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Clinical tools for foot and ankle providers – advanced practice providers

APP patient guidelines, anatomy images x-rays and moreAPP guideliens for lower extremity health

One of my roles as a hospital based podiatrist is mid-level provider oversight.  Our hospital utilizes both PA’s and NP’s to see the majority of patients in our orthopedics and wound care clinics.  Our team based approach has been successful in so many regards.  Even for an older doc like myself, I’ve come to see and value the input we have from our advanced practice providers (APPs).

In my work with APP’s, I’ve found the key to success is four part –

  • Define your roles and set up an ongoing series of clinical meetings
  • Make teaching a core part of your clinical program
  • Be available
  • Know how to access appropriate resources for patient care

In my experience with our APP’s, we work together to find our most productive and effective roles looking for top of scope practice.  For instance, our orthopedic PA’s screen patients for minor fractures and strains but know to refer for lower extremity reconstructive procedures.  We work together to define what procedures are appropriate to our facility.  PA’s are included in post op care so that they understand the indications for surgery.

When possible, I like to share my clinical work with Myfootshop.com.  What follows is a list of patient guidelines that our APP’s use in practice at our hospital.  These documents are free for your use with your patients.  Also included are links to x-rays and anatomy of the lower extremity that we use in patient education for lower extremity health.

Patient guidelines for lower extremity health

Treatment Guide – patient guidelines for treatment of fungal infections of the foot

Treatment Guide – patient guidelines for managing diabetic peripheral neuropathy

Treatment Guide – Post-op instructions for patients following nail surgery

Treatment Guide – calf stretches for Achilles tendinitis

Treatment Guide – Calf stretches for plantar fasciitis

Treatment Guide – Patient guidelines for diabetic foot care

Treatment Guide – Patient guidelines for toe nail fungus (onychomycosis)

Blog posts specific to lower extremity health clinical care for APP's

Diabetic peripheral neuropathy – patient examination guidelines for practitioners (part 1)

Diabetic peripheral neuropathy – patient examination guidelines for practitioners (part2)

Diabetic peripheral neuropathy – patient examination guidelines for practitioners (part 3)

Foot and ankle knowledge base articles (categories)

Toes

Forefoot

Midfoot/arch

Rearfoot/heel

Ankle

Leg

Skin and nail

Lower extremity anatomy images

Bones and joints

Vascular

Neuro

Muscles

Radiology

And one final note on APP’s in Colorado – the Colorado State Medical Board developed a set of guidelines for APP’s that includes guidelines for physician oversight.  Although developed primarily for PA oversight, Rule 400 has worked well in our institution to guide APP’s oversight for both PA’s and NP’s.  In Colorado, NP’s are independent clinical providers, but within our hospital setting, we still use Rule 400 as our guide.

Jeff

Dr. Jeffrey Oster
Jeffrey A. Oster, DPM

Medical Advisor
Myfootshop.com

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