ApacheIndian

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Do all DPMs see and treat all types of disease of the foot & ankle -- e.g. fractures, bunions, club foot, ulcers, PAD/CLI (Critical Limb Ischemia) and amputations? Or, do certain DPMs subspecialize and/or gravitate toward particular niches? I ask b/c I am seeking DPMs in my metro area who see a lot of PAD/CLI
 

ldsrmdude

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Do all DPMs see and treat all types of disease of the foot & ankle -- e.g. fractures, bunions, club foot, ulcers, PAD/CLI (Critical Limb Ischemia) and amputations? Or, do certain DPMs subspecialize and/or gravitate toward particular niches? I ask b/c I am seeking DPMs in my metro area who see a lot of PAD/CLI
Yes, a lot of us tend to gravitate towards a specific niche that we like. For the most part, most podiatrists (especially more recent graduates) get pretty well-rounded training, but some people don't like wound care and focus more on sports medicine. Or they don't like reconstructive surgery and focus more on wound care or office procedures. Podiatrists who see a lot of wound care see a lot of PAD.
 
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ApacheIndian

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Thanks Idsrmdude. Wound care DPMs, that makes sense. Is there a specific way to find these wound care-specialized DPMs, like a professional organization or the like for them? Or would one simply have to do some google searching?
 
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ApacheIndian

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Also, where are the wound care DPMs getting their referrals from? Are they getting them from vascular surgeons and cardiologists?
 

ldsrmdude

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Thanks Idsrmdude. Wound care DPMs, that makes sense. Is there a specific way to find these wound care-specialized DPMs, like a professional organization or the like for them? Or would one simply have to do some google searching?
There isn't one specific organization that all podiatrists who do wound care belong to. My best suggestion would be to find local wound healing centers and see who is on staff there.
Also, where are the wound care DPMs getting their referrals from? Are they getting them from vascular surgeons and cardiologists?
At the wound center I work at, most of my referrals come from PCPs, but I do get some from vascular surgeons. In any case, I refer to vascular surgeons on an almost daily basis and I have a good rapport with my local vascular group. We have a limb salvage program that we are working on to keep track of patients and try to prevent problems before they happen and address vascular issues when wounds pop up.
 
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At TUSPM clinic we get them all the time. I have only been in clinic a few months and already have ordered up several ABI's. Had this arterial ulcer that you could see the achilles and the whole calf and distal was very cold. She stated she had an ABI and something was found, but was tired of getting procedures dones. Needless to say she did not take too kindly when we informed her that wound is not going to do a whole lot unless you get revascularized.
Anyway I digress, but where I am at yes we get tons of PAD people.
 

ApacheIndian

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Where is are your PAD patients coming from - direct "off the street", from cardiologists, from vascular surgeons, from IMs/PCPs?

And then who do you send them to for limb salvage? Vascular surgeons at Temple?

I'm trying to figure out how the back scratching works in the DPM world vis-a-vis PAD and limb salvage
 
D

dyk343

One of the first things we check for is pulses, ABI, warmth of foot, angiogram, etc etc. Often we are the ones to diagnose PAD and refer to vascular specialists for further workup. Wound care is usually on our end. Blood flow is on their end.

In return since you send so many patients to vascular they tend to send patients they acquire with foot wounds to you. Especially when they see that you can heal wounds.
 

ApacheIndian

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Often we are the ones to diagnose PAD

Where is are these PAD patients coming from - direct "off the street", from cardiologists, from vascular surgeons, from IMs/PCPs?
 
D

dyk343

Yes... Off "the streets" or from referal for "foot pain" or "foot ulcer"
 
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