02/02/2024    Steven Kravitz, DPM

New PSSD Diagnostic Device (Allen Jacobs, DPM)

I've been following the stream of posts that was
originated by Dr. Jacobs regarding PSSD and the
diagnosis of peripheral neuropathy including the
related double crush syndrome.

This device has been a around for many years and
the basic principles behind the current application
are still the same. Dr. Jacobs' original comments
were well stated indicating the controversy that
continues with the treatment and that it has not
been it has not been accepted into mainstream
medicine.

That said, Dr. Roth has interesting comments and
there no reason why a practicing physician cannot
apply new techniques to their patients as long as
they are informed as he indicated especially if
out-of-pocket money is required, or there is a lack
of solid good evidence in the literature.

I am well aware for the ethical questions brought
out previously in the stream of posts. The other
aspect brought up by Dr. Jacobs is the cost
involved in the equipment, vs. the reimbursement
level and probability of not having an ROI that
makes sense.

The cost of healthcare keeps increasing. New
techniques, though interesting, do not always add
to the efficacy of treatment or diagnosis.

There is a red flag here. Scenarios such as this
put the provider at a negative cash flow and the
tendency to over utilize intentional or otherwise.

Practitioners getting involved in early practice
should be very cautious of high price items that
have a lot of bells and whistles look attractive
and have very good marketing consultants to "sell
the goods".

The big lesson here is not just PSSD, but
developing practice model that selectively chooses
treatments that are efficacious, provide benefit to
the patient that otherwise will not be available,
and from a practice management standpoint, cost-
effective as much as possible.

Steven Kravitz, DPM, Winston-Salem NC area

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