How Will Obamacare Affect Podiatry?

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Neal Frankel, DPM, FASPS, FACFAS

   So what you should expect in the months to come and how should you gear your practice to be able to be profitable?

1. You need to get a handle on what it actually costs you to see a patient and determine your price per patient to see how you may be able to continue being profitable with reduced reimbursement.

2. You need to gear up your office to be able to perform more services for cash including office-based surgery for those patients who will have larger deductibles and may not be able to have procedures at the hospital or surgical center.

3. Review your collection procedures to collect a greater percentage of these increasing large deductibles upfront rather than attempting to collect after the fact.

4. Be more diligent in verifying benefits since it is not clear that the actual plan the patient signed up for will be listed on his or her card. Make sure you are aware of how you will get paid before performing the service.

5. Research the new managed care plans opening in your state to see if you can negotiate a contract before these plans close. Be assured that insurers will not contract with a great number of podiatrists per geographical area.

6. Gear your practice for a greater ability to have more cash-related services, (i.e. fungal nail laser, shockwave, in-office dispensing, etc).

7. Look to see if a podiatric supergroup is functioning or forming in your area.

Final Thoughts

My personal opinion of this law is although it will produce a greater number of insured patients, it will be impossible to actually reduce costs with the government having to “kick in” more tax dollars to subsidize many of them. The only way to truly reduce costs with increased utilization would be to cut payments to providers and reduce the size of the networks, which will ultimately result in rationing of care.

   I believe the podiatrists who can maximize their efficiency and increase their non-insurance based services will survive in this new environment.

   Dr. Frankel is a Fellow of the American College of Foot and Ankle Surgeons, and the American Society of Podiatric Surgeons. He is board certified by the American Board of Ambulatory Foot Surgery and the American Board of Podiatric Surgery. Dr. Frankel is in private practice in Chicago.


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   Editor’s note: For further reading, see “What You Should Know About Accountable Care Organizations” in the April 2013 issue of Podiatry Today, the November 2013 DPM Blog “Is It Time To Switch The Dial On Insurance Networks?” by Stephen Barrett, DPM, and “How Can We Adapt To Inherent Challenges In Healthcare Reform?” in the June 2013 issue.

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Dr.Adam Katzsays: January 4, 2014 at 1:00 am

Nice Article! Going with my practice regardless of Obamacare.

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Michelle Alex, DPMsays: January 5, 2014 at 12:43 am

With ACA & ICD-10, now more than ever podiatrists need to start changing the way they practice.

Ten years ago, I walked away from the limitations of insurance and started conducting clinical trials. I have never looked back! The majority of clinical trials in the field of foot disorders, foot care and treatment of lower extremity disorders are being conducted by MDs and DOs. Podiatrists are considerably highly qualified and can be considered as experts in the disorders and treatments related to the lower extremity. However, the majority of podiatrists are not taking advantage of the large number of clinical trials available to them.

By incorporating clinical research into your private practice, you increase the value of your business and by that I mean increasing your revenues, profits and equity should you decide to sell your practice or exit in some way.

It's time for podiatrist to discover the lucrative world of clinical research. If you are interested in learning how to incorporate clinical trials in your practice, send me an e-mail.

Michelle Alex, DPM

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Brian Schultz DPMsays: January 7, 2014 at 3:14 pm

I would be very interested in learning more about the clinical trials.



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Stefan Zweig, DPMsays: January 5, 2014 at 3:05 pm

I'd like info about conducting clinical trials. Thanks.

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Michelle Alex, DPMsays: January 7, 2014 at 9:52 am


Send me an email and we can talk.

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Lynnsays: March 2, 2014 at 10:48 pm

It's a sad day. I voted Democrat thinking that Obamacare was great to offer everyone insurance. I have type 2 diabetes, $300,000 in student loan debt and I am in private practice. I have managed to run a successful practice for 10 years, based strictly on quality patient care and superior customer service with a top of the line EMR. Due to low reimbursement, increasing overhead and the constant battle to fight and justify to be paid for my service and product, I'm not sure how long I can hold on. Is the private practice doctor being eliminated slowly? I did a 1-year residency, which included a good mix of medicine and surgery, but I am unsure of my future. I LOVE my job! I am sooooo disheartened about the future of podiatry! Any words of wisdom would be appreciated.

My email :

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