What's in a word? Suspension, Elevated Vacuum? Suction Socket? Subatmospheric Suspension? Active Suction? Pump?

All of these are just words, but if they are confusing, they can also be misleading. The issue that was brought to my attention is that they mislead case managers who are struggling to wrap thier heads around all of this newfangled stuff.

In truth there is a continuum in socket designs from a socket with socks as the interface, to suction socket, to elevated vacuum socket with a fixed amount of vacuum (hand pump), to an elevated vacuum socket in which the pump regularly adjusts and restores the vacuum (e.g. Harmony, Limb Logic, Edison).

Also we know that elevated vacuum is more than just a suspension method. It stabilizes residual limb volume, reduces perspiration, and adds improved linkage, reducing movement and control. It was suggested to me that we abandon the term "elevated vacuum suspension" as misleading and instead use the words, "elevated vacuum limb volume magangment system"

The other suggestion is to call a system with a hand pump "passive elevated vacuum" and a system with a more dynamic pump "active elevated vacuum".

The thought is that we now have many different suction socket variations, each with different features and benefits, different precription criteria, different cost and complexities and they, perhaps, warrant different reimbursements. One concern is that lumping different technologies, each with a different cost basis, under the same name will encourage insurers to simply set reimbursements at the the level of the cheapest system. And then there goes the proper payment for the more costly active pumps.  How about we look at the words we are using a little more carefully so we don't shoot ourselves in the foot?