When Robert Taylor stumbled upon an early TENS (transcutaneous electrical nerve stimulation) unit in the warehouse of a medical supply company he was working for in the early 1970s, he was somewhat intimidated. “When I opened the box and saw the batteries and wires and read about how the electrical current was to be used, I quickly put it away, wondering who would want to hook themselves up to such a device,” he says.

But as Taylor learned more about electromedical devices from a TENS sales representative, his initial concern changed to excitement. Here was a treatment that could reduce pain and edema without the dangers and side effects of drugs and surgery. Now, 30 years later, Taylor still believes that TENS units are one of the most effective means to manage pain and he has his own successful electromedical device supply company to prove it.

Targeting Workers’ Comp
Taylor is president of Medical Services Company (MSC), a Jacksonville, Fla, company he and his wife, E.J., founded in 1985 to market quality electromedical devices. To get MSC off the ground, Taylor—who already had experience marketing TENS to physicians and physical therapists—developed a flyer promoting the TENS units MSC carried and sent 1,200 of them to insurance companies and workers’ compensation providers. It worked. “We were flooded with calls,” he says.

They have not looked back since. Today MSC has 400 employees and a sales force of more than 50 individuals. As it continues to grow, it may even open satellite offices outside of Florida.

The Taylors decided to target workers’ compensation providers due to the growing number of work-related injuries occurring in the United States. The Occupational Safety and Health Administration (OSHA) reports that more than 600,000 Americans a year are injured due to overexertion or repetitive motion on the job. In addition, experts estimate that 75 million Americans suffer from acute or chronic pain.

With such a large group of potential customers, it is unsurprising that MSC is now a national leader in providing a wide range of medical products and pharmacy services to the workers’ compensation industry. Other services that MSC offers include prosthetics, HME, transportation, surgical supplies, nursing, and a retail prescription card network of 53,000 pharmacies throughout the country to fill workers’ compensation prescriptions.

In the electromedical niche, MSC has included products besides just TENS devices, such as muscular/ microcurrent electrical nerve stimulation (MENS) units, muscle stimulators, interferential current therapy devices, and galvanic stimulation units.

Robert Taylor

Case Management Model
MSC is structured as if it were a case management coordinator with vendor networks across the United States, Taylor says. It works directly with referrals from insurers and no longer makes sales calls directly to physicians and other health care providers. Instead, the insurance company or workers’ compensation provider orders the product and MSC ships it directly to the patient or physical therapist working with the patient.

Given a choice, Taylor prefers sending devices to the physical therapists. “Not only are they trained to use these devices, they understand their clinical value,” he says.

It can be tempting for some patients to hook up the devices by themselves, but if the electrodes are placed improperly, the treatment may be ineffective or even harmful. “Pain is subjective and moves around, so it takes a trained therapist to be able to locate the best areas on the body to place the electrodes,” Taylor says.

To assist its customers, MSC last year introduced online ordering of TENS units, and the number of insurance companies that preferred ordering directly through the Internet surprised Taylor.

However, MSC will not use Internet ordering as a way to reduce its number of customer service employees. Instead, strong customer service is how it sets itself apart from other companies with an Internet presence. The Web site allows customers to direct specific questions about products to appropriate staff, and it has a 24-hour, 7-day-a-week on-call service in case a patient or therapist has a question about the equipment.

Recognizing that in an era of cost containment, when the number of treatments by physical therapists is restricted by insurance companies, MSC also provides patients with detailed printed instructions on how to use the TENS units.

A Mature Market
TENS experienced the greatest growth in the late 1970s and early 1980s and this growth has leveled off in recent years. According to Taylor, the primary reason for this is that TENS units are no longer marketed as aggressively as they were in the 1980s. “In the past, sales representatives were very knowledgeable about TENS units and they met directly with physicians to educate them about these products,” he says. “This high level of promotion moved the product much more quickly than in today’s world.”

Pharmaceutical companies have also introduced a plethora of pain-killing medications, which are often used in place of electrical nerve stimulation.

Despite this, Taylor is still a strong believer in TENS and his company finds the devices to be a profitable product line. “In medicine, it is important that you have a variety of methods for treating a condition,” he says. “It would be terrible if everything depended strictly on surgeries and medications, so TENS offers a noninvasive approach that does not interfere with the body’s chemistry.”

TENS can be a good alternative for people with orthopedic injuries and conditions. However, pain management is a complicated business. Often TENS is used as a last resort instead of the first therapy tried, Taylor says, and consequently it sometimes gets a bad rap. “It is brought in after everything else has failed, and then it is blamed for not helping the patient when nothing would have actually helped the patient,” he says.

According to Taylor, in many cases physicians should prescribe TENS before resorting to surgery to manage pain. “Instead, what often happens is a cycle where a patient goes to his or her family doctor for pain, is then referred to a specialist, undergoes surgery, follows up with physical therapy, and yet still experiences pain,” he says. “When the patient checks back with the doctor, the patient is sometimes told that it is in his or her head when in fact the pain is real.”

Although Taylor admits that TENS is not a cure-all for pain, he is quick to say that studies prove it relieves symptoms for many patients. Workers’ compensation providers have been huge advocates of TENS since back pain is one of the most common work-related injuries and TENS is an effective and inexpensive modality for this condition.

Taylor also points out that a large number of TENS units are purchased for patients who underwent lumbar laminectomies (removal of the posterior arch of a vertebra) but still experience pain. And TENS has been used successfully for wound healing, childbirth, Cesarean sections, multiple sclerosis, Guillain-Barré syndrome (a paralytic disorder), and postoperative procedures.

Recent improvements to TENS units have made them less clunky and easier to use. “In the old days, you had to apply conductive jelly on the electrodes and you could not make adjustments without taking off the back panel with a screwdriver,” Taylor says. Now the units are cosmetically pleasing, smaller, and more comfortable.

“There will always be a need for TENS units and offering these devices has definitely made our company grow,” he says. “It has been one of my more rewarding moments in health care to receive feedback from all the customers who claim they have less pain because of TENS.”

Carol Daus is contributing writer for Dealer/ Provider.