About Dr. Fife
Dr. Fife is a world-renowned wound care physician. She is the Director of the Wound Care Center at CHI St. Luke’s The Woodlands Hospital, CMO of Intellicure, Inc., Exec. Director of the US Wound Registry & Editor of Today’s Wound Clinic.
Report Honest Healing Rates
It’s time for Wound Care physicians and providers to stand up for truly honest outcomes and transparent quality reporting. If we don’t we may see our entire profession wiped out. Click here to read more.
Resource Room
Explore Dr. Fife’s ever-growing library of helpful content related to Wound Care and MIPS. From videos to instructional materials, this knowledge base is completely yours to enjoy and use.
Latest Posts
Decreasing the Disadvantages of Medicare Advantage Plans When Patients Need a Cellular Product
An increasing percentage of my wound center patients have Medicare Advantage plans offered by private payers. As I’ve discussed on previous blogs, it’s getting very hard to use cellular and/or tissue-based products (CTPs) on chronic wound patients with...
Pizza University – Explaining Wound Management to Patients
Welcome to Pizza University for wound care! Check out the video below, and find out why we need to get rid of the cheese and hold the pesto:
Pyoderma Gangrenosum (PG): Not So Rare, and When in Doubt, Take a History.
Pyoderma Gangrenosum (PG) is one of the most painful wounds we see each year. It is called a “rare” disorder with an estimated incidence of 3 to 10 cases per million people per year.(1) That would mean there are about 20 new cases of PG in Houston, Texas each year....
My Staff Inspire Me (and a Wound Center Staff Photo Caption Contest)
Here’s my amazing staff and the CHI St. Luke’s Quarterly Mission and Annual Inspire Award event, honoring nominees and winners for The Woodlands' Campus. Our Wound Clinic team at CHI SLEH The Woodlands was nominated for “Team of the Year,” and our Program...
The Best Part About the Labor Day Holiday is Not Having to Fight the Traffic Driving to Work
Real World Evidence for Real World Wounds
I am just going to say it. The majority of prospective trials in wound healing have enrolled subjects whose wounds were more likely to heal than not. While more “generalizable” trials (meaning, actually relevant to real patients) are underway or in the planning...
The Undaunted Spirit Award
Here’s a photo of a gorgeous Texas quilt, hand crafted by an octogenarian wound center patient (she’s getting her dressing changed).
The Undaunted Spirit Award
This cane makes me think of the Johnny Cash song, “I’ve been everywhere.”
Yes! It IS a Pressure Injury! An Ischemia Reperfusion Injury…
The Undaunted Spirit Award
Here’s a nifty way to keep track of your phone and your pen if you are in a wheelchair.
The Undaunted Spirit Award
Patients inspire me every day. This lady in her 9th decade showed me a picture on her smart phone (which alone is an accomplishment). She’s at church playing the accordion and the piano at the same time. I’ll add her to my gallery of patients with “undaunted spirit.”...
Guest Post by Dr. Helen Gelly: Noridian starts post payment Medical review of Hyperbaric Oxygen Therapy- is HBOT what the doctor ordered?
Noridian has started sending out letters to notify hospitals of post-payment review of outpatient HBOT charged records from 2018 (G0277). See below for the pitfalls of writing the usual HBOT note. If you do not order the HBOT for that day, you will likely not get...
Pondering the Economic Model of Anti-Biofilm Agents
Guest Blog by Helen Gelly, MD – What is a Hierarchical Condition (HCC) Score and why should you CARE?
Nutrition and the Space Race
Fifty years ago I stayed up late with my grandfather to watch the Apollo 11 astronauts land on the moon. We sat riveted, watching grainy images on a tiny black and white television set, marveling at how far technology had advanced. In the 1960s, my father was an...
The Uphill path to Value Based Nutritional Assessment and Standing on the Shoulders of Giants
This month in TWC, learn about the history of total parenteral nutrition and how the Space Race of the 1960’s helped patients with malabsorption. I explain why QCDR quality measures have been a disappointment for all specialties, why Practice Improvement Activities...
Counting the Cost – and a Roadmap to Survival (Part 7 of 7)
I started this series of blogs with a discussion of Medicare audits and the impending bankruptcy of Medicare. We determined that audits come from perceived improper use and the reason that audits are accelerating is the impending bankruptcy of Medicare. Medicare is...
Counting the Cost – and a Roadmap to Survival (Part 6 of 7)
Every practitioner is being positioned on a grid in relation to the cost of care as described, and their quality score which is usually a score obtained from MIPS quality reporting. The ideal position on the grid is the top right corner. To CMS, that person delivers...
Counting the Cost – and a Roadmap to Survival (Part 5 of 7)
Why do my patients cost so much? I showed you the numbers in my MIPS “cost” category which concluded that I spend $58,000 per episode rather than $16,000, which is the average for a family practice doctor. Remember that these costs are being triggered by...
Counting the Cost – and a Roadmap to Survival (Part 4 of 7)
The table below is from one of my Quality and Resource Use Reports (QRUR). You can see the “ambulatory care-sensitive conditions include the conditions I mentioned on my last blog: bacterial pneumonia, urinary tract infection, dehydration, diabetes complications,...
Counting the Cost – and a Roadmap to Survival (Part 3 of 7)
Depiction of Total Per Capita Cost (per provider) After CMS calculates Medicare Spending Per Beneficiary (MSPG), it calculates a practitioner’s Total Per Capita Cost. This is the overall cost of care provided to each of the beneficiaries attributed to a specific...
Counting the Cost – and a Roadmap to Survival (Part 2 of 7)
I need to start with a disclaimer that I have no expertise when it comes to Medicare cost calculations. I am muddling through this by reading the materials on the CMS website. If you have a correction to anything I’ve posted or have better insight, I really want to...
Counting the Cost – and a Roadmap to Survival (Part 1 of 7)
A few people are starting to whisper about their experience with the Targeted Probe and Educate (TPE) process directed at claims for Hyperbaric Oxygen Therapy (HBOT). The Medicare Administrative Carriers (MACs) are supposed to educate the doctor, but so far, the...
Them That's Been Sued and Them That's Going to Be
Heads Up on Disposable Negative Pressure Wound Therapy for Patients with Home Health Services
There are days I feel like I am the only person who did not get the office memo. That’s how I feel about Disposable Negative Pressure Wound Therapy (dNPWT) when the patient has a home health agency. dNPWT has made NPWT more practical and convenient for smaller...
Guest Blog by Jule Crider: The President's Executive Order on Price Transparency
The Wounds With No Name… and the Patients Who Will Get No Care
“The wounds with no name” (WWNN) are wounds that are due to trauma (not surgical complications) that never heal, PLUS the chronic ulcers that are NOT diabetic, arterial, venous or pressure related. These two groups (accidental wounds and ulcers which are not obviously...
