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The Voice of Podiatrists
Serving Over 9,000 Podiatrists Daily
January 24, 2007 #2,792 Editor-Barry Block, DPM, JD
A service of Podiatry Management http://www.podiatrym.com E-mail us by hitting the reply key. COPYRIGHT 2007- No part of PM News can be reproduced without the express written permission of Kane Communications, Inc.
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Aetrex Introduces New iStep Podiatry Kiosk
Aetrex is proud to introduce the iStep Evolution-Rx, the most advanced digital footcare kiosk ever developed for podiatric practices. This patented technology is designed to facilitate and enhance your footwear and orthotic services and features products from many world renowned companies. Designed in conjunction with The Walking Company and leading podiatrists, iStep Evolution-Rx will help you provide a higher level of patient care, generate substantial additional revenue, increase office efficiency and modernize your practice.
To learn more click here http://www.aetrex.com/rx
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AT THE COLLEGES |
V.A.C. Study Suggests Real Benefit For Diabetic Wound Healing: Armstrong
The following is excerpted from an Interview of David Armstrong, DPM, PhD, Director of the Center for Lower Extremity Ambulatory Research at Rosalind Franklin University of Medicine and Science.
Ivanhoe: Can you tell me about your research on the V.A.C. device?
Dr. Armstrong: In the study, we compared severe diabetic foot wounds in people who needed part of their foot amputated. These were very large wounds. Some patients got very high quality standard of care, and others got the V.A.C. device. People who got the V.A.C. device were more likely to heal than those who did not get the V.A.C. device. It was a 16-week study, so relatively short.
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Dr. David Armstrong |
Interestingly, when we exercised the suggestion, fewer people there actually lost their legs. In fact, all high-level amputations were conducted on the control group, not the people who got the V.A.C.. In other words, the V.A.C. did seem to suggest a real benefit. I think future trials will have to confirm or refute that. I think it's very promising.
Source: Ivanhoe Broadcast News [1/22/07]
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STYLISH ELASTIC SHOES
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Orthofeet is introducing attractive stretchable shoes that are designed for diabetic patients, who need extra protection, but do not want to compromise on appearance.
The new elastic shoes are designed with unique features:
- Non-binding elastic upper provides a loose fit at the forefoot, and ease pressure on sowllen feet, bunions and hammer-toes.
- Firm heel counter offers excellent rearfoot support and stability.
- Seamless lining, padded with extra foam, provides superior comfort and extra protection.
- Washable: The shoes are made of synthetic materials that can be washed in lookwarm water.
- Four widths, including Women’s Extra-Extra-Wide and Men’s Narrow.
- Competitive prices- Shoes: $4200; Prefab inserts: $895; Custom inserts: $2200
For more information visit www.orthofeet.com
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PODIATRISTS AT PLAY |
Salsa Dancing Good for Feet: CT Podiatrist
Salsa consists of a mixture of African rhythms and European music that first appeared in the United States in the 1950s. While Puerto Rico is considered the salsa capital, salsa continues to be popular throughout the world. Dr. Jeffrey Gross, a Stamford podiatrist, feels the lessons are beneficial, not just for himself, but for his patients as well.
"Regular salsa dancing gives your muscles, joints, and bones a really good workout," said Gross, who lives in Danbury. "It can help delay the onset of osteoporosis and arthritis by keeping the joints mobile."
Source: Sandra Diamond Fox, The News-Times [1/20/07]
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MEDICARE NEWS |
New Medicare Commission Proposed
Sens. Pete Domenici (R-NM) and Dianne Feinstein (D-CA) unveiled a plan to establish a permanent, independent commission called the National Commission on Entitlement Solvency to shape legislation aimed at preserving Medicare and Social Security. The 15-member commission would make recommendations to Congress about the programs one year after the law’s enactment and then every five years.
The proposal would set mandatory timelines for Congress to introduce legislation based on the commission’s recommendations, take committee action and schedule debate. “The solvency of Medicare and Social Security rank among the highest and most significant problems that face our nation down the line,” Domenici said. In 2006, 52.3% of federal spending, or $1.42 trillion, went to Social Security and Medicare, Feinstein said. That number is expected to climb to 60.4%, or $2.54 trillion, by 2016. Projected deficits will exhaust Medicare in 2018 and Social Security in 2040, according to the Social Security and Medicare trustees.
Source: Matthew DoBias, Modern Healthcare 1/22/07
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MEETINGS / COURSES
REGISTER NOW FOR DFCON 07 AND SAVE $150
Register for DFCon 07, the Diabetic Foot Global Conference, by November 20 and save $150! Save extra $25 by registering on-line at www.dfcon.com. Join your colleagues at the premier international diabetic foot conference March 22-24, 2007 at Renaissance Hollywood Hotel in Los Angeles.
• 1,000 expected to attend from 50 U.S. states & 20+ countries • 40+ stellar faculty from N. America, Europe, Asia, Africa, Australia • Remarkable education program – unmatched quality • Earn 22.5 CMEs, 22.5 CPMEs or 27 Contact Hours • Stay at the glamorous Renaissance Hollywood – $179 sng/dbl • Co-chairmen George Andros, MD & David G. Armstrong, DPM
• Visit www.dfcon.com and register on-line today
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QUERIES |
Query: Hyaluronic Acid Injections 1st MTPJ for Hallux Rigidus
I would like to know if anyone has any experience in using hyaluronan injections (i.e., Synvisc, Supartz) off-label for hallux rigidus. If so, how many injections, how long between injections, and how many cc's do you inject? Robert Fridman, DPM, New York, NY
Query: Subtalar Arthroresis
A 10 y/o little girl with bilateral flexible pes planus (PTTD) that was treated for two years with physical therapy, orthotics, an alteration in footwear, as well as rest. Her parents noted that in spite of the orthotics, it seemed that her feet were looking worse and she was complaining of more discomfort. Last November, I performed a subtalar joint arthroreis. The surgery went well and she and her parents are quite pleased with the appearance as compared to the non-operative foot. The pre-operative pain has completely resolved and she has returned to all activities. At her post-operative visit (60 day) I noted that she has a mild but flexible hammered hallux on the operative side. There is no limitation in STJ motion (i.e., normal ROM without the pathologic pronation). She can stand on her toes, and walk on her heels. I have started her in some physical therapy. Any thoughts? Andrew H. Cohen, DPM, Saginaw, MI
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CODINGLINE CORNER |
Query: Removing Granulation Tissue
A patient presented with a bleeding second toenail without signs of infection. After debriding the nail back a little bit, there was a small granulation tissue "bud." I "nipped" (sterile tissue nipper) it out, dressing the digit, followed with advising the patient on soaks at home.
Is there a procedure code that could be billed for this, or is this included in the E/M service?
Charles Perry DPM, Cambridge OH
Response: When you state that you clipped the "nail back a little bit" and "nipped" out the granulation tissue, it appears, at least to me, that simple "procedure" would be included in the work-up and management of the presenting problem. Clipping back the nail, at least for the payers I am familiar with, would be routine foot care or expected to be included under a more comprehensive service/code. In this case, there wasn't since the use of a nipper to resect granulation tissue would involve minimal work. Personally, I would just bill an E/M service taking the work-up and management of the problem into account.
If the work is more than just "cleaning up" or resecting granulation tissue, you could consider debridement (CPT 1104x, if the tissue was truly debrided) or chemical cauterization of granulation tissue codes (CPT 17250, if chemical cauterizaton was used) or partial nail avulsion (CPT 11730, if the digit was anesthetized and more than just a clipping back of the nail was done).
Tony Poggio, DPM, Alameda, CA
Codingline subscription information can be found at http://www.codingline.com/subscribe.htm
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Treatment of Diabetic Foot Infections in the Era of MRSA
An On-Demand Webcast
Available 24-7 for Your Convenience
Presented by:
Warren S. Joseph, DPM, FIDSA
and
David G. Armstrong, DPM, PhD
To participate visit www.virtualrounds.com
This promotional Webcast is sponsored by Pfizer Inc and will not provide continuing education credits.
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RESPONSES / COMMENTS |
RE: NY Clinical Conference From: Dennis Shavelson, DPM
I attended the New York Conference and give credit to Dr. Joseph Sciandra. As Chairman, he has turned the conference into "The" major event by making it fresh.
Dennis Shavelson, DPM NY, NY
RE: Discharging an Employee (Name Withheld) From: Jon Purdy, DPM, Bob Levoy It is imperative that direct and timely action take place in cases of employee non-performance, failure to correct addressed issues and all other unacceptable behavior. It is also imperative that you as an employer have performed to certain standards. To start with, every employer should have an employee handbook that contains detailed job descriptions and duties. Have your employees read, understand and sign onto this document. If you do not have one, there is no better time to address that task than now.
We find it best to leave disciplinary actions up to the office manager that do not fall into the category of infractions with serious implications. If I directly observe problem issues, they are addressed on the spot and may prompt further action such as a formal write up from the office manager. Your employee manual should be the office manager’s guide in what is considered a disciplinary action, and what constitutes grounds for termination. It should be just as clear to the employee committing the action or inaction.
Jon Purdy, DPM, New Iberia, LA, podiatrist@mindspring.com
As I have written in my newest book, "222 Secrets of Hiring, Managing and Retaining Great Employees in Healthcare Practices, "the initial step in hiring an employee who is right for your practice is to prepare a written job description of the duties and responsibilities that the position entails. Such profiles will help simplify the hiring process, ensure that employees know what is expected of them, and provide supervisors with a guideline during performance reviews." If your decision to fire someone is based on performance issues as you indicated, you'd best have a clear and reasonable documented record that the person knew what was expected, that the employee had the tools and opportunity to succeed, and that he or she was given reasonable notice and a chance to improve. In other words: Make sure there are no surprises. Bob Levoy, Great Neck, NY, b.levoy@att.net
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PODIATRY MANAGEMENT'S AFFORDABLE ONLINE CME
You can Earn 15 CPME-Approved CME credits Online for only $139(Less than $14 per credit) http://www.podiatrym.com/cme.cfm Choose any or all of over 20 CME articles posted You Can Now Take Tests and Print Your CME Certificates Online
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CLASSIFIED ADS |
ASSOCIATE POSITION – MISSISSIPPI
Well established, busy, 3-doctor practice seeks PSR 12 or 24 trained podiatrist for associate position to fill vacancy of retiring member. East central location is a great area to raise a family and is a prime location for accessibility to several major cities. Competitive salary, benefits, and incentives. Partnership possible in 2 years to right individual. June - July start date. Applicant must be ethical, personable, and motivated. Please E-mail CV and letter of intent to shanegan@bellsouth.net
ASSOCIATE WANTED FOR SOUTH MIAMI AREA
Large group, busy, multi-office, partner potential. Motivated applicants only. Mail resumes and letters of intent to 999 N. Krome Avenue, Homestead , FL 33030. July start time OK, sooner preferable. E-mail lianadpm2@aol.com
ASSOCIATE WANTED - NORTH CAROLINA, CHARLOTTE AREA
Incredible opportunity to join a busy, well-established group practice. Looking for a self-motivated, hard-working individual seeking to become a partner. Hospital and surgery center privileges. Salary plus percentage, 401k and real estate opportunities. Send CV to universityoffice@ bellsouth.net
EXCELLENT ASSOCIATE OPPORTUNITY – SOUTHERN CALIFORNIA
Established 25 year well-rounded biomechanical and surgical practice seeking energetic, enthusiastic, personable and proficiently-trained PSR-24 or PSR-36 foot and ankle surgeon for associate with ultimate partnership opportunity in LA area. Excellent position for an individual interested in all aspects of podiatric medicine with emphasis on reconstructive foot and ankle surgery. Only 8% Medicare with No HMO. Email CV to dr4feet@sbcglobal.net
OFFICE SPACE TO SHARE – MANHATTAN / PLAINVIEW, NY
East 60th and or East 22nd in Manhattan and on South Oyster Bay Road Plainview. Turnkey operation, all equipment needed is available as well as an extremity MRI, fluoroscopy, x-ray and surgical equipment. Each office has an operating room with anesthesiologist available for iv sedation. Call 516 476-1815 or email to podo2345@aol.com include a phone #
ASSOCIATE POSITION—NORTH COASTAL CALIFORNIA
Two fully staffed rural offices with continually growing patient load. We take care of all aspects of podiatry: assisted-living centers, palliative care, wound care, biomechanics, surgery, diabetic care. Hospital privileges are available to those properly qualified. If you are interested in challenging and hard work leading to partnership, send your CV to jimf@humboldt1.com
POSITION AVAILABLE – SOUTHERN CALIFORNIA
Los Angeles and/or San Fernando Valley. House Call Practice, Doctor on maternity leave needs Podiatrist to assist with housecalls in San Fernando Valley and Los Angeles (310, 323 and 818 area codes). Must have own car and malpractice insurance. E-mail responses to Docrandi@sbcglobal.net
ASSOCIATE POSITION--PHOENIX SUBURB
Attractive opportunity for enthusiastic, proficient, and personable associate. Well-established modern practice with multiple newer spacious offices, technology and equipment. Solid referral base, close to hospitals, knowledgeable certified staff. 22% MCR. Practice and surgical center partnership potential opportunity. Prefer 24-36+ PSR. Send CV: AZpodassociate@aol.com
ASSOCIATE POSITION – ST. LOUIS, MISSOURI
Immediate Opening. Busy practice in prime suburban St. Louis location looking for a surgically trained associate, possible partner. Must be honest, ethical and hardworking. ABPS preferred, but not required. Please reply with CV and requirements to mdwrtw@aol.com
POSITION AVAILABLE - SOUTHEAST TENNESSEE/ NORTH GEORGIA
Immediate position available or will wait for the right individual. Unique practice opportunity in growing multi-physician/multi-office practice. Well established/cutting edge within the medical community. Close proximity to hospitals as well as opportunity to become involved with a free standing podiatric surgical center. Must be BQ/BC. Minimum PSR/24. Competitive salary, bonus structure and benefits. E-mail CV to afcjen@hotmail.com
ASSOCIATE POSITION - CENTRAL CALIFORNIA
Central California multi-location practice looking for PSR-36 associate leading to partnership. PSR-36 trained podiatrist with great opportunity for reconstructive surgical practice. Practice has Medicare-approved surgery center. Must have excellent interpersonal skills. Excellent salary and incentive. Respond to: westsidefoot@yahoo.com
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
WEEKLY SPECIAL - One week of ads (5x) for only $75
PM Classified Ads Reach over 9,000 DPM's and Students
Whether you have used equipment to sell or our offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 9,000 DPM's. Write bblock@podiatrym.com or call (718) 897-9700 for details. Note: For commercial or display ads contact David Kagan at (800) 284-5451 dekagan@aol.com
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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.
| Guidelines |
- To Post a message, send it to: bblock@podiatrym.com
- Notes should be original and may not be submitted to
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RE: (Topic)
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- Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.
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