Georgia Scope of practice questions?

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

cool_vkb

Member
10+ Year Member
15+ Year Member
Joined
Jun 24, 2006
Messages
1,583
Reaction score
3
hey, i thought i will give u guys a break from flypod discussions by asking my list of stupid questions.

According to Georgia scope of practice, we can work till Hip. iam kind of confused. why wud a Podiatrist need autonomy to go till Hip unless he wanna work on other parts of leg.

Lets say, a well trained Podiatrist in rural Georgia with no access to any Orthopedic surgeon nearby, gets a patient who has damaged his foot and ankle and parts of leg including knee. An elephant ran over him. ha ha ha!

Lets assume the Poditarist had a very good residency training and did a number of surgeries on leg and knees in his orthopedic rotation under Orthopedic Surgeons. Now there isnt any orthopedic surgeon in that area. And he is well capable of doing it. he has even attened a fellowship in switzerland:D and even Russia:D . he is sure he can handle it. So under Georgia laws, can this Podiatrist go above foot and start fixing the fractures or operate on his leg and knee. or he has to refer to a orthopedic surgeon.

Plzz dont bring this issue of ethics or morals or malpractice, lets use the word "TECHNICALLY" here. its more good. so "TECHNICALLY CAN HE OR CAN HE NOT DO THE ABOVE PROCEDURES other that foot"

Guys, i am gonna spend my whole life in illinois. So i have no plans to do such thing in my life. but i have some weird imagination "elephants in rural georgia" lol! and i imagine things and i ask questions. iam just curious.

Members don't see this ad.
 
hey, i thought i will give u guys a break from flypod discussions by asking my list of stupid questions.

According to Georgia scope of practice, we can work till Hip. iam kind of confused. why wud a Podiatrist need autonomy to go till Hip unless he wanna work on other parts of leg.

Lets say, a well trained Podiatrist in rural Georgia with no access to any Orthopedic surgeon nearby, gets a patient who has damaged his foot and ankle and parts of leg including knee. An elephant ran over him. ha ha ha!

Lets assume the Poditarist had a very good residency training and did a number of surgeries on leg and knees in his orthopedic rotation under Orthopedic Surgeons. Now there isnt any orthopedic surgeon in that area. And he is well capable of doing it. he has even attened a fellowship in switzerland:D and even Russia:D . he is sure he can handle it. So under Georgia laws, can this Podiatrist go above foot and start fixing the fractures or operate on his leg and knee. or he has to refer to a orthopedic surgeon.

Plzz dont bring this issue of ethics or morals or malpractice, lets use the word "TECHNICALLY" here. its more good. so "TECHNICALLY CAN HE OR CAN HE NOT DO THE ABOVE PROCEDURES other that foot"

Guys, i am gonna spend my whole life in illinois. So i have no plans to do such thing in my life. but i have some weird imagination "elephants in rural georgia" lol! and i imagine things and i ask questions. iam just curious.

you're completely missing the point of the law - we're not orthopedic surgeons and neither are the DPMs at Georgia. In residency training, you may scrub in for a few knee and total hip replacements but that doesn't mean you should attempt them - unless you are looking for professional suicide. The point of the scope is to allow DPMs in Georgia to use soft tissue from the hip and thigh in reconstructive procedures - not to allow them to do total hip replacements or operate on knees.

The fellowships you mentioned above are designed to further advance your training in the foot and ankle - i.e. educational purposes. They are not a crash course for you to become an orthopod in 3 months.

cool, you posted a few times regarding the scope so please keep one theme in mind, you are a DPM - your job is the foot and ankle (maybe the distal leg in some states) - Get the idea of you treating anything else out of your head unless you are trying to figure out a way to lose your license as fast as possible
 
you're completely missing the point of the law - we're not orthopedic surgeons and neither are the DPMs at Georgia. In residency training, you may scrub in for a few knee and total hip replacements but that doesn't mean you should attempt them - unless you are looking for professional suicide. The point of the scope is to allow DPMs in Georgia to use soft tissue from the hip and thigh in reconstructive procedures - not to allow them to do total hip replacements or operate on knees.

The fellowships you mentioned above are designed to further advance your training in the foot and ankle - i.e. educational purposes. They are not a crash course for you to become an orthopod in 3 months.

cool, you posted a few times regarding the scope so please keep one theme in mind, you are a DPM - your job is the foot and ankle (maybe the distal leg in some states) - Get the idea of you treating anything else out of your head unless you are trying to figure out a way to lose your license as fast as possible

Oh! now i understand. Naah man! iam happy with foot and ankle. i just get amused when i see laws or statements where pods do something else apart from foot and ankle. So i ask how it is possible. suppose if i wudnt have been a pre-pod, how in the earth wud i know what is soft tissue or bone. i cud just think Pods can operate upto hip in georgia.

its just that i get amused from these things and i want to understand exactly. Regarding fellowships i was informed by Dpmgrad and others that these are stricly educational:thumbup: , so that has been already expalined. thanks for that info also.

thank you boss!:thumbup:
 
Members don't see this ad :)
Well you didn't know if pods could use local anesthesia last week so who knows...plus aren't you already accepted into pod school?
 
hey, i thought i will give u guys a break from flypod discussions by asking my list of stupid questions.

According to Georgia scope of practice, we can work till Hip. iam kind of confused. why wud a Podiatrist need autonomy to go till Hip unless he wanna work on other parts of leg.

Lets say, a well trained Podiatrist in rural Georgia with no access to any Orthopedic surgeon nearby, gets a patient who has damaged his foot and ankle and parts of leg including knee. An elephant ran over him. ha ha ha!

Lets assume the Poditarist had a very good residency training and did a number of surgeries on leg and knees in his orthopedic rotation under Orthopedic Surgeons. Now there isnt any orthopedic surgeon in that area. And he is well capable of doing it. he has even attened a fellowship in switzerland:D and even Russia:D . he is sure he can handle it. So under Georgia laws, can this Podiatrist go above foot and start fixing the fractures or operate on his leg and knee. or he has to refer to a orthopedic surgeon.

Plzz dont bring this issue of ethics or morals or malpractice, lets use the word "TECHNICALLY" here. its more good. so "TECHNICALLY CAN HE OR CAN HE NOT DO THE ABOVE PROCEDURES other that foot"

Guys, i am gonna spend my whole life in illinois. So i have no plans to do such thing in my life. but i have some weird imagination "elephants in rural georgia" lol! and i imagine things and i ask questions. iam just curious.

The answer to your question is no. It is my understanding that the law in Georgia allows soft tissue work to the thigh, not bone. I dont think there is any law that allows a pod to go into the knee or above, at least I hope not. I think I would side with the orthos on that debate if there were such a law. The reason a pod would work on the thigh (soft tissue) is to take a skin graft that is needed for the lower leg or foot. If the pathology was limited to the thigh, refer it.
 
:
Well you didn't know if pods could use local anesthesia last week so who knows...plus aren't you already accepted into pod school?

accepted to pod school doesnt mean u know everything. if i wud know everything then why wud i go to pod school. i cud start my practice now only:laugh: . Plus podiatry is different in each state. in NY it is foot, in Illinois it is foot & ankle and tendions of leg. So its kind of confusing and no one knows everything abt every state and their scope of practice. i know thoroughly abt my state's scope of practice but how cud i know abt Georgia or Floria.
 
Bingo, this is great for skin grafts. Pods are many times forced to harvest from the calf or have a general surgeon harvest (which means the pod does it and the general surgeon stands there w/o being scrubbed, says "that looks good" and bills from $4000).

Also, this allows pods to treat compartment syndrome in the leg, DVTs, lymphedema, gait problems secondary to muscle weakness. Basically, things that we learn about, practice, and then in some states are not allowed to do.
 
Bingo, this is great for skin grafts. Pods are many times forced to harvest from the calf or have a general surgeon harvest (which means the pod does it and the general surgeon stands there w/o being scrubbed, says "that looks good" and bills from $4000).

Also, this allows pods to treat compartment syndrome in the leg, DVTs, lymphedema, gait problems secondary to muscle weakness. Basically, things that we learn about, practice, and then in some states are not allowed to do.

Dr Feelgood,

In your honest opinion do you see the states collectively standardizing the scope of practice for DPM's in the near future? (say around 2015, in which the APMA previously stated) Just curious...
I am planning on going back to MN, so I don't have a lot of concern about this issue. However, I was just wondering if you knew more about this since you been with ACFAS more and have more experience.
 
By all means, go ahead throw a few nails in, try a LISS plate. It can't be that hard you've seen it done.:eek:
 
By all means, go ahead throw a few nails in, try a LISS plate. It can't be that hard you've seen it done.:eek:

LOL, dawg relax don't worry this doesn't happen - its a misunderstanding on the scope...
 
By all means, go ahead throw a few nails in, try a LISS plate. It can't be that hard you've seen it done.:eek:

And you are referring to ???:confused:
 
No I do not see this occurring in the future until better leadership is in place. PPAC spends all of its time on the stupid Medicaid bill and not on important issues.

Also, pods can't even agree what the scope should be so w/o a consensus we cannot move forward.

To me the top two issues are scope and equal pay, not Medicaid. Dr. Yoho said it best, you don't invite yourself to dinner. If we make podiatry a vital position across the board, then it doesn't matter if you are listed as a physician in the Medicaid law b/c no one can do it w/o you. Cause dawg sure as heck is not going to take care of all of the diabetic ulcers and nail care. :)
 
Members don't see this ad :)
No I do not see this occurring in the future until better leadership is in place. PPAC spends all of its time on the stupid Medicaid bill and not on important issues.

Also, pods can't even agree what the scope should be so w/o a consensus we cannot move forward.

To me the top two issues are scope and equal pay, not Medicaid. Dr. Yoho said it best, you don't invite yourself to dinner. If we make podiatry a vital position across the board, then it doesn't matter if you are listed as a physician in the Medicaid law b/c no one can do it w/o you. Cause dawg sure as heck is not going to take care of all of the diabetic ulcers and nail care. :)

exactly, we leave the nails to the pods in our area and tell them to comeback if they need any other surgery.:laugh:
 
Ingrown toenails are coded as surgery. But I wonder are you going to do a Weil, I mean a shortening metatarsal osteotomy. (don't want to give the pod credit :laugh:)
 
Ingrown toenails are coded as surgery. But I wonder are you going to do a Weil, I mean a shortening metatarsal osteotomy. (don't want to give the pod credit :laugh:)

Yeah I will. Like I said though my guys are funny like that.
 
I'm just giving you a hard time. When I create some amazing surgery you can name it for the orthos okay??
 
No I do not see this occurring in the future until better leadership is in place. PPAC spends all of its time on the stupid Medicaid bill and not on important issues.

Also, pods can't even agree what the scope should be so w/o a consensus we cannot move forward.

To me the top two issues are scope and equal pay, not Medicaid. Dr. Yoho said it best, you don't invite yourself to dinner. If we make podiatry a vital position across the board, then it doesn't matter if you are listed as a physician in the Medicaid law b/c no one can do it w/o you. Cause dawg sure as heck is not going to take care of all of the diabetic ulcers and nail care. :)

Yeah, I hear what your saying. Why worry about the little things like Medicaid, when what should be changed about the scope and equal pay is bright as day. Do they not understand that we go through 7 years of Specific Medical training for this? C'mon:idea:

What I thought was interesting about diabetic ulcers was how much KCI charges for their wound vac. Hey, I understand this is an awesome invention of hooking up a vacuum to someones wound to increase healing time via rapid granulation. The DPM would charge somewhere between $30-40 depending on the size of the wound and KCI would let the patient take it home for $130 per day. Then Medicare says hey we see a significant rise in wound costs within the last few years, lets reanalyze this in 2007 and see if everything is necessary. Whats your take on this?

MEDICARE NEWS

10/02/2006

Wound Care Services

We will determine whether claims for wound care services were medically necessary and billed in accordance with Medicare requirements. Medicare-allowed amounts for certain wound care services billed by physicians increased from approximately $98 million in 1998 to $147 million in 2002. We will also examine the adequacy of controls to prevent inappropriate payments for wound care services
 
This is crapola. The problem is not the care it is that we are fatter and fatter. I do think that Wound vac is over priced similar to external fixation, but the thing works and well. I've put on at least a dozen vacs and I'm always amazed at what they can do.

To me if Medicare wants to decrease wound care costs, push podiatric foot screenings more. An ounce of prevention is worth a pound of cure.
 
Yeah, I hear what your saying. Why worry about the little things like Medicaid, when what should be changed about the scope and equal pay is bright as day. Do they not understand that we go through 7 years of Specific Medical training for this? C'mon:idea:

What I thought was interesting about diabetic ulcers was how much KCI charges for their wound vac. Hey, I understand this is an awesome invention of hooking up a vacuum to someones wound to increase healing time via rapid granulation. The DPM would charge somewhere between $30-40 depending on the size of the wound and KCI would let the patient take it home for $130 per day. Then Medicare says hey we see a significant rise in wound costs within the last few years, lets reanalyze this in 2007 and see if everything is necessary. Whats your take on this?

MEDICARE NEWS

10/02/2006

Wound Care Services

We will determine whether claims for wound care services were medically necessary and billed in accordance with Medicare requirements. Medicare-allowed amounts for certain wound care services billed by physicians increased from approximately $98 million in 1998 to $147 million in 2002. We will also examine the adequacy of controls to prevent inappropriate payments for wound care services

what does KCI means? u said right KCI charges $130 something.
 
This is crapola. The problem is not the care it is that we are fatter and fatter. I do think that Wound vac is over priced similar to external fixation, but the thing works and well. I've put on at least a dozen vacs and I'm always amazed at what they can do.

To me if Medicare wants to decrease wound care costs, push podiatric foot screenings more. An ounce of prevention is worth a pound of cure.

or ban the Big Mac
 
what does KCI means? u said right KCI charges $130 something.

KCI is the company that makes the Wound Vac system which is a negative pressure wound closure product AKA a portable vacuum that sucks out gunk and junk. The wound closure times are improved w/ a general decrease in bacterial load. But the system must be changed a lot and therefore lots of office visits and a need for home health care nursing.
 
Top