What is the GAO you ask? It is the United States Government Accountability Office. The office was charged with reviewing the care and benefits given to Medicare Beneficiaries from 2016 to 2019. This is a report that the Amputee Coalition of America was actively seeking in order to improve the care that people with limb loss receive. The full report can be read here.
Here is some of what stood out for us. The GAO report on Limb Loss for Medicare Beneficiaries reveals some eye-opening statistics. Only 30% of beneficiaries with limb loss receive prostheses, and a mere 40% consult PM&R specialists. These numbers are concerning – they show many amputees might not be getting optimal care.
Coming from the Midwest where I primarily worked with PM&R doctors, and now living in the West, I found the shortage of PM&R doctors here intriguing. Is it fewer training programs? Or perhaps varying Medicare reimbursement rates? Here in Silicon Valley, I've noticed PM&R doctors often gravitate towards sports medicine. Is it more lucrative? Does our tech-savvy, fitness-oriented population drive demand? Are research opportunities at our well known Universities in our innovation-centric environment geared toward sports?Â
Other figures that caught my eye:
Most limb loss beneficiaries live in the South, fewest in the West. Why? Higher rates of diabetes and vascular disease? Different healthcare access? More retirees?
More beneficiaries in urban areas than rural. Is it about access to care or lifestyle differences?
A whopping 71% of limb loss beneficiaries had diabetes, compared to 24% of all Medicare beneficiaries. We've long known the connection, but these numbers really drive it home.
These statistics raise important questions about care access and quality for amputees.Â
The Care Gap for Amputees in Silicon Valley
The reliance on primary care physicians or orthopedic/vascular surgeons for amputee care can be problematic. Primary care physicians often lack specialized knowledge about prosthetics, while surgeons may view amputations negatively as a "failure in care". This gap in specialized care can lead to:
Suboptimal oversight of patient care
Inadequate rehabilitation programs for amputeesÂ
Missed opportunities for improving quality of life
Potential complications due to lack of specialized follow-up care
What Can You Do? And How Can We Help You?
Our Fitness for Life Clinics, including our bi–weekly group classes are always available to physicians and other rehabilitation professionals.Â
Consider inviting your physician to the clinic when you are trialing a particular knee, foot, or hand. Ask them to join you for a training class, or Fitness for Life Clinic (e.g. A Day at the Stables).Â
If they cannot come to your appointment, perhaps you can set up a FaceTime or Zoom call with them while you show off your skills and technology.
We do know some PM&R Specialists in the area and can connect you. In fact, we are always on the lookout for specialists who are interested in caring for people with limb loss.
We cannot solve all of the gaps brought up in the report, but we do our best to influence our sphere of care right here in Silicon Valley. Let’s spread the word that jumping into and staying informed about prosthetic care is rewarding.
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