A Deeper Understanding of Wound Care - Episode 8
The panel shifts its attention to the role of a wound care center and wound care specialists.
Peter L. Salgo, MD: Well, we’ve been talking about wounds, who gets them? And talking about how we should initiate treatment and what the protocols are. Let’s get a little more specific. Wound care centers, we’ve mentioned them in passing. What is a wound care center? In the best of all possible circumstances, what is the role of a wound care specialist? That’s a phrase you’ve used a lot.
Robert J. Snyder, DPM, MSc, CWSP, FFPM RCPS: A wound care center is basically an area, usually in a hospital because that’s the only time that a wound care center can actually be paid for their services.
Peter L. Salgo, MD: Can you back up for a second?
Robert J. Snyder, DPM, MSc, CWSP, FFPM RCPS: Sure.
Peter L. Salgo, MD: You can’t be a free-standing wound care center?
Robert J. Snyder, DPM, MSc, CWSP, FFPM RCPS: You cannot. To be paid under CMS [Centers for Medicare & Medicaid Services], you have to be affiliated with a hospital.
Peter L. Salgo, MD: I’m shocked. I would think you could have a free-standing wound care center.
Michael T. Kazamias, MS, DPM: Managed care allows you some latitude with this.
Peter L. Salgo, MD: Does it? How so?
Michael T. Kazamias, MS, DPM: One of the companies that I have founded was a company that brought all of the advantages of a wound care center to the outpatient environment. The company was technologically enhanced. We used some nice, gee whiz bang type of technology to be able to render that care. To your point doctor, on a classic Medicare fee-for-service, freestanding outpatient wound care centers are rare. Managed care has the latitude to be able to create them.
Peter L. Salgo, MD: OK, but you can carve them out inside a hospital setting.
Robert J. Snyder, DPM, MSc, CWSP, FFPM RCPS: You can carve them out inside a hospital setting. Sometimes they’re managed by ancillary groups, management groups that will actually manage the clinics for them, the hyperbaric systems. Hire the nursing staff, the physicians, etcetera. It actually is a place theoretically where you have a group of experts practicing under 1 roof. You have nurses who are extraordinarily familiar with wound management protocols and therapies. People, as with any other specialty, will go to the specialty clinics for specialized care. Now is that always the case? Unfortunately, it is not.
Peter L. Salgo, MD: If I were to ask you to, in a nutshell, define the role of the wound care specialist, because when I was in medical school nobody said to me, “Gee, when I grow up I want to be a wound care specialist.” You laugh, but I’m sure that’s happening now. Some people do want to do this. What is the role of a wound care specialist?
Robert J. Snyder, DPM, MSc, CWSP, FFPM RCPS: Two things I wanted to say. One thing I wanted to say first. There has to be a metamorphous. To your point, no one goes to medical school or podiatry school and says, “I want to be a wound care specialist.” It has to be an evolution. What was the second issue?
Peter L. Salgo, MD: Well, what do you do? How would you define what a wound care specialist is and does?
Robert J. Snyder, DPM, MSc, CWSP, FFPM RCPS: A wound care specialist, to my mind, is someone who understands the appropriate protocols, as they currently stand, who is practicing evidence-based medicine, who understands the importance of education, who understands that the patient has to be the center of the equation, and can work in a multidisciplinary field.
Peter L. Salgo, MD: I’m simply going to make a statement here, for the record. I love podiatrists. I work with them every day. We’ve worked with them in the operating room. They are amazing. That’s a specialty that requires focus, and what they bring to the table is underappreciated. Thank you, all of you out there, and those of us on the panel too. It’s really amazing, it’s great.