December 2011

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DPMs Could Lead Hospital Staff Under Proposed CMS Rule

By Brian McCurdy, Senior Editor

As part of the proposed reforms for the Centers for Medicare and Medicaid Services (CMS), podiatric physicians would be eligible to attain leadership positions in hospital staffs.
The rule would change the requirements that hospitals and critical access hospitals must fulfill to participate in Medicare and Medicaid. Under current requirements, hospitals are permitted to assign management positions to MDs, DOs or, when permitted by state law, doctors of dental surgery or dental medicine.

   Noting that the rule does not intend to conflict with state laws that would bar DPMs from serving in leadership capacities, the CMS states that the rule would permit DPMs to serve as the president or an equivalent position of a hospital’s medical staff “in a significant number of states.” The CMS notes in such states, laws support the contention that “the education, training and experience of podiatric physicians are similar to that of their allopathic and osteopathic colleagues with respect to serving in such a hospital leadership position.”

   Neal Blitz, DPM, FACFAS, notes that if podiatric physicians can head hospital staffs, one positive would be the increased integration of DPMs into mainstream medicine as well as parity on the administrative front. Similarly, Andrew Rice, DPM, FACFAS, notes that as podiatrists seek leadership positions, this further validates that podiatric medicine is on par with the profession’s physician colleagues, helping to ensure equality for DPMs at the institutional level.

   Having DPMs in leadership roles at the hospital can also facilitate better patient care, according to Dr. Blitz. He emphasizes that diabetes-related foot problems comprise many visits to hospital admissions and emergency rooms. As Dr. Blitz explains, with podiatrists in charge, there will be less likelihood of the foot being neglected.

   Dr. Blitz and Dr. Rice also acknowledge challenges in integrating podiatrists into medical staffs. Dr. Rice warns that when heading medical staffs, podiatrists may face prejudice from those medical professionals who may view DPMs as ancillary providers and therefore not qualified for a leadership position.

   “It is important to let your peers know that DPMs understand pathophysiology beyond the foot because many hospital administrative issues involve specialty care related issues,” says Dr. Blitz, the Chief of Foot Surgery and Associate Chairman of Orthopedics at Bronx-Lebanon Hospital Center in New York City.

   Dr. Rice notes DPMs have a broad outlook on healthcare as the profession has worked with members of the multidisciplinary team whereas other specialties may have a more narrow focus on their areas of expertise. Furthermore, with most podiatrists being new to these positions, they may be able to provide a fresh, objective perspective when it comes to inpatient and outpatient activities, and hospital governance, according to Dr. Rice, the Chief of Podiatry at Norwalk Hospital in Norwalk, Conn.

   The American College of Foot and Ankle Surgeons (ACFAS) has been working with the Joint Commission to promote the passage of the new rule.

   “This rule solidifies CMS’ recognition that on many medical staffs across the country, the education, training and experience of credentialed and privileged podiatric surgeons is equivalent to their MD and DO partners on the healthcare team,” notes the ACFAS.

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