Cost Effectiveness in Podiatric Practice

Jarrod Shapiro, DPM
Practice Perfect Editor
Assistant Professor,
Dept. of Podiatric Medicine,
Surgery & Biomechanics
College of Podiatric Medicine
Western University of
Health Sciences,
St, Pomona, CA

During the past two years, while the economy has plummeted and everyone has tightened their belts, many have taken a hard look at the costs of doing business. The medical field has been no different. Cost effectiveness is the new buzz word in medical practice. Whether it’s a sole proprietor practice, multi-specialty practice, or large health organization such as a hospital, all administrators are trying to find ways to decrease the cost of medicine while providing high quality health care.

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At Western University, we're seeking efficiency through the ubiquitous use of technology such as electronic medical records systems and digital radiography. We’re trying to find easier and faster ways to cast patients for orthotics with several different scanners. There’s even a simplified casting method for total contact casts. Of course, some would argue all these attempts at greater efficiency and cost effectiveness are just the result of the medical profession’s catching up with the American capitalist philosophy.

Either way, whether it’s catching up with capitalism or the result of the economic downturn, cost effectiveness is viewed as one way to provide not only cheaper but better health care. Are there other ways podiatry can become more cost effective while becoming more efficient overall?

The obvious answer is yes. Here are a couple of ways in which podiatry as a profession can become more cost effective:

Research. More high quality research needs to be performed on just about every aspect of podiatric medical care, from nonsurgical and surgical treatments to effective practice methods. By answering the many unanswered questions, we’d be able to prove the effectiveness of various treatments, ending the constant argument over “experimental therapies,” saving everyone money in the long run.

Evidence-based practice. Moving hand in hand with # 1, we need to utilize evidence-based podiatric practice methods to understand the best treatments. For instance, is there a best bunionectomy? If this were answered with high quality research and utilized in an evidence-based manner, we would be likely to see less revisional surgery and decreased costs over time.
Centralized practice resources. Our national leaders, like the APMA and ACFAS, should expand the practice management resources available to their members. They should have our best practice management experts come together and create a centralized service that helps with daily practice questions and issues. For example, if I were to open a practice ,this service would provide me the tools to do so without the guess work and learning curve inherent to all entrepreneurial activities. Or they might create a centralized billing and coding service that eliminates the need for all the extra work that every practitioner puts into trying to get paid for what they do.

Education. All podiatrists could do with a better understanding of improving cost effectiveness in their practices, including some of the methods described above. Perhaps if we had our national experts prepare detailed Practice management mentoring lectures online in a recurring and updating series,the average podiatrist would have one more resource to become more efficient in his own practice.

There are, of course, limitations to the level of cost effectiveness any single specialty can achieve as long as healthcare reform remains unfinished. If, for example, insurance companies ran lower operating costs and a less complex system for providers to handle, money would be saved while providers would spend less time, effort, and staff dealing with these complexities. Imagine how easy practice would be if all insurances had one simple standard system for reimbursements. Wasted staff, time, and money is just part of doing business as a modern day doctor until this aspect changes. What other methods will improve the cost effectiveness of podiatric practice? Post your response on eTalk.