Thomas Serena

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authorization denied

by Thomas E. Serena MD, FACS, FACHM, FAPWCA

During the 2010 presidential campaign, Sarah Palin, the former governor of Alaska, quipped during a debate that then presidential candidate Obama's health care reform contained within it "death panels": bureaucrats with limited or no medical training making life and death decisions. She suffered interminable criticism for the comment and political fact checkers dubbed it the "lie of the year."

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the emperor's new clothes

by Thomas E. Serena MD, FACS, FACHM, FAPWCA

The Emperor's New Clothes was one of my favorite childhood stories. In this Hans Christian Anderson tale, two weavers clothe the emperor in what today would be referred to as "virtual finery." All of his ministers, advisers, factotums and subjects praise the beauty of the unseen linens until a small boy states the obvious truth, "Look, the Emperor is naked."

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by Thomas E. Serena MD, FACS, FACHM, FAPWCA

The American Professional Wound Care Association's (APWCA) annual meeting concluded in Philadelphia the last weekend in March. The meeting featured several novel ideas in wound care education. A hands-on competency session permitted attendees to place total contact casts, practice with two bedside grafting devices, assess vascular status, and become proficient in negative pressure wound therapy.

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Hyperbaric Chamber

by Thomas E. Serena MD, FACS, FACHM, FAPWCA

Pete Seeger died a year ago last January at the age of 94. Reading a tribute to the folk singer, I ran across his most memorable tune, "Where have all the flowers gone?" I have long enjoyed the numerous versions of this folk song recorded by dozens of artists. The fatalism of the lyrics and the circular verse form made it emblematic of a most unfortunate decade in American life: the 60s.

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Consensus Panel
Thomas Serena MD, Helen Gelly MD, Greg Bohn MD, Jeffrey Niezgoda MD

Endorsed by The American College of Hyperbaric Medicine

Introduction
The rise in specialized wound and hyperbaric centers across the United States has resulted in an increased need for physicians to oversee Hyperbaric Oxygen Therapy (HBOT). However, there are no published national standards or recommendations for credentialing physicians for this service. The American College of Hyperbaric Medicine (ACHM) has drafted this document to guide hospital credentialing committees in this process. It represents the consensus opinion of leaders in the field of hyperbaric medicine in the United States. It is important to note that although this document applies to both hospital-based and non-hospital affiliated centers, they have separate requirements.

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by Thomas E. Serena MD, FACS, FACHM, FAPWCA

The Black OPPS continues unchecked. My last blog addressed the recent Centers for Medicare Services (CMS) outpatient prospective payment system (OPPS) in regards to cellular and tissue-based products (CTPs). In the blog, I bemoaned the fact that CMS ignored the prevailing evidence for CTPs in assigning reimbursement for the various products pricing a couple of the living tissues with the most robust evidence on the market. Many of you requested our policies on CTPs, however the algorithm has changed almost daily since the beginning of the year. You will have to wait I'm afraid. In the interim, this month we will examine the change in facility payments.

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by Thomas E. Serena MD, FACS, FACHM, FAPWCA

Resting peacefully by the fire, eggnog in hand, wearied from stringing lights and eleventh-hour shopping, I settled in for the evening. My eyes lazily perused the laptop screen when the news bulletin shattered my serenity. The Centers for Medicare Services (CMS) had sabotaged the evidenced-based pyramid in the field of wound care. Our fragile edifice of evidence crumbled under the weight of the "Black OPPS." Sequestered beneath a mountain of digital output, which took hours to dig through, lay a new categorization of the most commonly used advanced wound care modalities: Cellular and Tissue-Based Products (CTPs), formerly called "skin substitutes."

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by Thomas E. Serena MD, FACS, FACHM, FAPWCA

Parents of most children growing up in the sixties read them Winnie the Pooh. My father, a Woodrow Wilson fellow in English literature, read us Homer’s Odyssey, four times. I remember listening with excitement and anticipation as Odysseus rowed between the fearsome sea monsters Scylla and Charybdis. More than 40 years later I find myself navigating two equally challenging concepts: Efficacy and Effectiveness.

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by Thomas E. Serena MD, FACS, FACHM, FAPWCA

I had the honor of lecturing to an audience of mostly European physicians at the M.I.L.A.N. Diabetic Foot Conference this past February in Milan, Italy. My session this year focused on our current and ongoing research in point-of-care diagnostics. To date, we have enrolled more than a thousand patients in a dozen clinics across the United States. All of these trials led to the development of the first commercially available wound diagnostic, WOUNDCHEK (Systagenix, Gargarve, UK), approved in Europe last year (it has not yet received FDA clearance for use in the US). A revolutionary product, I imagined that it would have received rapid, wide-spread acceptance among my European colleagues. At the end of the presentation I asked for a show of hands: “How many of you are using the test in your clinics or hospitals.” In an audience of nearly one hundred, only three attendees raised their hands.

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