The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

January 16, 2010 #3,755 Publisher-Barry Block, DPM, JD

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TUSPM Podiatrist Discusses Athlete's Foot Prevention

Athlete's foot and warts are highly contagious, and can be passed through direct contact, or contact with items such as shoes, stockings, and shower or pool surfaces. The infections can be picked up through small breaks in the skin of the bottom of the foot.

Dr. Tracey Vlahovic

In order to stop the spread of germs and viruses that cause both of these, Dr. Tracey Vlahovic, DPM, associate professor of podiatric medicine and orthopedics at Temple University’s School of Podiatric Medicine, suggests keeping your feet clean and dry. While socks are essential for people with diabetes, don’t wear dirty socks. Also, be sure to thoroughly clean your bath or shower area. “If one person in the household has it, everyone should be cautious and take proper precautions,” said Dr. Vlahovic. And if you must use a public shower, make sure to wear flip-flops to protect your feet. If you do develop an infection, see your doctor for proper treatment.

Source: DLife [1/15/10]

TN Podiatrist Publishes First Novel

Every unwed mother’s nightmare comes to life in the pages of Invasion of the Baby Daddy, a debut novel that echoes the emotional and cerebral frustrations of unwed mothers throughout the ages. Author Dr. John Bell, A U.S. Navy Gulf War veteran, who hosts his own program on KWAM here in Memphis, has the novel’s characters and story line interwoven with current and real facts about the volume of unwed mothers in the U.S. today.

Dr. John Bell

Dr. Bell, who has a master’s degree in Health Services from Strayer University and a doctorate of Podiatric Medicine from Ohio College (Cleveland), draws upon his own experiences to spice Invasion of the Baby Daddy with candor and detail.

Source: Tri-State Defender [1/14/10]

MO Podiatrist Pleads Guilty to Healthcare Fraud

A podiatrist from Webster Groves pleaded guilty Thursday to a federal obstruction of justice charge and admitted creating fake medical records after learning that he was under investigation for healthcare fraud, the U.S. Attorney’s office said.

Prosecutors say Dr. David Quang Pham, 50 also billed Medicare and Missouri HealthNet for foot care on patients who’d had their feet amputated, sent bills for caring for nursing home patients on days that they weren’t there and allowed an unqualified employee to care for patients.

Source: Robert Patrick, St. Louis Post-Dispatch [1/14/10]

Query: Ankle Exostosis

I have a 52 year old active male patient who presented with pain over the tibial malleolus, 1-2 years in duration. Most of his discomfort occurs while skiing. Clinically, there is a considerable enlargement of the malleolus. X-rays show an enlarged distal fibula with hyperexostotic bone. The medial gutter of the ankle is not involved.  There is no direct antecedent trauma, although a healing fracture is my number one rule out.

Ankle Exostosis

I gave him three options: 1. surgical remodeling of the distal tibial malleolus.2. A custom-molded ski boot 3. do nothing. Any other rule-outs on the exostosis of the ankle? Who would you refer him to for a custom ski boot with a cut-out for the tibial malleolus? Any other suggestons?
 
Michael Forman, DPM, Cleveland, OH

Query: Documentation of E/M Codes

Do physicians' notes/documentation have to state the amount of time spent with the patient when using CPT 99203-99204 and CPT 99212-99215?

Northeast Wisconsin Foot and Ankle Associates, Appleton, WI

Response: To quote CPT: "D. DOCUMENTATION OF AN ENCOUNTER DOMINATED BY COUNSELING OR COORDINATION OF CARE

In the case where counseling and/or coordination of care dominates (more than 50%) of the physician/patient and/or family encounter (face-to-face time in the office or other or outpatient setting, floor/unit time in the hospital or nursing facility), time is considered the key or controlling factor to qualify for a particular level of E/M services.

Documentation Guideline: If the physician elects to report the level of service based on counseling and/or coordination of care, the total length of time of the encounter (face-to-face or floor time, as appropriate) should be documented and the record should describe the counseling and/or activities to coordinate care."

So, counseling and coordination of care are the only times that the doctor needs to put time in the medical records.

Paul Kinberg, DPM, Dallas, TX

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

RE: Platelet-Rich Plasma Injection for Chronic Achilles Tendinopathy?
From: Michael Turlik, DPM

A recent article in the Journal of the American Medical Association (1) compared platelet-rich plasma injections to placebo for the treatment of chronic Achilles tendinopathy. The authors found that there was no difference statistically or clinically between the two treatments. The study seems to have high internal validity, a power calculation, and a clinically important difference specified. The results were presented with 95% confidence intervals.

1. JAMA 2010;303(2):144-149

Michael Turlik, DPM, Cleveland, OH, mmturlik@aol.com

RE: Off-Label Heel Fissure Treatment (Paul Busman DPM, RN)
From: Brian Kiel, DPM

I keep super glue in my office and use it regularly for fissures and superficial lacerations. I also recommend that patients keep it at home for such use. It is much faster drying than Gorilla Glue and quite effective.

I would also like to respond to the discussion about the Good Feet stores. In Tennessee, it is prohibited legally for these people to diagnose and treat specific conditions such as "plantar fasciitis." They can treat painful feet, backs, etc, but that is all. That will not stop them, but it does reduce their ability to treat our patients.

Brian Kiel, DPM, Memphis, TN, footdok4@gmail.com

RE: New Balance TV Ads (Allen Mark Jacobs, DPM)
From: Multiple Respondents

The action of New Balance is deplorable. I have recommended their shoes for many years. However, the failure is that of APMA. Many years ago as delegate to the APMA from Arizona, I stated that APMA must move in two main directions:
1. Parity with medicine by change of education and degree.
2. Massive unrelenting public relations program on a national scale, including radio, TV, and print media.

Sadly,  none has been accomplished despite massive funds available to APMA from membership.

Amram Dahukey, DPM, Tucson, AZ, drd@premiersurgeons.com

Foot and ankle orthopods are not incensed about TV ads for arch supports. They're too busy doing medicine and surgery. If our license didn't limit us to such a small area and non-systemic conditions, we too wouldn't care. If we were able to do more procedures and diseases, I believe that most podiatrists would rather do that than sell arch supports and shoes for income. The next direction for podiatric evolution is away from our chiropodal history,

Robert Bijak, DPM, Clarence Center, NY, rbijak@aol.com

Podiatrists who recommend specific sneakers to their patients can start to make a big difference by no longer recommending New Balance sneakers. Start explaining to the stores you refer to that you will no longer recommend New Balance sneakers. Align yourselves with the Brooks, Saucony, and Asics reps. We may be a relatively small group, but if we all start protecting our piece of the pie, the loss of many small referrals for NB sneakers can go a long way. Soon patients start to tell their friends that "my podiatrist is not recommending NB anymore," and they tell their friends, etc., etc. NB used to be the only company with varying widths, no longer!

I would normally recommend NB to my patients approximately 10 times a week. Brooks and Asics will be the immediate beneficiaries of New Balance's poorly thought-out TV ads. Maybe, if we can get our profession to join together in this effort, it can lead to us joining together in other national efforts. Maybe it’s also time for our national and state organizations to stop supporting New Balance and others with their seal of approvals if they don't support us the way we would expect.

Marc Klein, DPM, Boca Raton, FL, mbk418@gmail.com

I am a little nervous posting this reply, for it is not my intent to pour gasoline on this topic.  I merely wish to point out the difference between …

Editor's Note: John Luck CPed’s extended-length letter can be read here.

ASSOCIATE POSITION - SOUTH FLORIDA

Ft. Lauderdale/Miami office locations seeking associate leading to partnership for the right person. Active modern busy practice needs help. Competitive salary + benefits + incentives. Send resume to podiatrydoctor@aol.com

ASSOCIATE POSITION – TEXAS

Dynamic, growing practice in Dallas/Fort Worth area, seeking surgically trained, Board Certified/Board Qualified Podiatrist. Excellent salary and benefits compensation package, for the right candidate, with partnership/buyout opportunity. Contact/Send resume to: jmh6122@yahoo.com

ASSOCIATE POSITION IN WESTERN NORTH CAROLINA
Well diversified growing podiatry practice with good mix of office, surgery center and hospital procedures seeking a full-time associate. Must have NC license or taking state exam this year. Candidates should have excellent bedside manner equal to their medical skills. E-mail a cover letter and CV to DPMCAREER@AOL.COM

PRACTICE FOR SALE - ALABAMA, GULF COAST

26 year old practice for sale. Owner desires to sell. Practice operated 25 hours per week. Surgery and general podiatry. MD referrals. Surgery center and hospitals in close proximity. Highly profitable. Priced to sell. Seller will lease office to buyer. Contact Mike Crosby at 1-888-776-2430 or mcrosby@providerresources.com

ASSOCIATE POSITION – CINCINNATI, OHIO

This is your once in a lifetime opportunity to join one of the most successful practices in the United States. We do not have a seniority system. If you are motivated and have completed a PSR 24-36 residency, your income is limited only by your enthusiasm and desire to achieve. Email resume to khart@cincinnatifootcare.com

PRACTICE FOR SALE - TENNESSEE

Well established practice for sale. Full scope medical and surgical practice including DME. Exceptional practice with a high volume of new patients. Excellent hospital and surgical center privileges with investment opportunity. Great area for a family and the outdoorsman. 731-446-7285/E-mail nraines@charter.net

ASSOCIATE POSITION - MINEOLA, NEW YORK

Full-time associate position with future partnership potential available with busy multi-office practices on Long Island. Must be proficient in all phases of podiatry with emphasis on surgery, biomechanics and RFC. Minimum standards include either a three-year PSR, or board qualified/certified status with ABPS. Existing hospital privileges with a NY based facility helpful. Interested doctors are encouraged to e-mail their CV to mets724@gmail.com

PRACTICE FOR SALE - FLORIDA—CENTRAL/SOUTH

Turn-key operation grossing $570,000 annually based on one full-time doctor. Great opportunity for growing the top-line. Surgery is only 14% of the professional man-hours; it can significantly increase income. Medicare makes up 64% of revenues. Seller will assist with transition. Call 863-688-1725, ask for Chas.

PRACTICE FOR SALE - NEW JERSEY
 
Part-time practice for sale. Located in Bloomfield, NJ. Great location in professional building. All modern equipment including digital x-ray. Please contact doccapo@yahoo.com

ASSOCIATE POSITION - HUDSON VALLEY, NY

Recruiting a podiatrist who enjoys doing surgery! We are a seven–doctor podiatry group and we’re great to work with. A residency program is attached to our practice. Interviews will begin shortly for this special position. Please forward CV to: healthyfeet4ever@yahoo.com

PRACTICE FOR SALE - CENTRAL FL

Practice and medical building for sale, in beautiful, high quality of life, growing area, Central Fl.; 2000 sf bldg. fully equipped/ designed for podiatry; excellent location, features & exposure; near hospital, wound and HBO center. Great opportunity for expansion & investment; good insurance climate. 352-223-2713 / E-mail: windnwave@earthlink.net

ASSOCIATE POSITION FULL-TIME - SUBURBS OF CHICAGO

PSR 36 - month-trained podiatrist needed for busy suburban Chicago practice. Full benefit package included. If interested, please email your curriculum vitae to foot1st@yahoo.com

PRACTICE FOR SALE – MAINE

20+ years, full scope, turn-key practice in the same medical building location. Podiatrist-friendly hospitals just down the street, wonderful, appreciative and cooperative patients await. Excellent expansion potential. Maine offers an enjoyable life style, recreation abounds, reasonable housing costs, excellent school systems, low crime rates. Colleges and universities nearby as are cultural opportunities. Retiring seller will stay for transition. Please contact: mainefootdoc@yahoo.com

ASSOCIATE POSITION - CHICAGO AREA

Join one of the most successful, long-established podiatry practices in the Chicago area, with excellent salary and benefits. We have an immediate opening for a full-time podiatrist in a multi practice location in Chicago. Must have two years of surgical residency. Please e-mail resume to f-massuda@footexperts.com

ASSOCIATE POSITION - BROOKLYN, NY 
 
Full or part-time position available for a busy well-established podiatry practice in downtown Brooklyn. All phase of podiatry. Modern office with EMR, Ultrasound, digital x-rays with a great support staff. Must be highly motivated, ethical, with good communication and clinical skills. please email resume to tkd@gishpuppy.com

ASSOCIATE POSITION – ILLINOIS

Quality Podiatry Group provides quality services to residents at long term care facilities. We are currently offering full-time or part-time positions for motivated ethical podiatrists. Immediate openings are available. If interested, fax curriculum vitae to 847-674-2113 or e-mail to feetwork@aol.com

ASSOCIATE POSITION - MASSACHUSETTS

PSR-24 trained podiatrist for busy multi location practice, high volume and high-tech. Seeking energetic individual for high volume of patients with multiple needs. Orthopedic, sports medicine, wound care, pediatric orthopedics and surgery skills required. Looking for immediate hire for the right candidate with possibilities for partnership. Contact Debbie Roberts debbierobertsm4@hotmail.com

ASSOCIATE POSITION – NORTH AND CENTRAL FLORIDA

Quality Podiatry Group of Florida provides quality services to residents at long term care facilities. We are currently offering full-time or part-time positions for motivated ethical podiatrists. Immediate openings are available. If interested, fax curriculum vitae to 847-674-2113 or e-mail to feetwork@aol.com

PM News Classified Ads Reach over 12,000 DPM's and Students

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