The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

January 27, 2010 #3,764 Publisher-Barry Block, DPM, JD

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Cornelius Elected Chair of OR Medical Board

Dr. Lisa Cornelius has been elected Chair of the Oregon Board of Medical Examiners. In 2006, she became the first podiatric physician appointed to the Board. Initially, podiatry did not have a vote on the Board but due, in part, to her fine representation of our profession and legislation in 2007, she  gained a vote as a full member of the Board. 

Dr. Lisa Cornelius

Dr. Cornelius served on the Advisory Council from 2003 until 2005 when the Council was sunsetted by the new position on the Board of Medical Examiners.  Dr. Cornelius practices in Corvalis, Oregon and has also served as Vice President of the Oregon Podiatric Medical Association. She is a graduate of the California College of Podiatric Medicine and is Board certified by ABPS.

ASPMA Announces New Executive Director

The American Society of Podiatric Medical Assistants has announced their new Executive Director, Karen M. Keathley, PMAC. Karen has been on the ASPMA Board since 1995. She was President in 1998 and has acted as Membership Chairperson for the past 13 years. Karen received her certification in 1990. She has been the practice manager for the Perns Foot and Ankle Medical Center for 35 years. 

Karen M. Keathley, PMAC

Karen succeeds Sandra Lohrentz, PMAC who suddenly passed away in February 2009. 2010 is going to be a busy year for the ASPMA, as The Sandra Lohrentz Educational and Resource Center comes to fruition. The educational center will provide professional developmental tools and resources for podiatric medical assistants to enhance and succeed in their careers.  In the near future, the clinical and administrative exams will be available online.

LA Podiatrist Plans Return Trip to Haiti

Since the devastating earthquake struck Haiti on Jan. 12, podiatrist Dr. Tim Syperek has learned that a wound-care center for diabetics, in Port-au-Prince, where he volunteered in November, is still standing.

Dr. Tim Syperek in Haiti (November 2009)

The Advocate reported in December about Syperek’s medical mission trip to Haiti, along with Dr. Patrick DeHeer of Indianapolis, who helped found the wound-care center in Haiti’s capital city. DeHeer worked closely with Haitian physicians, Nancy and Philippe Larco, who have a foundation there devoted to bringing help to those in need of diabetic and cardiovascular care.

Source: Ellyn Couvillion, The Advocate [1/25/10]

Democrats Place New Roadblock to Healthcare Bill

Two centrist senators Tuesday threw up a roadblock to salvaging President Barack Obama's healthcare overhaul, as Democrats agonized over whether to push forward or shift to idle until political resistance subsides.

Sens. Evan Bayh, D-IN, and Blanche Lincoln, D-AR - both face re-election this year in Republican-leaning states - said they would oppose the strategy Democratic leaders are considering to reconcile the House and Senate bills and put comprehensive legislation on Obama's desk. That approach involves using a special budget-related procedure to go around Republican opponents in the Senate.

Source: Ricardo Alonso-Zaldivar, Associated Press [1/26/10]

An Uncluttered Desk Reduces Stress

Reduce stress by removing the clutter from your workspace. Organize your desk to organize your thoughts. Clearing your desktop clears your mind so that you can focus on the most important tasks you face.

Source:  Adapted from “Tips to Reduce Stress in the Workplace,” Cleveland Plain Dealer via Communication Briefings

Query: Palpable Mass in Dancer

I have an extremely active 15 yo female dancer with a firm palpable mass just above the insertion of the Achilles tendon. She dances competitively in all types of dancing and practices at least 5 times a week. The lesion is palpable on both direct and lateral pressure and does not exhibit any of the typical characteristics of verrucae. Since she does not want to stop dancing for any period of time, my treatments seem very limited. 

Palpable Lesion in Dancer

After ordering an MRI, my optimum approach would be surgical excision followed by a non-weight-bearing cast for approximately four weeks. What other approaches could be considered? Due to her footgear, orthotics seem too far-reaching.

Barrett E Sachs, DPM, Plantation, FL

Query: Letting DEA Registration Lapse

I have been disabled for a few years and it has become difficult, financially, to keep all of my licenses, professional organizations, etc. active as I would like to do. When I received the tri-annual registration for my DEA number, the $550 seemed quite extravagant for something that I wouldn't be using. I am tempted to allow it to lapse and re-obtain it, if and when I am able to practice again. Has anyone else faced this situation and have they had any difficulties in re-obtaining the DEA registration? 
 
Name Withheld

Query: DME Requirements

The doctor I work for recently got back from a meeting where a podiatrist was discussing the requirements of filing a Medicare DME claim. She was told that for each device billed, we must have an invoice in the patient's chart showing we bought the device, a letter signed by the patient stating we informed them that they could get this elsewhere, and a prescription from the doctor. Can someone please clarify?

Amy Ellis, Evansville, IN

Response: What you actually need are the following:

1) Documentation of medical necessity in the chart. No separate prescription is required if you are dispensing a device to your own patient. If you are only dispensing a DME device to a patient referred to you by another physician only for the DME device, that is a problem. In this situation, you would be required to go through facility accreditation and obtain a surety bond.

2) For custom devices, you should have at least the packing list from your vendor. Your "accounts payable department" should, of course, have copies of the invoices. As for stock items that you order in bulk, you would simply have to prove that you did, in fact, purchase these devices.

3) As for noting the patient could get the device elsewhere, I am not sure that you heard this correctly. This is only for devices which are under the competitive bidding program, and, again, the devices that podiatrists typically dispense are exempt from this.

If you were dispensing a device that was subjected to competitive bidding, since physicians are exempt, you would, only under these circumstances, inform the patient that they could obtain the device elsewhere.

Paul Kesselman, DPM, Woodside, NY

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RE: Vibram Five Fingers (Neil Scheffler, DPM)
From: Jenny Sanders, DPM

Vibram Five Fingers were first introduced in 2005. They are currently the shoe of choice for barefoot runners. Vibram originally designed this footwear to be worn while yachting and was surprised initially that anyone would want to run in them. Once they discovered this, however, this shoe with individual toes and Vibram soles became mainstream. I have posted more information about barefoot running shoes on my blog drshoe.wordpress.com/2009/12/04/barefoot-running/.

Jenny Sanders, DPM, San Francisco, CA, jenny@fdfac.com

RE: Physician Executive MBA Programs (Sloan Gordon, DPM)
From: Narmo L. Ortiz, Jr., DPM, Brian D. Battles, DPM

The American College of Physician Executives accepts podiatrists as members who can participate in their MBA program. You take core curriculum courses through them, and then complete the concentration courses from a choice of four major universities.

Another alternative is to contact your local college or university and inquire about their MBA program. Some programs are 100% online; some require on-campus participation.

Executive MBA programs tend to be more expensive than regular MBA programs, plus if you go to a public institution within your state, you may benefit from reduced tuition fees.

Narmo L. Ortiz, Jr., DPM, Cape Coral, FL, nlortizdpm@embarqmail.com

A few months ago, I received a letter from Texas Tech offering an MBA program to healthcare professionals. The classes would be taken on Saturday, and I think it would be completed in a year and a half. I do not recall if it had an MD/DO limitation.
 
Brian D. Battles, DPM, Groesbeck, TX, drbattles@centraltexasfoot.com

RE: Dropping out of HMO's, PPO's and Medicare (Steve Goldstein, DPM)
From: Multiple Respondents

I only participate with Medicare and Blue Cross and do just fine. If I didn't, I would not be able to practice here. I know of one DPM who dropped out, but eventually had to cave in and take BC.
 
Connie Lee Bills, DPM, Mount Pleasant, MI, staff@familyfootcare.biz

Several years ago, I started dropping out of all insurance as an in-network provider. I am still in Medicare. I have been in practice for 20+ years and located in an upper-middle class community. I don't know if I made the correct decision, but I do have greater piece of mind. I don't have to check the patient’s insurance card to see if I can take an x-ray, do an ultrasound exam, or vascular testing. Also, my staff does not need to call for authorization for orthotics, only to end up with a payment that is less than my cost. I see many fewer patients, but am able to spend 30-45 minutes with them, if needed.  When I do surgery, I end up with a decent payment. 

The trigger to begin this was when I received a check from United Healthcare for $5.79 after the patient paid their co-pay of $30.00 for an office visit. You do not make it up in volume as the insurance companies would have you believe.

Larry Cohen, DPM, Clinton, NJ, larrydpm2002@yahoo.com

Very few podiatrists give any attention to the demographics of the area they open in, purchase a practice or get employment with an established practitioner. There is a legion of difference between a concentrated (elderly) retirement area, a lower income blue collar area with significant unemployment, and a vacation resort area with high income patients, but many of whom might be absent during the non-active time.  

You get my point; demographics are complex. You will get pressure from a high retirement area for “free” nail care. Blue collar patients (who used to have insurance) can no longer afford to pay for any care out of their own pocket. During some parts of the year, if you are in a resort area, when there is little activity, your practice may suffer. No area is perfect; each has its own challenges.  
 
No matter where you are, you need to widen your choice of treatment patterns to teach a new variety of patients to come to you. We all tend to do what we enjoy best. This tends to constrict our practice pattern unnecessarily. Restricting means less income. We have nobody to blame but ourselves if we restrict treatment patterns. The solution is to go to seminars, and read and learn what other modalities are available. In a great many cases, this will NOT involve surgery, so you have no excuse even if you are not a “major” surgeon. Dropping out or staying in is less important than widening your treatment base. Either way, you have to adapt to your community and economy.

Michael M. Rosenblatt, DPM, San Jose, CA, Rosey1@prodigy.net

Editor’s note: Dr. Frank Lattarulo’s extended-length note can be read here.

ASSOCIATE POSITION - TEXAS

Wonderful opportunity! Successful multi-office, multi-professional practice seeks well-trained new and established podiatric physicians with expertise in sports medicine, podopediatrics, rearfoot/ankle surgery, or hospital podiatry. A must to be outgoing, motivated, and personable with a dedicated hard-working ethical desire to become a winner. Send resume, current photo and letter of interest to sierrajip@gmail.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

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.

ASSOCIATE POSITION - MARYLAND

Associate needed to join a multi-office podiatry practice in the Baltimore MD Region. Desired candidate should be surgically trained with Board Eligible / Certification. You must be hard-working, ethical, compassionate and confident in your abilities to deal with pathology, patients, staff and fellow physicians. Patient base is already established. Excellent income and growth potential for the right associate. Please forward a cover letter and resume and availability to FootDocMaryland@Gmail.com

SPORTS MEDICINE FELLOWSHIP

The Palo Alto Medical Foundation Surgical/Sports Fellowship Aug 1, 2010 -  July 31, 2011. Applicants must be able to obtain a California license. Responsibilities include assisting in all types of foot and ankle surgery, (approximately 500 cases), seeing patients in the sports clinic and must complete 2 papers/research projects. Benefits include salary of $56K/yr, medical, dental, malpractice, and CME allowance. Interviews will be at the Midwest Podiatry Conference March 11-13, 2010, but on-site visit is preferred. Minimum 24-month surgical residency training pre-requisite. Applicants should send a letter of interest, CV and three letters of recommendation to: Amol Saxena, DPM,  650/853-2927 HeySax@AOL.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 - 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

ASSOCIATE POSITION - MASSACHUSSETTS

Full-time/Part-time podiatrist needed for a busy nursing home practice. Please send inquiries to debbierobertsm4@hotmail.com

ASSOCIATE POSITION – MISSOURI

Expanding multi-location practice seeks motivated individual to contribute to growth. Practice enjoys strong reputation and name recognition. Prefer candidates with interest in partnership opportunity. Established locations available for PSR 24+ and includes incentive comp with benefits/coverage. Please send CV to jmurray@foothealers.com or call John Murray at 314.842.3875

ASSOCIATE POSITION - MARYLAND (Kensington/Rockville/Silver Spring)

If you are a graduating resident in July, or an esablished practitioner, and you are enthusiastic, personable, motivated and well-trained, we would be delighted to discuss an associate position, in our group, with you. Established practitioner relocating. 5-doctor, 3-office practice with significant patient flow already in place to keep you busy from the start! All the bells and whistles-EMR, digital x-rays, ultrasound, computerized scheduling, certified ambulatory surgical centers, hospital and physician referral base. Please send cover letter and resume to mddpmassociate@comcast.net We look forward to hearing from you.

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 - NORTHERN VIRGINIA/DC SUBURB

Excellent associate practice opportunity leading to partnership for PSR 24-36 foot and ankle surgically-trained physician. Currently 4-doctor/2 office practice in fast-growing area, expanding to 5 doctors. Hard working, personable, highly-motivated individuals needed. Great opportunity with excellent salary and benefits. No nursing homes. Top hospitals. Fax CV with references to 703-491-9994

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

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

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