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Hey do podiatrists treat the fractures of tibia and fibula or is it dependent on the state law?
Fractures of Tibia and fibula
- Thread starter cool_vkb
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It varies by state but also by hospital. Even if the state says you can do ankles, if a hospital says "no ankles" then you don't get to do ankles there.
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OR...you can tell the hospital administration that if you have had less training in ankles than all of the current attendings at the hospital, than you will not seek privileges there. BUT, if you've done more ankles in your residency training than any of the current attendings did in theirs, those attendings lose privileges too! I know a pod that recently did this at a hospital and got privileges (plus I think they became a little concerned with the legality of their former decision).
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Nice moves! One of my Partners did a lot of ankle 'scopes in Residency, but when he applied for privileges here the Podiatry Section fell under the umbrella of the Ortho section. The Ortho Chief of Staff happens to be a F&A Ortho. Guess what he said? "No 'scopes for you!" Seems like a bit of a financial conflict of interest there, wouldn't you agree? My Partner didn't feel like invoking the wrath of an Attorney against the town's only hospital right upon moving here so he decided to let that one go.
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So how much in terms of financial earnings is he losing because of not doing ankle. I mean is he compensating the "no ankle" with someother stuff like pre & post Operative care of the F & A or orthotics or etc, or he is just losing that money and happy with what ever he is getting in foot. And in general is there lot of money in ankle surgeries or is it more like a prestige issue?
And incase of your friend i know its his personal choice but seriously if a Pod decides to take this issue to court. Does he has any chance of winning or its gonna be a long hard battle?
Ok one more question, Do Physicians have the right to fight againts a hopsital decisions in court or is the hospital final authority. I mean for example, an apartment community is subject to housing laws and if they deny a certain member of race to their apartment housing then he/she can go and fight it in court. So can a physician who has been denied priviledge by hospital on some silly grounds or for no solid reason go to court and sort this out or whatever the hospital says its final and one cant argue it.
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My Partner thinks he lost very little in terms of ankle work. The referral patterns in this part of the state send ankles to Ortho, so at most we might get a dozen ankle chief complaints in a year (when the patients refer themselves).
The "bread & butter" of our group's business is bunions, hammertoes, ingrowns, heel pain, diabetic nail care, neuromas, athlete's foot (i.e., classic podiatry). We get a few rearfoot complaints (other than heel pain) per month. I guess we are "happy with whatever we are getting" as you put it, but all three of us work part time and make higher than average income.
The highest return we get is from ingrown nail procedures. If you figure the price of an office visit, minor surgical tray, and the PNA you're looking at around $500 for 20-30 minutes of work, with minimal follow-up care and high success rates without complications. In addition, they cost us little to do. It's mostly our time and effort, versus having to pay the lab for an orthotic for instance. If you look at income per time spent then ingrowns make us the most money in the least amount of total time. It's also one procedure for which the general public (and referring doctors) undisputedly feel Podiatrists are the best choice.
Ankle and trauma work held more lustre for me when I was a student and Resident, but now in practice with a family and interests outside of Podiatry, I honestly couldn't care less about it. Being on trauma call often means you have a higher chance of not getting paid and a higher chance of being sued, not to mention getting yanked away from whatever plans you had for that day. If you get lots of personal satisfaction from ankle work then by all means go after it.
I don't have the answer for the hospital privilege questions. I think one could seek the help of an Attorney if necessary to argue one's case.
Nat
P.S. - While you're learning how to do rearfoot and ankles, make damned sure you perfect your ingrown nail skills. You will probably see dozens of ingrowns per every one ankle. Since the public perception is that you're the one to see, then you'd better be sure you're great at it. The thing that most patients remember is whether or not the anesthetic injection was painful.
