Orthopedic Versus Podiatric Care of the Foot and Ankle

Allen, Charlotte; Younger, Alastair; Veljkovic, Andrea; Glazebrook, Mark

doi:10.1016/j.ocl.2020.12.004

Cited by 3 publications

(1 citation statement)

References 8 publications

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“…However, it remains important to acknowledge that while the concept of integrating vascular surgery and podiatry has made impressive strides, it is not a universally embraced practice across all healthcare institutions. In some instances, podiatry may find itself aligned within different hospital departments, such as orthopedic surgery [24], thereby giving rise to a potentially intricate landscape of overlapping interests in the provision of foot and ankle services [25][26][27][28]. Consequently, there may be potential challenges regarding clinical practice patterns, consultations and coverage, call schedules, and financial incentives.…”

Section: Discussionmentioning

confidence: 99%

The Opportunity for Impactful Integration of Vascular and Podiatric Care

Kim,

Southerland

2023

JCM

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Background: The importance of collaboration between vascular and podiatric surgeons has been well-established. High-level partnerships are integral to the development of multidisciplinary programs and wound care centers, ultimately resulting in improved patient outcomes. This vascular–podiatric integration is not universal, however, and podiatric surgery may not be aligned within a vascular surgery division at many institutions. As one such institution, we reviewed our single-center experience in order to identify opportunities for the impactful integration of vascular–podiatric patient care. Methods: Institutional electronic medical records were retrospectively reviewed for all procedures performed by vascular surgeons at a high volume, safety-net academic medical center. Data were collected on all primary and additional procedures, current procedural terminology (CPT) codes, case type (elective, urgent, emergent), surgeon specialty, and date/time of the procedures performed. CPT codes were linked to the Centers for Medicare & Medicaid Services’ Physician Fee Schedule to estimate the work relative value unit (wRVU) per procedure. Results: From 2018 to 2022, vascular surgeons performed a total of 12,206 operations, of which 1102 (9.9%) involved podiatric procedures. The most common vascular-performed podiatry procedures performed were toe amputations (38.1%, n = 420), transmetatarsal foot amputations (20.1%, n = 222), and ankle/foot debridement (16.2%, n = 178). Foot/ankle-specific procedures were identified as the primary procedure in 726 (65.9%) cases and as the adjunct procedure in 376 (34.1%) cases. A substantial proportion of podiatric procedures occurred on an urgent (n = 278, 25.2%) or emergent (n = 28, 2.5%) basis. A total of 163 (14.8%) cases occurred after hours (either before 0600 or after 1800), and 133 (12.1%) cases were performed on a holiday or weekend. Procedure-specific revenue included 4243.39 wRVU for primary procedures and 2108.08 wRVU for additional procedures performed. Conclusions: We report our single-center experience in which vascular surgeons provide a significant proportion of podiatric procedures. Our study underscores the potential for integrating podiatric surgeons within a vascular surgical division and presents opportunities for collaboration and enhanced patient care.

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Section: Discussionmentioning

confidence: 99%

The Opportunity for Impactful Integration of Vascular and Podiatric Care

Kim,

Southerland

2023

JCM

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Development of an integrated podometry system for mechanical load measurement and visual inspection

et al. 2022

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Variability in Surgical Case Volume Performed During ACGME-Accredited Orthopaedic Foot and Ankle Fellowship Training

Silvestre,

Reid,

Scott

et al. 2024

Foot & Ankle Specialist

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Introduction Previous studies have demonstrated a positive correlation between case volume and outcomes in foot and ankle surgery. This study elucidates surgical case volume benchmarks for Accreditation Council for Graduate Medical Education (ACGME)–accredited orthopaedic foot and ankle fellowship training in the United States. Methods The ACGME provided case logs for orthopaedic residents and foot and ankle fellows (2018-2021). Variabilities in reported fellowship case volumes were defined as the fold-difference between 90th and 10th percentiles. Reported case volumes were compared between training cohorts with parametric tests. Results Case logs from 65 orthopaedic foot and ankle fellows and 3146 orthopaedic residents were included. Fellows reported 1.3- to 1.5-fold more foot and ankle cases during fellowship training than during residency training (P < .001). On average, orthopaedic foot and ankle fellows reported 405.4 cases and most were arthrodesis (17%), forefoot reconstruction (17%), mid/hindfoot reconstruction (13%), tendon repair/transfer (12%), and trauma ankle hindfoot (11%). Case categories with the highest variabilities were amputation (14.8-fold difference), infection/tumor (11.6-fold difference), arthroscopy (9.2-fold difference), and calcaneus (8.7-fold difference). Discussion Case volume benchmarks can assist trainees and faculty during orthopaedic foot and ankle training. More research is needed to determine case minimum requirements needed for autonomous practice in foot and ankle surgery. Level of Evidence: Level III

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Orthopedic Versus Podiatric Care of the Foot and Ankle

Cited by 3 publications

References 8 publications

The Opportunity for Impactful Integration of Vascular and Podiatric Care

The Opportunity for Impactful Integration of Vascular and Podiatric Care

Development of an integrated podometry system for mechanical load measurement and visual inspection

Variability in Surgical Case Volume Performed During ACGME-Accredited Orthopaedic Foot and Ankle Fellowship Training

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