The Voice of Podiatrists

Serving Over 14,000 Podiatrists Daily

January 01, 2013 #4,653 Publisher-Barry Block, DPM, JD

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TN Podiatrist Publishes New Book for Diabetics

Dr. Mark Hinkes has just published a new book, Healthy Feet for People with Diabetes in both text and Kindle version.

Dr. Mark Hinkes and New Book

The book has been designed as a blend of a textbook and magazine with easy-to-read fonts, and interesting pictures. It focuses on how to deal with current foot health issues and how to prevent foot health tragedies. Hinkes previously wrote Keep the Legs You Stand on.

TX Podiatrist Co-Produces Podiatric Musical

Eddie Davis, DPM is the co-producer of "In Their Shoes," an original musical to benefit Street2Feet of SAMMinistries which will be playing at The Playhouse March 6 & 7, 2013 in San Antonio, TX.

Dr. Ed Davis

The story tells about Goody 2Shoes and her family. Guess what? Her dad is a podiatrist. Click this link to hear the playwright, psychologist Tova Rubin, PhD., singing the podiatry song. The song is sung in Dr. Davis' office.

ADA Releases Standards of Medical Care in Diabetes 2013

Researchers from the American Diabetes Association (ADA) reviewed current scientific literature and updated the Association's Standards of Medical Care in Diabetes for 2013. The new guidelines may reduce the number of people who need to take blood pressure medications, and they may help more people get insurance coverage for testing their blood sugar levels.

The report updates several aspects of diabetes care, including more specific recommendations for diabetes screening, management of dyslipidemia, nephropathy, and retinopathy screening, and medical nutrition therapy, as well as newly revised standards for self-management education and support.

Source: Diabetes in Control [12/27/12]

Query: Attesting After Switching EMR Systems

I used an EMR program from November of 2009 until December 1, 2012. I attested with that program for Medicare and received the $18,500. I switched my EMR program to TrakNet December 1, 2012. My question is: Can I attest using my old EMR system because I used it for 11 months in the year 2012, or do I have to wait and use my new system TrakNet for three months and then attest? 

Chris Mullin, DPM, Matawan, NJ

Query: Requirement of Signed Orders in Nursing Homes

Is it still a requirement for the attending physician for a nursing home resident to have a signed order for each visit every 61 days as long as it falls within medical necessity for podiatry coverage? Or is this requirement only for new residents? Do residents already seen need a signed order every time seen?

Stanford Rosen, DPM, Tuscaloosa, AL

Editor's comment: PM News does not provide legal advice. With regard to "routine orders", Medicare does not accept such "standing orders" as supporting medical necessity for the individual patient as is required by law. Medicare defines any order(s) that does not specifically address an individual patient's unique medical status, illness, or injury as not reasonable and necessary and services consequent to population-based or condition-based orders are not reimbursable. An order could be verbal, telephone or via fax but the physician still has to sign and date it for that individual resident.

Medicare may reimburse "standing orders" for physician services for an individual patient's treatment. An example would be: "Evaluate this patient's wound on a weekly basis for signs of infection or vascular compromise prior to dressing change or referral for physician evaluation times three." The medical record must demonstrate that the order is medically reasonable and necessary. (Source: CMS)

RE: Strapping Denial When Injection Given (Kathleen Neuhoff, DPM)
From: David E. Gurvis, DPM

Dr. Neuhoff said, "If you believe you are providing the best care, and your patients trust you, they will find a way to pay." In that single sentence, she has said it all. In my opinion, too many of our practitioners seem to devalue their services. Trimming toe nails on a patient who cannot reach is NOT a minor procedure.

Relieving pain with a strapping that only you know how to apply well is, again, NOT a minor procedure. Too many of us seem to feel embarrassed to charge what...

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

RE: Combination Drugs for Xerosis (John Brummer, DPM)
From: Barry Mullen, DPM
 
My objective experience grossly differs from Dr. Brummer's. For modest to severe inflammatory skin conditions, OTC topical steroids, typically available in 1% concentrations, exert minimal, if any, effect on the inflammatory process. The overwhelming majority of patients suffering with inflammatory symptoms, such as burning or pruritis, generally require medium to high potency topical steroids, only available by Rx.

In some select VERY mild dermatitis cases, OTC topical steroids exert some efficacy. For these milder cases, generally, patients have already tried and failed an OTC topical steroids. The one example that comes to mind where combination therapy occasionally works is with inflammatory tinea pedis, where therapy duration, rather than the actual anti-inflammatory agent, is likely responsible for success.

While I endorse product dispensal in our practice to assist in patient care, I am careful to gravitate towards those products I know have the greatest chance to work. 1% steroid concentrates are not on that list for the above reasons.
 
Barry Mullen, DPM, Hackettstown, NJ, yaxy630@aol.com

RE: Rising Patient Deductibles Spell Trouble for Doctors (Allen Jacobs, DPM)
From: Keith L. Gurnick, DPM

I would like to respond to Dr. Jacobs' note. The purposes of deductibles and co-pays are two-fold. First, as anyone who has PPO health insurance coverage is aware of, and any doctor in private practice has learned, these higher deductibles act as a strong financial barrier and disincentive for the paying patient to seek the "necessary" medical care sooner. Second, the higher co-pays and co-insurance cost shifting to the patient not only put added financial pressure on the patient and should....

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

RE: Rising Patient Deductibles Spell Trouble for Doctors (Allen Jacobs, DPM)
From: Richard A. Simmons, DPM
 
Dr. Udell expressed concern that his next colonoscopy will cost him thousands of dollars and that this might deter him from having this performed. Under the Affordable Care Act is the provision called Providing Free Preventive Care: All plans must cover certain preventive services such as mammograms and colonoscopies without charging a deductible, co-pay, or co-insurance. What one has to remember is that screening is free; however, if a procedure is performed with the screening, then there can be a charge to the annual deductible, co-pay, or co-insurance. For more information and a complete list of preventive services covered under the Affordable Care Act, click here:

Richard A. Simmons, DPM  Rockledge, FL RASDPM32955@gmail.com

EQUIPMENT FOR SALE - USED Q-CLEAR LASER

Still under warranty. New laser head just added. First Best Offer. Marketing and training included. Dr. Zuckerman will train you. e-mail with questions to mook863@comcast.net

ASSOCIATE POSITION - KANSAS CITY

Kansas City may be the perfect move for you and your family. I am looking for an entrepreneurial minded associate who wants to grow and then own part of an already successful practice. If you are the right candidate for this associate position, you will enjoy a competitive compensation package and you will be working with a doctor who is as committed to your success as he is to his own. Go to: www.YourFutureInPodiatry.com for full details.

ASSOCIATE POSITION - DAYTON, OH

Join a well-established modern practice in Dayton, Ohio. Excellent reputation and referral base. Base salary $120,000, benefits and bonus structure. EMR, diagnostic ultrasound, Padnet vascular studies, CO2 lasers, all aspects of DME. We seek a surgeon that is well-trained and personable to join our group of 4 podiatric surgeons. Would like to have this individual buy in to the practice eventually. Please send CV and to Ohiodoctors@aol.com

ASSOCIATE POSITION - NASSAU COUNTY, NEW YORK

Exciting Opportunity! Associate position. Must be Board Qualified. Joining all Board Certified Doctors in foot surgery and reconstructive rear-foot and ankle surgery. Respond to: Podiatryoffice@doctor.com

ASSOCIATE POSITION – NORTHERN CALIFORNIA/SF BAY AREA

We’re looking for someone entrepreneurial to join our growing practice. Must have great people skills, clinical/surgical skills, and positive demeanor. California license required. No nursing home visits. Send your CV and cover letter to: cvpodiatrist@gmail.com

PODIATRISTS WANTED - NORTHERN AND SOUTHERN CALIFORNIA

Excellent opportunity for independent, professionally managed practice in skilled nursing facilities. E-mail interest and CV to ZBUBBLESZ@aol.com

ASSOCIATE POSITION - FLORIDA

Associate wanted for well-established practice in central Florida. Experienced support staff, six figure salary, malpractice coverage and health insurance provided. Excellent opportunity for a promising future, this position will provide for the possibility of partnership in the future. To apply please go to www.yourcareerinpodiatry.com

ASSOCIATE POSITION - GRAPEVINE, TEXAS

Do you want to practice in a fast paced office environment? Do you like all aspects of podiatric medicine? Very busy 2 office practice looking for associate to add to our group of 5. If you are a forward thinking, surgically trained podiatrist send your CV to giacalone@faant.com

ASSOCIATE POSITION - MARYLAND

If you are a graduating resident, in July, or an established practitioner (available now) and you are enthusiastic, personable, motivated and well-trained, we would be delighted to discuss an associate position in our group with you. We are a 17-doctor group, with 12 locations. Significant patient flow already in place to keep you busy from the start! All the bells and whistles-EMR, digital x-rays, ultrasound, computerized scheduling, certified ambulatory surgical centers, hospital and physician referral base. Please send cover letter and resume to newdpm@footandankle-usa.com. We look forward to hearing from you.

ASSOCIATE POSITION - ORANGE COUNTY, NY

Full-Time or part-time. Looking for a highly motivated, surgical trained podiatrist in Orange County, NY (West Point). Hospital, wound center and surgical center affiliated. A busy practice that covers hospital in-patients, wound center, and ER calls. Must be trained in all foot surgery and be able to handle advanced diabetic wound care. 1 hour car ride from NYC and close to hiking, fishing, skiing and state parks. Email CV and contact info to: clsp4@yahoo.com

ASSOCIATE POSITION - NEW YORK

Established and modern podiatry practice seeking well trained podiatrist for our two offices located in the Hudson Valley. Individuals must be highly motivated, ethical, and have PM & S-36 training. Partnership potential! Please see our recruitment video (845) 471-2243, esims@simspodiatry.com

ASSOCIATE POSITION - CT - (FAIRFIELD AND NORTH HAVEN)

Join one of the largest podiatric groups in Connecticut. Well-established and progressive offices, including EMR, digital x-ray, vascular and NCV studies, Pinpointe and CO2 lasers, diagnostic ultrasound and electrical stimulation therapy. You can expect a full schedule of patients the day you start, and a very competitive salary. For more info www.greatfootcare.com. Send resume to Dr.Kassaris@yahoo.com

ASSOCIATE POSITION - MICHIGAN

Multi-doctor practice looking to add associate for two offices in Flint, MI. Partnership opportunity for right person. Needs to be proficient in forefoot surgery. Two docs already proficient in rearfoot/ankle surgery. Competitive salary, paid vacation and seminars. Patient schedule available “now” from retiring associate. Email resume flintfootdocneeded@gmail.com

SPACE AVAILABLE - NYC & LI

Office to sublet and share - East 60th Manhattan, and Plainview, Long Island. access to an MRI, Joint Commission certified operating rooms, digital x-ray, diagnostic ultrasound, and access to a multi-specialty ambulatory surgical center. Also availability E 22nd between 2nd and 3rd and E 70th off 3rd. Turn-key operation - no investment needed PODO2345@AOL.COM 516-476-1815.

ASTORIA PODIATRY OFFICE FOR RENT/SHARE

BEST ASTORIA location. 30TH AVE./32nd ST. Turn-key operation with 4 fully equipped, built-out exam rooms, private Drs.' Office/Consult room, X-ray, cryo-therapy, beautiful waiting area, large staff area, Shockwave, Multiple Lasers etc. Perfect for NEW PODIATRIST or SATELLITE location. ALL you need is a PHONE and COMPUTER! RENT includes all other standard expenses (utilities, cleaning, waste disposal etc.) P/T, $2500. F/T., $3500. Please send inquiries to hansfeet2@gmail.com.

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