Will Diabetic Limb Preservation Be A Priority In The New Health Care System?

In contemplating what I should post in my first blog for Podiatry Today, I reviewed several published articles describing procedures that have interested me. I initially thought I would write about techniques I have integrated into my practice.

Earlier in the week though, I had a very hectic morning of seeing patients with frequent necessary interruptions from hospital case managers, PAs, fellow physicians on our limb preservation team and home health care agencies. As I stood at the bedside of my young diabetic patient, I realized that she may lose her limb if our team loses the battle against her invasive ankle infection.

This experience is common for many of us who have dedicated a great percentage of our professional practice to diabetic limb disease. We realize that little of what we do in limb preservation comes with financial incentive. Our results, although often positive in outcome, are subject to great human variability based on genetics, disease state and comorbidities.

I often contemplate what my outcome “performance report card” will look like to the insurance bean counters. With the new health care reform breathing down our necks, threats of greater scrutiny by insurance companies and government and higher practice operation costs, how many more years will we continue to have the energy and resources to provide these complex services?

Strong in my memory are how many nights, weekends, holidays, kids’ birthdays and ball games I gave up to preserve that limb so my patient could be given an opportunity to walk out of the hospital. The reward is truly in giving as many of us do every day of our practice lives.

Will my young colleagues be so willing in the health care system of the future?