KY Podiatrist Discusses Heel Pain

 

“Heel pain is the most common complaint I hear from patients, and it’s also one of the most frequently misdiagnosed and untreated,” said Dr. Nicole Freels, a Lexington podiatrist and owner of Lexington Podiatry. “This new specialty practice will enable us to focus on heel issues and help patients who have not walked comfortably in months, even years.”

 

Dr. Nicole Freels

 

According to Dr. Freels, many cases of heel pain are related to over-pronation, or the rolling inward of the foot when a patient walks. Other conditions that can cause heel pain include plantar fasciitis, heel spurs, Achilles tendonitis, tarsal tunnel syndrome, inflammatory conditions, Sever’s disease, stress fractures, and problems associated with obesity. 

 

Source: KyForward.com [1/11/12]

MD Podiatrist Sentenced for $1 Miilion Medicare Fraud 

 

A 56-year-old Gambrills podiatrist was sentenced to more than four years in prison Wednesday for fraudulently billing Medicare $1.1 million over three years, according to the Maryland U.S. Attorney's Office. The scheme marked the second time Dr. Larry Bernhard had defrauded the federal agency, according to court records. 

 

In 2007, he signed a settlement agreement with the government admitting he'd billed for services he didn't provide between 2002 and 2004, and promising to abstain from using federal health care programs for three years. But he immediately launched another scheme, stealing nursing home patient identities and submitting phony bills on their behalf.

 

Source: Tricia Bishop, Baltimore Sun [1/11/12]

Doctors Have to Manage Smartphone Distractions

 

Physicians are accustomed to dealing with interruptions of all kinds -- nurses with questions, phone calls from the pharmacy, incoming test results. With recent surveys showing that more than 80% of doctors carry smartphones and about a third use iPads or other tablet computers, some doctors are raising concerns about the capacity of these always-with-you devices to cause new distractions that could hurt patients.

 

Evidence of harm caused by mobile technology is sparse, but as more doctors pick up smartphones and drop work-only pagers, the potential for personal distractions is rising. Physicians are interrupted nearly five times an hour by phone calls, emails and face-to-face interactions, said a recent study in the Journal of Medical Internet Research.

 

Source: Kevin O'Reilly, AMNews [1/2/12]

Query: ADA and Deaf Patients

 

I understand that as doctors we need to accommodate the disabled. In the case of hearing-impaired patients, it is our cost to have an interpreter present. Is the doctor able to dictate what interpreter will be used or does the patient decide who will be interpreting? As far as the charge for the services of the interpreter, how is the appropriate fee set? It takes about twenty minutes for us to see a hearing-impaired patient. We are told from the interpreting service that it is their policy to charge us for a minimum of two hours.

 

Jon Purdy, DPM, New Iberia, LA

 

Editor's comment: PM News does not provide legal advice. The ADA does not specify who is to choose the interpreter, so you are free to negotiate an acceptable arrangement. If you have more than one hearing-impaired patient, it makes sense to schedule all such patients in a two-hour block of time. 

Query: Wood Laminate Flooring in the Office

 

Does anyone have wood laminate flooring for an examination room or perhaps throughout the entire office? What have been your experiences?

 

Arthur Lukoff, DPM, Ellenville, NY

Query: Diabetic Shoes - BK Amputation

 

I have a Medicare patient who qualifies for diabetic therapeutic shoes. She had a below-the-knee amputation previously performed on the right limb, and can't get fitted for her prosthetic leg until she has the shoes. The prosthetic/brace lab doesn't do diabetic shoes. We fitted her for a shoe on her remaining foot with heat-molded inserts. How does the shoe and insert for the amputated extremity get billed since that foot wasn't present at the time of fitting? 

 

James Hatfield, DPM, Encinitas, CA

 

Response: I suggest these options: 

 

A) Bill the shoe and inserts for the left foot on the date it was actually dispensed. 

B) Bill the right shoe on the date the patient receives the prosthesis and is fitted with the shoe. 

C) Call the DME MAC D and ask for a Tier II CSR or outreach and education representative to assist you with this issue. 

 

Paul Kesselman, DPM, Woodside, NY 

 

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RE: Multiple Verrucae in 4 Year Old Child (David Kahan, DPM)

From: Sloan Gordon, DPM

 

You may want to try cimetadine 20mg/kg per day in divided doses (I generally use BID). I'm not sure that you will find the liquid anymore as this is an OTC product. I have had some success with topical antivirals such as acycylovir, applied QID. There are some other medications that are topical anti-inflammatories that work, but I think you're on the right path. I would not freeze the warts as they may just subside on their own by keeping the feet clean and dry with a topical humectant (powder or corn starch).

 

Sloan Gordon, DPM, Houston, TX, sgordondoc@sbcglobal.net

RE: Study Showing Efficacy of Therapeutic Diabetic Shoes (Charles Perry, DPM)

From: Lee C. Rogers, DPM

 

The Medicare Therapeutic Shoe Bill of 1993 requires a medical doctor or doctor of osteopathy to certify that the patient has diabetes, is under a comprehensive management program, and needs the footwear. The MD or DO must also attest that the patient has one or more of the qualifying conditions. This is potentially problematic. You could inform the patient that the doctor is unwilling to sign the certification, and perhaps some insistence from the patient would help.  

 

I discussed with APMA President Dr. Michael King last week at the AAPPM Millionaires Seminar about how this requirement infringes upon the podiatrist's privilege to independently practice. Unfortunately, the language has to be revised legislatively to allow podiatrists to maintain independent practice and provide this needed service to their diabetic patients at risk for foot ulceration.

 

Lee C. Rogers, DPM, Los Angeles, CA, lee.c.rogers@gmail.com

RE: Charging for Paperwork (Michael J. Hodos, DPM)

From: David T. Taylor, DPM

 

Our practice was so bogged down with paperwork from employers, private disability insurance (e.g., AFLAC, etc.), we inquired with local internal medicine/family practice physicians to see what they charged. The market rate was $25. We started charging this a few years ago. We have had limited backlash from our patients.

 

David T. Taylor, DPM, Flint MI, dttaylor_19@yahoo.com

RE: Insurance Company Controls (Ira M. Baum, DPM)

From: Elliot Udell, DPM

 

The old saying "what goes around comes around" may be applying to the economics of medicine. Years ago, patients paid doctors and if they were lucky to have insurance, they got some of it back. Then, they went to HMOs, paid a higher monthly premium, but paid a small co-payment to the doctor. Recently, I went to my own doctor and my co-payment was fifty dollars, and the insurance company paid him less than five dollars. If this isn't a swing back to the days when we paid doctors cash, out-of-pocket, what is it? 

 

The only difference is that in the "good old days" when I would pay my doctor cash out-of-pocket for a visit, I was paying my insurance company less than three hundred dollars a month and got money back after a visit. Now, I am paying the insurance company close to six hundred dollars for the honor of paying my doctor out-of-pocket for his/her services. Something doesn't seem right with this scenario.

 

Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

PART-TIME PODIATRIST NEEDED - LOS ANGELES, CALIFORNIA 

ASSOCIATE POSITION - LAS VEGAS/HENDERSON, NV

Well-established 22 year practice in Las Vegas/Henderson, Nevada seeking full-time associate. General podiatric care with moderate amount of surgery to be done in local hospital or surgery center. Competitive salary and benefits. Modern office in new area. Please respond by email to:lvfootandankle@gmail.com

ASSOCIATE NEEDED - NORTHERN CINCINNATI, OHIO (FAIRFIELD)

Lead to partnership &/or buy practice. Well-established, reputable & successful (700K collection annual) 25+ year practice. Newer 2k sq.ft office condo & w/5 tx rooms, Aver.80 new patients monthly, full hospital privileges, DME, Padnet, digital x-rays. Inquires to email:gsherwood1@cinci.rr.com

ASSOCIATE POSITION - EAST TENNESSEE

30 year old practice with 5 offices in greater Knoxville area seeking ethical, personable, hardworking, team player. $160,000 base salary with bonus incentives and benefits. Post-residency experience a plus. Please send resume to ddavidphawk@yahoo.com

ASSOCIATE POSITION - TAMPA BAY

Well-established, dynamic multi-doctor practice in the Tampa Bay, high-tech with EMR and digital x-rays. Sports medicine, surgery and potential partnership. No NH/ HMOs. Excellent hospital privileges. Choose an area of practice concentration that you are passionate about and enjoy a lifestyle second to none. C.V. to flpodiatrist@tampabay.rr.com 

ASSOCIATE POSITION - NEW YORK

Well established, well rounded, hospital based podiatry practice, looking for well trained podiatrist. Large number of new patients monthly, digital x-rays, EMR, and vascular and nerve testing. One partner is Chair of Pod Dept, other is involved in wound center. Two offices 75 miles north of New York City, in the beautiful Hudson Valley. More affordable cost of living than Westchester County; it’s a great place to live. Looking to hire a personable individual with strong ethics and high motivation. Seeking an associate leading to potential partnership. Must have PM & S- 36 training. Please call (845) 471-2243 or email eriksims@hotmail.com.

ASSOCIATE POSITION - NAPLES, FLORIDA

Great opportunity for PSR- 24/36 BE/BC podiatrist with strong surgical skills to join multi-office practice. Hospital privileges available at 648 bed hospital system, 200 bed hospital system and multiple surgical centers. Candidate should have the skills and desire to perform rearfoot/ankle surgery. Florida has a great scope of practice law and we rotate for ER call. Candidate needs to be ethical and motivated. Established practitioner or new practitioner. In a cover letter tell me why you should be selected for the team. Email cover letter and CV with subject line "I am your new team member." to:  Drgordon@gulfcoastfootcare.com

PRACTICE FOR SALE - SOUTHERN CALIFORNIA (ORANGE COUNTY)

 

Strong & diverse local economy, in a beautiful beach community. Well rounded, established since 1983, fully equipped. Consistently grossing over $600K. Many types of insurance, reimbursement and revenue sources.  Local hospitals allow full scope of podiatric care. Terms available. Contact josephdpm@gmail.com

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 516 476-1815 PODO2345@AOL.COM

Laserscope Model Lyra i YAG Laser system with 3 hand pieces, eyewear sets, calibration unit, complete manual foot control and video information, for fungus nails, vein therapy and hair removal. The unit has the attached cooling system and all accessories $8,750.00. flpodiatrist@tampabay.rr.com

 

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