Guest Editorial:
In our ongoing efforts to provide you interesting and useful content, I am happy to introduce you to Megan Lawton, DPM, AACFAS, who has recently completed her first year in podiatric practice. Many of you may already know Dr. Lawton from her multiple literary contributions to the podiatric community. Dr Lawton completed her three year surgical residency at Grant Hospital in Columbus, Ohio and is now in practice with the Foot and Ankle Management Group in Naples, Florida.
—Jarrod Shapiro, DPM
One Year Impressions From A New Doc
by Megan Lawton, DPM, AACFAS
Being in practice for a little over a year now, there are certain things I have seen that are now becoming noticeable patterns.
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Instant gratification: Having your own patients and being able to relieve their pain in a couple of minutes is one of the most rewarding things I have experienced.
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The paper trail: I thought that residency consisted of a lot of paperwork. That was just the warm-up! Between office notes, phone calls, forms to be filled out, and everyday visits from drug representatives, it seems that there is no time to actually see patients.
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The customer (patient) is not always right: Many times patients will have pre-conceived notions of what they have and what they want you to do to treat it. Nine times out of ten, the research was done on the Internet, and the other 1/10th is a friend that has diagnosed them. Luckily, once you explain what the real problem is, most tend to follow the treatment protocols.
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The never-ending question: Hold old are you? It may be because the area I practice in is generally an older population and I look young to them, but I even have kids ask me as well. I am getting to the age where I actually appreciate the comments, but I don’t think a patient would outright ask the age of an older doctor.
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The ‘management’ in practice: There are a lot of ancillary services to provide to patients that are good for business as well. Imagine from a standpoint of not knowing anything medically. You are told by an office to get a product, and when you get to the store, there are 100 different varieties. Which is best? Now, imagine going to an office, them giving you a certain product stating that it is the best option for your condition. It takes all the guesswork out and saves patients time and reduces their stress.
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Interesting gifts: One of the more interesting things that I have received is a ceramic statue of an obese man riding a bike with golf clubs on the back. In contrast, I did get a really useful gift, which was a Joe Mauer (Twins) jersey
I’m sure as the years go on the patterns will change, some for the good and some bad. Right now, I will just enjoy this exciting time and hope that you are or will be doing the same.
I would love to hear from you what you think of my list, or if you have any patterns to add. Or, let us know what interesting gifts you have received!
Megan Lawton, DPM, AACFAS
[email protected] |
LETTERS TO THE EDITOR
***Surgical Cases and Board Certification***
It's going to take at least few months to be credentialed with Medicare and the private insurance companies, but that doesn't mean you can't be the primary surgeon. My assumption is that your charges are being billed under one tax ID (the senior doc's practice), and you are applying to be credentialed as a provider within this group.
As long as your senior doc is an assistant surgeon, you can be the primary. I don't think the payment will be affected. (He does have to cosign your notes, and be present for the surgeries). And for boards, you do have to be the primary surgeon. (I'll be sitting for them this year). Hope that helps.
David Baek
[email protected]
***Tell it like it is***
In response to your discussion about "tell it like it is". I agree with everything you have said but would like to add a pearl.
When I have a patient that obviously needs some form of amputation that is not emergent, I will often review the science behind everything and the need for amputation and add in "We will give it a good try but if I get a sedimentation rate or X-ray that shows worsening signs of infection, then I have no choice." I will then send the patient for the study and the majority of time the patient feels as if there has been a defined objective threshold set rather than my subjective decision. I will then inform the patient of their sedimentation rate of 100 and they will then TELL ME "OK doc then I guess we need to do this surgery, I'm ready." I have found the key to this discussion is explaining the results before the test is ordered. If the case is stable then I may wait a week or so between the conversation and acquisition of the study, assuming it will not harm the patient.
—Anonymous |
