A patient sent me this message and I decided to post it. It speaks for itself.


I have many chronic medical conditions that contribute to recurrent wounds. I have chronic heart issues, and am wheelchair bound due to a muscle disease – among other challenges. I have been going to wound centers off and on for many years. I do heal, but months later, get a new wound.  I think I am now an expert at being a wound center patient. I’ve been at this a long time and I know a great doctor and a great staff when I see one. I also dread having to train new wound care Doctors and wound Care Nurses.  It seems like documentation requirements would be very basic stuff for wound care clinicians but apparently, they aren’t.

Let’s talk about implementing the plan you just made with the patient – specifically the documentation:

I had a great conversation with my new Wound Care Doctor and told him what products I’d like to use, and he agreed! So far, so good.

Unfortunately, neither the doctor nor the nurse documented the plan we agreed upon. I need supplies from a DME (Durable Medical Equipment) company and my previous doctor and staff knew what documentation was needed. Unfortunately, this one doesn’t. A patient can’t get “surgical dressings” unless a debridement is documented, BUT THE DEBRIDEMENT DOES NOT HAVE TO BE A SHARP DEBRIDEMENT. Documenting autolytic or mechanical debridement will qualify my wound for dressings. Unfortunately, at the new wound center, they don’t know this.

When I didn’t get my supplies, I called the DME. The DME company said that there was no debridement documented so they couldn’t send the supplies. However, after I called, they managed to find a note from my previous visits elsewhere and were able to use that. I called the new nurse to explain that the debridement issue, and she didn’t know that debridement types other than sharp debridement can be used to justify the supplies – as long as they document it.

I called the supply company again a few days later to make sure they got the correct documentation from the new wound center, but the right dressings were not documented in the note, so I got the wrong supplies.

I realize that these rules are frustrating and make things time consuming for the clinic – particularly if their documentation system is not designed for wound care. But, it still feels like no one is looking out for my needs. It’s really frustrating and I wonder what happens to patients who are too sick to advocate for themselves.

–Anonymous (but real) patient

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