more comfortable about an uncomfortable situation.
“When you come into our office, it looks like a living room,” explained Heard, who relocated to Florida in 1996 with her husband and young daughter.
“It’s a family atmosphere different than the usual doctor’s office environment. We always have the coffee pot on,” she said. “People like to come here. It’s horrible that they have to be here, but at least when they are here, they are comfortable.”
By April 1998, Heard was so busy she had to hire an assistant. In February 1999, Heard decided her relationship with her partner was not working out.
“He wanted to move into a larger community, but I thought it was important to stay here,” Heard said. She used her own money to buy out his interest.
“That was difficult. We are just recovering from that,” she said.
But so far, life on her own is working out. She hired a new prostheticist, brought the manufacturing in-house, which saves time and money, and expanded her staff to three.
Heard credits her involvement in the local chamber of commerce and business community for increasing sales and credibility. She serves on the boards of the chamber of commerce and her local Business and Professional Women’s Association in Orange City, Fla.
Through her community contacts, Heard was able to recruit the volunteer services of accountants, lawyers, nurses and other professionals to help her with her support group.
Only six members attended Unlimbited’s first meeting. Now, the group has grown to more than 50 people who meet monthly to listen to speakers and socialize.
She continues to reach out to the community to do the right thing. While shopping, Heard approached a man wearing a worn-down artificial leg. “I said, ‘You need a new leg,’ and gave him my card,” Heard recalled.
Shortly after the patient’s insurance paid $10,000 for the new limb, the patient lost his new leg in a house fire. Believing his insurance company would not replace the leg, Heard used her contacts and connections to secure a new leg for the patient and recruited a dentist to replace the patient’s dentures, also lost in the fire, at no charge.
Growing up in suburban New Jersey, Heard admits she never thought she’d become an entrepreneur, especially the owner of a prosthetics company in Florida.
“I want us to be known as operating a legitimate, caring practice,” she said.
Heard’s accomplishments have earned her quite a bit of local recognition. In 1998, she was named West Volusia Business Woman of the Year by the Greater Orange City Chamber of Commerce. She also ended up marrying Mick Heard, the bank vice president who refused to give her a loan.
But marriage has not changed Heard’s opinion of most bankers’ attitude toward small businesses. “I’m sure the bank would lend me the money now. But now, I don’t want it,” she said. “I wouldn’t give them the satisfaction.”
Reporting by Robin Wallace. Jane Applegate is a syndicated columnist and author of “201 Great Ideas for Your Small Business.” For more resources, visit [email protected].
