Originally Posted by Ankle Breaker
It seems like most conversations about residencies on this forum often lead us to the quality of surgical training one should be hoping to land. It appears the mantra is: great surgical training = you are more valuable then the next person = better job offers. It appears young doctors coming out of residencies, that do a lot of cutting, is the meal ticket to landing the F/A position with an ortho group. Again it's been discussed numerous time on these boards but most recently here: http://forums.studentdoctor.net/show...95&postcount=8
So I dare ask...what about the DPMs who graduate from residencies where they get superior wound care training? They get surgical training too, enough to sit for ABPS boards, etc. So why wouldn't an ortho group put a high value on an individual who can bring procedures that the group otherwise would have never seen?
It's been pointed out that F/A positions with ortho groups won't be available forever so why wouldn't an ortho group be inclined to hire DPMs who can provide great wound care along with the obvious palliative care a DPM usually provides?
Or is wound care over-rated? Would the ortho group be better off hiring a nurse or even a PT to do wound care? As a P3 student I am unsure if the quality of wound care training is similar across the board between a DPM vs. nurse vs. PT.
Excellent question. It may be that they don't hire DPMs specializing in wound care because they don't see a major financial advantage. Wound care is very rewarding professionally, but is not always rewarding financially.
Our office performs a lot of wound care and we staff a very busy wound care center. As a result, we treat a lot of patients at the wound care center, in our office and in the hospital for wounds. We obtain a lot of consults for wound care and perform a lot of debridements, I&D's, amputations, etc.
The majority of these patients have less than optimal health insurance and the vast majority of these patients are not wealthy or well educated. Although diabetes and vascular disease don't play favorites, the well educated and wealthy tend to take better care of their health care needs. Most of these patients have the knowledge and resources to obtain prompt care when there is a problem, vs. those who have financial difficulties and less education. As a general rule, these patients often wait until a problem is almost unfixable. It's a shame, but it's true. Of course this isn't to say that bright, wealthy patients don't end up with significant problems, but in MY experience, the majority of our wound care patients are not wealthy and not well educated.
These patients often can't AFFORD to take time from work to obtain care and often don't understand the potential sequelae.
As a result, many of the wound care patients we treat have insurance coverage that isn't exactly making us wealthy. These patients often end up back in the hospital every few weeks with recurrent problems. The time spent at the hospital, performing consults, following up, performing surgical procedures at various times during the evening and weekend, doesn't always make economic sense. However, it's a service that these patients need and deserve.
In my opinion, treating patients at a wound care center (or in the office) is often not economically "smart" and is not really a money maker. The best way to obtain a decent income from wound care is when you get reimbursed for supervising hyperbaric oxygen treatment dives. That's really where the money is regarding wound care.
So, the short answer is that wound care is hard work, a terribly needed service, time consuming and not always very profitable, in the absence of a hyperbaric unit. So this MAY be a contributing reason why the orthopods aren't looking for a DPM specializing in wound care.