Blaine A 1014
Podiatry Management Online


Podiatry Management Online
Podiatry Management Online



Search Results Details
Back To List Of Search Results



From: Robert Scott Steinberg, DPM


Dr. Musser asked for advantages and disadvantages. I'll give you one big disadvantage. If you do not do plaster slipper casts, then there is really nothing that separates you from chiropractors, physical therapists, pedorthists, or the shoe store salesman who does a scan. It does not matter which scanner you use. They all make you run-of-the-mill and..... beige. Let the slings and arrows fly, especially from those of you who don't want to get your hands dirty, or those of you who have "trained" your office staff to handle the mundane stuff, or those of you who failed to master the art of casting.


Robert Scott Steinberg, DPM, Schaumburg, IL,

Other messages in this thread:



RE: Millennial Expectations

From: James E. Koon, DPM


For some time now, patients have been researching their doctors on the Internet. I am consistently told by new patients that they chose me based on my Internet reviews. Word of mouth referrals are still a mainstay of my practice. I have never advertised. 


My experience has been that all patients’ expectations are rising. Everyone wants everything given to them and they all want their insurance to pay for it. Many come in with pre-conceived ideas of what they have because “Dr. Internet” has seeded their minds. Many come in wanting...


Editor's note: Dr. Koon's extended-length letter can be read here. 



From: Dennis Shavelson, DPM


I am a 71 year old practitioner and find myself more and more successful attracting millennial patients by marketing how I practice.

  •  I offer holistic cures, not just tunnel vision Band-Aid care.

  •  I offer care of treatable underpinning pathology (medical, biomechanical and   kinesiological).

  •  I practice Prevention, Performance Enhancement and Quality of Life Upgrading.

  •  I offer more seamless office visits and availability in the cloud.

  •  Rather than state that I treat everything for every foot, I market niche compartments of diagnosis and care (biomedical engineering and ugly toenail cures).

  •  I have hardship and sliding scale fees available.  

Dennis Shavelson, DPM, NY, NY



From: Bryan C. Markinson, DPM


My friend Dr. Robert Hatcher is absolutely dead on about "working smarter, not harder." There is no question that we should all strive for life balance and more efficiency in our practices. But "working smarter, not harder" is predominantly an empty sentiment....but only us old timers get it. I teach students, residents, and young colleagues on a regular basis. One of my most common points is "the days of 9-5 are long gone." If you want to coach little league and catch every ballet recital, and go to "mommy and me", you may need to settle for a three bedroom house instead of a 5 bedroom house. If you don't get what I am saying, advice on office efficiency and life balance is wasted on you.


Bryan C. Markinson, DPM, NY, NY



RE: Excessive NBPME Exam and Reporting Fees

From: Nicholas A. Ciotola, DPM


Why does NBPME/APMLE charge so much money? Because they can.


Nicholas A. Ciotola, DPM, Methuen, MA



RE: Time Wasted

From: Larry Schuster, DPM


An insurance company just requested we fill out and attest to demographic information on our practice. We have done this many times for many insurance companies. We usually look at a page of pre-filled info, and if no changes, click approve. It takes 5 minutes maximum. If you need passwords, etc. to get on the site, it takes a little longer. .


We are seeing more complex forms every day to the point of craziness. Today, I received a request to fill out such a form with the recommendation that I attend a 30-minute webinar on how to fill out the form. I will have to do this after finding my sign-on credentials.


Larry Schuster, DPM, Parsippany, NJ 



From: Arnold B. Wolf, DPM


In response to Dr. Freireich's recent post, I am compelled to respond to all issues pertaining to the MACRA/MIPS conundrum that we are facing. MACRA/MIPS is "supposedly" all about creating an environment of cost-effective and efficient delivery of healthcare services. Of course, this is being constructed by our federal government...a highly inefficient, wasteful organization. We, once again are the victims of their ineptitude. I liken their skillset to an orchestra conductor who can't read sheet music...and we're forced to play on. MACRA/MIPS is like all the other poorly concocted schemes foist upon physicians under the guise of trying to make healthcare delivery more efficient.


I submit that the additional data collection and additional data mining is a waste of time. Issues of meaningful use, quality measures, MACRA/MIPS and the like are created for one reason reduce reimbursement. Collectively, medicine is the only "government contractor" (recipient of public tax dollars under Medicare, Medicaid, FEP...) that gets "incentivized" by not getting "penalized". By submitting the data bundled in our insurance billings, we are providing more than ample information as to our individual practice patterns and utilization. That, in fact, should be enough. After all, it really is all about how much less we can get paid, and not how well we do our jobs. It would be nice if all doctors could resume the practice of treating patients and not focus on treating their computers.


Arnold B. Wolf, DPM, Sterling Heights, MI



From: George Jacobson, DPM


Since this topic has come up again, I would like to remind everyone of a posting that I wrote on 03/05/2016. You can search it in the PM News archives. In a nutshell, here is the main excerpt, "We received a letter from Palmetto GBA stating that they have received information from the National Supplier Clearinghouse (NSC) indicating  that we have not billed the Durable Medical Equipment Medicare Administrative Contractor (DME MAC) within the last four consecutive quarters."   


George Jacobson, DPM, Hollywood, FL 



From: Martin G. Miller, DPM


I went to the website that Dr. Kesselman referenced in his response, and after putting in my NPI, it correctly identified me and my specialty (podiatry), but it only said revalidation: TBD. I assume this means "To Be Determined". I guess I have to keep checking back to see if any date actually shows up. It would be far more helpful if the actual date was given.  


Martin G. Miller, DPM, Freeport, NY



From: P David Applegate, DPM


Congrats on making it to your third year! Before all, it's important to be aware of what kind of job you feel you'll fit best into. Podiatry has grown into a field with an array of practice options. This is something you'll have to answer and it will be based on your training and personal interests. Once you've gotten an idea what you're looking to do, it's never too early to start working towards finding a job. In fact, if you end up finding one in a state you weren't originally planning on going to, it's critical that you are aware of timelines on state licensing. In short - the earlier the better. Relevant job listings can be found in a number of places. A Google search will go a long way towards finding ones outside of PM News


There's also nothing wrong with taking an active approach and reaching out to every practice/hospital/etc. in a given geographic area that you're interested in and asking if they'd consider hiring you. The worst they can say is no, and many may know someone in town looking to hire someone. Other options include a year of advanced training in a fellowship, but make sure you're aware of the timelines and nuances of the application process. A list of ACFAS-recognized fellowships can be found here.  


P David Applegate, DPM, Katy, TX



RE: Enough Already with Time-Consuming Chart Requests (David P. Luongo, DPM)

From: David E Gurvis, DPM


I recently had a request for 50 charts to be reviewed. That was a very unusual request, but that is not my question. The insurance company said if I wanted to give them access to my online EMR, they could log in and review those charts in that fashion.  


While that sound convenient, more so than printing them all out, it just sounds risky as it relates to privacy concerns. Has anyone allowed an insurance reviewer into their EMR? Is that even legal?


David E Gurvis, DPM, Avon, IN



RE: Enough Already with Time-Consuming Chart Requests (David P. Luongo, DPM)

From:  Cynthia Ferrelli, DPM


I have experienced the same problem, so I came up with a solution several months ago that has been working fine. When my office is called for a chart review, we say we will comply but that their reps come to my office, will have to pull all the charts themselves, and find what they need in the chart. We tell them that this is how we do it and we set the guidelines. Set your boundaries. You are paying your staff to do work for you, not for the insurance companies. We seem to do enough of that already.


Cynthia Ferrelli, DPM, Buffalo, NY



RE: Enough Already with Time-Consuming Chart Requests (David P. Luongo, DPM)

From: Matthew B. Richins, DPM, Cynthia Ferrelli, DPM


When we get a request, my office manager charges a fee for our supplies and her time to the companies, to be paid in advance. Most pay. Others ask to send a representative out to make the copies. We tell them to bring their own paper, printer, and ink - and they do!


Matthew B. Richins, DPM, Joplin, MO



RE: Microscope for KOH Preps (David Kahan, DPM)

From: Carl Solomon, DPM


I've been doing KOH preps for a while and they're simple. KOH preps don't require a special microscope. No oil immersion, polarization, etc. are needed. You just need low/med power (10X, 40X, occasionally 100X). An adjustable condenser to increase contrast may help but you can do without it.


Carl Solomon, DPM, Dallas, TX



RE: Gary Dorfman, DPM Retires After 50 Years

From: Peter J. Bregman, DPM 


Dr. Gary Dorfman has officially retired from 50 plus years of podiatry. Dr. Dorfman is a former president of the American College of Foot and Ankle Surgeons. He has given much of his time and talent working in various aspects of podiatry and has helped thousands of patients and left his impression on his fellow colleagues.


Dr. Gary Dorfman


His most recent employment was at the Foot, Ankle, and Hand Center of Las Vegas. He finished his last four years of practice doing what he loves and creating bonds with his patients and colleagues that will last forever. Though he is leaving our profession, he will be fondly remembered for his contributions and we wish him well in his retirement.


Peter J. Bregman, DPM, Las Vegas, NV



From: David Gurvis, DPM


I also have a missed appointment fee. I find the “threat” alone reduces missed appointments. Do I apply the fee uniformly? No. Actually, I hardly ever use the fee unless a patient has been egregious in repetitive missing of appointments. What I find then is that if I apply the fee, the patient goes away. The desired result. They fire me and I don’t have to discharge them!


I don’t have the fee on new patients as it is too difficult to make sure that they understand my policy, but if they miss two appointments, I refuse to take them back. As always, there is common sense. Missing an appointment without a call later is frowned upon more than missing with a call later that indicates the patient is sorry and had a lapse in memory or perhaps a real reason.


David Gurvis, DPM, Avon, IN



From: Neil B. Levin, DPM, Mark K Johnson, DPM


We have been extremely pleased with the Konica Sigma CR units. We have three of them in different offices. The base unit fits on a countertop and we use our own X-Cels without any modifications or retro-fitting. It produces great images and and has excellent tools. Lease or loan payments are about $550/mo. for 60 mo. It was our best investment ever!


Neil B. Levin, DPM, Sycamore, IL


We went with the DR system A2D2 from Foz Networks (Zac Childress) , retro-fit to our X-Cel system in 2013.  Lease to own. The A2D2 is very reliable and have good support with minimal issues. Highly recommended.


Mark K Johnson, DPM, West Plains, MO



From: Lynn Homisak


I believe you are asking ‘should you bill a new patient you haven’t even seen yet?’ and ‘should you collect their credit card information prior to their appointment?' Instead of applying a Band-aid on an obvious problem and sending a negative message to patients before you even meet them, why not try to determine the reason WHY new patient cancellations are such an issue for you? 


Yes, new patients must occasionally cancel an appointment. It happens. It is not typical, however, to have a new patient cancellation "problem"; unless of course, new patients are scheduled so far out that...


Editor's note: Lynn Homisak's extended-length letter can be read here



From: Paul Kesselman, DPM 


There is no simple solution to this and there are multiple factors here. On one hand, asking for a credit card deposit on the phone does set a bad tone, but with high deductibles and co-payments and tight schedules, last minute cancellations are also unfair to other patients who otherwise would have been able to obtain care sooner. 


I agree that calling the patient the day before to confirm is far better than collecting a credit card "deposit" on the potential new patient. However, the reality is that tight schedules and last minute (24 hours is last minute) cancellations are unfair to...


Editor's note: Dr. Kesselman's extended-length letter can be read here



From:  Brian Kiel, DPM


I have a different perspective on this issue. Even though it can be aggravating to have no- shows, perhaps you are better without them in the first place. Those who do that frequently will be the ones who will not follow instructions for care, especially post-op or with wounds. I prefer not to have those patients in my practice. Also, another aspect is that we do slightly overbook on purpose and when there are no- shows, which happens every day, it leaves me a chance to "catch up.


Brian Kiel, DPM, Memphis, TN



From: Paul Busman, DPM, RN


I wouldn't require a credit card guarantee. Right off the bat, even before you'd established a doctor-patient relationship, you'd have shown distrust for that new patient. You've also suggested that getting their money is more important than taking good care of them. Missed appointments are a fact of life.


A better way would be to call that potential new patient the day before the appointment and remind them of the date and time, and tell them how much you're looking forward for the chance to care for them. 


Paul Busman, DPM, RN, Frederick, MD



From: Ivar Roth, DPM, MPH


Missed first appointments were a continuing source of irritation in my practice. We now take a credit card from all first time patients and bill a nominal amount to make sure the card is real. This amount is deducted from their visit if they come in. We send a confirmation email immediately after they call with a copy of our policy so there is NO miscommunication.  


This has worked well for us. Those who refuse to give us a credit card do not get an appointment. This is a real simple solution. We only charge $75 if they fail to show up or give notice. This policy is really to keep the new patient mindful that our time is valuable when they book an appointment.


Ivar Roth, DPM, MPH, Newport Beach, CA



From: G. Dock Dockery, DPM


I have never seen the dilute 4% dehydrated alcohol version available commercially. It is usually supplied in the 98% version of ethanol and is listed as Dehydrated Alcohol for Injection, USP. I think it is still available online or through Moore Medical Supplies.


G. Dock Dockery, DPM, Seattle, WA



From: Paul A. Galluzzo, DPM


Try Gill Podiatry. They usually sell it in 5ml bottles.  


Paul A. Galluzzo, DPM, Rockford, IL 



RE: Kudos for NYCPM Galway Seminar 

From: Patricia Lee Walters, DPM


I just returned from a fantastic seminar for wounds and podiatry in Galway Ireland. The lectures were great and the Galway Bay Hotel venue was phenomenal. I think every podiatrist should check this group out for next March's seminar. There were excellent lectures and a cadaver workshop was included. The seminar featured world renowned lecturers. Dr. Susan Rice was amazing in the cadaver lab. Thank you NYCPM. 


Patricia Lee Walters, DPM, Tarzana, CA



From: Elliot Udell, DPM


Dr. Secord shines a light on the fact that the exorbitant price of brand name medications charged by pharmaceutical companies to U.S. citizens could not be totally justified by the cost of research. Much of this research, as Dr. Secord points out, is done at institutions funded by taxpayers.


Even if we want to give an inch to big pharm's argument that research expenses are at the heart of why Americans pay so much more than "Canadians" for pharmaceuticals, it by no means explains how drug companies have cornered generics and raised the prices to astronomical levels. All of us are aware of how big pharm was able to exploit a legal loophole and start charging over ten dollars a pill for Colchicine when as a generic it sold for pennies for a tablet.


Econazole cream which is a generic antifungal, used to cost less than two dollars for an 85 gram tube. Somehow, the pharmaceutical firms were able to corner that market and raise the price to over $250 dollars for the same product. The ingredients in the EpiPen for which the company charges over $650 dollars (which we all have in our emergency crash carts) are available for less than $2 dollars. The bottom line is that the American citizens deserve close government scrutiny of what is going on and laws to protect its interests.


Elliot Udell, DPM, Hicksville, NY