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By Jeffrey M. Whitaker, DPM, FACFAS AT S O M E P O I N T, T H E n e u r o p a t h ic f o o t ulcer in the diabetic patient may extend to a deeper tissue layer and/or become infected. Given that limb preservation leads to improved overall outcomes, including lessened financial burden, in these patients, amputation prevention with the outcome of a functional and sustainable limb is the goal. 1 Many studies have shown that a mul- tidisciplinary approach to diabetic limb preservation which includes a surgical podiatrist is the optimal way to achieve the above goal. 1 Perhaps the most effective use of the surgical podiatrist on such a team is as the "point person" on the front and back ends of the hospital management of the threatened diabetic foot. However, given that many surgical podiatrists are still tied to private practices that are not hospital based, this becomes logistically difficult to achieve. One model that may make it feasible includes a small group of surgical podiatrists that is contracted with one or more hospitals to triage and oversee the management of the diabetic foot. This model would involve participation in the hospital's wound care center. It would also involve being on-call to the emergency room, the hospital floor, and hospital-based clinics. As-needed inpatient rounds, bedside debridements and trips to the OR, as well as consultations with other surgical specialties such as vascular and plastic surgery, would additionally be the duties of such a group. The hospital-based preservation of the diabetic limb will continue to evolve to become more efficient, successful and cost-effective. The above model may very well be part of that process. Jeffrey Whitaker, DPM, FACFAS, is board certified in foot and ankle surgery and a fellow of the American College of Foot and Ankle Surgeons. He is Division Head and Associate Professor of Podiatric Surgery at Kent State University College of Podiatric Medicine in Independence, OH. 1. Kim PJ, Attinger CE, Evans KK, Steinberg JS: Role of the podiatrist in diabetic limb salvage. J Vasc Surg 56:1168-72, 2012. ■ An Innovative Model for the Management of the Inpatient Diabetic Foot +++++++++++++++++++ +++ + +++ + +++++++++++++++++++ FOOT NOTES HEALTHCARE ADVOCATES, INDUSTRY LEADERS With more than 40 years of experience, our Healthcare Section offers Healthcare Representation & Counseling, Coding Review and Staff Training. We make it possible for you to focus on patient care, while we tackle the legal obstacles you are faced with on an ongoing basis. WE ARE THE HEALTHCARE SECTION OF KRUGLIAK, WILKINS, GRIFFITHS & DOUGHERTY, CO., L.P.A. 4775 Munson Street N.W. | P.O. Box 36963 | Canton, Ohio 44735 | 330-497-0700 | Fax 330-497-4020 John M. Tucker Randall C. Hunt Fred J. Haupt Jason F. Haupt Laura A. Brady Offices in Canton, Akron, Alliance, New Philadelphia & Sugarcreek KWGD.com 2 0 1 4 N OV E M B E R / D E C E M B E R ■ M D N E W S . CO M ■ MD NEWS Cleveland/Akron/Canton | 1 7