I have asked a dynamic group of practitioners to write editorials which contain a challenge to the profession and to YOU as residents. Dave Armstrong has answered this call with a great piece below. Please write in and comment on the role you see DPMs playing in the answer to this challenge... —John Steinberg, DPM, Editor
David G. Armstrong, DPM, PhD
Professor of Surgery
and Director
Southern Arizona Limb Salvage Alliance
University of Arizona College of Medicine
|
Against Proceduralism:
A Challenge to Podiatry for the Next 10 Years
Can teams trump technology in the new healthcare debate? I ask because I find myself frustrated by patient after patient we see in our SALSA unit, referred from elsewhere, who have been relegated to amputation. This is not because they haven't had access to technology. In fact, most have had extensive work done. What frustrates me, and I know my SALSA partners, as well, is the lack of access to team.
I am, as we speak, sitting in front of an x-ray of a patient who had extensive endovascular intervention—but no follow-through to manage her complex wound when the isolated procedure failed. Why? The cynic would suggest that it is because the procedure was reimbursed well, but the necessary healing and preventative follow up was perhaps less fiscally rewarding. Therefore, one may posit it easier to justify doing nothing or cutting the limb off.
Podiatry is in a unique position. Because of our position as hybrid medical/surgical specialty and the work we do in amputation prevention, we are at the beginnings of historic alliances with our colleagues in other like-minded medical and surgical disciplines. Teaming up will improve the quality of care and improve the continued move away from our medically segregated past. It is truly an exciting time.
The point is that our current and future healthcare discussion must work out some sort of balance to support medical and surgical teamwork instead of simply one-off fee for service proceduralism. I know there must be a way. This is a challenge to our discipline specifically and our greater healthcare system in general.
Too many smart people are involved and committed for this opportunity to pass.
| Get in on the eTalk Discussion — The Future of Podiatry |
|
|
Get a steady stream of all the NEW PRESENT Podiatry
eLearning by becoming our Facebook Fan.
Effective eLearning and a Colleague Network await you. |
 |
|
.jpg)
