Nursing Homes...

Discussion in 'Podiatric Residents & Physicians' started by 347932, Feb 8, 2012.

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  1. I just don't get the stigma with taking care of the elderly in Nursing Homes. Is it the most glamorous or lucrative aspect of what we do? It sure isn't, but you know what? It sure does make those old folks feel good.

    Not just because you are providing a service that they used to do for themselves, but no longer can. Not just because they get to hang out with a "youngster" for a little while. Not just because you eventually get to know them, and them you, and they get just as excited about that story about your son scoring as you did when it happened. Not because it opens a flood gate of potential opportunities to give a lasting, good impression to the staff that work there.

    Mostly, it's because it reminds them of how they used to be, and they are thankful they were there once.

    For me, it humanizes me. It makes me realize that one day, it'll be me sitting in that chair staring out the window, remembering when I was young and reliving it a little when that young doctor comes to chat and cut my toenails for me.

    It also makes me realize how, even though it's not fixing broken bones, or correcting bunions, it is still one of the most important jobs we have.

    Don't hate. It's part of who we are.
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  3. PADPM

    PADPM Banned 2+ Year Member

    Feb 22, 2009
    East Coast-maybe????
    What prompted that post???
  4. Meh, a little existential crisis.
  5. Ag123


    Feb 10, 2012
    I happen to work with physicians that provide care to nursing home residents and you are definitely correct. These people are underserved when they should be valued and treated with the best of care. Our physicians feel proud and appreciated for the work they do. Luckily, our company does generously compensate them for taking great care of these residents. I appreciated reading your post and if you or anyone you know is ever interested in caring for nursing home residents, please let me know.
  6. Adam Smasher

    Adam Smasher persona non grata 7+ Year Member

    Jul 24, 2008

    I basically agree with what you have to say, but I find the phrase "taking care of the elderly" to be a suspiciously elastic. Obviously, no one would dispute that if a senior citizen has an ingrown nail, a painful bunion, or fallen arches, you absolutely want to call in a DPM.

    What I don't fully understand is why we and only we are the go-to professionals for nail debridement. Don't get me wrong! As a provider of health care, I don't mind debriding mycotic nails while making small talk with someone older and wiser than I am. It's a pleasant change of pace from seeing more complicated stuff throughout the day. However, as a taxpayer, I'm not sure this is the best use of our medicare dollars, especially since a high school grad with a cosmetology license could probably do the same quality work.

    The reply I've heard is "yes, but we're trained to debride nails." Maybe others got something more involved, but my training consisted of spending an hour going to town with my nail nippers on a tongue depressor. I know you have a lot more experience than I have, and if you can explain to me where I'm wrong, I would love to be enlightened on the issue.

    Kind Regards,

    Adam Smasher
  7. Ankle Breaker

    Ankle Breaker Senior Member 7+ Year Member

    Sep 24, 2010
    Is a high school grad with a cosmotology license going to be able recognize and treat any new pathologies when they re-visist a specific nursing home? Sure pods may be providing just one service but you want someone there with the medical knowledge to able to treat any new pathologies that might have occurred since the last time they were there. I think it would be foolish for a pod to just show up and cut nails with out doing a basic foot exam first.
  8. podpal

    podpal 5+ Year Member

    Feb 18, 2009
    I agree with ankle breaker. The nursing home populations generally have patients who have many health concerns. Basic foot evaluations can expose diagnoses such as PVD, neuropathy, a multitude of dermatologic conditions, etc. We are doing more than simply debriding toenails. There are often ambulatory patients in memory wings..with dementia, etc. and many benefit by a simple padding therapy of hyperkeratosis. It's very rewarding to know that you've helped to alleviate pain/discomfort for someone. We will all be older someday.
  9. hematosis

    hematosis Slappin Da Bass 7+ Year Member

    Jul 27, 2009
    I've heard there is good money to be made from these nursing home visits. I intend to do a lot of nursing homes.
  10. Adam Smasher

    Adam Smasher persona non grata 7+ Year Member

    Jul 24, 2008
    Like I said in my first post, we definitely want the DPM to be the one who comes in to evaluate their feet medically on a periodic basis, about the same frequency as their PCP visits. And if there are new complaints, you come in sooner. Otherwise, nail debridement can be easily outsourced. It's only a matter of time before Medicare figures this out.

    Incidentally, my mother in law lives in a nursing home where the podiatrist does nothing more than trim nails--and he does a hasty job at that!
  11. PADPM

    PADPM Banned 2+ Year Member

    Feb 22, 2009
    East Coast-maybe????

    Remember you said that when you are at the nursing home at 6:30 am (they eat breakfast at 7, and have activities planned through the rest of the day), and you are going room to room, bending over beds, taking care of patients who may be contracted, in tight spaces, etc., etc., to "cut nails". It's not about making "good money", it's about providing a service, and although people think it's easy money, it can be very demanding physically and mentally.

    Additionally, although you PLAN on doing a lot of nursing homes, to some doctors these are gold. They don't have large practices, don't perform surgery, etc., and obtaining a nursing home is extremely difficult. There are also very large groups now contracting with facilities to provide podiatric, dental and optometric care and are pushing out sole practitioners. There are several companies advertising for podiatrists to work for them to provide nursing home care, and these companies are paying very well.

    While I've done my share of nursing home visits in the past to help get me where I am today, I can honestly say it was never something I personally enjoyed. I understand that it is a needed and valuable service, and these patients need care, but it's just not something that ever made me happy. I get much more gratification when a patient walks out of my office feeling less pain than when he/she walked in, etc. But that's why they make chocolate and vanilla.

    I've been there and done that, and I'm happy there are those who enjoy this service, since I do feel it's needed.

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