by Caroline Fife, M.D. | Jun 4, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
Welcome to “Throwback Thursdays” in June. How many different products do you use in your wound center? How many do you really need? Do you think you could care for patients with, say, only 5 categories of dressings? We used to do that in the 1990’s. Which products...
by Caroline Fife, M.D. | Jun 3, 2015 | Fight the Good Fight, Health Information Technology and Wound Care, Lymphatic Imaging & Lymphedema, Miscellaneous Musings
Welcome to “what is it Wednesdays” in June. What is this growth on the arm of a morbidly obese patient? It’s a form of “massive localized lymphedema” (MLL). They used to be considered rare but I am seeing it more and more often. Caroline Fife, M.D.Dr. Fife is a world...
by Caroline Fife, M.D. | Jun 1, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
Last month I focused on healthcare reform initiatives focused on how quality measures will be front and center in the move from volume based care to value based care by CMS. Performance on quality measures is also going to be used to determine physician compensation...
by Caroline Fife, M.D. | May 28, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
I am wondering how many of you have seen a change in your practice with the advent of the Affordable Care Act? Am I the only one who has noticed that more and more patients are coming in saying, “Doc, I can’t afford for you to [fill in the blank with any procedure].”...
by Caroline Fife, M.D. | May 27, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
One last case to get you thinking about the difference between TCOM and perfusion pressure is that of a 35-year-old female pharmacist who underwent incision and drainage of a left index finger abscess 3 months before I saw her. The day after the I&D a dark...
by Caroline Fife, M.D. | May 21, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
Did anyone ever think they would look back fondly at traditional Medicare? It’s clear to me that the Medicare “replacement plans,” which are increasing rapidly in adoption, are not following Medicare coverage policy but the policy of the private payer. We will look...
by Caroline Fife, M.D. | May 14, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
Today I had to write a letter to a NPWT company in order to prevent that therapy from being discontinued. The patient is a quadriplegic with an ischial pressure ulcer. I’ve been seeing him for the past 4 months and have managed to keep him out of the hospital,...
by Caroline Fife, M.D. | May 13, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
Last week I told you about the case of a 55 year old man with rest pain and a TCOM of 35mmHg on his anterior leg. Because he had been sleeping in a chair due to rest pain, he had some edema of his leg. In order to know whether a low oximetry value is due to ischemia...
by Caroline Fife, M.D. | Feb 4, 2015 | Fight the Good Fight, Health Information Technology and Wound Care, Miscellaneous Musings
Happy Hump Day everyone! Each Wednesday I will post wound photos and explain the diagnosis and treatment plan that set these patients on a path to healing. Sometimes physicians need to dig deeper into a patient’s medical history to fully understand their...
