Thomas Serena

Thomas Serena's picture
Evolution of the wound care specialist

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

"The average isn't average because its average. The average is average because its best." – J.B.S. Haldane

In 1972, Stephen J. Gould, the renowned paleontologist and masterful essayist, published the theory of punctuated equilibrium in which he challenged the long held belief that evolution occurred gradually over time. He knew that the creation of new species occurred when isolated populations of individuals faced environmental challenges to which they either adapted or perished. Gould asserted that this change happened rapidly when conditions favored it. Interspersed between the spikes in speciation are prolonged periods without change (equilibrium). In the case of the human species, globalization and a fairly stable environment have resulted in negligible change in our evolutionary history: we are enjoying equilibrium.

Thomas Serena's picture
Preparing for CMS PQRS measures deadline

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

An ancient Irish tradition dating back to St. Patrick permitted women to propose marriage to men on the additional day added during a leap year. The gender equality of modern society has turned this tradition into mere folklore, but it is hardly cause for concern here in Boston as we have no shortage of Irish traditions

Thomas Serena's picture
value formula

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

"Price is what you pay. Value is what you get"
-Warren Buffet1

Lawrence Mills introduced the concept of Value Analysis to the manufacturing industry a half century ago. The basic idea entails analyzing the function and importance of the various parts of a product as they relate to cost. He derived the following equation2:

Blog Category: 
Thomas Serena's picture
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."

Thomas Serena's picture
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."

Blog Category: 
Thomas Serena's picture

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.

Blog Category: 
Thomas Serena's picture
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.

American College of Hyperbaric Medicine's picture

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.

Blog Category: 
Thomas Serena's picture

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.

Thomas Serena's picture

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."

Blog Category: