The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

January 29, 2011 #4,076 Publisher-Barry Block, DPM, JD

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Preventative Care is the Key to Winter Foot Health: TN Podiatrist

It was a snowy scene across the Tennessee Valley earlier this month. While people bundled up to enjoy the snow and brave the cold weather. Podiatrist Doctor Ira Kraus says it's important not to forget to protect your feet. "I think the biggest problems are the simple problems that people are not wearing footgear and socks to protect themselves from the weather," says Dr. Kraus.

Dr. Ira Kraus

Dr. Kraus says preventive care is key. He says "preventive care, wearing appropriate socks and shoes, are going to help you with any of these problems."

Source: WRCB-TV [1/27/11]

TN Podiatrist Publishes Thought-Provoking Children's Book

Father, mentor, and self-described concerned citizen Dr. John E. Bell – a surgical podiatrist and a professor at Strayer University-Shelby Oaks campus – has just released the book he wrote after looking on shelves and not finding the kind of book he thought was needed to help parents and concerned adults help children with issues such as premarital sex, gangs, and drugs.

“It’s illustrated and thoughtful for children, yet it is impactful and encourages youth to do well in school, avoid the pitfalls of bad decisions, and most importantly dream big,” said Bell, a graduate of Morris College in Sumter, SC, a Gulf War veteran with 10 years in the US Navy, and a member of Phi-Beta Sigma Fraternity, Inc.

Source: Tri-State Defender [1/27/11]

Sewer Project Disrupts Practice for NY Podiatrist

When podiatrist Dr. Al Musella looks out from his Peninsula Boulevard office in Hewlett and sees the road being ripped up, he doesn’t see the new sewer piping being installed by Nassau County; he just sees his practice being interrupted.

Dr. Al Musella

A majority of his patients are elderly and walking is difficult. It is hard for them to maneuver around the obstacles created by the project that the county is currently doing. “It looks like they spend about two days in an area, where they block driveways so people cannot get in and out,” Dr. Musella said. ”The side streets in our area are a maze.”

Source: Jeff Bessen, Long Island Herald [1/26/11]

Obama Re-Nominates Berwick for CMS Administrator, But Outcome is Unclear

President Barack Obama renominated Dr. Donald Berwick to the position of CMS administrator, a move praised by the American Hospital Association but likely to face strong GOP opposition during the Senate confirmation process.

"We're very supportive of Dr. Berwick," said Linda Fishman, the AHA's senior vice president of public policy analysis and development. Under Berwick, the CMS has "been very open and willing to listen to the provider community," Fishman said. "He has a good vision for CMS and a good vision for healthcare." Fishman said she's not sure if Berwick can get the needed 60 votes in the Senate.

Source: Paul Barr, Modern Healthcare [1/27/11]

10 Reasons Why YOU Need a Practice Website - Part 2

5. Declare your distinctiveness - Look around at the many medical practice websites out there. You’ll be intrigued to see how generic and even formulaic they appear. Find a way to set yourself apart – show your authentic professional self. And clearly communicate the benefits of a relationship with you and your practice. Forget about telling them how wonderful you are!

6. Enhance practice productivity -Your website has the potential to be an industrious “employee” of the practice, never sleeping, always there to comfort and reassure, enlighten and facilitate office processes. Use it wisely!!

7. Generate revenue - Attention to all of these details adds up to money coming into the bank. The more patients can find you, the more they trust and like you, the easier it is to refer to you, the simpler it is to work with your practice — this is pure gold for your bottom line.

Source: Gary Ignotofsky

Query: Source for Laser Repair?

Does anyone have a source for repairing and recharging the Pfizer/Direct Energy model 10-C and 20-C CO2 lasers?

John Mozena, DPM, Portland, OR

Query: Sesamoiditis Injection

How would you code a therapeutic injection given for sesamoiditis?

Cristina Marquez, El Paso, TX

Response: CPT 20600-LT (or "-RT") for the injection.

Don't forget the "J" code for the steroid injected.

Mark Schilansky, DPM, Catskill, NY

Codingline subscription information can be found here
APMA Members: Click here for your free Codingline Silver subscription

RE: Radiographs and Plantar Fasciitis (Michael Forman, DPM)
From: Carl Solomon, DPM

I’d be very upset if standard of care were established by “truisms” and the personal opinions of some contributors to PM News. There are many ways to word it (and I’m obviously not a lawyer), but one of the definitions I found for standard of care is the following: “… the level at which the average, prudent provider in a given community would practice. It is how similarly qualified practitioners would have managed the patient's care under the same or similar circumstances….”

This site is composed of similarly qualified practitioners, right?  To me, the fact that we are seeing arguments on both sides of the issue makes a strong case that it is NOT the standard of care that x-rays be taken for all patients with heel pain! And I believe it is also a weak argument to say that an x-ray is necessary because it may disclose an otherwise unsuspected  bone tumor or occult fracture. As an extension of that logic, why not preach that all patients with heel pain should get an MRI or bone scan, since pathology may not show up on x-ray? The line has to be drawn somewhere. Shouldn’t history, clinical findings, and response to treatment (in other words, clinical judgment) dictate if and when x-rays are necessary?

Carl Solomon, DPM, Dallas, TX, cdsol@swbell.net

RE: Providing Post-op Care (Justin Sussner, DPM)
From: Dennis G. Shaw, DPM, Keith Gurnick, DPM

I would not do the post-op care - someone is doing the surgery, getting paid, and you should do the post-op care and listen to all the complaining?  No way. Tell her to take a hike. You would be legally liable for any problems that arise.

Dennis G. Shaw, DPM, Mc Kinney, TX,  Dop352@aol.com

Unfortunately, Dr. Sussner did not provide the readers with specific information regarding the complexity of the surgical procedures contemplated, the patient's age, health history, etc. My policy is, that barring unforeseen conditions, I will provide all the post-op care on my surgical patients, and I do not to provide post-op care on patients who have had recent foot surgeries by others, elsewhere. 

Of course, I can always modify or make exceptions to policies on a case-by-case basis, but why would YOU want to provide the post-op care for a patient who has so little respect for your talent that she would choose to travel elsewhere for the actual surgery and then delegate the aftercare (which he or she deems less important) to you.

Post-op care and visits ALWAYS are more time-consuming than the actual surgery, due to questions, dressing changes, patient education, rehab, and the multiple Q&A's. It can be equally as important in achieving excellent surgical outcomes we perform as doing the actual surgery, and the patient should be made aware of this. 

Keith Gurnick, DPM, Los Angeles, CA, keithgrnk@aol.com

RE: Employee Embezzlement (Name Withheld)
From: Martin R. Taubman, DPM, MBA

I shared office space about 15 years ago with a physician in San Diego. His office manager of many years, in retrospect, had demonstrated multiple suspicious behaviors - no vacations, always opened all the mail (no one else was allowed). She became ill and was out of the office for two weeks, and it became apparent that she had been stealing money and depositing patients’ checks in a bogus, personal account. Although the physician was the forgiving-type, the fact that she had stolen Medicare monies caused this to be a federal case. She spent two years in prison. The physician had no choice.

Martin R. Taubman, DPM, MBA, San Diego, CA, mtaubman@san.rr.com

RE: Universal Training of Podiatrists and Parity (Dan Klein, DPM)
From: Simon Young, DPM

I am in agreement with Dr. Klein in principle. I agree that a 3-year residency is the proper way to go. The main problem is we have graduated a significant proportion of residents, who in my opinion, are inferior in quality. Furthermore, these same residents, in my experience, often lack respect, professionalism, and knowledge. They expect knowledge to be acquired via osmosis rather than through hard work, study, and dedication.

How many residents who you interact with carry a stethoscope, much less a bandage scissors or flashlight. How many are versed in foot anatomy? Biomechanics? Gait evaluation? Medicine? How many residents review x-rays (if attendings bring them in) prior to surgery. How many do a physical exam - listen to heart or lung sounds? At my prestigious hospital, residents look at a residency as a job, not a learning experience. They want their time off, vacation, etc.

We need to graduate better quality students. We need to have fewer schools and fewer graduates. Inferior quality can be improved with candidates who want to work hard, show respect, and dedication, but we need to find these candidates. To date, I see these desirable qualities and traits in very few residents. We need to start from the bottom up.

Simon Young, DPM, NY, NY, simonyoung@juno.com

RE: APMA Takes Swift Action on Defamatory Video
From: Wenjay Sung, DPM, Alan L. Bass, DPM

I applaud APMA, ACFAS, and the SCPMA for their swift action to respond to this defamation video to our profession. I am calling for a boycott of all orthopedic medical equipment companies that this surgeon works/consults with. If any fellow podiatrist works with these companies, I ask that you call your corporate representative and voice your displeasure. I hope APMA, ACFAS, etc. can help coordinate this effort, although I am more than willing.

Wenjay Sung, DPM, Des Plaines, IL, wenjay.sung@gmail.com

I just finished watching this video. It is scary that an orthopedic surgeon can be so uninformed and so narrow-minded. I hope that the work from the CPA and the South Carolina Podiatric Medical Association can not only stop the distribution of this video and have it removed for its inaccuracies, but can educate not only this orthopedist but countless others who may think the same way.

Alan L. Bass, DPM, Manalapan, NJ, abassdpm@optonline.net

RE: Reimbursement for Wound Care 22% Lower in 2011: CA Podiatrist
From: George Jacobson, DPM, Joseph Borreggine, DPM

Dr. Rogers' assessment of the wound care reduction in reimbursement (22%) was generous at best. I just received our first EOB  for CPT 97958 and the allowable from BSFL was $25.87 regardless of the number of wounds debrided. That should close the debate from a few months ago as to our getting paid fairly for our expertise and services.
 
George Jacobson, DPM, Hollywood, FL, fl1sun@msn.com

The government does not need to reduce the Medicare fee schedule across the board as they have proposed, because little by little they are getting their way by going after procedures that they consider to be "over-utilized." Healthcare reform is coming, whether we like it or not.

The sweeping reforms that just happened with wound care proves my point. Dr. Lee Rogers' recent article featured...

Editor's note: Dr. Borreggine's extended-length letter can be read here.

IMMEDIATELY AVAILABLE- ASSOCIATE POSITION - DAYTON, OHIO

Join a well-established modern practice with an excellent reputation and referral base. Base salary $100,000 and benefits with a bonus structure. EMR, diagnostic ultrasound, all aspects of DME, Padnet vascular studies, and CO2 lasers. We seek a surgeon that is well trained, personable and motivated to join our group of 3 Podiatric Surgeons. Would like this individual to buy in the practice eventually. Please send resume to ohiodoctors@aol.com

ASSOCIATE POSITION - CT - (FAIRFIELD AND NORTH HAVEN)

Join one of the largest podiatric groups in Connecticut. Well-established and progressive offices, including EMR, digital x-ray, vascular and NCV studies, Pinpointe and CO2 lasers, diagnostic ultrasound and electrical stimulation therapy. You can expect a full schedule of patients the day you start, and a very competitive salary. For more info, www.GreatFootCare.com. Send resume to Dr.Kassaris@yahoo.com. Applications due by Jan 31st.

ASSOCIATE POSITION - BOSTON

Board certified podiatrist (ABPS, ABPOPPM) wanted to join Orthopedic & Arthritis Center at Brigham & Women’s Hospital, Boston, MA. The position is per diem, 2 days/ week. Interested candidates should send their CV to: Brenda Surowiec, Orthopedic & Arthritis Center, 75 Francis Street, Boston, MA 02115. Or email to bsurowiec@partners.org

PART-TIME / FULL-TIME PODIATRIST NEEDED ASAP - CHICAGO 

Part-time podiatrist needed for 2 offices in Chicago with an average of 20 hours/week. Must have Illinois license. Must have completed 2 years of surgical residency. If qualified, email to: A-Storjohann@footexperts.com

ASSOCIATE POSITION - SOUTH CENTRAL PENNSYLVANIA

Eight-physician podiatry group with six locations in South Central Pennsylvania looking for a ninth full-time associate with a minimum of a three-year surgical residency and interest in future partnership. We offer a very busy, fast paced environment with an excellent support team. State-of-the-art practice with our own physical therapy department and surgical center. We offer a six figure salary with competitive bonus incentives, CME allowance, 401K, paid malpractice insurance, as well as established patient base. Persons interested in pursuing this opportunity, email CV to: MFATRANS@AOL.COM

ASSOCIATE POSITION - PHILADELPHIA, SOUTHERN NEW JERSEY

Seeking motivated, independent foot & ankle surgeon to join large practice. Our multi-office practice covers all aspects of foot and ankle pathology, including heavy hospital volume. Offering competitive salary and benefit package. Send CV and two references to bleich5252@yahoo.com

PART-TIME/FULL-TIME PODIATRIST NEEDED - INDIANA

Part-time full-time Podiatrist needed for our Indiana offices. Must have Indiana license. Must have completed two years of surgical residency. If qualified email to f-massuda@footexperts.com

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

Douglas Richie, DPM is seeking a well-trained, motivated podiatric physician to join his two office practice located in North Orange County, California. Applicants must have completed a 3-year residency program and must have exceptional skills in reconstructive foot and ankle surgery, sports medicine and podiatric biomechanics. This is a salaried position with a goal of long-term buy-in for equity ownership. Send letter of interest and CV to drichiejr@aol.com

ASSOCIATE POSITION - NEW YORK CITY

One of the fastest growing podiatry practices in New York City and Queens seeks a podiatrist who participates with HealthFirst, Fidelis, and other Medicaid plans. Preferably a Spanish speaking podiatrist. Contact me at Podocare@aol.com

GREAT OPPORTUNITY AVAILABLE- PHOENIX, AZ
 
A great opportunity to join and gain ownership interest in a well-established, diversified practice in Phoenix. Seeking motivated, ethical, well trained, personable AZ licensed DPM with excellent office management and clinical skills in all phases of podiatry. Practice is state-of-the-art and encompasses all phases of podiatric care. New and established practitioners are welcome, or someone open to merging a smaller practice with ours. Board Qualified/Certified required. Please send CV  phxpod@gmail.com

ASSOCIATE POSITION - OHIO/INDIANA

PrimeSource Healthcare, a leading provider of mobile, on-site healthcare services at long-term and skilled nursing facilities. Our exceptional growth has created a need for traveling, independent contractors of podiatry services in Ohio/Indiana. Earn between $175k and $225k per year. E-mail CV to Kris Wright, kwright@pshcs.com. 847-580-5960. Visit us at pshcs.com.

EQUIPMENT FOR SALE - COOL TOUCH LASER

Cool Breeze Cool Touch CT3 plus laser used for fungus toe nail infections Less than six months old. Great price won't last long. Considering a laser? We also have the Q- Clear Q- switch laser too. This laser is perfect for you. E-mail footcare@comcast.net

EQUIPMENT FOR SALE - MICROVAS UNITS

Two lightly-used microvas units, 16-lead machines (included) , $7,000 each or best offer for both. Great therapy modality: edema, neuropathy pain, increases peripheral flow, increase soft tissue healing. Great practice from vascular surgeons sending patients for treatment, pays for itself. Unit will come with the charger. jhalvorsen@familyfootandlegcenter.com

SHOCKWAVE MACHINE FOR SALE

D-Actor 200 by Storz Medical. High Frequency Extracorporeal Pulse Activation Treatment (EPAT) System. A little over a year old, excellent results for plantar fasciitis and Achilles tendonitis. Must sell;  practice merger. Selling for $18,000 (new machine >30K) Will include onsite training if necessary. Email footdoc21@gmail.com

SPACE AVAILABLE- NYC & LI

Office to sublet and share with DPM and chiropractor, 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. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM

SPACE AVAILABLE - BRANSON, MO

Great opportunity to develop a podiatry practice in a four condominium Branson office building with a growing ophthalmology practice along with a well established optometry practice and a multi-disciplinary ambulatory surgery center in Branson, a top ten retirement destination.The available condominium is a grey box so it can be build out to specifications. Rental and/or ownership options are available for this condominium. Practice development financing and ASC ownership available for the right doctor. Great schools and affordable lakeside or golf course living available. Contact Dr. James Bureman @ jbureman@missourieye.com or 417-861-5839

PM News Classified Ads Reach over 12,500 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 12,500 DPM's. Write to bblock@podiatrym.com or call (718) 897-9700 for details. THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451.

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