December 23, 2017 #6,084 Publisher-Barry Block, DPM, JD
A partner of Podiatry Management http://www.podiatrym.com E-mail us by hitting the reply key. COPYRIGHT 2017- No part of PM News can be reproduced without the written permission of Barry Block
PM NEWS QUICK POLL
FINAL CHANCE TO VOTE
Will crytocurrencies like Bitcoin eventually be accepted forms of payment in podiatry offices?
PODIATRISTS IN THE COMMUNITY
NY Podiatrist Elected President of Staten Island Greenbelt Conservancy
The Staten Island Greenbelt Conservancy, the largest environmental organization on Staten Island, elected new officers to their board of directors. Dr. Howard R. Fox has been elected president.
Dr. Howard Fox
Dr. Fox has been a practicing podiatrist in the New Dorp area for 38 years. He has been hiking the 35 miles of Greenbelt trails for the last three decades and is also a trail maintainer for the Chapin Woods and Reeds Basket Willow Swamp, his "home" woods.
Source: Carol Ann Benati, Staten Island Advance [12/21/17]
INTERNATIONAL PODIATRISTS IN THE NEWS
Aussie Podiatrist Discusses Medical Pedicures
According to podiatrist and foot care expert at City Feet Clinic, Kate McArthur, anyone who has feet needs to schedule for a regular medical pedicure. A what? A medical pedicure is a non-invasive, dry procedure performed by highly skilled foot care specialists who combine podiatry with nail care.
“Usually, people who come in for a medical pedicure mention they have a slight pain or a corn on their little toe, but it turns out they’ve had it for months and it has become painful and turned into a full-blown ulcer simply because they just thought a medical pedicure wasn’t needed,” explains McArthur.
Source: Juna Xu, Body and Soul [12/22/17]
U.S. Life Expectancy Drops Again
Driven in part by the opioid crisis, U.S. life expectancy fell for the second straight year in 2016, from 78.7 to 78.6 years (it was 78.9 in 2014). The report also noted a spike in hepatitis C, likely also due to unsanitary needles during opioid use.
Though the drop of 0.1 years is small, it is the first two-year drop since 1962-1963 - and women are still outliving men by five years, 81.1 to 76.1 years on average. The top 10 leading causes of death remained unchanged, but the death rate from unintentional injury jumped almost 10%, led by - again - 63,600 deaths from drug overdoses.
Source: NCHS Data Brief via1440 [12/22/17]
FROM PM's CURRENT ISSUE
Several times a week, PM News posts an entire article from a recent issue of our partner, Podiatry Management Magazine. Please note that the views expressed in Podiatry Management Magazine do not necessarily reflect the views of PM News or Barry Block.
As more healthcare providers are considering potential changes in electronic health records, it's time to take a fresh look at the contracts they are signing. Providers need to insert more protections in their legal documents as they make decisions to change vendors.
1. Ensure EHR Certification is Current
The rotection afforded by the certification of a vendor's products is crucial. Providers should make certain that a vendor's products are certified, and contracts should specify their options if, in a worst-case scenario, a product is decertified or called into question by the federal government.
Source: Health Data Management
PRACTICE MANAGEMENT TIP OF THE DAY
Medical Practice Financial Reports Docs Need to See - Part 9
Hard data is crucial to Kyle Matthews, chief executive officer of a cardiology practice near Phoenix, and he regularly shares them with his physicians through 10 key financial reports. The numbers tell him — and them — when to hire and when to fire, who has too many appointments, and who has too few, and even when it's time to investigate missing referrals. Matthews recommended providing these financial reports to partner physicians:
9) Physician Compensation vs. Production
This report provides information per physician about details like work relative value units (wRVU) and collections per wRVU.
Matthews recommended caution regarding these reports because they are so sensitive and can cause friction. He suggested only providing them via paper at meetings and then collecting them when meetings end.
Source: Randy Dotinga, Physicians Practice [10/10/17]
Query: Joint Venture with Vascular Surgeon
We have been in touch with a vascular surgeon regarding a potential joint venture. In the past, we did a joint venture with a primary care group, but that business model failed. Our vascular doc insists that they have a lot to gain by having podiatry on their team. Are there any successful models for collaboration? Any advice would be appreciated.
Query: CPT 64450 + ICD-10 G57.3- Denials
CPT 64450 (injection, anesthetic agent; other peripheral nerve or branch) when billed with ICD-10 G57.31 or G57.32 (lesion of lateral popliteal nerve, right lower limb or left lower limb, respectively) is now (as of October 1) being denied by Blue Cross Blue Shield and Medicare (Novitas) as “investigational and not medically necessary”. The only LCD I was able to locate is L35107 which has been superseded or retired. I am not finding an active LCD.
Is anyone getting this paid? What am I doing wrong?
Emilie Arambula, CPC, Office of Deb Lewis, CPC; COS Op Mgr, Colorado Springs, CO
Response: In Colorado, your MAC is Novitas. They just retired the LCD for “Pain Management of Peripheral Nerves by Injection” (L35107) on December 1, 2017. CPT 64450 is included in that retired LCD.
Jeffrey D Lehrman, DPM, Springfield, PA
For information on Codingline subscriptions, click here
Dr. Borreggine's concern is legitimate but not from the perspective of the elimination of podiatry, but that the DPM degree does not allow us full scope. The step up of ancillary providers such as NPs and PAs is a natural extension of the changing environment in medicine that enables patients to get seen and still be economically solvent. There is no turning back from this.
The best approach for DPMs by far is to let every full scope nurse practitioner in your community know your availability and what you can do. Even lecture to them at their meetings. From my own personal experience, the one NP who decides to do foot care is completely outnumbered by the rest that will not. Nurse practitioners are a steady consistent source of patients in my practice.
All we have to do is show up at the dance! Attend the hospital meetings of dermatology, endocrine, vascular, etc. They will flood your office.
Dr. Borreggine has concerns about the implication for podiatry caused by expansion of ARNP scope. Dr. Herbert, in his response, related an interesting story about a podiatrist who later became a family practice physician, but his hospital did not offer him privileges for foot surgery. We should not view the efforts of other health professions to expand scope as a threat to podiatry. We should, instead, attempt to better define our scope of practice.
Podiatrists, relative to training hours, have the narrowest scope of practice of any health profession. APMA believes that we need to emulate the allopathic model and increase residency training time. How do you tell a prospective podiatry student that he/she will be offered training equivalent to an orthopedic surgeon but that the scope of practice can only be less than 15 percent of that of an orthopedic surgeon and then tell that person that he/she may not be able to call themselves a physician?
The dental profession has figured out how to maintain a degree as a “limited licensed practitioner” and make it work. We either emulate the model of dentistry or move toward providing the MD degree. Standing in the middle of the door is not advisable because the door will keep hitting and bruising us.
Eddie Davis, DPM, San Antonio, TX
YOU CAN'T MAKE THESE THINGS UP
RE: Outrageous Bandages of the Day
Inspired by Rudolph the red-nosed reindeer?
I just performed a couple of phenol matrixectomies on a teenager. When the mother who was sitting in the room watching saw the completed bandages, she blurted out, "Rudolph the red- toes reindeer". I'm glad I had some 1" red Co-Flex.
Source: Submitted by Dr. Keith Gurnick
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CLASSIFIED ADS - PART 2 ASSOCIATE POSITIONS AND FELLOWSHIPS
2018 GRADUATE ASSOCIATE POSITION - LONG ISLAND
Country Foot Care, a Long Island based, well-rounded multiple office group practice seeks 2018 third and fourth year graduating residents or fellows to join our state-of-the-art practices in July. Our practices are affiliated with multiple hospital systems, surgical and wound care centers and a residency program. Requirements: Caring, ethical, board qualified/certified candidates with surgical training and leadership qualities who are willing to live/relocate to the Long Island, NY metro area. Compensation includes biweekly salary, a generous bonus schedule, malpractice and health insurance, paid holidays and PTO. We invite all interested doctors to email their CV to DrLeeb@countryfootcare.com.
ASSOCIATE POSITION - HOUSTON, TX
Established, growing multi office, multi doctor practice seeking PSR-36 board certified/qualified foot and ankle surgeon. Must be personable, outgoing and motivated with excellent clinical and surgical skills. Practice is protocol-based, state-of-the-art equipped with the latest technologies and cutting-edge procedures with an extremely competent staff. Send CV, salary requirements to firstname.lastname@example.org.
ASSOCIATE POSITION– BROOKLYN, NY
Excellent, growing podiatry practice is seeking a full time podiatrist to add to our current 2 podiatrists. Excellent compensation for qualified candidates. Please send resume to Metropolitanfootcare@gmail.com
Large central NJ orthopedic practice looking for full-time podiatrist with interest in wound care, diabetes, and general footcare. Rearfoot/Ankle training not required. Upcoming 2018 grads and established podiatrists can apply. Must be willing to grow podiatry practice with the ability to maintain and attract patients. Must be willing to live in area as the candidate will actively participate in hospital call and be responsible for inpatient rounds. Please send cv to email@example.com
MOBILE PODIATRISTS NEEDED- LOS ANGELES, CA
Full Time Position available for podiatrists to visit home bound patients in the LA area and surrounding areas. Excellent compensation, flexible schedule, dedicated office support staff, cloud based EHR system. Email CV to: firstname.lastname@example.org
ASSOCIATE POSITION - SOUTHERN CALIFORNIA
Very busy practice seeking a full-time, self-motivated and hard-working podiatry associate. Competitive salary offered. Please email CV to: email@example.com
FULL-TIME POSITION - LOS ANGELES, CA
Multi-specialty surgical group expanding and looking for podiatrists to join our team. Practitioners will focus mostly on wound care in all settings, including hospital, office, and nursing facilities. Opportunity for general podiatric surgical cases as well. Full-time position available with benefits and profit-sharing. New graduates encouraged! E-mail CV to firstname.lastname@example.org
ASSOCIATE POSITION – TRACY/MANTECA, CA
Federally Qualified Health Center looking for a dedicated medical and surgical podiatrist to work with our team of Primary Care Physicians. Email CV to email@example.com
ASSOCIATE POSITION - SOUTHERN MARYLAND
Established practice looking for a full-time podiatrist for our Waldorf, MD and Clinton, MD locations. Must live within 20 miles from the office. The ideal candidate will have strong clinical skills including ulcer care, diabetes, surgery and general footcare. Must have a strong office personality with the ability to maintain and attract patients. Must be willing to merge into an already established protocol based office. Please send CV to firstname.lastname@example.org
ASSOCIATE NEEDED – WARREN/YOUNGSTOWN, OHIO
Ankle & Foot Care Centers operates 20 locations in Northeast Ohio. We are looking to add a full-time podiatric physician to help cover expansion of our Outreach/Home Care Services. Tremendous growth opportunity for a hardworking individual with an interest in wound care, nursing home and house call patient care. To learn more about us, visit our website at www.ankleandfootcare.com Please email your letter of interest and CV to Michael Vallas, Practice Administrator at email@example.com.
ASSOCIATE POSITION - NORTHERN NJ
Established office w/ 5 DPMs. Large referral base from PCPs, vascular, peds and orthopedists. Well-rounded hospital/surgical center based practice. All aspects of foot and ankle care. Many new patients weekly, solid surgical schedule. Modern office w/ EMR. Involved with residency program. Must have strong ethics and highly motivated. Serious associates only leading to partnership. Must have PMSR/RRA or equivalent training. Competitive compensation package. Starting July 2018. Please email CV to Northnjpod1@gmail.com
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