APMA News - September 2013 - (Page 26)

T Collaboration is Key at Limb Salvage Clinic hanks to an integrated team approach at the NoDr. Motew said he also has learned which patients are not vant Health Forsythe Medical Center in Wingood candidates for limb salvage, when many times a prosston-Salem, NC, podiatrists have achieved surgical thetic will accomplish a better quality of life and shorter healprivileges for the first time in 30 years—and patients are ing time than limb salvage. reaping the benefits. The multidisciplinary team at the center consists of podiTimothy Vogler, DPM, was the first podiatrist to be grantatric surgeons and vascular surgeons; hospitalists; social ed surgical privileges at the hospital, where for 30 years his workers; and specialists who handle orthotics, nutrition, and colleagues had been denied despite multiple lawsuits. many other matters bridging the entire continuum of care. When vascular surgeon R. Bradley Thomason, MD, first On average, there are 12–13 inpatients and two to four approached Dr. Vogler about starting a limb preservation new patients from around the region each week, most of team, Dr. Vogler was skeptical. “I didn’t see it happening withthem on Medicare or Medicaid. RN Navigator Laura Harout surgical privileges.” vey, said, “Even with no advertisements, we have patients Dr. Thomason developed an interest in wound care who come from Virginia and South Carolina, just by word while treating a tremendous of mouth.” number of diabetic foot comWhile there are plans to plications. He saw that, expand outpatient services, Ultimately, hospital executives alone, vascular surgeons much of the center’s focus lies were swayed by the numbers. weren’t doing all they could in treating acute infection for diabetic patients and realand progressive ischemia and When they saw the cost savings ized foot and ankle specialproviding overall limb salcare by podiatrists would bring ists needed to be integrated vage care in the highest-risk into the wound-care team. patients. to the hospital, coupled with the He faced an uphill battle And it’s working. Since number of at-risk patients leaving convincing the hospital. Dr. the center opened, patient Thomason and others worked town to get help, they were on board stays have gone from several with committees at the hospiweeks to only five or six days. with what has become the thriving tal, and Dr. Vogler lectured on The hospital has seen impodiatrists’ wound care exproved outcomes, monetary Limb Preservation Center. pertise. Ultimately, hospital and time savings, and a greatexecutives were swayed by ly reduced amputation rate. the numbers. When they saw the cost savings care by podiaDr. Motew said the center’s goal is to build a stronger trists would bring to the hospital, coupled with the number focus on prevention and improve transitions of care, but, of at-risk patients leaving town to get help, they were on as it is, patients are seeing lasting benefits from the inteboard with what has become the thriving Limb Preservagrated care. tion Center. Dr. Vogler recommends that podiatrists who may be inDr. Vogler said the center never would have been possible terested in starting a limb-preservation team open a diawithout a partnership with vascular surgeons. logue with vascular surgeons in the area. “In some settings, Vascular surgeon Stephen Motew, MD, senior vice presivascular surgeons are very familiar with what podiatrists dent of physician services with Novant Health, recalled a key do, but at our hospital, they were blown away at what DPMs lesson he learned about wound care from Dr. Vogler that concould do—especially Charcot foot care and our training vinced him that including DPMs was necessary. and background.” n “As vascular surgeons, we dealt with [the] majority of acute foot infections that may not have had vascular disease,” said Dr. Motew. “I had a patient with a horrendous mid-foot infection. Based on the size of the wound, I was Editor’s Note: APMA and the Society for Vascular Surgery (SVS) prepared for a below-the-knee amputation, but Dr. Vogler continue to strengthen their relationship through collaboration to said he thought he could salvage it with skin grafting and ensure the success of both professions. SVS offers podiatrists physimultiple debridements. That’s when I realized as a vascular cian membership. APMA members are encouraged to apply for surgeon it was no longer appropriate for us to handle foot membership with SVS and to build relationships with local vascuinfections. I ended up only amputating the third, fourth, and lar surgeons to educate them about podiatric medicine. Visit www. fifth toes.” vascularweb.org to learn more. 26 APMA News September 2013 http://www.vascularweb.org http://www.vascularweb.org

Table of Contents for the Digital Edition of APMA News - September 2013

APMA News - September 2013
President’s Message
Contents
What Happens in Vegas: The 2013 Annual Scientific Meeting
Annual Scientific Meeting Sponsors
Humanitarian Surgical Missions: A Different Kind of Residency Training
Collaboration is Key at Limb Salvage Clinic
Center for Professional Advocacy Reviews Recent California Medicaid Lawsuit
Oregon Podiatrists Achieve Physician Status
Letters to the Editor: Solving Our Residency Crisis; Remembering Our Heroes
Resolutions Submission Deadlines
Reimbursement
ICD-10: How to Code for Painful Hammer Toes
Federal Advocacy Forum
Cosponsors to the Helping Ensure Life- and Limb-Saving Access to Podiatric Physicians Act
APMAPAC Chair Report
Coverage Corner
Bylaws Propositions Due
IT Consultant
Website Wisdom
On the Road with APMA
Small Business 101
CPME Update
In Short
Worthy of Note
Affiliates Corner
New Members
Death Notices
APMAPAC Update
Development Update
Classified Advertising
Dates to Remember
Advertising Index
10 Questions
Your APMA

APMA News - September 2013