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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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