I practice in a rural community hospital in Kentucky, which serves a higher risk and marginalized population of patients. As patient well-being and care always come first, my practice has strived to stay ahead of the pandemic to ensure safety and protect those at highest risk.
Since March 16, we have pushed back all non-essential services. This effectively cuts our typical 100 patient visits each week down to about 20 in-person visits. We have postponed all elective surgeries. We have implemented telemedicine and continue to work out its kinks.
With this immediate contraction in our practice volume, we have cut staffing down to a bare bones approach with a single medical assistant and receptionist. We are still seeing patients in our wound center, following recent guidelines published by Rogers and colleagues.1 We are working with our emergency department and local urgent care facilities to triage as much as possible directly to our office.
Even with these measures in place, we struggle to remain financially solvent. My staff are like family to me and it hurts to see these people I care about filing for unemployment. Frankly, I am very uneasy regarding the short- and long-term effects of this disaster. Although I am hospital-employed, my reimbursement relies heavily on patient volume. A hospital near me has already laid off 300 employees.2
The value of podiatry in the health-care system has never been more important for at-risk patients. Our practice will continue to follow both state and federal recommendations as we continue to provide lower extremity care to those patients.
Dr. Malan is an Associate of the American College of Foot and Ankle Surgeons. He is in practice at LifePoint Health in Lebanon and Versailles, Ky. Dr. Malan can be reached at email@example.com.
- Rogers LC, Lavery LA, Joseph WS, Armstrong DG. All feet on deck – the role of podiatry during the COVID-19 pandemic: preventing hospitalizations in an overburdened healthcare system, reducing amputation and death in people with diabetes. J Am Podiatr Med Assoc. 2020. Available at: https://www.japmaonline.org/doi/10.7547/20-051 . Accessed March 26, 2020.
- Acquisto, A. Morehead hospital furloughs 300 staff amid COVID-19 outbreak for lack of revenue. Lexington Herald-Leader. Available at: https://www.kentucky.com/news/coronavirus/article241524521.html . Published March 26, 2020. Accessed March 26, 2020.