Rolling the right way: the physician's role in wheelchair prescription.

Ms. Rholing, a 45-year old mother of 2 with primary progressive multiple sclerosis, presented to the wheelchair clinic at Southern New England Rehabilitation Center for evaluation of her mobility status. Two years ago, with a prescription from her well-intentioned doctor, this unfortunate woman obtained a simple power chair that no longer meets her needs. Like 177,000 other Rhode Islanders, Ms. Rholing has Medicare as her primary insurer. Due to her physician’s lack of awareness of stringent Medicare guidelines and documentation requirements, she is now precluded from obtaining a new, more appropriate, wheelchair. In an era of advanced medical technology, wheelchair prescription remains a misunderstood and undervalued service. Had Ms. Rholing initially been evaluated at a wheelchair clinic by a team of experts including a physical therapist, an occupational therapist, and a qualified medical supplier, the outcome would have been much different. In this article we offer a model for a comprehensive wheelchair and mobility evaluation. Ideally, the evaluation should include: