Many years ago, I took a job with a Multiple Sclerosis Society in another state that had nearly 500 members registered.
It was supported by 10 United Funds. The primary service consisted of a diagnostic and treatment clinic every Friday afternoon staffed by a neurologist, ophthalmologist, physical therapist and social worker. Also, a "loan closet" of assistive equipment such as canes, walkers, wheelchairs and other items was available to patients. Home physical therapy was the third service offered.
As the new director of the society, I could see several unmet needs that we could address in time. As a matter of policy, we didn't charge for the loan of any assistive equipment that we made available. It was expected that the equipment would be returned to the agency when it was no longer needed.
One day, a patient requested an electric hospital bed. We only occasionally had those in the loan closet and did not have one available at that time and were not likely to have one available. The patient asked what the price of the bed would be, new. With our not-for-profit discount, I told him the cost. He told me he would like us to purchase one for him and if we could allow him several months, he could pay us back the entire amount and when he no longer needed it he would donate it to us. As we had never done that before, I said I would have to talk with my board of directors before we took further action.
The board, very involved and dedicated people, were reluctant at first because this was an unusual proposal. An important factor was that they thought the patients would have enough trouble adjusting to their life situations without having to pay for equipment as long as we could provide it.
During the give and take of communications over the next several days, the patient said he would feel a lot better if he were able to buy the equipment rather than being given it. It was actually therapeutic for the man to pay for the bed rather than being loaned the bed. We agreed to his offer and purchased the electric hospital bed, delivered and installed it. After that, in cases of direct purchase of assistive equipment, the patient determined how much and how often to pay for it. He was given no instructions or suggestions for how to do it.
This began a dramatic new policy for the society and in time generated a considerable amount of money to be used for additional equipment or to pay for activities. It was not generally known who paid for equipment or who received it gratis.
A second significant program was initiated when we decided we could develop a discount purchase program with a medical formulary, or list of approved medications, for all patients who wished to participate. Those who participated could purchase at a discounted price the medical supplies they needed. This proved to be a boon to patients and their families that was broadly appreciated. This was before the days of Medicare and medical insurance, as we know it today.
Other programs introduced included a week-long, summer, family camp program that was oriented to physically disabled people needing wheelchairs and other special assistive equipment. Most of those people had never had a camping experience. In many cases the patients, their children and spouses enjoyed the experience together.
We had a one-morning-a-week plunge at a community center pool. Again, some of these folks had not been in a pool in years. We had physical therapists and helping volunteers in the water to protect and aid them. The buoyancy of the water helped people walk who otherwise could not.
Other programs introduced included a once-a-month family dinner at a community center and a billiards club of about a dozen men that met weekly at a bowling alley that donated the time.
All these programs were so well received that additional contributions came into the agency unsolicited. Some of the people wanted to pay for what they got, they wanted to participate in their own treatment when possible. We found that the policy of patient participation enhanced the therapeutic experience, as it benefited the agency.