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Predictions for the next five years
EDITORIAL
Predictions for the Next Five Years As we enter into a new Millenn... - I just can't stand that word any longer so I will just make my predictions. Practice Style - The number of solo practicing podiatric physicians will further dwindle as small groups begin to form and podiatric specialists join orthopedic and multi specialty groups. Large podiatric groups will form (and break up) to provide comprehensive foot health services at a good value to the public. Practice Income - Income will continue to undergo pressure in 2000 and then turn around in 200 I as rock bottom causes medicine to finally stand up and say, "we are not going to take it anymore." Unions will flourish and the first doctors' "strike" will take place before 2002. Podiatric specialists will discover new ancillaries to maintain economic practice growth while providing a better service to their patients. Practice Technology - This will be an amazing change in the next 5 years. The techniques of minimally invasive foot and ankle surgery will continue to improve and robotics will become commonplace in major reconstructive procedures. Absorbable screws, pins, plates, and implants will finally be perfected to compete with their metallic counterparts. Allografts will be shaped into every conceivable shape and device that may be needed. Lasers will finally be available to aid in precise bone cuts for osteotomies. Three-dimensional stereoscopic CT and MRI will be commonplace, allowing the surgeon to "crawl inside the foot." Digital radiographs will be available in 75% of podiatric offices by the year 2005. Extracorporeal Shockwave Therapy (ESWT) will have an impact on the successful and noninvasive treatment of heel pain syndrome, bone healing, and reduction of pain in other musculoskeletal conditions. Genetic engineering and cartilage transplants will finally make their way to the foot for the enhancement of the treatment of arthritic disorders. Foot orthoses will universally be casted from digitizers and in-office customized over-the-counter orthoses will become the first level of care for the foot-sore public. Practice Management - Voice recognition software will become universally used to develop electronic
Lowell Scott Weil, Sr., DPM
medical records in 80% of podiatry offices by 2003. Transcriptionists will join answering services in early retirement or retraining. Insurance companies will provide patients with "smart cards" which can be "swiped" for all necessary insurance and demographic information. Electronic insurance billing will still take 3 months to pay the provider and lose claims on a regular basis. Office assistants will play an important role in care as greater volumes of patients are seen for preventive care. The Internet will play an important role in patient communications, such as e-mail questions to the doctor and staff, request for appointment, confirmation of appointments. sending prescriptions to the pharmacy, sending consultation letters to referring doctors and other parties, and general mass announcements to patients. Podiatric Medical Training - The training of podiatric medical and surgical residents will undergo a vast change as the training sites are transferred to ambulatory surgical centers (ASC) and ambulatory sites. Hospitals will playa small role in the care of the podiatric patient as the services of these patients shift to the less costly and efficient ASC. The CON process will be eliminated and single-specialty, licensed surgical centers will become commonplace in orthopedics and podiatric surgery. VOLUME 39, NUMBER 2, MARCH/APRIL 2000
65
Three-year podi atric surgical residencies will be available to all graduates of podiatric medical schoo l by the year 2005. At least two more schools of podiatri c medicine will become part of an academic medical center by the year 2003. At least one podi atric medical school will merge or close by 2002.
66
THE JOURNAL OF FOOT & ANKLE SURGERY
I will still be worki ng 60 hour s a week doing what I love - fixing feet and writing from the "bully pulpit. "
s-,
Lowell Scott Wei!, DPM Editor-in-Chief
Predictions for the Next Five Years As we enter into a new Millenn... - I just can't stand that word any longer so I will just make my predictions. Practice Style - The number of solo practicing podiatric physicians will further dwindle as small groups begin to form and podiatric specialists join orthopedic and multi specialty groups. Large podiatric groups will form (and break up) to provide comprehensive foot health services at a good value to the public. Practice Income - Income will continue to undergo pressure in 2000 and then turn around in 200 I as rock bottom causes medicine to finally stand up and say, "we are not going to take it anymore." Unions will flourish and the first doctors' "strike" will take place before 2002. Podiatric specialists will discover new ancillaries to maintain economic practice growth while providing a better service to their patients. Practice Technology - This will be an amazing change in the next 5 years. The techniques of minimally invasive foot and ankle surgery will continue to improve and robotics will become commonplace in major reconstructive procedures. Absorbable screws, pins, plates, and implants will finally be perfected to compete with their metallic counterparts. Allografts will be shaped into every conceivable shape and device that may be needed. Lasers will finally be available to aid in precise bone cuts for osteotomies. Three-dimensional stereoscopic CT and MRI will be commonplace, allowing the surgeon to "crawl inside the foot." Digital radiographs will be available in 75% of podiatric offices by the year 2005. Extracorporeal Shockwave Therapy (ESWT) will have an impact on the successful and noninvasive treatment of heel pain syndrome, bone healing, and reduction of pain in other musculoskeletal conditions. Genetic engineering and cartilage transplants will finally make their way to the foot for the enhancement of the treatment of arthritic disorders. Foot orthoses will universally be casted from digitizers and in-office customized over-the-counter orthoses will become the first level of care for the foot-sore public. Practice Management - Voice recognition software will become universally used to develop electronic
Lowell Scott Weil, Sr., DPM
medical records in 80% of podiatry offices by 2003. Transcriptionists will join answering services in early retirement or retraining. Insurance companies will provide patients with "smart cards" which can be "swiped" for all necessary insurance and demographic information. Electronic insurance billing will still take 3 months to pay the provider and lose claims on a regular basis. Office assistants will play an important role in care as greater volumes of patients are seen for preventive care. The Internet will play an important role in patient communications, such as e-mail questions to the doctor and staff, request for appointment, confirmation of appointments. sending prescriptions to the pharmacy, sending consultation letters to referring doctors and other parties, and general mass announcements to patients. Podiatric Medical Training - The training of podiatric medical and surgical residents will undergo a vast change as the training sites are transferred to ambulatory surgical centers (ASC) and ambulatory sites. Hospitals will playa small role in the care of the podiatric patient as the services of these patients shift to the less costly and efficient ASC. The CON process will be eliminated and single-specialty, licensed surgical centers will become commonplace in orthopedics and podiatric surgery. VOLUME 39, NUMBER 2, MARCH/APRIL 2000
65
Three-year podi atric surgical residencies will be available to all graduates of podiatric medical schoo l by the year 2005. At least two more schools of podiatri c medicine will become part of an academic medical center by the year 2003. At least one podi atric medical school will merge or close by 2002.
66
THE JOURNAL OF FOOT & ANKLE SURGERY
I will still be worki ng 60 hour s a week doing what I love - fixing feet and writing from the "bully pulpit. "
s-,
Lowell Scott Wei!, DPM Editor-in-Chief