I know this is an old thread, but the topic could benefit from someone in the field.
Any wound specialist I’ve dealt with was a nurse with advanced training. They probably are ANP s. They can prescribe medicines and treatments(like hyperbaric oxygen chambers ). I personally have been seen by one for a number of visits. She was wonderful and helped a lot. She knew when to send me back to see the doc/surgeon and she was easy to contact in an emergency. Wound specialists have been around for many years.
I believe you are talking about home health providers. Yes, there are lots of competent home health midlevels who provide good service, as well as .. less than ideally trained.
They usually make around 150k-200k at full time, but I personally know midlevels who make just north of 250k. I think the upper limit for a midlevel is about 400k, but I don't think that is a sustainable level. At that point, you aren't really spending enough time with each wound.
Typically a retired surgeon or a doc in any specialty that gives up on regular practice. Not a viable option for a new grad.
This has been true. But I don't think this comment will stand the test of time. Most people who are not in this space will not know about this, but Medicare has been pushing hard to get surgeons out of hospitals and into community settings. And the only way they know to do this is with money.
Let's say a person just graduated from gen surg and want to break into the competitive California market. They can join Kaiser or a private group and make around what.. 250 to 400? Maybe you could make close to 500k but that comes with all the calls and emergencies and the stress.
Wound care market can provide a 7-3pm schedule with no nights and weekend calls. Dinner with family every night and spend every weekend doing stuff at home with spouse and children. And that will pay 350k. More if that person wants to manage midlevels.
Somebody will call BS, and point to me on sub 200k figure on glass or indeed or something, but what they don't know is how those companies are run. The 350k plus offers don't happen on the internet. You don't have to believe me, but there is a good solid financial reason on why I stopped contemplating going back to residency.
Christ in a handbasket I can’t imagine a more horrible job. Bad smells, bad patients, bad outcomes - the unholy trinity.
This is an area where I welcome mid level creep. They can do all the wound care their hearts desire.
Yeah it's true some wounds smell bad and the patients are difficult to work with. But what you don't understand is that.. it doesn't have to be that way.
I deal with bad necrotic wounds packed full of fecal matter, and sometimes I have to change how I breathe so I can work on the wound and not get a headache, but I do it because if I do my job well, the wound is clean next week and there is no fecal matter in the wound anymore because I've thought the nurses and patients how to keep stool out of the wound. After 2 months of meticulous care, the exposed bone is granulated over. In another 2-4 months, the wound contracts and closes up, provided that there is enough laxity in the peripheral tissue.
So yeah bad smell for a couple of weeks and patients need a lot of psychological pep talk. But you take care of the wound and you earn the trust of patients and things get better.
And there are some hard working midlevels who are doing good work healing wounds and making $$$. More power to them, I say.
It doesn't have universal appeal but I feel like anyone who wants to do it and cares to do it well should be able to. Will also mention that some non-board eligible physicians (especially those with some surgery training) may find this a reasonable income job. There are part-time options with this, and the hours are good too (outpatient only, no call).
This was my exact situation. I left gen surg residency due to medical leave. I was always fascinated with wounds and did a lot of wound-related research with a few publications under my belt. So when I was looking for a non BE/BC work last year, the wound care work was the best option for me.
Now I make a comfortable living to provide for a family in the California market. I am busy when I work but I don't worry as much when I am home. It's good living.
I remember reading a thread about how a fresh Midwest plastic surgery graduate started his own private practice and it was fascinating to read about all the nitty gritty things about the business aspect of what he was doing.. I think he eventually was offered a buyout of his practice from a larger healthcare system and don't recall what happened after that. I want to do a write up like this in the future, if there is enough interest.
