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01/07/2014
RESPONSES/COMMENTS (PM NEWS QUICK POLL)
RE: Have you recently been dropped from an insurance network?
From: Al Musella, DPM
According to last week's PM News Quick Poll, 23% of us were dropped by an insurance network. This should be the number one issue for the APMA. This means that these doctors will not get paid from some of the largest insurers, and those patients affected will have to change doctors. The entire concept of an insurance panel is insane. How could we have let insurance companies decide which doctors a patient can use. They have no right to interfere with that selection.
We should fight it - and get the MD groups as well as patient groups to press for an "any willing provider" law. About 1/2 of the states have it - but NY does not. It should be enacted in all states.
Other messages in this thread:
03/07/2023
RESPONSES/COMMENTS (PM NEWS QUICK POLL) - PART 1B
From: Michael M. Rosenblatt, DPM
Dr. Hywnak provided a stunning new direction for podiatrists interested in becoming physician "associates." My podiatry license in WA State identified me as a "Podiatric Physician and Surgeon." I think this was helpful politically, and in WA State we had a good "podiatry practice law." I did not find the practice limitations of podiatry to be any particular obstruction or blockage to a highly satisfying and gratifying career.
But podiatry is literally hands-on. I say this, not derisively but proudly. This is true whether you choose a surgical or non-surgical podiatry practice. However, some podiatrists over the years sustain a kind of manual disability that may limit their ability to practice basic podiatry. Some, breathing in fomites from nail dust may develop a mild COPD. There are other reasons why it may not be possible to continue practice. For planning purposes, certification as a physician associate may allow a DPM who did NOT purchase disability insurance to continue in a fulfilling career.
Rather than criticize this opportunity, I suggest that some of us welcome it and utilize it if it fits your professional lifestyle. But like any other career, it likely contains both positive and negative attributes. In my Medicare Certified Surgical Center, I actually hired MD/DO anesthesiologists. I would never have assumed this possible or likely as a 2nd year DPM student! If you suggested this would happen to me, I would have laughed out loud. For me, podiatry opened like a flower in the most unexpected ways. I'm sure this career is not an easy qualification. I congratulate Dr. Hrywnak for this creative opportunity and request that my fellow DPMs not criticize him for opening doors for us.
Michael M. Rosenblatt, DPM, Henderson, NV
08/02/2016
RESPONSES/COMMENTS (PM NEWS QUICK POLL) - PART 1A
From Richard A. Simmons, DPM
Dr. Smith asks Dr. Siegel, “what makes him so special” because Dr. Siegel’s health is doing well because of ACA. My answer is a simple word: civilization. We live in a civilized society. I do not complain that I have to pay taxes for the parks in my city that I do not use; I do not complain about paying taxes for schools for children I did not have; I do not complain that I supplement a transit system that allows your patients access to your office; I do not complain that I pay taxes to build the roads that your patients use to travel to your office. These are the prices we pay for civilization. There are many who have that independent attitude that “I have mine; screw you!”
For you, I say, there is plenty of land available where many can go to live self-sufficient: you can sink your own wells, handle your own sewage, farm your own land. Have at it. That civilization can provide medical treatment and care for Dr. Siegal is a win/win situation for all of us: 1) he is working member of society who I am sure pays taxes, etc., and 2) we have a very intelligent man who is able to contribute to the well-being of citizens in his community by being a podiatrist. You see, those children that I pay taxes for their education, one day, they will take care of me. This is what we call civilization.
Richard A. Simmons, DPM, Rockledge, FL
06/24/2016
RESPONSES/COMMENTS (PM NEWS QUICK POLL) - PART 1B
From: Jay Kerner, DPM
Like any prescription with possible psychoactive side-effects, medical marijuana must be prescribed appropriately and with careful selection of patients. For conditions running the gamut from ischemic pain, diabetic neuropathy to delayed onset muscle soreness, medical marijuana would certainly be appropriate.
I completed the four-hour NY State course for medical marijuana prescribers. However, when applying for the next step, I was told by the NY State Health Department that prescribers must be MDs. I was also informed that this could only be remedied legislatively.
Jay Kerner, DPM, Rockville Centre, NY
06/24/2016
RESPONSES/COMMENTS (PM NEWS QUICK POLL) - PART 1A
From: Randall Brower, DPM
I would not be in favor of prescribing marijuana if it was legal, assuming it is traditionally smoked. I argue that I would be liable for any patient who develops lung cancer or other cancers from smoking it. Until they can FDA-approve, study it, and put it in reproducible delivery systems that deliver regulated quantities for proper treatment selection, I refuse to jump on that boat.
That said, I have seen anecdotally in my practice many patients who get real relief of pain from marijuana, and they actually have quite a significant decreased use of narcotics post-surgically.
Randall Brower, DPM, Avondale, AZ
02/08/2016
RESPONSES/COMMENTS (PM NEWS QUICK POLL)
From: Stephen Doms, DPM
I recall two occasions when degree changes were granted in a very short period of time. In California in the 1960s, the CMA tried to eliminate DOs by having them change to MDs and then closed the DO schools. I think that about 85% of DOs turned in their degrees to obtain an MD certificate.
Then in the late '60s or early '70s, the DSC chiropodists were able to change to DPM degrees with evening and weekend courses at the colleges of podiatric medicine, specifically with courses in pharmacology and surgery. It can be done.
Stephen Doms, DPM, Hopkins, MN
11/26/2015
RESPONSES/COMMENTS (PM NEWS QUICK POLL)
From: Ron Freireich, DPM
Not only are we not getting incentives or payment for the work we do in the form of PQRS measures, but it costs us not to be penalized. I checked with the PQRS Registry today recommended by my EMR vendor, and it will cost $500 for the first NPI/tax ID combination that we bill under, and $250 for each additional combination. What's wrong with this picture?
Ron Freireich, DPM, Cleveland, OH
11/11/2015
RESPONSES/COMMENTS (PM NEWS QUICK POLL) - PART 1B
From: Paul Sommer, DPM
A one-day strike wouuld be highly unlikely and not legal. Another angle would a cash only day.
Paul Sommer, DPM, Valparaiso, IN
11/11/2015
RESPONSES/COMMENTS (PM NEWS QUICK POLL) - PART 1A
From: William Deutsch, DPM
American physicians should regard the happenings in Great Britain as junior doctors ballot for a strike to oppose unsafe working conditions in hospitals. Long hours, reduced overtime, a paltry pay raise has the junior doctor's (residents) Union ready to vote. They have the full support of the BMA. They're not talking about a one-day strike which would go unnoticed. The advantage they have is their strike is against the government which salaries NHS doctors.
Who is the one-day strike in America directed against? The only effective response American physicians can offer is non-participation in all insurance plans, and not just for a day. An insurance company that has no participating physicians is out of business. PPACA reform began and ended with insurers. The fallout from PPACA on the landscape of healthcare wasn't accidental.
EMR and MU are the government's 'common core' response to physician-administered healthcare. They are administrative burdens which only help bean counters, while leaving doctors to drown in a sea of confusion. Like the good lemmings we are, we march dutifully to our own demise.
William Deutsch, DPM, Valley Stream, NY
11/10/2015
RESPONSES/COMMENTS (PM NEWS QUICK POLL)
From: Eric Trattner, DPM
A strike traditionally is a stoppage of labor, essentially holding hostage an industry in the hopes of receiving better terms. The power of a strike is both in the scope of participation as well as the uncertainty of its length. The longer a strike goes on, the more deeply will the loss of service be felt, especially with 100% participation.
In a proposed one-day physician strike, I question first the level of participation, mostly due to the fact that there is no union, and therefore no "bosses" to come down on the "scabs" who do not strike. But mostly, there is no real threat. No one actually believes essential medical care would ever be withheld from sick or injured patients. Nor should it ever! However, even in a scenario where all elective care IS withheld for 24 hours, for what purpose? There is no one in any position of authority with whom to bargain, and even if there were, we would be striking from a position of weakness. "Don't worry, tomorrow we'll be back on the job."
While a one-day strike may attract some attention to "our plight", I doubt it would garner any sympathy, let alone any positive results. The fact is we have very little power as individuals and, as I've seen over the past 25 years, it appears neither do our professional organizations. The only ones with any true negotiating power are the large groups and hospitals. Sure, we can threaten to drop out of insurance plans, but that goes right back to the issue of participation. The other 3 or 10 podiatrists on my block will still accept all insurance plans.
Eric Trattner, DPM, Cleveland, OH
02/12/2014
RESPONSES/COMMENTS (PM NEWS QUICK POLL) - PART 1B
From: Steven J. Kaniadakis, DPM
What do the topics of a three-year surgical residency, the results of the recent survey about the percentages of podiatrists doing RFC, and the past survey about percentages of DPMs performing bone versus soft tissue surgeries indicate about today's podiatrist? Are we training our residents for the vision we wish to achieve or for the realities of today's podiatrist?
01/11/2014
RESPONSES/COMMENTS (PM NEWS QUICK POLL) PART 1A
From: Billie A. Bondar, DPM
I am writing again...to say that the stress and frustration that one goes through when dealing with network termination is not to be taken lightly. I had voiced my words negatively at APMA when indeed they were on board for me with a letter of support.
Let me note that I was heading for a second appeal to this network with an attorney per PICA to find that the network's medical director had sent a rejection letter to me for the first appeal accidentally, pushing a wrong key on his computer. I won the appeal and did not need to get an attorney. My credentials, my integrity, my clean record, my training, and my board certification choice were of strong standing in...
Editor's note: Dr. Bondar's extended-length letter can be read here.
01/02/2014
RESPONSES/COMMENTS (PM NEWS QUICK POLL) - PART 1B
RE: Would You Change Occupations if You Could?
From: Judith Rubin, DPM
There are many people who would have loved to be something else if they had the chance. But, I know many of you feel like I do. Back in the early 1980s, I felt very special being a 2-year residency-trained surgical podiatrist. I got paid what I asked for, and all was good.
We could open up cold and the profession was there to help you. Now, going out on your own isn't an option due to the money. I was always a little rebellious trying to put myself on par with my MD colleagues. Being a woman made it...
Editor's note: Dr. Rubin's extended-length letter can be read here.
01/02/2014
RESPONSES/COMMENTS (PM NEWS QUICK POLL) - PART 1A
From: Ira Baum, DPM
Dr. Kiel makes a point regarding the dissatisfaction of a broad cross-section of medicine, but that's not the point. The concern is our profession. It is also incorrect to pigeon hole the dissatisfaction to earning capacity. Podiatry has had internal and external issues that have not, in my opinion, been addressed with any practical solutions for both the short and long-term vision of our profession.
I have no interest in expressing how I might solve some of the fundamental issues; there have been more than a few reasonable solutions expressed in PM News. There are many variables that impact personal satisfaction when it comes to a career that serves the public and for those of us who have families and financial responsibilities, that if not met would surely negatively affect an individual's love of their chosen career. I am in the sunset of my career, and have made a great life for myself and family, yet that doesn't mean that the profession shouldn't address these issues so that our young colleagues and students can look forward to satisfying careers.
12/30/2013
RESPONSES/COMMENTS (PM News quick poll) - PART 1A
From: Brian Kiel, DPM
In response to Dr. Kornfeld's letter regarding podiatrists' dissatisfaction with their profession and its sweeping assumptions, I say let's dig a little deeper before we make such condemnations. A recent Time Magazine poll of U.S. physicians found that of 13,000 doctors, 2/3 were dissatisfied with their profession. In a poll by Forbes magazine, of 24,000 doctors, 54% would choose another profession and in Surgical Products magazine, 40% were unhappy. I don't think that we are any different than the others in the medical field. The non-medical pressures that we face on a daily basis can be overwhelming to many and cause this dissatisfaction.
In his letter, Dr. Kornfeld mentions "making a living" several times, as if that is the driving force for being a doctor. Of course that is important, but most of us went into medicine to provide a service to the public, and if your only motivation is to "make a living," then it is more likely for unhappiness to develop. Enjoying what we do, curing illness, and why we do it, to serve the public are the best reasons to do what we do and the recipe for happiness. By the way, I am one of the 30% who would not change occupations.
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