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PMNews
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| PM News | |
The Voice of Podiatrists
Serving Over 17,250 Subscribers Daily
January 15, 2016 #5,578  Publisher-Barry Block, DPM, JD
A partner of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2016- No part of PM News can be reproduced without the
written permission of Barry Block
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| PM NEWS QUICK POLL |
Quick Poll
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Should Dr. Scholl's be allowed to advertise "custom-fit orthotics"? |
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| PODIATRISTS IN THE NEWS | |
Pitted Toenails Could Indicate Psoriasis: MD Podiatrist
If you notice pitted toenails, it could be psoriasis. If you find tiny holes, grooves, or ridges in your toenails, you may have nail psoriasis. Though most people who experience nail psoriasis also have skin psoriasis (an autoimmune disease that makes skin patchy and irritated), 5 percent of people with nail psoriasis aren’t affected elsewhere.
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Dr. Gary Pichney |
"If you’ve never been diagnosed with psoriasis, but your toenails have little pits in them, you should get them checked out," says Gary A. Pichney, DPM, a podiatric surgeon of The Institute for Foot and Ankle Reconstruction at Mercy Medical Center. Other symptoms include white patches and horizontal lines across the nails. To treat psoriasis, your doctor may prescribe topical creams or steroids to be injected under the nail.
Source: Kelsey Kloss, Readers Digest
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| FROM PM's CURRENT ISSUE | |
Twice a week, PM News posts an entire article from a recent issue of our partner, Podiatry Management Magazine. Please note that the views expressed in Podiatry Management Magazine do not necessarily reflect the views of PM News or Barry Block.
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Today's featured article |
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| DERMATOLOGY RESEARCH | |
Empirical Terbinafine for Nail Fungus Is Most Cost-effective
Empirical treatment of onychomycosis with terbinafine is far more cost-effective than confirmatory testing before treatment, according to new findings. Confirmatory testing would cost millions of dollars per clinically relevant case of liver toxicity prevented, Dr. Arash Mostaghimi of Brigham and Women's Hospital in Boston and colleagues found.
"As the cost of the medication has been reduced, the amount of money that you'd have to spend in order to prevent a case of liver injury is prohibitively high," Dr. Mostaghimi told Reuters Health in a telephone interview. "What we know now over time is that the risk of liver injury is much smaller than we thought it was."
Source: Anne Harding, Reuters Health via Medscape [1/14/16]
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| MEDICARE NEWS | |
Meaningful Use Will Likely End in 2016, CMS Chief
The meaningful use program is on the cusp of major changes, the Centers for Medicare and Medicaid Services Acting Administrator Andy Slavitt said late Monday, adding that 2016 would likely see the end of the program altogether.
The Medicare Access & CHIP Reauthorization Act of 2015, with its emphasis on a new Merit-Based Incentive Payment System and alternative payment models, demands a new streamlined regulatory approach, he said, speaking at the J.P. Morgan Healthcare Conference in San Francisco. While offering few specifics, Slavitt said CMS "will be putting out the details on this next stage over the next few months."
Source: Mike Miliard, Healthcare IT News [1/12/16] via Dr. Steven Tager
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| QUERIES (CLINICAL) | |
Query: Tailor's Bunionectomy - Standard of Care
Over the years, I used a variety of different surgical approaches for this common problem. I have generally been dissatisfied with a simple ostectomy. I have seen good and long-lasting results with distal osteotomies. I generally avoid 5th metatarsal base osteotomies. I generally perform a chevron or "reverse Austin" osteotomy with Orthosorb fixation (single tapered pin). I am interested in other fixation options for this procedure. I am also interested to hear what other procedures my colleagues are performing for the tailor's bunion deformity with good and durable results.
Greg Caringi, DPM, Lansdale, PA
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| QUERIES (EMR) | |
Queries: Meaningful Use Penalties
RecentIy, I received a letter from CMS letting me know that as an eligible professional, I did not demonstrate meaningful use for reporting period for 2014 or 2015. They were very nice to let me know I will get slammed another 2% on top of PQRS and electronic Rxs from 2012. Then they let me know that if I don't continue to meet meaningful use for future years, I'll get slammed even more. Soon, I will be writing out checks to CMS when a Medicare patient walks into my office.
For those of us who were smart enough to never get involved with EMR, are they getting all of the same penalties? Do the non-users get more or less penalties? If I were to let CMS know that I no longer want to be an eligible professional for meaningful use, do the penalties stop? We tried to talk with CMS the other day to get some answers and after 3 hours on hold, we somehow got disconnected.
Brian Zale, DPM, Sugar Land, TX
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| RESPONSES/COMMENTS (NEWS STORIES) - PART 1A | |
From: Lee C. Rogers, DPM
There are serious flaws which discredit the Fedorko hyperbaric oxygen study on amputations.
1. The primary endpoint was amputation. However, the patients in the study did not actually have real amputations. They only met the criteria for an amputation (BKA or metatarsal level) as determined subjectively by a single vascular surgeon. Furthermore, the vascular surgeon did not actually examine the patients, only the photos and chart notes, and subsequently made a recommendation of amputation.
2. The secondary endpoint was wound healing. The authors included 46 of the 103 patients who had Wagner Grade 2 ulcers. There is no scientific basis for using hyperbaric oxygen on Wagner Grade 2 ulcers. It is not an indication for HBO treatment in the U.S., and most will heal with good conventional therapy alone. Therefore, if you put a bunch of patients into a study that do not require a treatment, you cannot expect the treatment to work. And oddly, the authors considered a wound healed if it had a Wagner Grade 0 or 1 ulcer. I don’t know any patient who considers their Wagner Grade 1 ulcer healed.
Disclosure: Dr. Rogers is medical director of the Amputation Prevention Centers of America, a division of RestorixHealth, which manages 130 wound healing and hyperbaric centers in 24 states.
Lee C. Rogers, DPM, Los Angeles, CA
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| RESPONSES/COMMENTS (NEWS STORIES) - PART 1B | |
From: Ira Baum, DPM
"HBOT does not offer an additional advantage to comprehensive wound care in reducing the indication for amputation or facilitating wound healing in patients with chronic DFUs." A summary of an article by Fedorko L, et al. Diabetes Care 2016 is another research article that will become part of EBM that will negatively impact HBOT, a treatment that has benefited both patients and reduced comprehensive cost of amputation. This is because, like many other R&D articles, there may be variables that may not have taken into consideration such as previous vascular or endovascular reconstruction that failed to heal the wounds (In all fairness, I did not read the entire article).
Without blood flow to an area, there is little chance HBOT will have any benefit as demonstrated in the article by Grolman Re, et al. (Am Surg. 2001 Nov Transcutaneous oxygen measurements) which predicts a beneficial response to hyperbaric oxygen therapy in patients with non-healing wounds and critical limb ischemia. "An increase of tissue O2 tension of > or =10 torr when breathing pure O2 suggests that the patient may benefit from HBO therapy. Those patients with an increase of <10 torr are unlikely to receive benefit from this treatment modality." This article will give third-party payers more fodder not to pay for a service that under the correct circumstances could benefit patients and save lives and money.
Ira Baum, DPM, Miami, FL
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| RESPONSES/COMMENTS (NEWS STORIES) - PART 2 | |
From: Edwin Oghoorian, DPM
I have to strongly disagree with Dr. Sherman regarding his comment that non-citizens shouldn't receive government aid because they don't pay taxes. In fact I find it insulting for immigrants like myself. My family migrated to the U.S. in 1979 legally with a visa and applied for a green card which we got in 1980. From day one of arriving here, my family (including the children) received a social security number and worked and paid taxes. I also worked from the age of 14 and paid taxes including Federal income tax, social security tax, Medicare, disability, state tax, and every other tax that a citizen pays as well. Both my parents and I worked hard and paid for me and my brother's and sister's education.
I'm sorry to say but it is ignorant to think that every non-citizen doesn't pay taxes. Don't confuse us with illegal aliens who do not have social security numbers and have no documentation to work legally in this country and thus may not pay taxes. Those who are non-citizens doesn't mean they don't pay taxes and should not receive government aid.
I think before posting such inflammatory comments here, one should check their facts first. There is a huge difference between "non-citizen" legal residents and those who are "undocumented." You seem to have no problems accepting the Medicare payments that those so called non-citizens paid into the system but you don't want them to get any government benefits? Shame on you.
Edwin Oghoorian, DPM, San Dimas, CA
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| YOU CAN'T MAKE THESE THINGS UP | |
RE: Outrageous Shoe of the Day
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What to wear when watching Willie Wonka? |
Source: Ute Faber via Virtual Shoe Museum
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MEETING NOTICES
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NEED CME CREDITS FAST?
PODIATRY MANAGEMENT'S AFFORDABLE ONLINE CME
You can Earn up to 50 CPME-Approved CME Contact Hours Online
Earn 15 Contact Hours only $210
(Only $14 per credit) http://www.podiatrym.com/cme.cfm
All required credits can be taken online for AL, AK, AR, CA, CO, CT, DE, HI, IN, KS, KY, LA, MA, ME, MD, MI, MN, MI, NV, NJ, NM, ND, OH, OR, RI, SC, SD, UT, VA, WV, WI, & WY
Partial required credits can be taken online for AZ, CT, FL, GA, ID, KY, IL, IA, MO, MT, NE, NH, NY, NC, OK, PA, PR, TN, TX, VT, WA, and DC
Choose any or ALL from 30+ CME Category-1 articles posted
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| CLASSIFIED ADS - PART 2- ASSOCIATE POSITIONS AND FELLOWSHIPS |
ASSOCIATE POSITION - CENTRAL NJ
We are seeking a qualified Part Time or Full Time podiatrist for our office. We're a busy podiatry office with locations in Central NJ. The office has been in practice for over 25 years and has great reputations in its communities. The ideal doctor will be comfortable participating in community services such as health fairs, educational lectures and complimentary screenings. The office will provide you with every tool needed for your success such as treatment protocols, peer networking groups, as well as a full time marketing person. We're looking to hire immediately. Email jessica@stopfootpainfast.com
POSITIONS AVAILABLE - FULL TIME/ PART TIME WISCONSIN
Opportunities to serve residents of long-term care facilities in Madison and Eau Claire areas of Wisconsin. High earning potential with competitive benefits as part of a 40 year old company for the right candidates. Contact ckestner@preferredpodiatry.com for additional information.
ASSOCIATE POSITION – NEW YORK CITY / NEW JERSEY
Highly ethical and motivated practitioner sought. Experienced, assertive, podiatric surgeon wanted. All aspects of forefoot, rearfoot, and ankle surgery. Board qualified or certified. Please send C.V. to bunioncenter135@yahoo.com
ASSOCIATE POSITION – ILLINOIS
Carle Physician Group with over 400 physicians in Urbana-Champaign, Illinois is seeking an additional office-based, non-surgical BE/BC Podiatrist to join our 15 member Orthopaedic Department; employed model, Monday through Friday practice with no call; large built-in referral network; Big 10 University city; email CV to Karen.uden@carle.com.
ASSOCIATE POSITION - SOUTHERN CALIFORNIA
Very busy practice seeking a full-time, self-motivated and hard-working podiatry associate. Competitive salary offered. Please email CV to: podiatrists@icloud.com
ASSOCIATE POSITION - WESTERN PHILADELPHIA SUBURBS
Multi doctor group has an associate position available to join our busy practice. Candidate must have a minimum PMSR/36 with RRA training. Our practice is extremely diversified with all aspects of podiatry including wound care. If you are well trained, outgoing, personable and would like to join our team, please e-mail a cover letter and your cv to joinourgroup2016@gmail.com
ASSOCIATE POSITION AVAILABLE - CALIFORNIA
Busy three office practice in Santa Cruz County, California seeking new associate. Must be BQ or BC. Full scope of patient care. Competitive salary, and health insurance. Come join us on the beautiful California coast. Please forward cover letter and CV to skyandellie@yahoo.com.
ASSOCIATE POSITION - OHIO
Well-established group practice in Ohio seeks a well-trained surgeon, PSR24/36. Our practice provides all of the latest technology needed to provide patients with the best care, including ultrasound, lasers, PAD testing, DME, EMR and digital x-ray. Competitive compensation package including salary base $120,000 and bonus. Please send CV to: DPMgroup1@yahoo.com
ASSOCIATE POSITION - TEXAS - DALLAS SUBURBS
Seeking well rounded individual to join our well established, modern practice. Surgery, orthopedics, wound care, primary care and sports medicine. Very competitive salary with bonus structure and benefits. Early partnership opportunity for the right person. This is a rare opportunity. Please send letter of interest and CV to: Podiatrysbest@gmail.com
ASSOCIATE POSITION - UPSTATE SOUTH CAROLINA
Established practice seeking ethical, skilled, hard working associate in summer 2016. Must be BQ(or BC) ABFAS and 3 year residency trained. Competitive salary and benefits with bonus and early partnership opportunities. Should have strong interest in advanced wound care. Great location and community. Forward cover letter and CV to: scsoledocs@gmail.com.
IMMEDIATE ASSOCIATE POSITION - INDIANAPOLIS, INDIANA
Available in busy three office practice Leading to Partnership. Position available for graduate in 2016. Two locations in Indianapolis and 1 location outside of Metro area. Competitive salary and benefit package including 401, profit sharing, Health insurance. Surgery Center Ownership Available If interested forward letter and resume to Imalament1@comcast.net
FELLOWSHIP – DIABETIC FOOT & WOUND (TEXAS)
One position for a 12-month TMB-approved Diabetic Foot and Wound fellowship beginning July 1, 2016. Candidate must have completed a podiatric residency/plastic surgical residency/general surgery residency and be eligible for Texas Medical License. Training involves all aspect of diabetic foot management. Curriculum focuses on surgical limb salvage, and medical management of the complex wound patient. Interested candidates should email their CV, personal statement and 3 letters of recommendation to latonya.rosales@utsouthwestern.edu. UT Southwestern is an Affirmative Action/Equal Opportunity Employer. Women, minorities, veterans, and individuals with disabilities are encouraged to apply.
PM NEWS CLASSIFIED ADS REACH OVER 16,500 DPMs AND STUDENTS
Whether you have used equipment to sell or are offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 16,500 subscribers. For details,click here or write to:bblock@prodigy.net or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at (800) 284-5451.
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| CLASSIFIED ADS PART 1 - PRACTICES FOR SALE OR WANTED, EQUIPMENT FOR SALE |
PRACTICE FOR SALE – CENTRAL FLORIDA
Practice available in a small town in Central Florida. Podiatrist retiring. Was full 4 day practice but now 2 days due to illness. Easily expanded. Same location over 30 years. Surgical and hospital privileges available but not required. Purchase equipment and assume patient care . Send inquiries to: DDave9388@aol.com
PRACTICE FOR SALE - BRITISH COLUMBIA, CANADA
Have you ever dreamed of owning a practice where you can see 0-50 patients daily, average 100 new patients monthly, have zero accounts receivable, gross $440K per year, live in a beautiful community with skiing, hiking, fishing and boating on your doorstep? Contact pistone@telus.net or call 250-754-4192.
PRACTICE FOR SALE – PENNSYLVANIA
Great opportunity for a new practitioner to step into a busy group practice with one doctor retiring. Practice is well established with a good mix of RFC, rearfoot and forefoot surgery, wound care, and diabetic foot care. Full EHR implementation. Practice is in a medical office building with many specialties providing an excellent referral base. Great small town to work in and raise a family. Approx 45 minutes to Baltimore Owner willing to finance and stay during transition. Contact: papodiatry616@gmail.com
PM NEWS CLASSIFIED ADS REACH OVER 16,500 DPMs AND STUDENTS
Whether you have used equipment to sell or are offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 16,500 subscribers. For details,click here or write to:bblock@prodigy.net or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at (800) 284-5451.
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| Disclaimers |
Acceptance and publication by this newsletter of an advertisement, news story, or letter does not imply endorsement or approval by Barry Block or Kane Communications of the company, product, content or ideas expressed in this newsletter. Podiatric Medical News does not represent the views, and is a separate entity from Podiatry Management® Magazine and Podiatry Management® Online. Any information pertaining to legal matters should not be considered to be legal advice, which can only be obtained via individual consultation with an attorney. Information about Medicare billing should be confirmed with your State CAC.
THIS MESSAGE IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR
ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS
PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE.
If the reader of this message is not the intended recipient or an
employee or agent responsible for delivering the message to the
intended recipient, you are hereby notified that any dissemination,
distribution, or copying of this communication is strictly
prohibited. If you have received this communication in error, please
immediately notify me and you are hereby instructed to delete all
electronic copies and destroy all printed copies.
DISCLAIMER: Internet communications cannot be guaranteed to be
either timely or free of viruses.
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