Office procedures

Members do not see these Ads. Sign Up.

I recall from conversations with US pods previously (probably 10 years or more), that it was common for a number of relatively simple surgical procedures to be performed in an office situation rather than operating room. I was wondering if this is still the case and, if so, what sort of procedures would currently be undertaken in this non theatre setting.

cheers

s

 

Simon:

I will do nail avulsions, surgical matrixectomies, currettement of verrucae, removal of buried surgical pins and incision and drainage in the office setting. Even though I don't have a dedicated surgical suite in my office, I do know that other podiatrists in the States have converted one of their treatment rooms into a dedicated surgical suite where bunionectomies, hammertoes, neuromas, etc. are also done. In my community here in Sacramento, nearly all the podiatrists have surgical privileges at one of the many surgery centers here in town, where we do our osseous surgeries and more complicated soft tissue surgeries.

Hope this helps.

 

Hi Simon (and Kevin)
I routinely perform all digital procedures (hammer toes, exostectomies), nail and wart procedures in the office. We use to do more and our dedicated surgical suite is now "semi" dedicated.
It just doesn't pay to do more since insurances do not reimburse well for surgical supplies.
If you have a licensed ambulatory facility you can charge rather well.

Steve

 

Thanks both,

from what you say, would it be fair to say that office based procedures are performed less often then they used to be; either because more folks have privileges in surgery centres and insurers prefer this setting, and/or that stocking your own surgery suite is relatively expensive. Are there any standards that you guys have to adhere to in terms of requirements for a clean room in your practice?

regards

s

 

" Are there any standards..............."

OSHA, HIPAA and State Regulators do have a "few"!!!!!!!!!!!!!!!!!!!!!!!!!!!!! and the Pope is somewhat religious.

Yes Simon, I would agree that the improved training and residency programs available do make it more common for Surgically trained Podiatrists to work in the hospital setting. Also, for various reasons, ambulatory surgery has increased dramatically over the past 15 years. Out patient centers and out patient departments within the hospital have realized that the Surgeons time is very valuable and have streamlined the process for outpatient procedures.
At least in my town where I utilize one free standing Ambulatory Surgical Center and three different hospital Out Patient departments; very little time is wasted in performing several out patient procedures. These venues either have very quick room turnover (less then 15 minutes) or flip between two ORs for subsequent cases. After you have been in practice a few years NOTHING seems more important then your time.

Steve

 

Would you try using Wright Medical's Xpansion micrografting system in your procedure room?

 

David G. Armstrong, D.P.M., M.D., Ph.D., Professor of Surgery, and director of the Southern Arizona Limb Salvage Alliance (SALSA) at the University of Arizona stated, "The XPANSION(R) System allows for a very small harvest site which has resulted in minimal morbidity for my patients, allowing these procedures to frequently be performed in the clinic under local anesthesia.

 

I think that Simon's question concerning standards (no doubt he can speak for himself) is because in the U.K. any surgery which may be considered 'bone surgery' is forbidden in anything other than a full operating theatre (OR) setting. The Association of Surgeons in Primary Care over here is looking at the subject with a view to extending 'clean room' surgery. Generally 'soft tissue' surgery is deemed suitable, and as far as Pod Surgery is concerned that acceptable would be along the lines detailed by Kevin.

Bill