When a wound outgrows the office visit
Most wounds that come through a primary care office heal with ordinary care. Some do not, and a short office slot is not enough to work out why. Wound care referrals for primary care practices usually start at that point.
Gateway Wound Care arranges visits from partner clinicians who focus on wounds and see patients where they live, across Greater St. Louis and the Metro East. Your office sends the request. We coordinate scheduling, records, supplies and follow-up around the visit.
Patients a practice commonly refers:
- A wound that has not improved after several weeks of standard care
- A foot ulcer in a patient with diabetes or neuropathy
- A venous leg ulcer with swelling that keeps coming back
- A pressure injury in a patient who is bedbound or chairbound
- An incision that reopened after the surgeon’s last visit
- A patient who keeps missing wound appointments because leaving home is hard
What your office gets back
The usual complaint about referring out is silence. The patient leaves with a referral, and the next entry in the chart is a hospital discharge summary.
When you refer through Gateway, tell us who in your office should receive updates and how you want them sent. We coordinate communication from the treating clinician to that contact: findings, order changes, and questions that need your input, such as a recent lab value or a medication you manage.
You stay the patient’s primary care clinician, as our page on primary care and wound care together describes.
How a referral works
- Call 314-325-0126, fax 314-786-7966, or start a referral request online. The web form takes contact details only, so keep clinical information to the fax or the phone call.
- Send what you have: a recent office note, problem and medication lists, allergies, relevant labs, any vascular studies or imaging, and a line on what has been tried so far.
- We contact the patient or family, confirm the address and care setting, and check visit availability for that location.
- A partner clinician sees the patient, assesses the wound and writes orders.
- We coordinate supplies, follow-up visits and updates to your office.
Visit availability is confirmed by location and care setting, so we do not quote a standard timeline. Gateway is not an emergency service.
What Gateway coordinates
Our work is the logistics around the clinical visit: the intake call, scheduling, records from your office and any hospital or facility involved, and delivery of the clinician’s orders to whoever carries them out, whether a family member, a home health nurse or facility staff.
We also coordinate wound supplies and equipment tied to those orders, transportation arrangements for outpatient tests or procedures, and referrals to vascular and other specialists when the treating clinician asks for one. If your practice prefers a particular specialist, tell us.
What stays with the treating clinician and with your practice
The treating wound clinician makes every clinical decision about the wound: assessment, diagnosis, orders and treatment. Clinical decisions belong to the treating clinician.
Your practice keeps what it manages today: chronic conditions, medications, preventive care and the patient’s other referrals. Wounds are often slowed by things you manage, including glucose control, edema, nutrition and circulation. When the wound clinician has a question about one of those, we route it to your office so the two clinicians can sort it out directly.
Coverage is not ours to decide either. Participation and benefits depend on the treating provider, the patient’s plan and the care needed. Your staff or the patient can raise insurance questions with us before a visit is scheduled.
Patients who cannot get to your office either
Some patients you refer for wounds have also stopped coming in for primary care because they cannot manage the trip.
If a patient needs medical visits at home for a while, or has no primary care clinician at all, ask us about in-home primary care in St. Louis. Tell us whether the patient plans to return to your office, so it is clear who is managing what.
Starting with one patient
The simplest way to start is with one patient whose wound worries you. Call or fax, and see how the communication works for your staff. Our overview of how Gateway works with physicians covers the model in more detail.
Independent practices that want help with supplies, billing or care-program administration can read about practice support for primary care practices, a separate service from patient referrals.
Common questions
Does the patient stay with our practice after a wound referral?
Yes. A wound referral adds a treating wound clinician for the wound. It does not transfer primary care. You keep managing the patient’s chronic conditions, medications and preventive care, and we coordinate updates from the wound care team to the contact your office names.
Do we need to write wound orders before the first visit?
No. The treating wound clinician assesses the patient and writes the wound orders. If your office or a home health agency has orders in place now, send them so the clinician knows what the patient has been doing. Until the first visit, the patient’s current orders stay in effect.
Can we refer a patient who lives in a facility?
Yes. Partner clinicians see patients in private homes, assisted living, memory care, skilled nursing and rehabilitation settings. For a facility resident, give us the facility name and a nursing contact if you have one. We coordinate with facility staff on visit arrangements and on who carries out orders between visits. Availability is confirmed for each location.
Can a patient or family member contact Gateway without going through us?
Yes. Patients, family members and caregivers can call 314-325-0126 directly, with or without a referral. It helps if they give your practice’s name, so records can be requested and updates can reach your office. If you would rather make the first call yourself, that works as well.