Where podiatry visits leave gaps
A podiatry practice can debride, offload and plan surgery, but it sees the foot for a few minutes every week or two. The days in between are out of view: whether the dressing was changed, whether the patient walked to the kitchen without the boot, whether a ride fell through and the appointment was missed.
Wound care coordination for podiatry practices is aimed at that gap. Gateway Wound Care arranges visits from partner clinicians in homes, assisted living and skilled nursing facilities across Greater St. Louis and the Metro East, and coordinates the scheduling, records and supplies around those visits.
Patients podiatrists commonly send
- Patients with a diabetic foot ulcer who miss office visits because of transportation, dialysis schedules or limited mobility
- Residents of nursing facilities and assisted living who cannot easily travel to your office
- Patients recovering from a toe, ray or transmetatarsal amputation whose amputation site needs watching between post-operative visits
- Patients with a neuropathic foot ulcer and no one at home able to help with dressings
- Patients whose wounds extend above the ankle or elsewhere on the body, outside what your practice manages
Decide who directs the wound plan
Two treating clinicians on one foot works only when the roles are stated. When you refer, tell us which arrangement you have in mind.
- Shared care. Your practice keeps procedures and surgical decisions. The visiting clinician sees the wound between your appointments.
- Temporary handoff. The visiting clinician follows the wound while the patient is in a facility or cannot travel, and the patient returns to your office afterward.
- Full handoff. The wound is outside what your practice manages, and you want to stay informed only.
Whatever the arrangement, the visiting clinician makes their own clinical decisions at each visit, and the plan is settled clinician to clinician. Gateway’s part is making sure each side knows the arrangement and has the other’s notes.
What Gateway coordinates around the foot
Offloading often breaks down on logistics. The device was never delivered, does not fit, or sits by the front door. We coordinate offloading for foot wounds as ordered: the paperwork, the delivery, and follow-up when a patient reports a problem with fit.
Circulation is the other common stall. When you or the visiting clinician want vascular studies or a surgical opinion, we handle vascular referral coordination, including scheduling, records and transportation arrangements. Patients at risk of amputation often have several specialists involved, and our limb preservation page covers how that coordination works.
Glucose control belongs to primary care or endocrinology. If a patient has lost touch with primary care, ask us about diabetes care at home through a partner clinician.
What stays with your practice and the treating clinician
Your practice keeps its own scope: office procedures, surgical planning, post-operative protocols, routine foot and nail care, and footwear prescriptions. A referral to Gateway does not change who the patient’s podiatrist is.
The treating clinician at each visit is responsible for the assessment, diagnosis, orders and treatment given at that visit. The treating clinician makes clinical decisions and selects appropriate products. The health plan determines coverage. Participation and benefits depend on the treating provider, the patient’s plan and the care needed.
Changes that get routed back to your office
Tell us what you want to hear about and who should receive it. A typical list:
- Spreading redness, new drainage, odor or fever
- A new wound on either foot
- A change in the color or temperature of the toes
- A patient who has stopped using the offloading device
- A missed or cancelled visit before your next appointment
The treating clinician decides what is urgent, and clinical questions are handled clinician to clinician. Gateway is not an emergency service. Patients and staff should call 911 for an emergency.
How to refer and what to send
Call 314-325-0126, fax 314-786-7966, or send a referral request online. The web form collects contact details only, so send clinical records by fax.
Useful records include your last office note with wound measurements, the offloading currently in use, vascular studies, imaging, culture results, recent surgery dates with weight-bearing status, and the date of the patient’s next appointment with you. We confirm visit availability for the patient’s location and care setting, then contact the patient or family.
Independent podiatrists can also read about practice support for podiatry practices, a separate service from patient referrals.
Common questions
Will my patient still come to my office?
Yes, unless you decide otherwise. A referral adds wound visits where the patient lives. It does not replace your appointments. Tell us your next scheduled date, and we coordinate the visit calendar around it. If travel is the barrier, we can also coordinate transportation arrangements for office visits and tests.
Can a visiting clinician follow my surgical patient after an amputation?
A partner clinician can see the patient at home or in a facility between your post-operative visits if that fits your plan. Send your post-operative instructions, weight-bearing status and the date of the next visit with the referral. Decisions about sutures, revision or a return to the operating room stay with you as the surgeon.
Who orders the offloading device or therapeutic shoes?
The clinician who prescribes the device writes the order, whether that is you or the visiting clinician. Gateway coordinates the paperwork and delivery and follows up on fit problems the patient reports. Whether a device or shoe is a covered benefit depends on the patient’s plan and the supplier.
What if I think the patient needs a vascular workup first?
Say so in the referral. If you are ordering the studies, we can coordinate scheduling, transportation arrangements and delivery of results to your office. If you would rather the visiting clinician evaluate circulation and decide on studies, note that instead. Either way, we work to get the results in front of both clinicians.