The Voice of Podiatrists

Serving Over 14,000 Podiatrists Daily

January 03, 2013 #4,655 Publisher-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2013- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

NC Podiatrist Provides Foot Health Tips for 2013

Picking the right shoe to wear for running, walking, or other activities also plays an integral role in taking care of your feet. "When purchasing a shoe, pick one that bends right behind the toe area, not at the arch. Also, a proper shoe should not be flimsy enough to easily twist side to side, or pinch the back sides of the heal area inward—it should be firm. Wearing shoes with proper support can help ensure foot health," say podiatrist Dr. Kathryn Egerton.

It is also important to pay attention to any changes or abnormalities on the feet. "Common foot problems include warts, ingrown toenails, athlete’s foot and odorous feet. If you are experiencing any of these conditions or any pain in the feet, it is important to get them checked and properly treated by a podiatrist, " says Egerton.

FL Podiatrist Participates in Athletes Helping Athletes Event

A group of Pine Crest School students piled 105 shoe boxes filled with brand new athletic sneakers high up against the Village Academy Gymnasium bleachers in a show of kindness and gift-giving to their peers via the Athletes Helping Athletes program that helps underprivileged student-athletes get that perfect fit with proper athletic shoes.

Dr. Jodi Schoenhaus (R) with Pine Crest School Athletes

The event held last week at Village Academy included an appearance by Jodi Schoenhaus, DPM, podiatrist at the Foot, Ankle & Leg Vein Center. Dr. Schoenhaus checked the Village Academy athletes for arch issues, wear, and damage from improper athletic footwear. She then checked other foot diagnostics and offered podiatry services on-site.

Source: David Dipino, South Florida Sun-Sentinel [12/31/12]

Fiscal Cliff Package Covers Doc-Pay Fix with Cuts to Other Medicare Providers

The Senate's last-minute fiscal cliff package staves off a sharp Medicare physician pay cut by cutting billions from other Medicare providers, including hospitals, pharmacies, and dialysis clinics. Early on New Year's Day, the Senate voted 89-8 to approve the American Taxpayer Relief Act, which permanently extends middle-class tax cuts and postpones the automatic spending cuts known as the sequester for two months. The legislation also averts the expected 26.5% Medicare physician payment cut and extends current Medicare payment rates for doctors through Dec.31, 2013.

Instead, the bill offsets the cost of a one-year patch to the sustainable growth-rate formula through reductions to other Medicare programs, most of which affect hospitals. For instance, a documentation-and-coding adjustment that seeks to recoup past overpayments to hospitals because of the shift to Medicare Severity Diagnosis Related Groups, or MS-DRGs, would save about $10.5 billion.

Source: Jessica Zigmond, Modern Healthcare [1/1/13]

Query: Lesions in Feet of Diabetic with Pancreatic CA

My patient is a 78 y/o white male  diabetic who is taking chemo and undergoing radiation for pancreatic cancer. He recently developed these lesions bilaterally with no complaint.

Lesions in Diabetic Patient With Pancreatic CA

I do not intend to punch holes in him for biopsy or suggest any topical with even the slight chance of systemic absorption. I have sent him for a dermatology consult. I will eventually get a report, but was curious if anyone has seen this before and knows what it is.

Larry Aronberg, DPM, Lake Worth, FL

RE: New Wound Care Tracking App
From: Narek Garukyan, DPM 

I would like to introduce a new application for IOS called Wound Tracker Professional. I developed this application which allows users to take photos, measure the surface area, and keep track of chronic wounds along the treatment course. The user can view the progress of the wound either as a single measurement with a corresponding picture, can choose to graph multiple measurements, or can convert the entire wound history into a PDF report.

PDF reports can be viewed locally, printed, or emailed. The application is available for sale on the Apple App Store, and works with the iPhone 5, 4s, 4, 3gs, iPad, and iPad mini. This application can be used for wound care centers, private practice, and for busy hospitals.

Narek Garukyan, DPM, Woodland Hills, CA, narekgarukyan@gmail.com

RE: Strapping Denial When Injection Given (Michael Forman, DPM)
From: Charles Morelli DPM

So walk me through this one please. A new patient comes in. You treat the patient and bill for the visit, x-rays, injection, and possibly dispense a brace, pre-custom orthotic, etc. All of the above are either covered and/or paid for out-of-pocket. You bill and make between $125 and $200 (roughly). After you apply a strapping that takes 60-90 seconds, you are now going to charge the patient. What is your fee for that? 

For me, the strapping that I will not get paid for will demonstrate to the patient (in many cases) how important it is to support the arch, take pressure off of the fascia, and relieve the pain. When the patient sees how effective it is, 9 times out of 10, the patient will agree to buy a custom orthotic. I just made ~$700. I will never charge for a strapping as I feel it is “nickel and diming.” I understand the argument, but I choose not to bill for it. We ALL do things daily that are not covered and we do not get paid for, and they usually take a few moments of our time. I’d rather provide and “exchange in abundance”, and make up for the initial loss of revenue with an increase of patient referrals. 

Charles Morelli, DPM, Mamaroneck, NY, podiodoc@gmail.com

RE: Is it Okay Not to Schedule Medicare Patients? (Stephen Lasday, DPM)
From: Chuck Ross, DPM

I have been reading the comments regarding how to handle Medicare patients and not see them on a particular day, so as to free up time for other individuals. Our community has lost 7 PCPs over the past year. Many of them were in larger group practices. What I have seen is that the larger groups are NOT taking on the transfer of Medicare patients to those physicians remaining in the group. There is now a significant shortage of physicians (compounded by a shortage prior to the departure of 7 physicians), and the seniors in my community are experiencing difficulty in getting appointments.
 
I have been led to believe that this was in anticipation of the 26.5% cuts which have now been delayed for another year, but I suspect this will continue to be a trend as physicians continue to take a beating while Congress continues to undercut the true fabric of what our country has stood for.

Chuck Ross, DPM, Pittsfield, MA, cross12@nycap.rr.com

RE: Rising Patient Deductibles Spell Trouble for Doctors (Robert Bijak, DPM)
From: Martin R. Taubman, DPM, MBA

I believe that Dr. Bijak's posts, submitted under the guise of being a “Devil’s advocate,” and acting as a podiatric “antagonist” in order to stimulate discussion, in reality cause more harm than good. I find his remarks enlightening at times; however, the positiveness of his inputs are outweighed by his attempt to simply be a rabble-rouser. There’s a fine line between constructive criticism, being “witty,” and simply causing disharmony by caustic and acerbic input. In my opinion, Dr. Bijak, it’s time for you to put down your pen and expend your editorial energies in a more positive manner.

Martin R. Taubman, DPM, MBA, San Diego, CA, mtaubman@san.rr.com

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

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 - NORTHWEST IOWA

A well-established, midwest multi-physician practice with strong hospital affiliations seeking FT podiatrist. Applicant should be well trained surgical physician, completed a 12/24 month residency, & board eligible. Practice offers high surgical volume, advanced wound care and good mix of general podiatry. Competitive salary, excellent benefits. Fax resume: 712-258-9977.

ASSOCIATE POSITION - FLORIDA

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

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 - 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 - 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

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.

PM News Classified Ads Reach over 14,000 DPMs and Students

Whether you have used equipment to sell or our offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 14,000 DPMs. Write to:bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $115 for a 50-word ad. THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451.

• To Post a message, send it to:    bblock@podiatrym.com
• Notes should be original and may not be submitted to other publications or listservs without our express written permission.
• Notes must be in the following form:
  RE: (Topic)
  From: (your name, DPM)
  Body of letter. Be concise. Limit to 250 words or less). Use Spellchecker
  Your name, DPM City/State
• Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.