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12/31/2012
RESPONSES / COMMENTS (NEWS STORIES) - PART 1B
RE: Rising Patient Deductibles Spell Trouble for Doctors (Allen Jacobs, DPM)
From: Elliot Udell, DPM
Allen, I pray that your prediction comes true, and people will not allow high insurance company deductibles to deter them from having serious diagnostic procedures. Neither one of us can see into the future; however, a local oncologist in my area has a sign in his office saying that he worked out a deal with a local radiology practice to offer mammograms to uninsured or underinsured people for 40 dollars. This deal would not have been worked out if people were not putting off potentially life-saving tests because of monetary considerations.
I am due for my next colonscopy in three years. My last one was totally covered by insurance, but the next one will force me to pay up to two thousand dollars out-of-pocket. I'll go because I know the risk of not going, but I am hearing from some of my staff members who have the same insurance that they might put it off when the time comes.
As for whether people will pay for laser treatments for nails, speak to some of your friends who are cosmetic surgeons. The person who will bark about an office co-payment for a painful condition or life saving test will not blink an eye at paying ten thousand dollars for a facelift or tummy tuck.
Elliot Udell, DPM, Hickville, NY, Elliotu@aol.com
Other messages in this thread:
09/14/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 1B
RE: CT Podiatrist Receives 3 Year Sentence and $134K Restitution
From: Ira Baum, DPM
These articles are sickening. Most responses focus on two issues: 1. Fraud and 2. Aggressive (or overly aggressive) post-payment audits. Fraud hurts every podiatrists and is fuels the fire for overly aggressive post-payment audits. No one can condone that. Overly aggressive post-payment audits negatively affect the doctor-patient relationship, increase physician psyche on practicing defensive medicine, and cause a reaction from third-party payers (not only the federal government). The response adversely affects the provision of healthcare, and potentially dangerous outcomes for patients. Regulations can be made that are impossible or impractical to follow. The enforcing, or not enforcing these types of regulations is a method of control and intimidation.
Drilling down the issue to services in nursing homes or geriatric patients, Medicare guidelines are antiquated, unjust, and need revision. It's simply unfair for those podiatrists who provide these needed service, and for the patients who need the care, but don't meet the regulatory requirements. Contact your legislative representatives and explain why these services are needed and why the regulations need to be more humane. Unfortunately, it is the only process that may lead to a resolution.
Ira Baum, DPM, Miami, FL, ibaumdpm@bellsouth.net
09/12/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 1B
RE: Remembering 9/11
From: Michael Lawrence, DPM
Once again, the 9/11 PM News contains a pointed reminder of the evil lurking in our world that so horribly expressed itself that fateful day. The words of the editor, as he attempted to process the events as was witnessed in real-time, are prolific and remain a reminder of the horrors of that day. They need never be forgotten, both for the human losses and some of our very innocence, as well as that the same evil continues to exist in our world today.
But as bad as those events surely were, in the same edition a wonderful story of good a loving concern for others, appears as well. The success of the Musella Foundation, begun by our colleague Al Musella, hitting ONE MILLION DOLLARS, given to help others, is staggering in a wonderful, heart-warming way. This is a true example of good which, thank God, also continues to exist today. And it is in every one of us, giving the opportunity to make real, positive differences. Thanks, Dr. Musella, for being such a wonderful example and an inspiration.
Michael Lawrence, DPM, Chattanooga, TN, ftdoc@joimail.com
07/16/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 1B
RE: Good Hygiene Prevents Fungal Infections/Odor: Singapore Podiatrist
From: Doug Richie, DPM
To clarify a slight error in the original posting of this story, Chelsea Law is not an Indonesian podiatrist. She practices in Singapore. Through a partnership with the California School of Podiatric Medicine at Samuel Merritt University, I had the privilege of serving as a visiting professor for the entire Singapore podiatry staff in March this year. Ms. Chelsea Law was one of my organizers and hosts for this one-week experience. She is truly one of the most delightful, professional, and compassionate podiatrists I have known. Congratulations Chelsea!
Doug Richie, DPM, Seal Beach, CA, DRichieJr@aol.com
05/07/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 1B
RE: Laker Basketball Star's Injury May Have Been Preventable: TX Podiatrist (Brian Fullem, DPM)
From: Ed Davis, DPM
How can Dr. Fullem make the remarks about my original communication when he has not read it? The Wall Street Journal story extracted information from my email communication, particularly those items that were of heightened interest due to the recent Achilles rupture by Kobe Bryant. It contains less than 30% of the original content.
There are many theories as to the cause of Achilles rupture but...
Editor's note: Dr. Davis' extended-length letter can be read here.
04/13/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 1B
RE: MI Podiatrist Sentenced to Prison in Healthcare Fraud Scheme (Ted Cohen, DPM)
From: Lawrence J. Kansky, DPM, JD
Alan Stiebel DPM and Ted Cohen, DPM should be commended for their letters of support of jailed podiatrist, Dr. Anthony Kirk. It is a waste of taxpayer money to jail this man for his alleged misdeeds. Dr. Kirk should have to pay all the improperly received money back with interest, pay a substantial fine, and do much needed community service. May I dare say, his State Board of Podiatry should even let this first time offender practice podiatry under strict billing supervision so he can remain a productive taxpaying member of society.
To those naysaying podiatrists: having defended many alleged criminals in court, there are many reasons innocent defendants take plea deals. Fear of publicity, legal costs, protection of loved ones, not wanting to be subjected to brutal cross examination if they take the witness stand, and facing an unpredictable jury are some of them.
There are many podiatrists getting away with doing far worse things than Dr. Kirk such as performing surgical and office procedures that do more harm than good, prescribing orthotics to everyone who walks in the door, using unnecessary and expensive technology, and denying 104 residencies to qualified podiatric graduates. I wish Dr. Anthony Kirk and his family the very best, and pray for peace in his life.
Lawrence J. Kansky, DPM, JD, Wilkes-Barre, PA, larry.kansky@gmail.com
04/06/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 1B
RE: 104 Applicants Not Matched for Residency Positions
From: Bret Ribotsky, DPM
To the 100+ graduates of podiatry school without a clear path today, I want to share a lesson in life, “Sometimes your worst times become your best.” I have had the opportunity to interview over 210 (so far) of the best podiatrists in the country on Meet the Masters and there are a few distinctions that are evident. Regardless of any bad situation (divorce, death of a family member, hurricane, or fire), what you focus on that will affect your destiny and, in turn, your life.
Dealing with the problem in front of you today, I offer a few suggestions for you to consider:
• Contact residency programs and offer to attend without compensation. Even if you do not get credit, you will gain...
Editor's note: Dr. Ribotsky's extended-length letter can be read here.
03/30/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 1B
RE: 104 Applicants Not Matched for Residency Positions (Jeanne Arnold, DPM)
From: Philip Radovic, DPM, Joseph D. Pasquino, DPM
The residency shortfall crisis requires immediate attention. An instant impact might be made in generating more entry-level positions by having CPME rescind the requirement that a hospital be a sponsor/co-sponsor for residency approval. This would bypass much of the burdensome red tape required by hospitals for sponsorship. The vast majority of podiatric surgery is performed in outpatient surgery centers across the country. Many surgery centers have the resources to financially support a residency and can affiliate with a hospital for inpatient training and trauma rotations, etc. (the hospitals can still obtain GME dollars).
Shifting first year residents to these entry level positions for a two-year certificate would allow for state licensure in most states. Those seeking further training could obtain it through the limited 3-year programs or fellowships. I have asked CPME to consider this avenue.
Philip Radovic, DPM, San Clemente, CA, phil@feetfixer.com
In an answer to certain of the concerns about the residency shortage raised in the letter from Dr. Arnold, I direct PM News readers to Resolution 13-13 presented to the March 2013 APMA House of Delegates by the Pennsylvania Podiatric Medical Association and seconded by the New Jersey State Podiatric Medical Association. This Resolution is on the APMA website and it contains the most up-to-date facts concerning residency development that we could determine.
If the current programs in development are authorized, we are told that will...
Editor's note: Dr. Pasquino's extended-length letter can be read here.
03/21/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 1B
RE: 104 Applicants Not Matched for Residency Positions
From: Brian Kashan, DPM, Robert Scott Steinberg, DPM
I awoke this morning and read my daily PM News, only to see that 104 of our students will not be getting residencies. My blood pressure immediately rose, and I started my day off badly. How can this happen? The excuses that more people passed the Boards, and the first graduating class of a new school added to the numbers are ridiculous! When we open a school, it should be based on need. I have seen many postings debating whether another podiatry school was even needed. I guess we now know the answer to that.
Blaming more students passing the boards is equally ridiculous. Aren’t they supposed to pass the boards? Isn’t that the goal? If anyone fails...
Editor's note: Dr. Kashan's extended-length letter can be read here.
If this isn't a time for "finger pointing", then maybe it's time for toe pointing. This problem lies at the feet of the AACPM and CPME. They were supposed to be the profession's forward thinkers. Both knew there is a residency slot ceiling, yet they continue to push for larger class sizes. This is dishonest to the students who are graduating with huge school debt. Now there are 104 of them in a sheer state of panic. Preceptorships are NOT the answer.
Robert Scott Steinberg, DPM, Schaumburg, IL, Doc@FootSportsDoc.com
01/03/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 1B
RE: Rising Patient Deductibles Spell Trouble for Doctors (Robert Bijak, DPM)
From: Michael M. Rosenblatt, DPM
While I do agree with Dr. Bijak that podiatry as a political unit should achieve a wider range of licensing (read MD degree), I wonder if most podiatrists would even use it. In a long article I wrote for Podiatry Management Magazine last year, I listed a large number of conservative, non-surgical treatments that most podiatrists don’t even do. In other words, they don’t even fully utilize their present licensure.
Let’s for a moment agree with Dr. Bijak, that DPMs have mostly an elective dinner on their plate. At least 80% of our gross economy shares that with podiatry. There are too many examples to mention here, but they would certainly include Whole Foods Market, whose business model is basically rich people. Don’t forget the extremely wealthy and powerful life insurance industry. I personally purchase many dongles and electronics I certainly don’t need, starting with the latest in cell phone technology.
The need for podiatric care for thickened nails, work-related sore feet, and diabetes remains remarkably constant throughout the years. Podiatry as a profession weathered the economic storm of 2008-2012 with breathtaking resilience. Sure, we could always use more. We need the MD degree for political reasons and for greater opportunity, but we could all start out by fully utilizing what we already have.
Michael M. Rosenblatt, DPM, San Jose, CA, Rosey1@prodigy.net
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