HELP WANTED: Health care professionals needed to provide specialized product and service. Has potential to make good money and improve reputation with referral sources. Must be willing to meet criteria and work to dispel consumers' misperceptions. Not suitable for those looking to make easy money, but outcomes are beneficial with effort.

Curious? Several years ago, you probably would not have considered something like this, but with all the change in the air, you may be willing to check out your options.

Compression garments are no longer the stereotypical "grandma stockings" as so many still refer to them. With new technology, fibers, and understanding of various conditions, they have come a long way. No longer is it just the gray-haired grandmother in a housecoat who wears them. It's the 25-year-old flight attendants, 50-year-old businessmen, 15-year-old burn victims, 62-year-old breast cancer survivors, and 38-year-old athletes who are wearing compression garments.

The increased awareness of the impact of circulation on all aspects of health—and the preventable death of a well-known person—has created more interest in compression garments. The general public and an ever-widening range of health care providers are realizing the relatively low-cost benefits of treatment with compression. This, combined with the retail movement of health care, has created a niche in the market that is growing in appeal.

While the demand for compression garments is increasing, it can sometimes be difficult to find knowledgeable providers. There are the drugstores, Internet sites, and discount chains selling compression stockings. However, consumers must be knowledgeable and able to make decisions based on the limited information on the package. Because compression does have the ability to greatly affect various functions of the body, there is a need for educated, experienced, and knowledgeable providers. Many health care providers are also finding that good providers who educate patients mean better treatment compliance.

Compression garments are more than just "socks." Depending on the condition being treated, its severity, and the treatment options, compression can be used on just about every part of the body. While surgical procedures and medications have come a long way, health care providers still find good reasons to rely on the simplicity of compression. Various garments include:

Shelly Weber

• compression stockings—calf, thigh, full panty—ready made or custom;
• lightest compression—18 mm Hg;
• T.E.D. hose is a brand name doctors may prescribe;
• light compression—16 to 20 mm Hg;
• class I stockings—20 to 30 mm Hg;
• class II stockings—30 to 40 mm Hg;
• class III stockings—40 to 50 mm Hg;
• lymphedema treatment garments—ready made or custom made;
• arm;
• torso;
• leg; and
• post-burn/scar formation garments—ready made or custom made.

Before you order two cases of compression stockings (just because you've heard they are non-Medicare items), be sure to ponder the challenges. With a little thought and investigation, you will be able to determine if your situation is right to add compression to your product mix.

SHOULD YOU CARRY COMPRESSION HOSIERY?

If you are going to be a compression therapy garment provider, you need to be willing to commit to:

• Personnel: For start-up situations, one person is usually adequate. Add staff members if demand increases. Depending on your market, you may want to have male and female trained personnel to accommodate the needs and comfort level of patients, as there is some degree of undress during fittings.
• Privacy: You will need a private room with a door, an examination table long enough to lie down fully, chairs with arms, a writing desk, and a small storage cabinet. An area behind a curtain or in the bathroom is not suitable.
• Adequate stock: Be prepared with supplies such as disposable gloves, examination robes, and examination table paper to avoid bodily fluid contamination.
• Sanitation: Be willing to discard tried-on and contaminated, returned, used, or custom garments that did not work. People want to be assured the personal garment they are purchasing has not been worn by anyone else. While steps can be taken to minimize waste, it does happen and it can be a large financial bite, especially with custom garments. Of course, you can have a strict return policy, but you risk losing the lucrative repeat customer, which is high for this product.
• Time: Compression garments can take as little as a half hour and up to several hours per fitting, depending on the condition, its severity, and the type of garment required. Custom measurements are labor- and time-intensive as are fittings for the garments. If you rush through a custom measure job and the garment does not fit, you throw out hundreds of dollars.
• Inventory dollars and space: There is potential for a large volume of inventory when you consider the variety of styles, lengths, colors, and compressions. You can start out with a small initial investment, but you should be tracking sales to make sure your inventory is covering the demand. As you grow this niche, your inventory should grow with it. Thankfully, the packaging is relatively small.

Realizing the seriousness of what you are dealing with forces you to be a better provider. This is not a display by the cash register. Compression affects other major bodily functions such as the kidneys, lymphatic system, circulation, and blood flow. Diagnosed and unknown conditions, such as pregnancy, diabetes, blood clots, edema, kidney disease, congestive heart failure, venous ulcers, and arterial insufficiency, can be greatly affected by compression. You can't tell a customer, "See if it works."

THE DISPLAY

Put only the lightest compression stockings out for display, as recommended by some manufacturers. If a customer needs something in class I, II, or III, they should have a prescription. If a customer asks if you have something "heavier," explain that they should check with their doctor first and ask for a prescription in the desired level of compression. Liability issues are another reason to limit your display.

LEARNING CURVE

Compression garments have a similar experience curve as rehabilitation seating and positioning. Do not expect to be able to do everything and anything with any degree of expertise right away. There is a range of compression, and as compression increases, so does the need for health condition and product knowledge. The manufacturer's training provides you with enough information to get started at a basic level, especially if you are totally unfamiliar with compression garments. As you become more experienced, you will be able to handle more difficult cases. It is certainly advantageous if you can hire someone who is already experienced.

Shelly Weber, CMF, is marketing director and women's products manager for Clark's Orthopedic & Medical and The Appearance Center manager at Clinic Cancer Care, Great Falls, Mont. She is a third-generation certified mastectomy and compression stocking fitter. Weber can be reached via e-mail: .