The Voice of Podiatrists

Serving Over 10,600 Podiatrists Daily

January 12, 2008 #3,139 Editor-Barry Block, DPM, JD

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Subtalar Implant Can Reduce Flatfoot Pain: NY Podiatrist

Dr. Stuart Mogul, a Manhattan podiatrist says the problem with flatfeet actually begins in the ankle. “People with flatfeet rely on the posterior tibial tendon to provide support for the collapsed arch, which results in inflammation of the tendon” says Mogul.

Dr. Stuart Mogul

When anti-inflammatories and orthotics don’t work, Mogul inserts a small titanium implant into the foot. “During the surgery, a small 1 cm. incision is made and the implant is inserted. The subtler implant acts as a “doorstop” to limit motion and reduce pain” says Mogul.

“This potentially avoids reconstructive rearfoot surgery, which can be quite debilitating, says Mogul.

Source: Sapna Parikh, Fox 5 News [1/8/08]

IL Podiatrist Wants Case Dismissed For Lack Of Report

A podiatrist is asking Madison County Circuit Judge Nicholas Byron to dismiss a medical malpractice suit against him because the plaintiff attorney failed to file a written report from a health care professional detailing the cause for filing suit. Shelia Kelly filed the suit against Alan Gitersonke, D.P.M., alleging she had to have her right leg amputated below the knee because of an infection after a bunionectomy Gitersonke performed.

Kelly claims Gitersonke performed the procedure on Jan. 22, 2007, in order to treat a bunion on her right foot. According to Kelly, Gitersonke violated his duty to possess and employ knowledge and use the degree of skill and care necessary in the proper diagnosis, care, and treatment that is ordinarily used by members of his profession and specialty. She also claims he negligently failed to use appropriate diagnostic tools to properly diagnose her condition, failed to identify and treat in a timely fashion an infection which causally related to the amputation of her foot and leg.

But Gitersonke wants Byron to dismiss the suit arguing that under 735 ILCS 5/2-622 a plaintiff must file a copy of the written report from the reviewing health care professional which identifies the professional's name, address, current license numbers, and states of the license numbers. "This report must also clearly identify the plaintiff and state the reasons why the health care professional believes there is a basis for filing the action," the motion to dismiss states.

Source: Steve Gonzalez, Madison County Record [1/10/08]

Supreme Court Won’t Hear Peer-Review Case

The U.S. Supreme Court has declined to review a case that hospitals hoped would clarify whether federal courts must defer to state laws protecting the confidentiality of peer review. The 11th U.S. Circuit Court of Appeals ruled in June that peer-review records should be fair game for a urologist attempting to prove he was the target of racial discrimination at 186-bed Houston Medical Center in Warner Robins, GA. Houston appealed to the Supreme Court.

No federal law provides a privilege for hospital peer-review, but all states have laws that protect the confidentiality hospitals say they need in order to foster the participation and candor crucial to identifying and addressing mistakes.

Source: Gregg Blesch, Modern Healthcare [1/10/08]

Query: MicroVas

Does anyone have any experience with the MicroVas from Neurovasix? Is it therapeutic and is it profitable? The unit costs $15,000 and runs about $350/month on a lease. I do not have a lot of information on it and was hoping to hear from some people who have been using it for more than six months. What are the pros and cons?

Peter J. Bregman, DPM, Tewksbury, MA, Footdoc@PAINFREEFEET.COM

Query: Capsulorrhaphy Coding

How would I code a capsulorrhaphy (suture of joint capsule) on a patient who also had a bunionectomy?

Susan Doerner, Office of Richard Goldstein, DPM, New York, NY

Response: The performance of a capsulorrhaphy is included in the global allowance of the bunionectomy procedure. No additional CPT code is warrented; no additional payment is due.

Mark Schilansky, DPM, Catskill, NY

Dr. Schilansky will be a featured speaker at the Codingline NYSPMA "Strictly Coding*" Seminar on January 24, 2008. Click on www.codingline.com/events-ny.htm for details and registration information.

Codingline subscription information can be found at:
http://www.codingline.com/subscribe.htm

RE: Windswept Toe Deformity (Tip Sullivan, DPM)
From: Thomas Graziano, DPM

Windswept Deformity Submitted by Tip Sullivan, DPM

Crossover toe deformity has always been notoriously difficult to treat effectively. The key in correction is really the 2nd ray. It is the most stable metatarsal/cuneiform component. Examples of this stability are seen when it undergoes hypertrophic changes in the face of a hypermobile 1st ray. It also is the cornerstone of the met/cuneiform region if broken allowing LisFrancs' injuries to progress.

To that end one must address the 2nd metatarsal with a decompression osteotomy to remove its influence and allow the 2nd toe to "seat itself" in front of the metatarsal head. Soft tissue releases are an integral part of the correction as well as plantar plate transposition if necessary. I always combine an interphalangeal arthrodesis with the metatarsal osteotomy. If you don't you may find that the toe will drift dorsally in time. I once did a study on approximately 50 cases, mapping out a stepwise intra-operative approach. You can find it in Clinics of Podiatric Surgery. Graziano, T.A.: Correction of Crossover Second Toe Deformity. Clin. Poditar. Med. Surg. 13 (2): 269-78, 1996


Thomas Graziano, DPM, Clifton, NJ, TGrazi6236@aol.com

PART-TIME PRACTICE FOR SALE - FLUSHING, NY

40 year old part time practice for sale. Priced for quick sale. Please contact me at footdoc60@gmail.com. Serious inquires only, please

ASSOCIATE POSITION- KANSAS CITY, MO

Excellent opportunity for a hard working, ethical podiatrist to join a vibrant, successful and growing podiatric medical and surgical practice. Dedicated, supportive staff with strong marketing and medical knowledge. Must be board eligible/certified. PSR/24. Partnership opportunity. Competitive salary, bonus structure, benefits. Wonderful place to raise a family. Fax CV to 816-455-8901

ASSOCIATE-TO-PARTNERSHIP OPPORTUNITY NEW HAMPSHIRE

Established practice located 1 hour north of Boston in tax-free New Hampshire is seeking a well-trained graduate of a 24-month surgical/general podiatry residency. This is a practice with a nice mix of surgery, biomechanics, injuries, diabetic and general care. No nursing homes. Very modern office with EMR, US, excellent referral base, and a well-trained staff. E-mail inquiries howardbon@aol.com

ALTERNATIVE PATHWAY TO BOARD CERTIFICATION PETITION

I am seeking to gather the names of my fellow podiatrists who are being denied the opportunity to sit for the board certification exams and would like to join my efforts to petition our leadership for a fair alternative within the system. To join this effort, please email your name and contact information podiatrydoc@gmail.com

Outcome Medical, (see our ad in Podiatry Management) is looking for reps to call on podiatrists and primary care physicians to market our pain program. Our FDA-cleared technology for pain and circulation is currently used by hospitals and doctors throughout the country. We provide training and technical support. On staff, certified billing, coding, and compliance specialist. Attractive commissions and leads furnished Website, www.outcomemedical.com. Request our representative package by email @ don@outcomemedical.com phone, 770-487-0029; Fax 770-692-0116

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