02/03/2014    Michael Forman, DPM

Elimination of RFC Patients (Simon Young, DPM)

Again I agree with Dr. Simon Young - this time in
reference to "routine" and "at-risk" foot care.
This service is in the domain of the podiatrist
and that is where it should stay. I can accept
healthy patients seeing a pedicurist if they
choose, however all "at risk" patients must be
seen in a podiatry office.

It is wonderful that so many of our colleagues are
so busy that they don't want to bother with this
type of patient. This is the patient who needs us
the most. I have several podiatric colleagues who
do only foot and ankle surgery. That's great and
speaks well of our profession. Many of our three
year resident graduate choose not to do
conservative care. That certainly is their choice.

I see another avenue for the rest of us. I feel
that podiatry is in the same place that dentistry
was in fifty years ago when dentists performed
their own oral prophylaxis. Not so today. Dentists
employ dental assistants dental hygienist, and a
new super assistant who is trained to do
restorations.

It is time for podiatry to catch up. I employ two
assistants who I have trained to do conservative
care. They are artists who do the best "CNC" that
I have ever seen (without blood letting). They
don't make diagnoses. They trim toenails and
keratomas under our direction. One of our doctors
ALWAYS sees the patient, sometimes twice during
the visit. particularly at the end of the visit.
Approximately 20% of these patients will complain
of another problem which is addressed at that
time. This is what keeps our practice busy. Ohio
specifically states in the revised code that an
assistant can perform any task if they are
properly trained, capable of successfully
performing the duty, and under the direct
supervision of a physician.

I believe the majority of podiatrists should have
full service practices that offer the gamut of
foot and ankle care. Let's keep foot care in our
field.

Michael Forman, DPM, Cleveland, OH, im4man@aol.com

There are no more messages in this thread.