Practical Advice and the Future of Wound Care

Expert panelists share closing thoughts on future cost and management of wound care.


Peter L. Salgo, MD: I’m going to go around the panel. We’ve come to the point now where I’m going to get the seers of wound care, that would be you guys, not “ea” but “eers” of wound care. Take a look in the future. Take 30 seconds, 45 seconds. Tell me what you see going on forward from here. Michael, you want to start on this?

Michael T. Kazamias, MS, DPM: Sure. The future is that first of all, we know full well and what’s one of the sobering aspects is that Medicare itself has determined through its economic model that a chronic wound of a certain severity is 1 of the top 5 most expensive conditions that can beset a Medicare beneficiary. They adjust for it accordingly. That’s a huge opportunity for product manufacturers, for managed care plans, for provider groups to get together and develop programs bearing risk, if you will, or within a managed care environment, in coordination with CMS to be able to implement appropriate protocols, standardization of care, and economic models that can heal these wounds. They’re one of the top 5 most expensive conditions that can beset.

Peter L. Salgo, MD: Robert, you’re next up.

Robert J. Snyder, DPM, MSc, CWSP, FFPM RCPS: I agree first and foremost, you need the economic models to prove the point. I think once you have them, it will become crystal clear to people like us sitting on this panel that they’re truly going to find that if you intervene sooner and you’re doing the right things, and you’re educated to these conditions appropriately, and you understand the evidence, then these patients more often than not will do better than if they didn’t have that care. I also think that as we move to a value-based system from a fee-for-service model, I think things like point of care diagnostic tests are going to be extraordinarily important, so that we don’t have to wait a week to determine whether a patient may need a particular type of topical or systemic therapy.

Peter L. Salgo, MD: One of the bad points about being right all the time is you have to go last. They’ve used all the good stuff. What do you see the future of this problem being?

Samuel D. Young, MD, MBA, CPE, CHCQM: I think I’m going to use his, it depends. There are 2 futures that I can foresee. The more dismal future is we continue as is, that the cost from an economic standpoint as well as in just a general wellness standpoint of wounds, remains under appreciated and under recognized by the medical profession. Or, we help educate the medical profession on how serious a problem and how costly a problem this is. We get our primary providers who are our gatekeepers to appreciate the impact of a wound on an individual’s well-being and to intervene sooner than later.

Peter L. Salgo, MD: I want to thank all of you for being here. It’s been a tremendous discussion and for me, an eye-opener. It’s rare I sit on a panel and get surprised all the time. I want to thank all of you for sharing this information. To your point, one of the ways that we inform providers is to do just what we did. I hope you had a tremendous time watching this discussion. I want to thank you for joining us. I hope you found this Peer Exchange to be useful and informative. I’m Dr Peter Salgo, and I’ll see you next time.

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