Paul Busman DPM, RN
Although I've retired from podiatry, Dr. Shavelson's recent comments on providing (aka selling) instruments for home self-podiatry care have inspired me to come out of retirement. An extra income stream is always welcome. I'm in negotiations now with a supplier of podiatry instruments and medications for the creation of Dr. Paul's Home Hammertoe Repair Kit. The kit will include a syringe and needle along with injectible lidocaine for local anesthesia plus a scalpel handle and blades, bone cutter, rasp, needle holder, and sutures, and other simple hand tools to do the job. Dressing materials included of course. All instruments would have extra long handles since the average patient might not be able to easily reach their own toes with conventional instruments.
We would arrange for me to instruct the patient in real time via Zoom on how to perform the procedure (Can anyone tell me the appropriate CPT codes for billing Zoom surgical support? Can I bill for a second surgeon fee?). Listen, we've all done digital arthroplasties and know how simple they usually are. What could possibly go wrong?
Seriously, I've read Dr. Shavelson's comments on this newsletter and have usually found them to be informative and sensible. This one is out of the pale though. After spending countless years counseling patients against "bathroom surgery", should we be enabling them to do exactly that? To me it seems irresponsible at best, dangerous at the worst. Doc, have you run this business model past your professional liability company? How enthusiastic were they?
Paul Busman DPM, RN, Frederick, MD