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| PM News | |
The Voice of Podiatrists
Serving Over 18,832 Subscribers Daily
February 15, 2018 #6,124  Publisher-Barry Block, DPM, JD
A partner of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2018- 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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How has the opioid crisis affected your prescribing? |
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| PODIATRISTS IN THE NEWS | |
Show Your Feet Some Love on Valentine's Day: CA Podiatrist
“Your feet will bring you to where your heart is,” says an Irish proverb. “Feet are often an afterthought,” said California Podiatric Medical Association Director Jenny Yu, DPM, a podiatric physician and surgeon in private practice in San Leandro, California. “For all we depend on them to do, feet get very little respect. They manage, support, and carry the weight of the body all day, helping to move it forward against the opposing forces of gravity. In order to respond and react to constantly changing surfaces, feet need to be strong and mobile enough to move and transfer weight efficiently.
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Dr. Jenny Yu |
Tension, stiffness, weakness, imbalances, and lack of mobility in the feet can compound any structural issues (knees, hips, back, neck, etc.) further up the body. “Valentine’s Day is a great time to show these often disrespected and neglected masterpieces some much needed attention and love,” said Dr. Yu.
Source: Cision [2/13/18]
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| PODIATRISTS IN THE COMMUNITY | |
NY Podiatrist Recognized for Support of Veterans
Members of Veterans of Foreign Wars (VFW) Post 2913 cooked breakfast and gave thanks to the donors who have helped to upgrade the post and support the efforts of the VFW. Certificates were given to Steven Brook, DPM of Country Foot Care, Paul Wekerle of Wekerle Agency Inc., Home Depot in West Patchogue, and Awards and Gifts, Inc.
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(L-R) Jack Krieger, Rob Calarco, David Rogers, Dr. Steven Brook, Jackie DeRosa |
Also present to give out certificates was County Legislator Rob Calarco, and Patchogue Deputy Mayor Jack Krieger. Letters of thanks were also given to the employees of Home Depot who came out to support the project and Jackie DeRosa of Country Foot care who organizes all the programs with Dr. Brook.
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| PRACTICE MANAGEMENT TIP OF THE DAY | |
What You Need to Know About Office-Based Surgery Laws - Part 6
6. Physicians interested in establishing or joining an OBS practice should also determine whether the OBS practice can charge a “facility fee” in addition to the reimbursement paid to physicians for professional services. OBS practices are not always guaranteed to receive a facility fee – i.e., payment for the use of the physical location and equipment. While rules and policies governing the payment of facility fees vary from state-to-state, third-party payors often deny payment of a facility fee charged by an OBS practice.
As such, revenues attributable to OBS procedures may be limited to the professional fee reimbursement for such procedures. Profits margins will be further limited if the professional fee reimbursement does not adequately cover expenses associated with an OBS practice, such as rent, equipment maintenance, wages for non-profession extenders or technicians (who generally cannot bill for their services), and compliance with regulatory and accreditation requirements.
Source: Conor Murphy and Yulian Shtern, Esq., Physicians Practice [2/1/18]
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| RESPONSES/COMMENTS (CLINICAL) - PART 1A | |
From: Charles Morelli, DPM
You stated that these two lesions are lateral 3rd toe and 2cm sub 1st met. These are classic locations for an IPK, which may be the reason previous treatments have failed. When treatments are not working, take a biopsy.
Just because a patient is on blood thinners does not necessarily mean they can not have these excised. Proper technique, not going too deep and applying a topical coagulant and compressive dressing can suffice, and consider using a tourniquet along with epi in your injection (but not in the toe). Some may disagree with this, but I have performed surgery on patients on blood thinners, and they too have done well.
Working on the assumption that these are in fact warts, when I have had resistant lesions that have not responded, I resort to injections of Candida albicans extract. Give the patient an Rx. It will cost them about $175 and they can bring it to the office (and make sure to keep it refrigerated). You can get 3-4 treatments out of a 1cc vial. The technique is easy (although can be painful and can be readily found on-line. Basically, use 0.3cc weekly with a tuberculin syringe. I have done this about six times in my career, and it has always worked. Look for clearing by six weeks after initial treatment.
Charles Morelli, DPM, Mamaroneck, NY
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| RESPONSES/COMMENTS (CLINICAL) - PART 1B | |
From: Stephen Musser, DPM, Neil Barney, DPM
Use a local anesthetic with epinephrine (1:200,000) and pack it well with a post-op dressing.
Stephen Musser, DPM, Cleveland, OH
I have had success using 5% 5 fluorouracil daily with adhesive tape occlusion for those very stubborn verruca. It can take many weeks but is painless. Check on the patient every 2-3 weeks. In most cases, you do not even have to debride the lesions as it shrinks on its own. Pain from the lesion subsides quickly after a short time of use. I gave up excisions long ago as it is too painful and can cause scarring and severe disability while healing.
Neil Barney, DPM, Brewster, MA
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| RESPONSES/COMMENTS (CLINICAL) - PART 1C | |
From: Jesse Riley, DPM, Ben Cullen, DPM
I recommend Bleomycin injections. After having used everything else, they have given me the best results, are the least invasive, and are not very painful for the patient. You would want to shave down the superficial layers first, but then I would inject each lesion with Bleomycin reconstituted with 1% lidocaine with epinephrine. An alternative to injecting is to do a “needle-free” version using a Madajet. It’s a great idea for kids, as it lessens the anxiety.
Jesse Riley, DPM, Evanston, WY
I recommend trying topical Imiquimod. I have had a couple of lesions that did not respond to months of various treatment measures and then were gone within a couple of weeks of applying this 3x/week at bedtime.
Ben Cullen, DPM, San Diego, CA
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| RESPONSES/COMMENTS (CLINICAL) - PART 1D |
From: Sherwin Tucker, DPM, Roody Samimi DPM
Clearly a patient on anti-coagulants (blood thinners) can have an excision successfully performed. Common sense dictates that you either contact the prescriber of the anti-coagulants to see if any pre-excision changes in the medication needs to be made; or refer the patient to a provider who is more comfortable at treating a patient on anti-coagulant therapy.
Sherwin Tucker, DPM, Hartford, CT
Look up the Panacos procedure; it takes 8 months, but it works. Stitch in an inverted punch at one of the lesions).
Roodabeh Samimi, DPM Stockton, CA
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| RESPONSES/COMMENTS (NON-CLINICAL) | |
Dr. Zale, I have also lost my son to narcotic abuse, so you have my sincere thoughts. There isn’t a day goes by when I wonder, “what if?”…that day never will come. I prescribe narcotics when appropriate, and when they are not, I don’t. It doesn’t always need to be post-operative. If you stub your big toe running into the wall at basketball and fracture the proximal phalanx into 5 fragments... you deserve some. Fall and fracture your fibula…sure.
Ingrown toe nail? Probably not, but then again, there are some who call and need something mild yet more than ibuprofen. I am seeing people writing in sounding as if they would give an OTC ibuprofen for a foot run over by the local school bus and anything more is abusive. We do not, and I do not, treat chronic pain with narcotics; that is not in our purview. But we do treat acute pain, and to deny narcotics when appropriate is wrong and poor practice.
This pendulum swing reminds me of the early '70s when I heard a physician in the cancer wing of the hospital referring to a terminal patient, "we can’t give him narcotics, we don’t want him to die addicted." Let’s not revert to that!
Name Withheld
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| RESPONSES/COMMENTS (DME) | |
From: Justice Anderson
Amerx Health Care spent the better part of last year working with CMS and our attorneys to develop our NEW Patient Direct Program. This program allows physicians to expand the utilization of their DME license by supplying Amerx’s advanced wound care products directly to patients' doorsteps without the need to inventory products in the practice. Amerx’s program allows you to focus your attention on treating your patients, and takes away the burdens of pre-authorizing patients' insurance, deductibles, and inventory management. As your warehousing and logistics partner, Amerx will store and ship products on your behalf and provide the necessary billing support to ensure accurate billing of the DME items ordered. Many podiatrists are already experiencing the benefits of Amerx’s Patient Direct Program. I can assure you our program is tested, and has been approved by CMS.
Amerx has proudly supported the podiatry profession for almost 20 years and will continue to invest in ways to support the growth of your practice. Before you sign any contract, I encourage you to contact your Amerx representative to compare our program’s advantages.
Justice Anderson, President, Amerx Health Care
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| RESPONSES/COMMENTS (OBITUARIES) | |
My sympathies to the Krauklis family in the passing of Robert (Always Bob to me!). Bob and I served together at several Navy training bases rendering podiatric care to military personnel. We met up periodically in Chicago, Illinois for the Midwest Podiatry conferences as well. He was a devoted military officer and was well respected for his podiatric skills. He helped many of our warriors remain functional on their feet. May the Almighty watch over his loving family.
Arnold Pock, DPM
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| RESPONSES/COMMENTS (NEWS STORIES) | |
From: Richard G. Macdonald, DPM
It truly warms my heart to see a podiatrist, Dr. Hall IV, reach the status he has accomplished in Lake Charles LA. I had the great honor of being a close friend of another Lake Charles LA native - Nathan Le Doux. Nat was the first black man hired as executive in a local bank and eventually became head of HR for the local Central Illinois utility company. His life story was unbelievable, with stories of segregation growing up in Lake Charles. I congratulate Dr. Hall on his success after knowing the previous history of Lake Charles through the words and eyes of Nathan Le Doux.
Richard G. Macdonald, DPM, Tremont, IL
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| YOU CAN'T MAKE THESE THINGS UP | |
RE: Outrageous Shoe of the Day
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Don't you love these Valentine's Day shoes? |
Source: TrendyMods.com
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MEETING NOTICES
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| CLASSIFIED ADS - PART 2 ASSOCIATE POSITIONS AND FELLOWSHIPS |
WOUND CARE FELLOWSHIP - NEW YORK
CPME-APPROVED 12 month fellowship beginning July 1st, 2018. Hospital and clinic environment, with onsite hyperbaric medicine. Working with infectious disease, dermatology, as well as plastic, general, vascular, and podiatric surgeons. Must have completed a PMSR residency. Please contact drarnoldhertz@aol.com or jtfootcare@gmail.com. EOE ( equal opportunity employer)
ASSOCIATE POSITION - SOUTH CENTRAL VIRGINIA
30 year practice. Two office locations. Hospital privileges. 30–40 new patients per month. Seeking well-trained motivated podiatrist. All amenities including malpractice insurance. Good mixture of general podiatry care /surgery/biomechanics/diabetic management. E-Mail CV to: footcare2020@aol.com
POSITIONS AVAILABLE - NEBRASKA, MINNESOTA, KANSAS, OKLAHOMA, ALABAMA
Preferred Podiatry Group is seeking providers to join our growing practice servicing long term care facilities in several areas. We offer a competitive commission based income as well as a benefit package to our employed podiatrists. Full-time and part-time positions are available. Contact Dr. Chris Kestner at ckestner@ppgpc.com for more details about opportunities with PPG.
MOBILE PODIATRISTS NEEDED - NEW JERSEY
Well established and fast growing House-call podiatry practice (www.homefootcareservices.com) is looking for FULL-TIME podiatrist to do home visits to home-bound patients in New Jersey. We are looking for hard-working, energetic and compassionate doctor. Excellent pay, benefits, administrative support. Send CV to lana.raginsky@homefootcareservices.com
ASSOCIATE POSITION - WESTERN PHILADELPHIA SUBURBS
Is your ideal practice opportunity one with all aspects of podiatry included? We are a group practice with 6 offices looking for the right surgically trained board qualified/certified doctor to joint our family. Forefoot and rearfoot surgery, as well as, wound care and limb salvage with privileges at 2 local hospitals are available. Partnership is certainly part of the long term plan. We are looking for the right candidate with the position available as early as this Spring or early summer. Send all inquiries and CVs to sgrulke2002@yahoo.com.
ASSOCIATE POSITION - TUCSON, ARIZONA
Growing practice in Tucson, Arizona is looking for a motivated associate. Candidate must be enthusiastic, with strong clinical and surgical skills. Outgoing personality is a must in this busy and flourishing practice. Arizona license required. Check with Arizona State Board for application deadline if you do not currently hold a license. Send CV and letter of interest to transcription697@aol.com.
ASSOCIATE POSITION - CENTRAL VALLEY/SOUTHERN CA
Seeking associate with partnership availability. Must be highly motivated and have good patient skills and personality. Salary excellent with all paid benefits/incentives including malpractice/401k and profit sharing. Compassionate and well-trained for immediate position. Surgery Center and hospital based with no HMOs/no rest homes. Bilingual in English and Spanish preferred. Offering a permanent position/partnership in a multi-million dollar hi-tech practice with Partnership also in Surgery center. Please e-mail CV and short biography to: Tonya@wetreatyourfeet.com
ASSOCIATE POSITION - LONG ISLAND/QUEENS
Advanced Podiatry Seeking Full Time DPM for upscale practices located at the Americana Manhasset, Huntington and Queens. Excellent work environment and company culture. Latest technology with digital x-ray, laser, EHR, Ultrasound, the latest Apple software and iPads. Must be surgically trained, motivated, with a great work ethic. Very competitive salary with significant upside. Great opportunity to work in one of the country's premier practices. Visit www.LIFootCare.com and email evieira1@nshs.edu for more info.
ASSOCIATE POSITION – TUCSON, AZ
Amazing associate opportunity leading to long-term arrangement/partnership in sunny beautiful Tucson, AZ. Very busy solo podiatry practice with unlimited earning potential. Tons of new patients daily. Seeking warm, motivated, personable and patient care oriented practitioner. Practice very well known with exploding constant referral sources. argfootdoc@yahoo.com
ASSOCIATE POSITION – RICHMOND, VIRGINIA
Highly respected, high referral, busy podiatric practice seeking a dedicated, hardworking, motivated candidate with an excellent bedside manner. Located on the campus of a major hospital with an excellent working relationship with the hospital administration and the orthopedic, vascular and plastic surgery providers. We’re seeking a long-term team player dedicated to providing high quality patient care. Must have a minimum of 3 years surgical residency training and comfortable with foot and ankle reconstructive surgery. We currently have 3 podiatric surgeons. Please send CV to: mwaskin@footandankle-usa.com or call the practice administrator at (804) 320-3668 to arrange a phone meeting.
ASSOCIATE POSITION - FLORIDA
We are a growing practice with three podiatrists working in 1 office and on staff at 3 hospitals, seeking PSR-36 board certified/qualified foot and ankle surgeon. Practice is equipped with certified EMR, digital x-ray, and laser. Highly trained bilingual staff. Must speak fluently English and Spanish. Send CV to tvaldizan@birdroadpodiatry.com
ASSOCIATE POSITION - SOUTHERN MARYLAND
Established practice looking for a full-time podiatrist for our Waldorf, MD and Clinton, MD locations. Must live within 20 miles from the office. The ideal candidate will have strong clinical skills including ulcer care, diabetes, surgery and general footcare. Must have a strong office personality with the ability to maintain and attract patients. Must be willing to merge into an already established protocol based office. Please send CV to footdocs17@gmail.com
ASSOCIATE POSITION – SOUTH CAROLINA
Physicians Footcare is a multi-doctor, multi-location practice currently seeking a highly skilled, personable, and hardworking physician to join our TEAM. South Carolina License is necessary and next exam is June 2018. Exam application must be submitted 90 days prior to exam date. If you are ready to earn a comfortable six figure salary; send letter of interest and CV to: scdpmjobs@gmail.com
ASSOCIATE POSITION – SEATTLE, WA
Seattle suburban practice seeks an associate that has interest in gradual complete purchase over a 2-5 year period. For details, please contact footdoc@aol.com
PM NEWS CLASSIFIED ADS REACH OVER 18,500 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 18,500 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 davidekagan@gmail.com or call (215) 808-0770.
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| CLASSIFIED ADS PART 1 - PRACTICES FOR SALE OR WANTED, EQUIPMENT FOR SALE |
PRACTICE FOR SALE - SUN CITY, ARIZONA
Small non-surgical practice near Sun City, Arizona retirement communities. Front door parking. Hospital nearby. Great starter or satellite office. Good potential for growth. Reasonable. Cutera GenesisPlus laser with practice or for sale separately. Email Art at Igogolfing2@aol.com.
PRACTICE FOR SALE - OCALA, FLORIDA
3,500 sq. Foot Office. 27 year old surgical practice. Surgical suite. Two New Micro-100 complete sets as Well as two large surgical trays. Operate in office or hospital! FIRE SALE - MUST SELL IMMEDIATELY!!! Email OPC55@aol.com or call 352-816-1155
PRACTICE FOR SALE - UPSTATE NEW YORK (BROOME COUNTY-VESTAL, NY)
Unique, well established, 38 year practice. No 3rd party insurance-NONE! Patients pay full fee at time of service. I work 2.5-3.5 days/week as desired, with 6-8 weeks of vacation/year yielding an average gross income of $625K & an average net of $250K. Practice emphasizes biomechanics, utilizing video & F-Scan analysis; & PinPointe laser for onychomycosis. Modern 2500 sq. ft. office and equipment. Reply to: uniquepractice@gmail.com
PM NEWS CLASSIFIED ADS REACH OVER 18,500 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 18,500 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 davidekagan@gmail.com or call (215) 808-0770.
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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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