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04/27/2020 James Burruano, DPM
Podiatrists and FQHC
Podiatrists can be strong, progressive influencers in healthcare and health outcomes. Podiatrists in the state of New York are not recognized as physicians. In my own experience, the need for a podiatrist to be considered a physician is important in certain circumstances. I wanted to share my experience(s) as a podiatrist in a Federally Qualified Health Center (FQHC) in Buffalo, NY. I was hired in 2013 as a staff podiatrist. At the time, there was no scope of practice for podiatrists in an FQHC at Neighborhood Health Center (NHC).
Once added, NHC became my new practice that I worked part-time at while I closed my private practices. After meeting with our CEO to discuss full-time status, she asked whether I wanted to interview for a position as the chief medical director. After taking time to think about this, I decided to interview for the position. I was offered the position, and after about 7 months my title changed to Chief Medical Officer. In 2014, NHC had a unique patient base of 16 thousand patients, with about 76 thousand patient visits between the podiatry, dental, family medicine, pediatrics, Ob/Gyn, nutrition and behavioral health departments. Having a total of 19 providers when I started in 2013, we had grown to 62 providers in 2019, with 27 thousand unique patients and 99 thousand visits per year.
This immense growth was in part due to opening two additional offices in Buffalo. I was very proud and humbled to be a part of this substantial growth – NHC was able to reach the most vulnerable patient populations in the Buffalo area. We also passed our HRSA site visits with perfect scores. Then, in early 2019 the NYS DOH came in (after HRSA onsite visit) and gave us a perfect score. However, they explained that a podiatrist cannot hold a title of Medical Director in New York State. The verbiage was that an MD/DO or "other qualified healthcare professional" can be the medical director of a FQHC.
Unfortunately, a podiatrist does not fit the description of "other qualified healthcare provider!" On behalf of NHC, I needed to step down, but our CEO decided that we would simply create a new title and change it to Chief Medical Administrator so I could continue to help with our organization’s growth. Devastated and disappointed, I felt that we, as podiatrists, should urge our local and regional associations to lobby for these opportunities. Many of us can excel at managing healthcare organizations that are ahead of the curve when it comes to advanced primary care as well as integrated care services.
James Burruano, DPM, Buffalo, NY
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