ABOUT US circa 2023
PHYSICIAN FOCUSED RISK MANAGEMENT TEXTBOOK
– Finally –
e-Podiatry Consent Forms™ is an innovative new suite of software programs from the Institute of Medical Business Advisors [iMBA, Inc]. Our products solve your informed consent problems and enhance the education, discussion and documentation of the informed consent process for all podiatrists performing foot, ankle and leg reconstructive surgical procedures.
THE PROBLEM
All podiatrists are being pressured by the Centers for Medicare and Medicaid Services [CMS], the Joint Commission on Accreditation of Healthcare Organizations [JCAHO], liability carriers and private insurance payers to make their consent process more patient-friendly, informed and easily understood. And, the pressure to standardize and comply is great.
Most recently, based on the need to make healthcare even safer, the Agency for Healthcare Research and Quality (AHRQ) undertook a major study to identify patient safety issues and develop recommendations for “best practices”.
The AHRQ Evidence Report
The AHRQ report identified the challenge of addressing shortcomings such as missed, incomplete or not fully comprehended informed consent, as a significant patient safety issue and opportunity for improvement. The authors of the AHRQ report hypothesized that better informed patients “are less likely to experience errors by acting as another layer of protection.”
And, the AHRQ study ranked a “more interactive informed consent process” among the top 11 practices supporting more widespread implementation; especially for surgical consent forms.
Austin/Chevron HAV Repair
[Copyright: Courtesy Dr. Mark D. Dollard; FACFAS]
THE SOLUTION
Why Us: https://epodiatryconsentforms.com/why-us/
One answer to the modern risk-management problem of “informed consent interactivity” may be e-Podiatry Consent Forms™ We license two core interactive surgical products, and a reference library, with related concepts and products in development:
- Forefoot, Mid-Foot and Simple Rear-Foot Version
- Complex Rear-Foot, Ankle and Lower Leg Version
- Comprehensive content library for extreme customization.
Each e-Podiatry Consent Forms™ CD-ROM is increasingly trusted as the simple solution to standardized communications across the entire office-enterprise; from managing-risk, informing-patients and complying with modern regulatory requirements through enhanced patient-centric informed consent encounters.
Thus, by improving the consistency, details, documentation and effectiveness of the informed consent process, e-Podiatry Consent Forms™ equips all podiatric surgeons with the tools needed to augment quality standards, reduce litigation potential and improve patient outcomes and safety.
[Copyright: Courtesy Dr. Mark D. Dollard; FACFAS]
Founders and Advisors
The founders and advisors of e-Podiatry Consent Forms™ are a group of technology focused doctors, nurse-executives, attorneys, psychologists, healthcare administrators, engineers and educational visionaries who decided that there must be a better way to achieve real informed patient-consent and physician-focused risk management information.
Since inception, we have become the leading provider of non-sponsored, non-advertiser driven and unbiased books, essays, informed consent forms and risk-management templates; as well as traditional and ESL educational tools for the podiatric medical space. With expanding products lines, and deep research and development, we are well positioned for future innovation and growth.
Medical Advisory Board Members
Dr. Charles F. Fenton III; FACFAS, JD
Dr. Jay S. Grife; FACFAS, MA, JD, Esq.
Hope R. Hetico; RN, MHA
Eugene Schmuckler; PhD, MBA, M.Ed
Engineering Intern
Mackenzie H. Marcinko
Our Philosophy of Success
Our success at e-Podiatry Consent Forms™ rests in the belief that you achieve more innovation for learning environments with a diversity of minds – podiatric, allopathic, osteopathic, educational, legal and doctoral – than with a sole expert or single institution.
Inform – Document – Relax ™
[Satisfaction Guaranteed]*
Dr. David E. Marcinko; DABFAS, FACFAS, MBA, MEd, CPHQ
[iMBA Inc CEO and Risk Manager]
[Insurance Agent and Consultant]
[Medical Witness and National Expert]
e Podiatry Consent Forms 
Greetings Podiatric Medical Colleagues,
Remember, this is a document production service for physician use only. It is not medical advice. It is not the standard-of-care in your locale. And, it is not a medical, surgical or clinical care treatment plan. Nevertheless, it may be an innovative solution to a growing problem! Your thoughts and comments are appreciated.
*Now, with a product-backed guarantee.
And, for all your podiatry board examination preparation solutions, please visit: http://www.PodiatryPrep.com
Good Luck!
iMBA Inc, Risk Management
http://www.ePodiatryConsentForms.com
Dr. David E. Marcinko; FACFAS, MBA
October 4, 2008 at 2:49 pm
Medicare Approves New Accrediting Organization
I understand that CMS just approved the first new hospital accrediting organization in more than 40 years. The decision allows Det Norske Veritas [DNV] to determine if hospitals are in compliance with Medicare-Conditions of Participation [COP].
DNV joins the Joint Commission on the Accreditation of Healthcare Organizations [JCAHO], and the American Osteopathic Association [AOA].
But, it is the only agency to integrate accreditation with ISO 9001 standards
Link: http://www.DNV.com
My Concerns:
1. Why is a new accrediting body for hospitals needed?
2. What is ISO 9001?
3. Will these new Agency for Healthcare Research and Quality [AHRQ] styled consent-form recommendations be required?
4. Is this a new paradigm shift in the medical consent form documentation preparation process?
Any thoughts are appreciated?
A Confused Podiatrist
A Confused Podiatrist
October 5, 2008 at 2:14 pm
David,
I like the idea, but I have never been one to like a “cookie-cutter” approach to templates, consent forms or office notes. I think the generaliities of what should be included in a consent form would be helpful, but each pt. demographic is varied, therefore the level of communication will vary. I would suggest you sponsor a seminar for a nominal fee with advice from some of our malpractice carriers, lawyers and some of us in the field who have enough experience and the ability to communicate with our colleagues. This would also allow you to expand your website.
Greg
Greg Amarantos
March 25, 2009 at 12:50 pm
Greg,
Many thanks for your comments. And, how right you are!
The e-PodiatryConsentForms™ philosophy is not a cookie-cutter form; or template, at all. And, like you, I have spoken out, opined and written against such generic paper, and digital operating-room “macros” or “office visit templates”, for more almost two decades now. I have opined in speeches, publications, books, malpractice depositions and civil court, thusly.
Of course, traditional paper templates, or even more modern electronic machinations are not intrinsically evil; but may be seductively “tempting” to the user – and ripe for alarmingly easy change and abuse. I have seen electronic templates work against the doctor’s interest in the legal, payment and reimbursement, and office valuation and appraisal arena; in far more cases than not.
And so, our concept is really the exact opposite of the above.
Rather, ePodiatryConsentForms™ represent a fully customizable process; not just a static form or fill-in-the-blank template [electronic, paper or otherwise] that would benefit 80% of all practitioners today. Those who will especially benefit from the collective surgical and procedural wisdom of our more than 25 strategic alliance partner-podiatrists are; newbie’s, mature-doctors and for those where English is a second language. After, creating, reviewing, criticizing and sometimes even applauding podiatric surgical consent forms for 25 years, the range of disparity is truly expansive and frightening. In other words, make them your own – but make them – and the entire “process” – comprehensive and really “informative.” Our document production software will greatly assist.
This collaborative consent form situation is not unique to podiatry. It is rife in the medical community, as our medical colleagues originally pioneered this burgeoning space several years ago. We are merely “slow-followers” who watched other “fast-followers” in the accounting, engineering and legal documentation production communities. And, with the potential mandates for increased medical thoroughness, eHR acuity and eMR standardization of CCHIT and the Obama administration; etc, the concept will only grow going forward. It may even become a matter of political fiat, in the near future.
Why?
According to the Institute of Medicine’s [IOM] repot, “To Err is Human”, more than 1 million injuries and nearly 100,000 deaths occur annually in the United States due to mistakes in medical, surgical, informed consent and other care. Wrong patient, wrong-side, wrong-procedure, wrong extremity and wrong-toe surgery are particularly egregious; along with the overpromise of success and under-appreciation of related surgical complications.
In fact, these are among the several other “never-events” that Medicare, and an increasing number of private insurance companies are refusing to reimburse. Based on the need to make healthcare safer, the Agency for Healthcare Research and Quality (AHRQ) even undertook a study to identify patient safety issues and develop recommendations for “best practices”. This may just become another best-practice, sooner than later. So, “forewarned is forearmed.”
Finally, your suggestion for seminars is a good, but unwieldy, one in the era of websites, podcasts, email, twitter, wikis; and the like.
As you know, many traditional seminars are flagging today, and on topics far more sophisticated and costly than ePodiatryConsetForms™ and PodiatryPrep products. In fact, our best-selling, but unrelated allopathic/osteopathic health dictionary handbook series http://www.HealthDictionarySeries.com was initially produced though virtual wiki modeling. Such virtuality is just faster, more secure, pervasive, better, cheaper and collaborative than seminars; and it is just right for the Health 2.0 space that is our raison d’être.
Note: We believe in this message so absolutely, that we pursue almost no traditional print magazine, journal, seminar or onsite advertising for any of our products, or current oeuvre of expanding services. To do so would only imprint a last-generation stigma to our decidedly new-wave businesses brand identity.
Greg; many thanks again for reaching out to us! Feel free to review all pages and links on the website for a better understanding of “what we do – and who we are?”
Our goal is to keep professional “fly” for as long as possible.
PS: Be on the look-out for my upcoming interview with Medical Business News, Inc., the publisher of Medical News of Arkansas on the healthcare and hospital economy; online, in-print; and on our blog.
Fraternally,
Dr. David Edward Marcinko; FACFAS, MBA CMP™
Full disclosure: David Edward Marcinko is a former insurance agent, registered investment advisor, board certified foot, ankle and lower leg reconstructive surgeon and Certified Financial Planner™. As a clinician and past president of a privately held regional physician practice management corporation in the Midwest, he helped consolidate 95 solo medical practices, with $50 million in revenues as the company’s IPO roll-up attempt was aborted due to adverse market conditions, in 1999. He was also managing partner of a successful ambulatory surgery center that was sold to a publicly traded company in 1998. Dr. Marcinko holds general securities (Series # 7), uniform securities state law (Series # 63) and registered investment advisory representative (Series # 65) licenses from the National Association of Securities Dealers (NASD-FINRA). He is a member of the American Society of Health Economists (ASHE), the International Health Economics Association (iHEA), the American Health Information Management Association (AHIMA), the Healthcare Information and Management Systems Society (HIMSS), the Microsoft Professional Accountant’s Network (MPAN) and US Microsoft Partner’s Program (MPP), the Microsoft Health User’s Group (MS-HUG), the Sun Executive Boardroom program sponsored by CEO Jonathan Schwartz, and SUNSHINE [Solutions for Healthcare Information, Networking and Education]. He is also the founding Editor-in-Chief of the two volume – 1,200 pages – institutional print-journal Healthcare Organizations [Financial Management Strategies].
Podiatry Initiatives
• http://www.PodiatryPrep.com
• http://www.ePodiatryConsentForms.com
Dr. Marcinko is Founder and Chief Executive Office of the Institute of Medical Business Advisors Inc, and related medical management and healthcare administrative firms.
Healthcare Initiatives:
• http://www.MedicalBusinessAdvisors.com
• http://www.HealthDictionarySeries.com
• http://www.CertifiedMedicalPlanner.com
• http://www.HealthcareFinancials.com
* http://www.HealthcareFinancials.wordpress.com
All opinions expressed herein all those of the respondent, and not necessarily iMBA Inc., or its affiliates.
Dr. Marcinko
March 25, 2009 at 2:33 pm
CSPM Announces New Surgical Textbook
The Department of Podiatric Surgery at the California School of Podiatric Medicine (CSPM) at Samuel Merritt University has produced a new surgical textbook, Lesser Forefoot Surgery, published by Data Trace. This textbook is a compilation of 30 years of experiences by the members of the surgery department in evaluating and determining the most effective surgical therapies for the more common problems of the lesser forefoot.
Lesser Forefoot Surgery presents the pathomechanics and evaluation of the most common lesser forefoot pathologies in a problem-specific manner that cannot be found in any currently published textbook. It also presents in a “cookbook” format the indications and contraindications for the common surgical procedures utilized to correct lesser forefoot pathology, along with a detailed description of the surgical techniques. Each chapter involving the surgical procedures also discusses the recommended post-operative management and the inherent complications associated with the procedure.
PS: The term “cookbook” is obviously not a bad word to all podiatrists or physicians.
Submitted by Hope Rachel Hetico; RN MHA
[Source: Verbatim Podiatry Management Magazine]
http://www.PodiatryPrep.com
Hope Hetico
April 2, 2009 at 1:04 am
Of Checklists, Cookie-Cutters and Cookbook Medicine,
Some doctors tend to eschew document production tools and templates, or even checklists, as a form of “cook-book” or “cookie-cutter” medicine. Yet, it is nothing of the sort, if combined with intelligent patient specific input! In fact, some attorneys, quality gurus, and medical management consultants embrace their appropriate use in modernity today.
THINK: Legal Zoom
Why? Well, the Institution of Medicine [IOM] study, a few years ago, reported more than 100,000 needless hospital deaths due to medical errors, and more than 1,000,000 patient complications because of same http://www.HealthcareFinancials.com Can you say doctor negligence and/or medical malpractice? Or, consider the costs savings reaped from the abscence of same.
THINK: “Medicare red-flags” and “CMS never-events.”
One informed position is a hybrid of both the traditional informed heuristics — and — a document production tool posture for podiatrists. This suggests a “best-of-breed” ePodiatryConsentForm approach as a cogent and flexible starting-point for modifications and embellishments, as needed.
In this way, a powerful mental meme and digital quality care mechanisms is launched, especially when combined with a CD-ROM like the “Comprehensive Library of Podiatric Medicine and Surgery”, produced by the Foot and Ankle Research Consortium, Inc http://www.PodiatryPrep.com
Cordially
Ann Miller; RN, MHA
[Former Hospital CXO]
Ann Miller, RN, MHA
April 3, 2009 at 11:59 am
Most hospitals, physicians, and especially niche providers like podiatrists do not have the resources to create and maintain their own best-of-breed practice protocols, guidelines, document productions tools and/or order-sets, etc. The amount of new information each year just exceeds the capacity of any single doctor to review it all. The only way to keep knowledge content current is thru continuous electronic connectivity by medically focused modern technologists.
I am grateful to the people at http://www.ePodiatryConsentForms.com and http://www.PodiatryPrep.com for creating these interoperable educational, and best-of-breed decision support system [DSS] tools, and document production software for all podiatrists.
A Satisfied DPM
Satisfied DPM
April 8, 2009 at 10:40 am
It’s no secret that many in the industry are proponents of increased standardization in medical care, especially in podiatry, if it adheres to evidence-based practice guidelines.
This assumes however, that the recommendations themselves are rigorous and have been shown to help patients. That’s why these software document production tools are a solid best-of-breed hybrid that combines both visions [technology ease – combined with physician input].
More than six thousand successful DPM clients of the Foot And Ankle Research Consortium [FARC], Inc can’t be wrong.
TEAM
http://www.PodiatryPrep.com
FARC, Inc
April 16, 2009 at 10:29 am
Doctors and “Cook Book” or “Check List” Medicine
You are already practicing “cookbook” or “check list” medicine when you:
* Pre-certify a case
* Use the PRD
* Pre-approve a procedure
* Join an HMO, MCO or other “panel”
* Use a formulary and/or generic drug
* Use an outpatient, rather than in-patient facility
* Use a surgical template
* Use a clinical database
* Use a pre-loaded PDA
* Don’t practice EBM [evidence based medicine]
* Don’t use CME [comparative medical effectiveness]
And, you have been doing so for more than 20 years when some 18 y.o
“support” person on the phone/fax or internet tells you how to treat
your patients; just to get paid.
Docs, get a clue; “Checklist-medicine” is here, is now and is HIGHLY beneficial
and recommended by many quality gurus and experts.
So, please DO practice cookbook and checklist medicine; and read more here:
Link: http://healthcarefinancials.wordpress.com/2009/01/20/a-homer-simpson-moment-of-clarity-on-medical-quality
Now, can you think of any more examples?
Please advise us all!
Ann Miller; RN, MHA
[Executive Director]
http://www.HealthcareFinancials.com
http://www.HealthcareFinancials.wordpress.com
Ann
May 5, 2009 at 7:05 pm
$750,000 Verdict – Failure to Obtain Informed Consent for Foot Surgery (New York)
Read more about this damages-only case in New York that involved the plaintiff’s right to decide whether or not to receive additional medical treatment/surgical procedures to the feet, which established the podiatrists’ duty to inform the patient (informed consent).
From the Podiatry Malpractice Blog
Link: http://www.podiatrymalpracticeblog.com/2008/10/articles/another-category/750000-verdict-failure-to-obtain-informed-consent-for-foot-surgery-ny
Ann Miller; RN, MHA
[Executive-Director]
Ann Miller; RN, MHA
May 10, 2009 at 8:50 pm
According to George Lundberg MD:
“And, (conservatively) something like 20% of the total US health care expenditures (perhaps $ 500 000 000 000 annually) is expended for medical practice activities that are not based on scientifically sound evidence and do not improve patient outcomes. The habits of those over-spending and under-achieving American medical geographic regions and many medical/surgical specialists could/should be changed drastically to better conform to those right-spending or mini-spending and maxi-achieving geographic regions and medical practice organization patterns. From this change, we can expect NO loss of quality, indeed likely improved outcomes. And, some $150 000 000 000 is expended annually for clinically superfluous actions to defend against potential future medical liability allegations.”
Question: Will standardized consent forms help? The answer is clear.
Link: http://www.thehealthcareblog.com/the_health_care_blog/2009/05/beware-the-bursting-of-the-health-care-bubble.html#comments
Hope Hetico; RN, MHA
[Former Hospital Administrator]
Editorial staff
May 13, 2009 at 12:26 am
WHO Pushes for Surgical Checklists
Did you know that the World Health Organization [WHO] has a surgical safety checklist that is being used by more than 700 hospitals according to the institute for Healthcare Improvement [IHI]? There are 19 basic guidelines and surgical consent forms are included among them.
And, a new study in the New England Journal of Medicine [NEJM]demonstrated that the use of checklists improves patient safety and medical care quality.
http://content.nejm.org/cgi/content/full/NEJM/sa0810119
Hospitals & Health Networks
[July 2009]
Editorial staff
July 30, 2009 at 11:04 am
TEACHING INFORMED CONSENT
Most medical students don’t take classes on how to discuss informed consent, that is, talking about the risks and benefits of a medical or surgical procedure with a patient.
http://www.kevinmd.com/blog/2009/08/should-the-informed-consent-discussion-be-formally-taught.html
But, some experts increasingly believe it should be formally taught in medical school. So, do we!
Dr. David E. Marcinko; MBA
[Chief Executive Officer]
Dr. David E. Marcinko; MBA
August 20, 2009 at 10:28 am
I think that Clinical Guidelines and Medial Treatment Algorithms can certainly be interpreted as “cookbook medicine”.
The idea behind CGs or MTAs is that for a given set of symptoms or problems, there is a best answer as to the optimal treatment or course of action. This may be termed “cookbook medicine”, but most doctors certainly agree that these types of guidelines can improve care and also result in significant cost savings. Doctors fear that these guidelines might not allow for appropriate exceptions or variations from the recommended treatments.
However, I think that most of these algorithms recognize the need for some individualization of treatment. If these guidelines are designed appropriately to allow for individualization of treatment as well as the use of alternative and innovative treatments, then I think that they will be accepted by the medical community.
Brian J. Knabe; MD
Dr. Knabe
August 24, 2009 at 10:11 am
On Templates and Checklists
[Homer Simpson’s Moment of Clarity on Medical Quality]
Accountants do it – Attorneys do it – Why Not Docs?
Like the Nike slogan, hospitals should just do-it! Make checklists, that is! A new report by the Associated Press, on January 15, 2009, suggests that simple templates and checklists might improve medical quality and save hospitals $15 billion a year.
http://healthcarefinancials.wordpress.com/2009/01/20/a-homer-simpson-moment-of-clarity-on-medical-quality/
Your thoughts are appreciated.
Ann Miller; RN, MHA
[Executive Director]
Ann
August 24, 2009 at 11:01 am
Pre-Operative Consent Form Signatures
The law states that the podiatrist, or any health care provider, must get the patient’s consent to the surgery after giving the patient information including the risks, benefits, and alternatives to surgery, including NOT HAVING THE SURGERY at all.
Most consider a signed consent form, without explanation, inadequate to get the patient’s informed consent. The podiatrist should sit down with the patient and verbally explain the surgery.
Some podiatrists get the patient’s consent moments before the surgery. Some consider that to be bad practice. More important is whether the patient is calm enough to understand the details of the procedure and all the risks and alternatives. Most patients would rather not have this important information moments before surgery but rather days or weeks before the surgery so they can discuss it with their family or friends or just take their time and think it over.
Source: http://www.podiatrymalpractice.com/podiatry-services.html
Editors
August 29, 2009 at 8:13 pm
Teaching Informed Consent
Here is a NYT link on the topic.
http://www.nytimes.com/2009/07/30/health/30chen.html?_r=1&partner=rss&emc=rss&pagewanted=all
And, here is another link for your review.
http://psychdata.blogspot.com/2007/05/psychiatry-residents-often-skip.html
Psychiatry and Podiatry … strange bedfellows.
It seems as though http://www.ePodiatryConsentForms.com is ahead of the curve.
Dr. Lee
Dr. Lee
October 8, 2009 at 10:29 am
Safer Surgery
Make your sugery safer with checklists:
http://www.scoap.org/checklist/
Editors
Editors
October 25, 2009 at 8:02 pm
Dear Greg,
I must say that I have to agree with Dr. Marcinko. Perhaps your reluctance to use checklists and templates is a generational thing?
If so, please get over it. Here’s why?
Top surgeon urges doctors to use ‘The Checklist’
http://www.usatoday.com/news/health/2010-01-27-checklist27_st_N.htm?loc=interstitialskip
You and Dave may not be very eloquent, but his philosophy is the future, and I respectfully believe you are past your professional prime in this instance.
Jeff
Jeff
February 2, 2010 at 5:18 pm
More on Checklists and Quality Care
Surgical checklists are “hot”, and save lives according to the WHO:
http://healthcarefinancials.wordpress.com/?p=20548
Professor Hope Hetico; RN, MHA
[Atlanta, GA]
Hope Hetico; RN, MHA
February 7, 2010 at 4:37 pm
These e Podiatry Consent Forms are ideal for eMRs and email, too.
We love using them and could never go back to traditional paper forms, again.
Debra
[Office Manager]
Debra
February 12, 2010 at 8:50 pm
Harvard uses templates and checklists:
http://www.hsph.harvard.edu/news/press-releases/2009-releases/hospital-sites-demonstrate-surgical-safety-checklist-drops-deaths-and-complications.html
Sam
Sam
February 24, 2010 at 2:19 am
ME-P Readers
I just finished The Checklist Manifesto, by Atul Gawand MD, and it is a must read. Checklists are fast making their way into medicine, particularly in the area of surgery.
Dr. Gawande is a surgeon, and most of the anecdotes in his book are surgical. On the other hand, these podiatric surgical templates are to the informed consent process, what Atul must be to the general surgeon’s Operating Room; flexible and responsive.
Linda
Linda
February 24, 2010 at 11:22 pm
Implications of the surgical “buy-in” when discussing informed consent
Pauline Chen had a post in the New York Times recently about surgical informed consent.
http://www.nytimes.com/2010/09/10/health/10chen.html?_r=1
As you know, informed consent is an important part of the surgeon/patient communication transaction. And so, this essay is a “must read” for all podiatrists.
Ann Miller RN MHA
[Executive-Director]
Ann Miller RN MHA
March 28, 2011 at 8:48 pm
Electronic Patient Consent System Planned
Given the public’s concerns about online privacy and ID theft, ONC is launching a pilot project that will build trust in data exchange.
An e-patient consent system will soon become reality if the Office of the National Coordinator for Health Information Technology (ONC) has its way.
In fact, according to a listing on the Federal Business Opportunities website, ONC is currently seeking a vendor to conduct market research that will identify patient concerns as they design an e-consent pilot that will foster patient trust.
http://www.informationweek.com/news/healthcare/patient/229402438
Editors
April 29, 2011 at 12:28 am
What Wisconsin Court Ruling on Informed Consent Means to States and ACOs
Government Health IT (May 22, 2012)
A recent Wisconsin Supreme Court decision affirmed a dramatic expansion of the scope of what physicians must disclose during informed consent. This closely-watched decision may have long-term implications for other states and may foreshadow a new paradigm for patient-centered communications – communications that are becoming increasingly more relevant with the advent of Accountable Care Organizations.
Editors
Editors
May 29, 2012 at 12:17 am