On the Hill—Part 1

by Jason Prigozen, MD, FAPWHc

Representation for Those Involved in Care for Chronic, Non-Healing Wounds

The sky is not falling, but in both relative and real dollars, physicians’ payments are. Every year since 1997, when the sustainable growth rate (SGR) was put in place as part of the Balanced Budget Act, physicians have taken a pay cut. While our legislators have only once let the SGR’s formula give providers a true pay cut (4% decrease in 2002), we have been threatened yearly with up to 24% cuts in payments to providers. In addition, we take an inflationary cost of living pay cut annually. In inflation adjusted dollars (i.e. the true value of a dollar), we physicians have taken a pay cut for 17 years in a row. And in that time we have been asked to increase our productivity and efficiency. Complex new computer-based electronic medical records certainly have many benefits, but also place an increase burden in time and costs to comply with an increasing bureaucratic system.

But with all of these factors our largest concern is the quality of care. Many of the changes that the healthcare system continues to face are based on cost-effective treatment, which unfortunately may not always lead to that which is optimal—quality care. The best care for patients should be the biggest concern, and then applying this in a cost-effective manner.

The Academy of Physicians in Wound Healing (APWH) is the only physician-specific membership association representing allopathic, osteopathic and podiatric physicians and surgeons who are directly practicing wound care, as well as those who are involved in caring for patients who have or are at risk of developing chronic non-healing wounds. We have amongst our ranks all types of physician providers– interventional radiologists, vascular surgeons, cardiothoracic surgeons, podiatrists, orthopedic surgeons, family physicians, microvascular reconstructive plastic surgeons, hyperbaric medicine doctors, and limb salvage specialists.

No other organization in wound healing can be as focused on the needs of the physician as the APWH. The Academy is the ONLY organization in the United States providing physician-directed education, advocacy and representation. The APWH represents all physicians to legislators and administrators in order to address the ongoing changes in the national healthcare system. In addition to our strength as a physician advocacy group, our educational directives differ from other wound healing organizations. This is because the APWH addresses physicians’ needs.

Other organizations involved in wound healing have large membership bases of non-physician healthcare providers. This is an important factor that influences the educational programming, as well as the business interests and initiatives of these groups. The APWH is best positioned to provide a positive impact for our fellow physicians treating patients with non-healing wounds. This includes working as a resource for government and insurance agencies to help to bring about changes to physician payment programs so that physician reimbursement is appropriate for all involved.

We hope to share our plans to address our insurance concerns regarding the healthcare delivery system, as well as explain our physician-directed education directives, in the next issue.