12/03/2024
QUERIES (NON-CLINICAL)
Query: Incorporating Foot Care Nurses into a Podiatry Practice
Is anyone incorporating foot care nurses into their practice? If so, how? I assume if they are employed by me, I can bill accordingly while they help me with time-consuming covered at-risk foot care. If this is the wave of the future, why not get on board with it and utilize it. I'm sure there are drawbacks as there are to any new changes. Is it worth investigating? Most MDs today use some level of assistants or nurse practitioners to extend/enhance their practice. Seems it could be an asset greater than its liability. Practically all dentists use dental hygienists in their practice as employees/contractors and its now widely accepted and seems to be a profit enhancer.
Glenn McClendon, DPM, Conway, AR
11/09/2024
QUERIES (NON-CLINICAL)
Query: Hyoscyamine for Neuropathic Pain
Has anyone ever used hyoscyamine for neuropathic pain?
Jeffrey Klirsfeld, DPM, Levittown, NY
11/05/2024
QUERIES (NON-CLINICAL)
Query: Source for Dehydrated Alcohol
Are there any sources for injectable dehydrated alcohol for neuroma injections, which are reasonably priced?
Louis Cappa, DPM, New Windsor, NY
10/25/2024
QUERIES (NON-CLINICAL)
Query: Virtual Services
Does anyone have direct firsthand experience using virtual services, specifically for front desk/front office duties such as phone calls, scheduling, and insurance verification? And if so, please provide your recommendation. Most of the companies that I’ve found all advertise these services, and more. We are having extreme staffing issues and have exhausted all avenues to find staff such as online ads, temp agencies, and recruiters. The time and effort spent to train these employees just for them to leave after a short time is draining. If these virtual services are in place and work as they should, I would hope that it would alleviate a lot of the burden on the existing staff.
Anas Khoury, DPM, Passaic, NJ
10/19/2024
QUERIES (NON-CLINICAL)
Query: Replacement Product for Gordon's Number 5 Spray Foot Powder
I am sorry to hear about Gordon Labs' pending closure. We have been using and selling Gordon's Number 5 spray foot powder for decades. Does anyone have a suggestion for a replacement product?
Neil H Hecht, DPM, Tarzana, CA
10/15/2024
QUERIES (NON-CLINICAL)
Query: Source for Compounded Glycerin
I am looking for a source for compounded glycerin for sclerotherapy. I would appreciate any recommendations.
Troy Harris, DPM, Jacksonville, FL
09/19/2024
QUERIES (NON-CLINICAL)
Query: Substitute for Hoover S1361 Canister Vacuum
Can anyone recommend a substitute for the Hoover S1361 canister vacuum?
Patty DiCaprio, Mohawk Valley Podiatry
09/11/2024
QUERIES (NON-CLINICAL)
Query: Alternatives to Cantharone?
Our clinic has been effectively and safely using Cantharone and Cantharone Plus for years to treat warts. Any suggestions where to obtain other topical destruction application chemicals, such as sodium hydroxide (NaOH ?%), potassium hydroxide (KOH 10%), tricholoroacetic acid (TCA 70-80%)?
Gian Steinhauser, DPM, Houston, TX
09/02/2024
QUERIES (NON-CLINICAL)
Query: Hospital Credentialing
I am assisting a colleague in a credentialing dispute regarding podiatric privileges. The podiatrist, while trained to do mainly forefoot bony surgery, e.g. bunions, hammertoes, implants, etc. has refocused his practice to do general podiatry and wound care. He is board certified by ABPM and in practice for over 30 years. The podiatrist's privilege request was to perform those procedures that he has been actively doing of late and he submitted recommendations from doctors attesting to his ability.
He limited his privilege request to level 1 and level 2 procedures (which in this case were mainly soft tissue and nail surgery) and requested all levels of ulcer care. The podiatrist then requested the ability to assist other podiatrists on staff in whatever privileges they had, and that were within the scope of his license. In other words, if a colleague was scheduling a Haglund’s deformity, for example, he wanted to assist. He was denied the privilege to assist his colleagues. The argument given was that in order to enter the operating room, he would have to be able to independently perform the procedures himself prior to being able to assist others that are already credentialed. This makes no sense to me. Am I missing something here? Any advice would be appreciated.
Name Withheld
08/27/2024
QUERIES (NON-CLINICAL)
Query: URGO K2 Compression System
Who is using the fairly new Urgo K2 compression system as a replacement for other compression wraps such as Unna boots or multi-layer compression systems for VLU or a similar indication? Any billing or documentation pearls would also be appreciated.
David Kahan, DPM, Sacramento, CA
08/05/2024
QUERIES (NON-CLINICAL)
Query: NJ Cultural Competency CME Requirement
NJ requires 6 CME credits for licensure including:
1. Context for the training, common definitions of cultural competence, race, ethnicity and culture and tools for self-assessment.
2. An appreciation for the traditions and beliefs of diverse patient populations, at multiple levels- as individuals, in families and as part of a larger community.
3. An understanding of the impact that stereotyping can have on medical decision-making.
4. Strategies for recognizing patterns of healthcare disparities and eliminating factors influencing them.
5. Approaches to enhance cross-cultural skills, such as those relating to history-taking, problem solving and promoting patient compliance.
6. Techniques to deal with language barriers and other communication needs, including working with interpreters.
Where can I take this course?
Mark Stempler, DPM, Lakewood, NJ
08/02/2024
QUERIES (NON-CLINICAL) -PART 1
Query: Replacement for Cantharone
Is there a replacement for Cantharone that works well on plantar warts?
Cheryl Martinetti, PMAC, Howell, NJ
08/01/2024
QUERIES (NON-CLINICAL)
Query: Source for Cantharone
I am looking for a source for cantharone or a similar product. Any suggestions?
Donald Carlson, DPM, Hermiston, OR
06/27/2024
QUERIES (NON-CLINICAL)
Query: Financing Companies for Podiatric Services
For many years, we have been utilizing CareCredit from Synchrony Bank to finance podiatric services for patients who need/want to have these services performed, but could not afford to pay for them in full. Recently, we have noticed a significant decline in their level of customer service and we have decided to close our account with them.
I am hopeful that some of my colleagues who have had positive experience with other companies offering similar financing services can please share their experience and the name and contact information for that company.
Richard M. Cowin, DPM, Orlando, FL
06/10/2024
QUERIES (NON-CLINICAL)
RE: Stealing Associates
We were approached by a company for practice acquisition. After we signed the non-disclosure agreement (NDA) and handed them our financials, they asked for associates contracts and collections by each associate. After a month of negotiations, they came back with an excuse that our practice makes a lot of money and if they acquire our practice, they will have to pay the associates higher salaries.
One week after I informed our associates about the possible merger, one associate suddenly resigned without telling us to where the associate was going. A month after, the other associate resigned, and we found out that they were hired by the group. They used our financials basically to destroy our practice and to steal our associates. We just want to make sure that this does not happen to other practices. Any word of advice is appreciated.
Names Withheld
06/06/2024
QUERIES (NON-CLINICAL)
Query: Monochloracetic Acid
I have been using monochloracetic acid for topical treatment of veruccae for many years; however now I have not been able to find anyone that sells it or can make it in small volume. My office treats many veruccae so we would be willing to buy bottles as large as 500ml. Does anyone know where it can be purchased?
Kenneth Meisler, DPM, NY, NY
06/05/2024
QUERIES (NON-CLINICAL)
Query: Resource for Practice Appraisal
Do you have any recommendations for a practice appraiser? I know PM News had someone listed in the past but this topic has not appeared recently.
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05/21/2024
QUERIES (NON-CLINICAL)
Query: Upperline Health
I have been approached by Upperline Health to hire me as an employee and potentially buy out my practice, but I am unfamiliar with their business model and would like to know any feedback from those who have a business relationship with them.
Name Withheld
05/09/2024
QUERIES (NON-CLINICAL)
Query: Podiatry-Specific Billing Companies?
I’m looking for recommendations or names of companies that do podiatry-specific billing?
Douglas Webb, DPM, Alvin, TX
04/08/2024
QUERIES (NON-CLINICAL)
Query: Alternative to Quickbooks
I have been using Quickbooks for my office checkbook for several years. I originally purchased the disks for a couple hundred dollars and downloaded it onto my computer. My 11 year old version started causing problems so I contacted Quickbooks for an updated version. They put me in contact with a company that downloaded the 2024 QB version and converted all the files from the old version onto the office computers for over $1,000. Now Quickbooks has contacted me claiming that I need to purchase a 1-year license for this new version for $1,200, or data will possibly be lost.
There are only 2 users in my office (me and my billing person) and we do only basic functions on the program, as payroll is outsourced and we only print about 6-8 checks per month. The new version of QB Pro Plus has a lot of bells and whistles that we will never use. Is there a simple, cheaper checkbook program that others are using that they would recommend and won't cost me over $2,200 for a year's use?
Tom Silver, DPM, Minneapolis, MN
03/28/2024
QUERIES (NON-CLINICAL)
Query: Fee for Credit Card Use
I'm considering adding a fee on all credit card charges. I'm paying about $300-400/month in credit card processing fees. With today's lower reimbursements and higher costs, these fees are becoming onerous. Many restaurants and retail stores are charging a fee for credit cards. What experiences have podiatrists had with charging a credit card fee?
Edward Orman, DPM, Perry Hall, MD
03/27/2024
QUERIES (NON-CLINICAL)
Query: Wound Care in TN
I am thinking about starting a practice in TN. My current practice does a decent amount of wound care, split between my private office and the hospital/wound care center. I would like to continue to do this if I move my practice. I was wondering if the providers in TN have a similar split? Or is wound care primarily done in the office setting?
Name Withheld
03/14/2024
QUERIES (NON-CLINICAL)
Query: Podiatrists Who Have Had Trigger Finger Surgery
I am wondering if anyone has any experience with trigger finger surgery. I have a busy mobile practice and I debride a lot of mycotic nails. As a result, I have developed a trigger finger of the 4th finger of my dominant hand. I’ve had 2 cortisone injections which provided temporary relief and two different hand specialists say they’ll only give two injections and then the treatment is surgery.
My question is, if you’ve had this condition and surgery, how much time did you realistically need to take off before you could resume debriding nails? One surgeon said it would be a week but I am not sure this is realistic so I am looking for some experience from those that have had the surgery.
Name Withheld
03/07/2024
QUERIES (NON-CLINICAL)
Query: AI Medical Scribes
I am curious as to what my esteemed colleagues feel about AI medical scribes. There's a lot to discuss. Are there medical-legal ramifications about the note (can one just blame the AI in a deposition?) Do you think patients want their notes taken in that way? Has anyone out there tried it, how does it pick up on a biomechanical exam with ROM measurements and x-ray reports?
Will notes have more errors or less? If we will need to re-read the notes that the AI made at the end of the day to make edits, does it really save us time? Are there ethical implications? Informed consent ramifications? Or any other unintended consequences?
Philip Wrotslavsky, DPM, San Diego, CA
02/14/2024
QUERIES (NON-CLINICAL)
Query: Source for PowerPoint on Wound Care
Since retiring, I am now teaching clinical skills in the healthcare sciences at my local community college. I have been asked to present a brief lecture on wound care to the nursing/medical assistant students. I am looking for a PowerPoint presentation that contains pictures of various wounds and common treatments.
Greg Caringi, DPM, North Wales, PA
