Wound Care: It’s About Healing the Whole Patient, Not Just the “Hole”
Editor’s note: Dr. Traci Kimball is a full-time dermapathotraumatologist. It’s not just about wound care, it’s about caring for the whole patient. Her passion for her craft is exceptional. Whether you’re considering a career in wound care or not, this is a great field to understand! I expect that this field will continue to grow and shape the future of wound care, pathology, trauma, and surgery for years to come.
Never having actually practiced General Surgery full time, the last 3 years have found me working in wound care management. It has been exciting trailblazing a path within a unique medical specialty caring for a very sick and diverse patient population. The specialty isn’t yet recognized by the American Board of Medical Specialties, but it’s an important field that serves a huge need.
Chronic wounds affect all patients, indiscriminate of age, gender, ethnicity, religion or creed. Unfortunately, they also place a significant financial and quality of life burden on patients and their families.
I am treating patients who live with chronic medical conditions like terminal cancer, multiple sclerosis, ALS, diabetes, CHF and COPD. Healing the skin amidst these challenges is extremely rewarding.
It’s about healing the “whole patient and not just the hole.”
Surgical techniques have validity and value. However, healing by secondary intention utilizing stem cell therapies, skin substitutes and epidermal closure systems may be more cost-effective. Such techniques may also have a better chance at a cure over other more costly options like major amputation or plastic flap surgery.
My biggest challenge however, has nothing to do with wound care and achieving cures! We have more difficulty getting the
recognition we deserve for the great work that we do. We are a taxonomy like any other: Dermapathotraumatologists.
It’s a challenge to convince payers that I am a skilled specialist with experience and knowledge that transcends multiple ABMS-recognized medical specialties. Most payers seem to be singular in thought that I must only evaluate and manage the one wound I specifically treat. What they often don’t realize is that I also evaluate and make recommendations for improving the background of chronic comorbidities inhibiting the wound healing process.
What recourse does a professional have when payers do not pay for the highly specialized services one renders, despite that work being supported by substantial clinical proof for efficacy and safety?
Early in my career, I struggled with payers and even local hospital credentialing committees refusing to work with me simply because I lacked a board-certification in General Surgery. Of course, that certification had nothing to do with my scope of practice.
I began to ask the question of whether I should pause and return to training in a different medical specialty that would set me up for a fellowship in hyperbarics, like Preventive Medicine or Family Practice. This was initially my solution by which I could acquire the credibility I needed to lobby payers that I should be recognized as a provider of specialty care for wounded patients.
This was a difficult decision since I had already spent 8 years in post-graduate training and another 5 years in clinical practice. In that time, I had been successfully healing and reducing utilization of healthcare in my patients. Luckily, I found a better path: Program of All-Inclusive Care for the Elderly (PACE). PACE is a value-based, coordinated care model where I can thrive and have longevity in my career as a Dermapathotraumatologist. I believe, my PACE experience will lay the foundation that is needed to convince payers that Wound Management is a medical specialty like any of the others.
The path of a dermapathotraumatologist is not a simple one, but it’s highly rewarding! If you’re interested in a career in wound care, this is definitely a path you should consider.
