07/15/2013
RESPONSES/COMMENTS NON-CLINICAL) - PART 1B
RE: Inexpensive Cast Cutter (Judd Davis, DPM)
From: Burton J. Katzen, DPM
"It's disturbing to me that once a piece of equipment is labeled "medical", the price can be marked up ten-fold or more."
I had to laugh when I read Dr. Davis' comment about something labeled as "medical" being marked up. It reminded me of something that happened to me a few years ago. I have had three Great Danes and two Dobermans who have had their ears done. There is a round tubular material called drainage tile that we use to hold the ears in an upward position. As I remember, it sold for about $6.00 for a 50 foot roll in any hardware store.
A few years ago, I had a rep come to my office and asked if I used toe crests. I told them I usually made them out of cotton rolls and elastoplast and just give them to patients. He said he had a new "special" medical grade material that wouldn't lose its elasticity and was nicely packaged in two three inch rolls for $11.00. You guessed it. Drainage tile. Great idea. I never thought of it. I've been buying it from Home Depot for my patients ever since.
Burton J. Katzen, DPM, Temple Hills, drburtonk@aol.com
07/15/2013
RESPONSES/COMMENTS NON-CLINICAL) - PART 1A
RE: Inexpensive Cast Cutter (Judd Davis, DPM)
From: Howard R. Fox, DPM
When I started my practice 33 years ago, instead of spending $100 on a stainless steel kick bucket and rollers from a medical supply company, I saw a pile of hundreds of them stacked up alongside a barn while driving in Pennsylvania. I found the farmer, asked him what he wanted for one of them. Five bucks! Stainless steel. I then went to the local Electrolux store, and for another $5, got a round roller base which the bucket fits perfectly on. I still own this.
One word of caution: Working in risk management for the last 17 years has taught me if something were to go wrong with your Sears oscillating multi-tool and your patient gets injured, don’t count on Sears to share any damages with you, as their saw was never designed, marketed, or meant for medical use (although we all know it’s the exact same saw). A good percentage of just about anything we purchase, doctor and non-doctor alike, goes for product liability and insurance.
Howard R. Fox, DPM, Staten Island, NY, fox.howard@gmail.com
02/13/2013
RESPONSES/COMMENTS NON-CLINICAL) - PART 1
RE: Equality For Podiatry
From: Raymond J. Uscinski, DPM
Is the APMA misguided or moving too slowly to advance the podiatric profession? This is the question that I have wrestled with for over 40 years.
The American Association of Medical Colleges projects a physician shortage of 62,000 physicians in the U.S. by 2015 due to the increased medical needs of an aging population and a growing number of people who will be insured under the Affordable Care Act of 2010. I am confident that our podiatric medical schools can be adjusted to partially fill this shortage. We know that podiatric medical schools are superior in education and training to...
Editor's note: Dr. Uscinski's extended-length letter appears here.
01/17/2013
RESPONSES/COMMENTS NON-CLINICAL) - PART 1
RE: Regranex Alternative? (Elliot Udell, DPM)
From: Elliot Udell, DPM
Today, I spoke with a representative from Healthpoint, the company that recently bought Regranex. According to the person I spoke with, they moved their manufacturing to a new location and they need to satisfy certain FDA requirements before manufacturing more product. Hence, they are willing to dropship the remaining stock of Regranex to any pharmacy, but anything they have in stock will expire at the end of January. They do not have a firm date as to when the FDA will allow them to restart making the product. They hope this will be within a few months.
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com
09/24/2012
RESPONSES/COMMENTS NON-CLINICAL) - PART 1A
RE: A Bullied Teen Patient (Billie Bondar, DPM)
From: Ira Baum, DPM
Thank you very much Billie Bondar, DPM for pointing out this sad and preventable condition. Bullying is a form of abuse and just like other forms of abuse, leaves a lifetime scar and affects the psychological development of the victim.
Ira Baum, DPM, Miami, FL, ibaumdpm@bellsouth.net
09/05/2012
RESPONSES/COMMENTS NON-CLINICAL) - PART 1
RE: PM News Classified Ads
From: J. Ressler, DPM
Within the last several weeks, I have used the PM News classified website twice. Once to find equipment I needed, and the other time to sell equipment. Both times were very successful. The equipment I purchased saved me thousands of dollars. I was also able to sell a chair. The amazing part to this is I had posted ads on other "free" podiatry classified websites and never received any calls.
Podiatrists should not be discouraged about selling power chairs due to the logistics of shipping. I am using a moving company named Plycon. They ship throughout the U.S. and are very dependable with very reasonable rates. As we all know, PM News is a powerful source of information within our podiatric community. You should think about using this resource for your equipment needs.
J. Ressler, DPM, Lauderhill, FL, redwingcrzy@aol.com
09/03/2012
RESPONSES/COMMENTS NON-CLINICAL) - PART 1B
Checking Medicare Eligibility (Laura R. Lefkowitz, DPM)
From: Mak Yousefpour, DPM
Try Checkmedicare.com. It will give instant access to their eligibility and deductibles, along with any managed care organization they belong to. There is a set-up process, and you pay for how many patients you want to check. Currently, I pay $100 per month for 400 patients.
Mak Yousefpour, DPM. Los Angeles, CA, makdpm@yahoo.com
09/03/2012
RESPONSES/COMMENTS NON-CLINICAL) - PART 1A
Checking Medicare Eligibility (Laura R. Lefkowitz, DPM)
From: Richard A. Simmons DPM
Dr. Lefkowitz wants to know of a site on-line to check for Medicare eligibility. To my knowledge, CMS does not allow direct access to this site; however, there are companies, such as CheckMedicare.com that will provide you access to the CMS site for a fee. The CMS site that one can access through CheckMedicare.com provides a wealth of information, and you can print this information (hard copy or with a pdf writer) for chart access.
I grew tired of receiving those Overpayment Requests from CMS that contained the wording, “you knew or should have known and are therefore liable…” Most of the information is updated at CMS at the first of the month, so make sure that your report is within the same month you render services.
Richard A. Simmons, DPM Rockledge, FL, RASDPM32955@gmail.com
09/01/2012
RESPONSES/COMMENTS NON-CLINICAL) - PART 1
RE: Get Rid of the Randomized Trial; Here's a Better Way
From: Marc Katz, DPM
This video suggests a great alternative to the almighty randomized placebo-controlled studies. Are these studies a thing of the past?
Marc Katz, DPM, Tampa, FL, dr_mkatz@yahoo.com
08/29/2012
RESPONSES/COMMENTS NON-CLINICAL) - PART 1
RE: Compensation in a Wound Care Center (Ed Dosremedios, DPM)
From: Phil Organ, DPM
At a hospital wound center, one can be a salaried employee or an independent contractor. The independent contractor bills for services just like in private practice and indicates the hospital center as the place of service. If the podiatrist is salaried, the hospital bills and collects all fees. As for HBO - the physician can bill for monitoring the dive, but the diagnosis for the dive would have to be in scope.
Phil Organ, DPM, Naples, FL, Philorgan@gmail.com
08/28/2012
RESPONSES/COMMENTS NON-CLINICAL) - PART 1
RE: Compensation in a Wound Care Center (Ed Dosremedios, DPM)
From: Daniel D. Michaels, DPM, MS
If you get money back from the hyperbaric center for sending patients, then this would be a Stark violation if you didn't own the hyperbaric chamber (i.e., the chamber is part of your own practice). Usually at a wound care center in a hospital, you bill for the services you render with the place of service at the hospital so you will receive a reduced amount, as the insurance company has to pay you and a separate fee for the facility.
You can prescribe hyperbarics if you need to, but you would not be compensated for this. You can prescribe wound care supplies, but...
Editor's note: Dr. Michaels' extended-length letter can be read here.
08/27/2012
RESPONSES/COMMENTS NON-CLINICAL) - PART 1
RE: Scope of Practice (Robert Bijack, DPM)
From: Paul Kesselman, DPM
Is Dr. Bijack serious about his opinion on podiatrists not discussing BMI with their patients? Is it his interpretation that podiatrists can't discuss how systemic body functions and illnesses affect the foot and ankle?
Why does he limit his opinion to obesity and not also include smoking, diabetes, hypertension, high cholesterol, and other systemic maladies which certainly DO affect the foot. I dare say the average podiatrist sees the ravages of all of the above on a daily basis.
Most public health policies have the exact opposite opinion from Dr. Bijack. Why else would...
Editor's note: Dr. Kesselman's extended-length letter can be read here.
08/23/2012
RESPONSES/COMMENTS NON-CLINICAL) - PART 1
RE: 25,000 Hours
From: Hal Ornstein, DPM
Recently, I sent Barry Block a message about how much I love the Podiatry Management Hall of Fame Luncheon at the APMA National Meeting and seeing so many caring, loving, and dedicated individuals for the good of our profession in one place. I thought it would be neat to add up how many hours everyone has given collectively to grow our awesome profession.
I was curious and asked Barry how many hours he has put into PM News since its inception and was simply amazed with his answer. In the past 18 years, he estimates that he has spent 25,000 hours putting out over 4,500 issues of this daily publication. This equates to three solid years of his life! This is such a reflection of the giant Barry is for our profession and how many lives he has touched and changed. I am so proud to call him a friend. From us all… Thank you Barry.
Hal Ornstein, DPM, Howell, NJ, toetoe@optonline.net
08/21/2012
RESPONSES/COMMENTS NON-CLINICAL) - PART 1
RE: Terminating an Office Manager (Name Withheld)
From: Cindy Pezza, PMAC
Letting go of any TEAM member, especially one who holds a managerial position is difficult. The most important thing to remember is that your practice is your business and your life line. As time goes on and we develop relationships with our TEAM, it becomes a matter of looking at the impact every individual has on your practice. It is wonderful to have nice people working with you, but "nice" doesn't mean efficient, and it certainly doesn't pay the bills.
My suggestion would be to re-assign your manager while training someone new to take her place. Sometimes, a different title will change the way a person performs and will affect the entire dynamic of your office. I highly suggest making sure that you can afford this title change as well as a new, possibly part-time manager. Be respectful of your current manager's feelings, but ultimately think of the future of your practice.
Cindy Pezza, PMAC, South Easton, MA, Cpezzapmac@yahoo.com
08/21/2012
RESPONSES/COMMENTS NON-CLINICAL) - PART 1
RE: Microphone for Dragon Med 11 (David Kahan, DPM)
From: Jack A. Reingold, DPM
I am a big fan of Dragon and have been using it for for more than ten years (since 3.0.) I have always dealt with KnowBrainer.com. Not only does he have the best prices, but he customizes microphones for the program. He compares all of the microphones on his site.
Jack A. Reingold, DPM, Solana Beach, CA, footdoc@san.rr.com
08/06/2012
RESPONSES/COMMENTS NON-CLINICAL) - PART 1
RE: Source for Looking up Deceased Patients? (J Ressler, DPM)
From: Lori Preece
We have a paid subscription to Ancestry.com to use their Social Security Death Index to identify deceased patients, but if you go to Wikipedia and type in Social Security Death Index, there is a link to a free site for the Death Master File under the heading “Criticisms”. This file has deaths listed which occurred before November 30, 2011. We have found the Ancestry.com SSDI file to be current and reliable.
Lori Preece, Office Manager for Dr. Jeffrey H. Katz, jeffreykdpm@sbcglobal.net
07/24/2012
RESPONSES/COMMENTS NON-CLINICAL) - PART 1
RE: Artificial Toenail Innovation/Successes (Eric Hart, DPM)
From: Michael Forman, DPM
Regarding Dr. Hart's question about fake nails, contact Maria Barle, Nail Creations, 440-944-5882. nailcreations1@gmail.com Be aware that these are very temporary and are meant to protect the nail bed after matrixectomy.
Michael Forman, DPM, Cleveland, OH, im4man@aol.com
07/23/2012
RESPONSES/COMMENTS NON-CLINICAL) - PART 1
RE: Artificial Toenail Innovation/Successes (Eric Hart, DPM)
From: Janet McCormick, MS
Artificial toenails have been being applied for 30 years, actually. However, they were a hard acrylic, not a gel product, so the nail had to be very short to prevent damage if the client stubbed her toe or such. Gels flex, so are safer on a nail that is compromised.
Your patients will love them! Many of them would love to wear some sandals, but they will not due to embarrassment about the appearance of their toenails. Get them to where they can wear sandals instead of tennis shoes at the beach, and you will be their savior!
This service has a lengthy learning curve, but anyone can learn to...
Editor's note: Ms. McCormick's extended-length letter can be read here.
07/09/2012
RESPONSES/COMMENTS NON-CLINICAL) - PART 1
RE: Nurse Practitioners Modernization Act ?(Robert Bijak, DPM)
From: Bret Ribotsky, DPM
Between the nurse practitioners and the dental therapists working independently – it should be crystal clear to all physicians that the future of first-level care in this country is going to be provided by “non-doctors.” If DPMs were given an MD overnight, this problem would not change; internal medicine and family practitioners are facing this problem head on.
It’s time for real strategic thinking for our personal survival, and that of our profession to start now. As ACOs and large hospital practices become “at-risk” and capitated, many of the tasks that most DPMs currently perform will be assigned to less compensated providers. Physical therapists have take a great interest in biomechanics and the off-loading wound care patients. Wound care nurses, and even medical assistants are doing palliative foot care. The mandate for outstanding healthcare is gone, and is not rewarded when it is provided. Evidence-based medicine is all you hear, along with cost-containment. BUZZZZZZZZ! The alarm is going off. Action is needed.
Please join me for a 90-minute lecture on Sunday morning at the APMA National, as together we work through many of the obstacles and critical thinking needed to chart our success into the future of our healthcare system. Then attend the Greenbrier Coding and Practice Management Workshop in nearby West Virginia. Success is possible with a well-structured plan for the next 5 years.
Bret Ribotsky, DPM, Boca Raton, FL, ribotsky@gmail.com
07/07/2012
RESPONSES/COMMENTS NON-CLINICAL) - PART 1
RE: Facebook Scam
From: Arthur Gudeon, DPM
Read the message below concerning a scam Facebook message from a purported NYCPM student, who ends up asking for money. Upon checking with Lisa Lee at NYCPM, she was found to never have been a student. Unfortunately, I see on FB that many DPMs HAVE already friended her, and are unaware of the situation. I tried to have FB warn them, but it doesn't seem to be working.
"Hello dear Arthur. I think we have things in common. I did not continue my podiatry education because I have to travel back to Ghana Africa as I lost my parents and did not have anyone to take care of my school fees. Hope to hear from you soonest as I have something important i will like to discuss with you." - Kathrine Rafael
Arthur Gudeon, DPM, Rego Park, NY, afootdoc@hotmail.com
07/06/2012
RESPONSES/COMMENTS NON-CLINICAL) - PART 1
RE: Nurse Practitioners Modernization Act (Robert Bijak, DPM)
From: Ira Baum, DPM
Well stated. With all the surgical training and trauma that podiatrists are experienced in, it’s a shame that, even if we don’t believe it, we are still perceived by many as ancillary practitioners. If you don’t think so, how many podiatrists are now working with orthopedists doing their foot and ankle surgery? They really are “Dr. Practitioners”. If they don’t think so, here is a litmus test. Go out on your own, see how much you get reimbursed for the same procedures, and if there’s an orthopedic surgeon specializing in foot and ankle, see how many referrals you get. Podiatrists need to stand up for themselves, no matter what it takes. If not, we’ll be begging for scraps as the new healthcare paradigm matures.
Ira Baum, DPM,Miami, FL, ibaumdpm@bellsouth.net
