Memes of Podiatry

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Don't remember if I did this one...losing track of them.
 
I missed the title of the newspaper. Laughed again.
 
Wow great stuff here
 
icebreaker32 said:
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Why do people think using a PCR for wounds is legitimate?

Why does PCR for wounds even exist?

How did medicine ever function without abusing PCR for wounds? Oh wait it did…

I mean seriously. Why are podiatrists doing this? Why do insurance companies even reimburse for this crap?
 
CutsWithFury said:
Why do people think using a PCR for wounds is legitimate?

Why does PCR for wounds even exist?

How did medicine ever function without abusing PCR for wounds? Oh wait it did…

I mean seriously. Why are podiatrists doing this? Why do insurance companies even reimburse for this crap?
Click to expand...
PCR gives you results much faster and more comprehensive than standard culture. Definitely has helped my practice, but we use an outside lab so we’re not motivated to PCR sample stupid stuff (nails, cough cough).
 
CutsWithFury said:
Why are podiatrists doing this? Why do insurance companies even reimburse for this crap?
Click to expand...

Because some podiatrists have to wreck it for everyone.

Insurance covers it because PCR microarray are powerful tools used by ID and other competent providers to narrow appropriate antibiotic therapy within hours instead of days. It is truly revolutionary.

Since you are doing the salvage/recon side of our profession lookup biofire array. Some decent studies from Mayo backing it.

The problem are the people who…
1. Use swabs… tissue culture is gold standard
2. Culture the base of wounds…the colonization/bio burden is not meaningful
3. Obtain superficial cultures, if it ain’t deep it is junk
 
I think the funniest part about PCR podiatry garbage is that we should have seen it coming. How many people here went to some sort of junk podiatry conference where someone was pushing you to have a "lab in your office". I never for a second spoke to any of those people. Seemed like the dumbest thing in the world. Little did I know they were pushing a path for you to bill $750 of unnecessary care a wound.

I'm not bothered by inpatient PCR- ie. I believe for the last few months of my residency they were using PCR for blood cultures and the results were coming back way faster. Seems like there should be value in finding and identifying a positive blood culture as soon as possible or the right antibiotic for a bone infection that you aren't going to be able to resect.

The problem for me is that the majority of outpatient wounds do not need to be cultured. They need definitive treatment leading to closure as soon as possible. I'm willing to admit there are circumstances that are more complicated then this and people with deep infections, but there's an enormous cohort of wounds where people fiddle forever when the wound could have been closed in 1-2 weeks instead of a year if they were treated right. The reimbursement for a 5th metatarsal head resection is less than the reimbursement for the PCR that didn't need to be performed.

I frequently have someone present with new onset cellulitis to a diabetic wound on the tip of a toe. They get antibiotics, return in a week with improvement, and undergo flexor tenotomy. The chronic swelling that toes with an ulcer have resolves rapidly the second the ulcer closes. I get it. This ain't a Charcot case. But I suspect the people who own these things are hitting everything that comes in with it.
 
CutsWithFury said:
This is a typical response. Podiatry leadership has shown repeatedly it’s a club and majority are on the outside looking in. Please stop acting like anyone from the profession can be heard and contribute.
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Our leaders are mainly like politicians. It is what it is, as you said it is like a club. We desperately need excellent leaders sure. The real problem is our demand is no where near our supply. I might even give our profession the benefit of the doubt 20 years ago believing diabetes and aging boomers would increase demand…….well it did not, so stop using that line.

Biggest lie on the internet is from AACPM president…….LECOM will help to meet unmet demand in podiatric care. Where is the proof for a statement like that? We should demand answers. That was a well thought out written statement……a big lie.

What VA job goes unfilled for podiatry? Answer…..zero and often over 70 applicants, sometimes over 100 per listing. What VA job goes unfilled for MDs, RNs, CRNAs etc…….plenty and often 0 applicants for months at a time for certain jobs.

You can do OK or sometimes even very well in podiatry or you can crash and burn. You most often have to be self made. Demand is not your friend.
 
CutsWithFury said:
This is a typical response. Podiatry leadership has shown repeatedly it’s a club and majority are on the outside looking in. Please stop acting like anyone from the profession can be heard and contribute.
Click to expand...
Oh come on man. Memes are fun and games. Cant applaud derogatory memes then get huffy when someone posts a counter meme. This thread is supposed to be spicey. Thats the point.
 
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