When local doctors disappear, patients pay the price

A patient with a dying leg won't drive 20 miles for care. In Devin Zarkowsky's town, that's not a hypothetical. Vascular surgeon Devin Zarkowsky runs a solo office-based practice in a San Diego County town where peripheral arterial disease patients had nowhere local to go, and Jason McKittrick is the executive director of the Office-Based Facility Association. They discuss the KevinMD article "Why local care matters for peripheral arterial disease." You will hear how the Medicare physician fee schedule pays hospitals for big-ticket equipment but pays solo doctors out of the same bundled rate they use to cover staff and wire and drapes, why a four-figure atherectomy or Shockwave catheter swallows a week of revenue when there is no separate reimbursement, and why Congress is finally looking at fixing it after years of small fixes that did not close the gap. You will hear what local care actually means when a patient cannot drive and the limb cannot wait.

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