Advancing Your Wound Care Career: Advice From Industry Professionals & Providers

“What is your five-year plan?”

This is a question that most professionals have heard or thought about regardless of their career choice. Whether one’s goals, for example, are to increase the number of patients impacted, share expertise and research with peers, gain management experience, reduce physical strain by transitioning to an administrative role, increase earning potential, prepare for a broader leadership role, or simply “try something new,” there are a plethora of reasons for wound care professionals to constantly assess their career goals and contemplate strategies to achieve those goals. On the other hand, many passionate wound care professionals are content to continue with their current roles for the foreseeable future. Still, unpredictable and uncontrollable changes within the industry, such as transitions among management personnel, shifts in patient volumes and budgets, and facility closures and relocations, as well as personal and family circumstances that may arise, can quickly result in the desire (or need) for any professional to consider a career adjustment. As such, anyone looking to grow professionally within the wound care industry should regularly assess where they have been, where they are currently, and where they want to go in order to fulfill any specific aspirations. 

This article will offer advice from a variety of industry professionals with varied career experiences and offer actionable initiatives to explore when considering the fast-paced healthcare field. In addition to discussing their own career paths, the authors have gathered insight from multiple professionals in the wound care community through recent interviews and conversations in an attempt to better represent a diverse range of backgrounds and experiences. The participant panel includes clinician and nonclinician professionals.

CAREER-BUILDING COSIDERATIONS FOR HEALTHCARE PROFESSIONALS

In addition to being knowledgeable, proficient, enjoyable to work with, and having the ability to reliably perform all job responsibilities, there are many expectations to set when it comes to showcasing the skills and confidence necessary to impress those professionals who are making the hiring (and related) decisions within an organization. The primary goal for any professional should be to ensure that one’s peers and superiors are confident that you are the right person for the job, whether you are seeking a new position or are intent on maintaining present employment. Ideally, we as professionals are not only focused on what it is that we excel at. We also want to expose ourselves to new arenas, even if that means going beyond our “comfort zone,” as long as there is no unnecessary risk to any patient or colleague involved. Consider these seven areas of business that could be considered as options to career advancement or transition:

1. Patient Acquisitions:If your facility has a process for driving referrals, such as printing and delivering patient progress reports to the referring provider or participating in hospital grand rounds, consider volunteering to help with that process. If not, ask to propose and execute such a plan. Be sure to measure where you are before and after (new-patient volumes, first-time-referring providers, etc.), so that you can measure and report on the impact that the plan has had and to be able to replicate successes.

2. Clinical Operations: The flow of any facility can constantly change. Understanding why patients are scheduled in a particular manner and how the staffing ratio is established will help provide a full scope of the operational picture. Ask questions about workflow. Many electronic health records allow workflows to be configured to streamline processes. Conducting a time study (with a stopwatch) to identify improvement opportunities for clinical flow can provide information for roadblocks and barriers. Understanding the clinical treatment options and modalities, as well as the documentation requirements, will help with risk management. Case management of patients can assist with chart reviews and offer a teaching opportunity about different treatment options and modalities for patients. Case management can also help identify cost-efficient treatment options and ensure best-practice guidelines are followed. Building a relationship of trust with one’s supervisor can open the doors to increased opportunity. Some administrators may allow staff to assist in scheduling employees, timecard management, marketing and community education efforts, and/or quality tracking. Setting a strong first impression and proving to be trustworthy is a great start toward the path for advancement or upward mobility.

3. Financial, Billing, & Revenue Cycle Management: The business of healthcare is a hot topic as revenue and costs are continually changing. Understanding the full revenue cycle for the clinic and other departments and business units (eg, laboratory, imaging, surgical services, inpatient, home healthcare) is key — from patient registration and admission, through coding and billing, to payment and denial management. Clinical operations are vital to the success of patient care, but revenue cycle management is vital to the longevity of offering the service. Just as administrators should understand clinicians’ thought processes and rationale for product selection or specialist referrals, so too should clinicians benefit from understanding the revenue cycle and how treatments, product selection, and documentation affects that — ultimately impacting the resources that can be invested back into the wound care program. Likewise, the prior authorization, patient access, and financial review processes can be just as important to the patient’s experience as scheduling or pain-management issues are. Learn as much as you can about billing guidelines, coding, and denial management to ensure longevity of the service line. There are educational opportunities provided by the industry to assist in understanding revenue cycle management as well.

4. Continuous Quality Improvement: We all know about chart audits, but what do we get from them? Dive into the data! Looking at routine tasks in a different light can change the perspective of what you get out of the results. Data analytics combined with SWOT (strengths, weaknesses, opportunities, and threats) analysis¹can be very effective and help to identify marketing opportunities, audit flags, educational opportunities, and workflow optimization, as well as assist in revenue cycle management. As healthcare continues to change, quality reporting has shifted from Meaningful Use and the Physician Quality Reporting System to the Merit-Based Incentive Payment System and the Medicare Access and CHIP Reauthorization Act. Understanding quality data reporting assists in documentation guidelines, workflow optimization, and regulatory compliance. Collecting industry-specific data through wound care-specific registries can strengthen quality-reporting benchmarks and result in increased revenue and compliance. Another means of quality reporting is to be a part of an accountable care organization (ACO). According to the Centers for Medicare & Medicaid Services, ACOs are groups of doctors, hospitals, and other healthcare providers who come together voluntarily to give coordinated, high-quality care to Medicare patients. Understanding how your facility provides quality measure data reporting will help you be more valuable to your organization. Consider implementing Lean processes²as well.

5. Leadership Meetings, C-suite, & Management Company Dynamics:Depending on facility type and whether a management company is involved, wound care professionals may have the opportunity to participate in leadership meetings, one-on-one conversations with C-suite executives to discuss various initiatives, and/or regional and onsite management company meetings. Ask to sit in on or participate in these discussions if possible. Offer to help prepare brief presentations and/or reference materials that explain clinical and business-related successes or failures. Likewise, ask for the opportunity to review and discuss materials that colleagues may have prepared. This will provide exposure to a holistic view of the wound care business, and perhaps more. (This type of experience looks great on a resume or curriculum vitae [CV], too!) 

6. Nonclinical Delivery of Care: For professionals who are actively treating patients, this area might be less relevant. For nonclinical managers, administrators, or interns, consider taking the time to get involved in the delivery of care. This doesn’t mean performing debridements and applying allografts, but, rather, assisting clinicians in the preparation of supplies, assisting patients as they enter and exit an examination room, and, of course, helping to clean and sanitize those rooms (to give a few examples). By taking this type of initiative, professionals can gain an appreciation for the manner in which wound assessment, patient mobility, and treatment selection affects the time required to schedule and care for different types of patients. As a bonus, this approach can positively affect team morale and can encourage clinician colleagues to perform office duties to assist their nonclinician peers as opposed to saying, “That is somebody else’s job.” 

7. Industry: While it is not easy for wound care providers to weave in and out of industry-type jobs (and vice versa), a good way to start thinking about a possible transition is to ask local sales representatives about their job responsibilities and challenges. Industry professionals can do the same to learn more about their customers and build rapport. One sales rep in the durable medical equipment sector recently revealed that he leveraged interactions with customers to become a director at a wound care center after a few years on the job. Those professionals who have the ability (and not everyone does due to compliance issues and time constraints) to shadow a sales rep in the wound center setting (and vice versa) can learn yet another way to build professional expertise in a holistic, well-rounded manner.

CONCLUSION

The navigation of one’s career path has changed drastically in the 21st century. Remaining with one employer over a long period of time does not guarantee increased opportunity or stability. Napoleon Hill, author of the bestseller Think and Grow Rich, famously wrote, “The man who does more than he is paid for will soon be paid for more than he does.” Of course, in this country’s current healthcare environment, going “above and beyond” does not necessarily lead to higher pay. Yet, Hill’s wisdom is still quite relevant and can be applied to wound care professionals who are eager to advance professionally. Wound care professionals at all phases of their careers and all levels of an organization should consider “doing more than he or she is paid for” because, generally speaking, that mentality leads to more career engagement, mobility, profitability, security, and flexibility, in the opinion of the authors of this article. 

Rafael Mazuz is managing director of Diligence Wound Care Global LLC, an advisory firm providing wound care executives, investors, and specialists confidence in their business decisions.
He previously opened and led award-winning wound care centers for the world’s largest provider of wound care management services and advises wound care product and services stakeholders in both the developed and emerging markets. He may be reached at rafael@diligencewcg.com
Jonathan Scott is director of the Wound Healing Center and Hyperbaric Medicine at Tri-State Memorial Hospital & Medical Campus, Clarkston, WA. He may be reached at jscott@tsmh.org

References 

1. Fallon N. SWOT analysis: what it is and when to use it. Business News Daily. 2018. Accessed online: www.businessnewsdaily.com/4245-swot-analysis.html

2. Lean Enterprise Institute. What is lean? 2018. Accessed online: www.lean.org/whatslean

3. Six Sigma. What is six sigma? 2018. Accessed online: www.isixsigma.com/new-to-six-sigma/getting-started/what-six-sigma

4. Boysen PG. Just culture: a foundation for balanced accountability and patient safety. Ochsner J. 2013;13(3):400-6. 

5. Corporate Scorecard. About corporate scorecard. 2018. Accessed online: www.corporatescorecard.com.au

TWC Board Members and Industry KOLs share career experiences and advice 

Frank Aviles, Jr., PT, CWS, FACCWS, CLT
Wound Care Service Line Director, Natchitoches (LA) Regional Medical Center; Wound Care and Lymphedema Instructor, Academy of Lymphatic Studies, Sebastian, FL; Physical Therapy (PT)/Wound Care Consultant, Louisiana Extended Care Hospital, Natchitoches; PT/Wound Care Consultant, Cane River Therapy Services LLC, Natchitoches; Editorial Advisory Board member, Today’s Wound Clinic

Career Path Taken: While in college, Frank had no choice but to change his childhood dream of becoming a jet pilot, and the decision to pursue a career in the healthcare field with an emphasis on treating chronic wounds is the best decision he has ever made. Since earning his degree in physical therapy, he has worked a minimum of two jobs in various capacities.  Frank’s journey continues to allow him to push the envelope in a field that he is very passionate about.

Advice for Wound Care Professionals: “Map your career path on paper to help you arrive at your destination. Have a “copilot” (mentor) to help you navigate the rough course, be passionate, and, most importantly, remember to do what's right while being a patient advocate. Learn to adapt to the never-ending healthcare changes. Success will be possible when you learn how to persevere in the face of failure.”

Melodie Blakely, DPT, CWS
Clinical Director, Orlando (FL) Wound Institute; Editorial Advisory Board Member, Today’s Wound Clinic; Board Member, ABWM Foundation

Career Path Taken: Melodie fell in love with wound care while earning her doctorate in physical therapy. Though pursuing a career in wound care as a physical therapist has its challenges, she has taken every opportunity to follow her passion: first in acute care, then in long-term care, and finally in the outpatient setting, where she has developed wound care and wound-prevention programs, implemented electronic health record systems, and participated in clinical research. Relationships and experiences developed during this time have also led to teaching and speaking opportunities, as well as her working several years as a clinical specialist for a major industry firm. Dr. Blakely is currently the clinical director of an independent wound center in Orlando and is privileged to serve on the boards of the ABWM Foundation and TWC.

Advice for Wound Care Professionals: “Accept opportunities that expand your experience, especially ones that scare you. Know the value that you add to your team and your profession. Find a mentor (or several). Be an early adopter of new technologies. Understand the business of wound care. Take excellent wound pictures. Imagine things from the patient’s perspective.” 

Cheryl Carver, LPN, WCC, CWCA, CWCP, FACCWS, DAPWCA, CLTC 
Wound Care Clinical Specialist, American Medical Technologies, Irvine, CA; Medical Writer, Blogger, and Educator

Career Path Taken:Cheryl began her career in long-term care, earned her wound care certification, and then ventured into hyperbaric medicine and wound care with a national wound management company. She then advanced into a program director’s role for a national physician, at which time she began developing a comprehensive education and training program for physicians across the country. This eventually lead her into entrepreneurship, consulting, and medical writing, which has presented opportunities for her to further share her knowledge and expertise worldwide.  

Advice for Wound Care Professionals:“With only one year of education on paper, I have found that certification is one way that clinicians can set themselves apart and validate their expertise. Experience and specialized training solidifies career advancement and can expand employment opportunities. Make it a point to enhance your education as much as possible, with or without a nursing or advanced degree.” 

Caroline E. Fife, MD 

Medical Director, CHI St. Luke’s Wound Clinic, The Woodlands, TX; Chief Medical Officer, Intellicure Inc., the Woodlands, TX; Executive Director, U.S. Wound Registry; Clinical Editor, Today’s Wound Clinic

Career Path Taken: After a residency in family practice, Caroline completed a two-year fellowship in undersea and environmental medicine at Duke University’s FG Hall Hypo-Hyperbaric Laboratory, spending three summers in Turkey as the diving physician for the Institute of Nautical Archeology, which was excavating the world’s oldest shipwreck. She then spent 23 years on the faculty of the University of Texas Health Science Center at Houston, with an emphasis in diving medicine and altitude decompression research with NASA. Her interest in wounds developed from an interest in tissue oxygenation and because, in 1992, her chairman told her she “had to open a wound center.” The unsatisfactory treatments for lymphedema led her to spend a decade working with Eva Sevick, PhD, developing real-time lymphatic imaging. The need to collect structured data for billing and research resulted in her co-founding a health information technology company and a registry for reporting quality data to the Centers for Medicare & Medicaid Services (CMS). She entered private practice in 2013 to experience firsthand the impact of healthcare reform and quality reporting on the practicing physician. 

Advice for Wound Care Professionals: “The most important, meaningful, and life-changing projects I’ve been associated with happened because there was a problem that had to be solved to move forward. Figuring out how to assign the correct evaluation-and-management code to a physician encounter every single time led to developing an electronic health record system that could internally calculate it. Bringing lymphedema treatment out of the 19th century required developing a way to visualize the last ‘invisible’ organ system in the body. Ensuring that the fields of wound care and hyperbaric medicine had enough data to protect reimbursement (in the absence of adequate funding for research) meant leveraging the CMS mandates for quality reporting. It sounds cliché, but problems really are opportunities in disguise Don’t ask the staff to do anything that you wouldn’t do. I pick trash up off the floor, I get patients coffee, I assist the nurses, if that’s the logical flow. I tell them how much I appreciate them. I learned an important lesson later than I should have — my attitude sets the tone for the whole enterprise. If I complain, then everyone is discontented. If I am in a bad mood, then everyone is irritable. Be willing to accept constructive criticism, and make sure there is someone you trust near you who is willing to give it. Having a nonhealing wound is awful, but I love it when patients say, ‘I will miss coming here.’ Every day, some situation arises — sometimes with low stakes and sometimes with high stakes involved — and I just remind myself, ‘It’s never wrong to do the right thing.’"

Emily Greenstein, APRN, CNP, FACCWS, CWON
Wound Care Nurse Practitioner, Sanford Health, Fargo, ND

Career Path Taken: While working toward an undergraduate degree in business, Emily decided to pursue a nursing education instead. After receiving her bachelor’s of science, she started her career as a charge nurse on a transitional care unit at Sanford Health. When that unit closed, she decided to move into the facility’s wound care department. She received her certification in wound, ostomy, and continence nursing, and fell in love with the complexity and challenges that wound care can bring. Emily then went on to complete her master’s degree in adult gerontology and accepted a position within the same department at Sanford.

Advice for Wound Care Professionals: “Never stop learning, always ask questions, and seek out new information. Get involved in your professional organization — this will give you the opportunity to network with other professionals in your field who can be a great resource to answer medical questions that you might have. Finally, always set goals and write them down; I carry many notebooks with me. Remember, no matter how old you are or how much experience you have, if you are willing to put in the time and effort, your life will have no boundaries.” 

Rafael Mazuz, MBA (co-author)
Managing Director, Diligence Wound Care Global LLC, Washington DC; Editorial Advisory Board Member, Today’s Wound Clinic; Consultant, Advisory Board Member, Wound Care Industry

Career Path Taken: Following experience in management consulting post-undergraduate business studies, Rafael developed an interest in healthcare from his time serving as a combat medic. Upon completion of his master’s in business administration, he worked for one of the large wound care management firms in the United States. He has opened, directed, and mentored multiple wound care centers across academic and community hospital settings. He ultimately leveraged that background to found Diligence Wound Care Global, an advisory firm providing business confidence to wound care product and services executives, investors, and specialists worldwide.

Advice for Wound Care Professionals: “Become involved in responsibilities that are not part of your primary role. Clinicians can help drive patient referrals and financial efficiencies; office staff may contribute to clinical quality improvement efforts or help order, stock, and assess wound products; and managers and directors should assist with facility, regional, or system/corporate initiatives. Doing so gives you valuable experience beyond your daily duties, impresses leadership with initiative, and helps determine which roles you would most enjoy or dislike. Likewise, non-industry wound care professionals may consider industry roles (and vice versa), either temporarily or as a permanent transition.” 

Kathleen D. Schaum, MS

President and Founder, Kathleen D. Schaum & Associates, Inc.; Founding Editorial Advisory Board Member, Today’s Wound Clinic;Author, Business Briefs; Advisory Board Member, Wound Care Industry

Career Path Taken: Kathleen feels fortunate that every position she has held throughout her career in some way has given her her real-life experience in medical reimbursement strategy (eg, nutrition services payment coordinator, medical sales representative and sales director, reimbursement director). She has been fortunate to have had wonderful mentors who taught her the “ins-and-outs” of coding, payment, and coverage. She maintains her knowledge by attending many reimbursement education programs each year and by reading approximately 1,000 pages of reimbursement material weekly. She also experiences reimbursement processes by consulting with wound care providers and manufacturers. Even though she is hired to improve her client’s reimbursement issues, every consulting hour teaches her something new about reimbursement issues in the real world. Kathleen reinforces her reimbursement knowledge by educating wound care professionals, executives, and sales and marketing personnel. The more she educates others, the more she learns. 

Advice for Wound Care Professionals: “Many wound care professionals tell me that they want to understand wound care reimbursement, teach it like me, and purchase the ‘magic wound care reimbursement book.’ I always remind them that such a magic book does not exist. Instead, they should start by learning how they and/or their employer are reimbursed. That learning should include acquiring and reading up-to-date reimbursement books; Medicare coding, payment, and coverage documents; reimbursement handbooks and medical policies from contracted private payers; and by attending wound care reimbursement seminars, etc. In addition, they should reach out to the coders and billers (who are a wealth of reimbursement knowledge) in their organizations. Finally, I tell them not expect to learn reimbursement in one or two years. It is an evolutionary process that changes frequently and often defies logic.”

Jonathan Scott, CHT (co-author) 
Director, Wound Healing Center and Hyperbaric Medicine, Tri-State Memorial Hospital & Medical Campus, Clarkston, WA

Career Path Taken:Jonathan has launched, worked in, and managed four wound care programs across three states (Idaho, Utah, Washington), including independent and outsourced-management firms. He began his wound care career as a hyperbaric technician (eventually becoming certified in hyperbaric oxygen therapy [HBOT]). Then, as an HBOT safety director, he contributed to the launch of a new wound care center, ultimately becoming the director of wound healing, hyperbaric services, and podiatry at his current program. He has implemented electronic medical records at multiple facilities and has served as a consultant, assisting in startup decisions and operational procedures for multiple wound care centers.  

Advice for Wound Care Professionals:“Many of us still think about ‘what we want to do when we grow up.’ I think that is a never-ending journey, so enjoy the ride. Putting in the time as you climb the career ladder will give you key experience as you advance in your professional responsibilities. Not only will you understand many different roles, but the benefit of devoting time will assist with team-building, communication, and organizational vision. Being proactive and assertive in current roles can help streamline advancements. Understanding the business of healthcare is pivotal in advancing into a leadership role. Learning some of the business ‘lingo,’ such as SWOT analysis, a planning technique used to identify the strengths, weaknesses, opportunities, and threats related to business competition or project planning;¹the Lean Method to eliminating waste of product and processes while satisfying customer wants;²the Six Sigma methodology, a disciplined, data-driven approach to eliminating defects;³Just culture, a values-supportive model of shared accountability;⁴and corporate scorecards/quality-tracking systems for analyzing risk reviews and performance metrics⁵will help to jumpstart success. As you are able to understand the business side of the industry as a clinician, you will be able to provide a much-needed balance to any organization. If you have the desire for advancement, set goals and dream big. As a famous quote states, ‘action is the fundamental key to all success. Let others see your passion for the industry and pursue your dreams.’"