The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

January 05, 2011 #4,055 Publisher-Barry Block, DPM, JD

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CA Podiatrist Discusses Heel Pain

Do you have excruciating pain as soon as you wake up in the morning? Do you have the same pain when you walk or stand which makes you have to sit? If so, you suffer from a common complaint which afflicts a large number of adults. "It’s hardly surprising because the calcaneus is the largest bone in the foot, and the first to contact the ground. When you walk, it absorbs the weight of the body," says Dr. Michael Cornelison, a California podiatrist. "With advancing years, the plantar fascia, a thick connective tissue which joins the heel to the toes and supports the arch of the foot, loses its elasticity. Heel pain typically affects one heel first and then the other, generally as a result of compensation," says Cornelison.

Dr. Michael Cornelison

"The first line of treatment is to rest your foot and avoid walking as much as possible. However, if the pain recurs or persists, you should visit a podiatrist for a proper diagnosis because heel pain can be caused by a number of reasons where the symptoms appear to be similar," says Cornelison.

Source: Healthcare and Hospital News [1/3/11]

CA Podiatrist Appointed to State Board of Podiatry

Governor Arnold Schwarzenegger today announced that Dr. Karen Wrubel, 53, of Rancho Palos Verdes, has been re-appointed to the California Board of Podiatry, where she has served as a member since 2007. She has been owner and podiatrist of Far West Podiatry (formerly known as Karen Wrubel Podiatry) since 1985.

Dr. Karen Wrubel

Wrubel is a member of the American Podiatric Medical Association, California Podiatric Medical Association, Los Angeles County Podiatric Medical Society, American College of Foot and Ankle Surgeons, American Professional Wound Care Association, Hear My Voice, and the California Podiatric Medical Association Governmental Affairs Committee. This position does not require Senate confirmation, and compensation is $100 per diem.

Source: Media-Newswire.com [1/2/11]

ACFAS Extends Eary Bird Registration for Annual Meeting

The “early bird” registration deadline (for discounted fees) for the  March 9-12 American College of Foot and Ankle Surgeons (ACFAS) Annual Scientific Conference in Fort Lauderdale, FL has been extended to January 11. 

DPMs can register today and book hotel rooms by clicking here.

CA Podiatry Group Collects 300 Pairs of New Socks for the Needy

Mark Wolpa, DPM and staff collected over 300 pairs of new socks, which were then distributed to homeless shelters in the Bay Area in December.

Dr. Mark Wolpa and Staff

"The sock drive entitled "Save Our Soles" was a huge success, thanks to our patients who responded when asked to bring in a new pair of socks for the less fortunate." said Dr. Wolpa.

Query: Concrete Floors and Plantar Fasciitis

I recently treated a patient for plantar fasciitis/heel spur syndrome. I then received a letter from an attorney asking me to opine as to how her work activities (standing on a concrete floor as a waitress for 13 years) could have been a cause of her condition within a reasonable degree of medical certainty. I suspect she is applying for disability. Could anyone direct me to a study that either supports or diffuses the theory that long periods of standing on concrete cause plantar fascitiis?

Name Withheld

Query: Contact Management Software
 
I am looking for a software program that can store all of our office contacts (suppliers, consulting physicians, hospital contacts, anything except patient information). However, I want to have one central database so that if one person enters the information, all work stations can access it. In  addition, I need the database to be available to approximately 10 workstations. Microsoft has a business contact manager in Outlook, however, it is only good for 5 workstations. File Maker Pro is a good program but costs $270 per work station. What other programs have  people used for this purpose?

Ken Meisler, DPM, NY, NY

RE: Undiagnosed Diffuse Skin Lesions (Elliot Udell, DPM)
From: Simon Young, DPM

We know that most of our biopsy results show no pathology. Using clinical visual observation of a potentially malignant lesion is as reliable as the last contract that I DIDN'T sign. Dr. Udell never confirmed whether the original diagnosis of his punch biopsy was correct when he totally excised his patient's pigmented lesion.

I recently read a biopsy report which stated that there was a potential malignant lesion. When I spoke to the pathologist and forwarded a photo, an amended report for a benign lesion was sent back to me. It continues to be of paramount importance to send as much information to the pathologist or radiologist when requesting an opinion or diagnosis.  All this information is truly needed.

Simon Young, DPM, NYC, simonyoung@juno.com

Query: Which Provider to Bill Under?

Dr X goes on vacation, but prescribes a DME (e.g., diabetic shoes, orthotics, brace, etc.) before leaving. Dr Y is covering for Dr X, and dispenses the item above when it arrives (whether it's Medicare or another insurance). Which doctor submits the claim, the prescribing or the dispensing physician? Both doctors are in the same practice.

Nancy, Office of Michael Carroll, DPM, Greenwood, IN

Response: I am assuming that if the doctors are in a group practice, they are billing under a group practice tax identifier (corporate tax ID). That being the case, it is Dr. X who prescribed and ordered the DME item, and Dr Y who is the rendering supplier. It is, therefore, Dr. X's name and NPI which appears in boxes 19 and 19A, and Dr Y's which appears in Box 24J. The PTAN and NPI of the group practice would be placed in 33 and 33A.

Since the physicians are in group practice and billing under the same tax ID, this would be acceptable. However, if they were not in group practice, and Dr. X was in a different office than Dr. Y, and Dr. Y dispensed a DME item prescribed by Dr. X, Dr. Y would require a surety bond and facility accreditation.

Paul Kesselman, DPM, Woodside, NY

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RE: Practice Fusion (Steven Frydman, DPM)
From: Joshua Kaye, DPM

About a year ago, I evaluated Practice Fusion in-depth. I decided against using Practice Fusion for similar reasons that I did not select other EMR companies. Practice Fusion does not allow independent back-up. It is important to remember that once you convert your paper medical records to a digital version, an easily accessible backup is critical. There will be no paper files. It may be comforting to know that your medical records are backed up "in the clouds", which means the Internet. However, what happens if your EMR company goes out of business, is sold to another organization, or decides to triple their monthly charge? Are your records stored in a commonly used format such as .pdf, or are they in a proprietary format that is only owned by that particular EMR company?

The best back-up system combines both a cloud back-up and an office external hard drive back-up. Test your back-up periodically to be sure you can read the contents independent of your EMR software. You can also create your own additional independent back-up using a system such as Mozy or Carbonite for a cost of about $5 per month. We spend a great amount of time and money documenting our medical records to protect ourselves and our patients. Imagine for a moment if we could not quickly and easily access those records.

Joshua Kaye, DPM, Los Angeles, CA, jk@joshuakaye.com

From: RE: X-Ray Comparison (Martin R. Taubman, DPM, MBA)
From: Jeffrey Kass, DPM, Bob Saltzman

I think that Dr. Taubman's posting is unfair. I have digital x-rays and while I love having them, I do not see how I make as much money as with a wet system. To me, the benefits of the system are - a perfect development each time without the need to worry if my wet system has been cleaned of late, etc. I like that I can e-mail films for a second opinion with ease, etc. However, when I do the math - on purely monetary levels, I come out on the shorthand. I don't buy the time efficiency either, as my wet developer had film out in almost the same time, a minute difference is not really going to make a difference. At least not in my practice, because as the film is processing, I am busy taking a second view.

I pay $850 for software support a year, this does not include any hardware support for which the company wanted something like $4,500 a year. So, in the event of a hardware failure, I would have to pay as I go. I agree with the posting a few days ago, better to make the investment on a modality that will bring in income. (Assuming your wet developer is giving you good reliable films)
 
Jeffrey Kass, DPM, forest Hills, NY,  jeffckass@aol.com

On the “heels” of Dr. Taubman’s comments and great insight regarding digital x-ray conversions, I see this topic has shifted from the original query asking about comparisons of digital x-ray systems to an analog vs. digital cost justification, therefore allowing me to respond without it sounding like a sales pitch. I have devoted my career to medical imaging and have seen many aspects of this industry evolve, but none in comparison to electronic imaging (digital x-ray).

As all of my competitors would agree if given the chance,... 
 
Editor's note: Mr. Saltzman's extended-length letter can be read here.

RE: The Passing of John Carson
From: John E, George, DPM

I was saddened to hear of the passing of John Carson. I am sure I speak for many APMA past-presidents when I say that John was responsible for many of the professional advantages we now share. He will be missed. May he rest in peace.
                                    
John E. George, DPM, Worcester, MA

ASSOCIATE  POSITION - SOUTHEAST FLORIDA

Southeast Florida practice seeks PMS-36 graduate for associate position. Candidate should posses strong work ethic, motivation and excellent interpersonal skills. He/She should be comfortable in multiple clinical settings and all aspects of foot and ankle surgery. Competitive salary, benefits, incentive structure.
Reply to petaldaisy@gmail.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. Applications due by Jan 31st.

ASSOCIATE POSITION - BOSTON

CPME Board certified podiatrist wanted to join Orthopedic & Arthritis Center at Brigham & Women’s Hospital, Boston, MA. The position is per diem, 2 days/ week. Interested candidates should send their CV to: Brenda Surowiec, Orthopedic & Arthritis Center, 75 Francis Street, Boston, MA 02115. Or email to bsurowiec@partners.org

ASSOCIATE POSITION - NEW YORK CITY
 
One of the fastest growing podiatry practices in New York City and Queens seeks a podiatrist who participates with HealthFirst, Fidelis, and other Medicaid plans. Preferably a Spanish speaking podiatrist. Contact me at Podocare@aol.com

PART-TIME / FULL-TIME PODIATRIST NEEDED ASAP - CHICAGO

Part-time podiatrist needed for 2 offices in Chicago with an average of 20 hours/week. Must have Illinois license. Must have completed 2 years of surgical residency. If qualified, email to: A-Storjohann@footexperts.com

ASSOCIATE POSITION - CHICAGO

Weil Foot & Ankle Institute, Des Plaines, IL (www.weil4feet.com) is seeking associate position in summer 2011. This 15 member podiatric medical and surgical group is internationally acclaimed. Twelve locations throughout Chicagoland, with a 3 operating room surgery center, MRI’s, computerized footprint analysis, orthotic and brace laboratory, radiofrequency coblation technology, extracorporeal shockwave devices, PRP and clinical research program. Successful candidate will have completed a 3-year residency, experience in wound care, trauma, and sports medicine. Competitive salary, bonuses commensurate with experience and training. E-mail letter of interest and CV to Harriet Kass, HR, hkass@weil4feet.com 847-390-7666

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

Douglas Richie, DPM is seeking a well-trained, motivated podiatric physician to join his two office practice located in North Orange County, California. Applicants must have completed a 3-year residency program and must have exceptional skills in reconstructive foot and ankle surgery, sports medicine and podiatric biomechanics. This is a salaried position with a goal of long-term buy-in for equity ownership. Send letter of interest and CV to drichiejr@aol.com

PART-TIME/FULL-TIME PODIATRIST NEEDED - INDIANA

Part-time full-time Podiatrist needed for our Indiana offices. Must have Indiana license. Must have completed two years of surgical residency. If qualified email to f-massuda@footexperts.com

PRACTICE FOR SALE- MARYLAND, DC SUBURBS 

Be an owner not a worker. Well established and equipped practice for sale. Office includes state licensed Ambulatory Surgical Center. Present owner is retiring but will stay on as needed for smooth transition. Average gross over past 3 years is $575 K. dpmpracticeforsale@yahoo.com

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