There are a plethora of medical conditions that
can and should be added to Dr. Marks' dementia
list for at risk foot care coverage. These
include, but are not limited to, blindness (and a
multitude of other physical and mental conditions
that preclude patients from safely rendering self
foot care), immuno-suppression from ANY cause,
anticoagulant therapy, DM, to name but just a few.
That said, be careful what you wish for. Cash is
always a preferred compensation for medically
needed, rendered podiatric services; if the at
risk foot care coverage parameters are amended,
we'd collectively stand to sustain some income
loss with respect to those Medicare eligible
patients who currently pay cash because of
existent coverage glitches in the system. The
financial good news is this is unlikely to occur
given the current financially strapped government
health care state, who like any other actuary,
looks to restrict coverage as much as possible to
save healthcare resources.
However, fair is fair and right is right! This
patient demographic is often on fixed incomes.
Many forego needed palliative, podiatric service
in favor of filling prescriptions, or placing
food on the table...and some of our brethren may
find themselves in similar circumstances one day.
The financial, forced choice to forego needed
palliative foot care occasionally leads to the
creation, or exacerbation of podiatric medical
issues potentially preventable by receiving that
care. I'm certain every single podiatrist can
attest to this!
Why is it that a patient can see an internist for
a sniffle, be told they have a cold, go home,
told to take a cold tablet and get some rest and
that is a billable evaluation and management
service, yet at risk palliative foot care
coverage is limited solely to PAD, and in some
cases, LOPS? It makes zero sense! Our leadership
should continue to fight for at risk foot care
coverage parameters extended well beyond those 2
risk factors.
While our income would likely be reduced, for
this financially strapped health care consumer
group, it is the right thing to do. The irony is,
the pittance of compensation podiatric physicians
receive for these services pales in comparison to
the costs associated with hospitalization,
antibiotics, surgery, etc. when an untoward event
occurs as a result of the omission of that
palliative care. The "thinking outside the box"
ball has been dropped for far too long by
those "experts" who review those outcomes, while
more importantly, Medicare eligible health care
consumers have ALL been placed at risk from this
faux pas. Elderly patients unable, or compromised
from performing self foot care should be covered
in the exact same light as a PCP is for the
common cold.
Frankly, we shouldn't even have to argue, nor
fight this point...it should be a given because
it is the common sense, right thing to do...and
then I wake up to the reality that our government
treats its senior citizens no differently than
the rest of the insurance carriers treat their
subscribers. Shame on them for their
omission...shame on us for not being strong
enough to right an obvious wrong on behalf of
this financially challenged health care consumer
group that exponentially grows every year!
Barry Mullen, DPM, Hackettstown, NJ,
yazy630@aol.com
