The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

February 17, 2009 #3,471 Publisher-Barry Block, DPM, JD

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Henry G. Bryant, Jr., DPM

Dr. Henry G. Bryant Jr., 71, entered into rest on Wednesday February 11, 2009 at Doctors Hospital.

Dr. Dr. Henry G. Bryant Jr.

Dr. Bryant was a long-time member of First Baptist Church of Evans. He was a graduate of North Georgia College and a 1962 graduate of the Illinois College of Podiatric Medicine. Dr Bryant was a member of the Georgia Podiatry Association for 35 years and past president, the National Podiatry Association, Georgia Cattleman Association, Columbia County Sheriffs Auxiliary, and one of the original founders of Westlake Country Club where he was a current member.

Dr. Bryant's son, Henry G. Byrant, III, DPM practices in Evans, GA.

Source: Augusta Chronicle [2/12/09]

Vasyli Medical Receives Medicare HCPCS Coding for Diabetic Foot Care

Vasyli Medical, a leading global supplier of heat-moldable orthotics and orthotic footwear, has received HCPCS Coding approval for Medicare billing on the Vasyli-Armstrong diabetic footbed. Podiatrists and medical practitioners may now use code A5512 when dispensing the Vasyli-Armstrong customizable orthotic to their diabetic patients. The new Vasyli-Armstrong orthotic footbed, featuring the innovative GlideSoft construction with Teflon and a unique combination of Plastazote ® and EVA materials, moves with the plantar surface of the foot to dramatically help reduce shear and frictional forces.

Vasyli Medical collaborated with Dr. David G. Armstrong, Professor of Surgery and Director of the Southern Arizona Limb Salvage Alliance (SALSA) at the University of Arizona, to develop the unique orthotic that directly addresses the key problem areas of the diabetic foot. “Wounds that get infected on the foot account for one-third of all diabetic hospitalizations," states Dr. Armstrong. "The Vasyli-Armstrong- footbed is the first scientifically and clinically-proven insole to address diabetic foot care and prevent skin irritation."

"This new orthotic footbed protects against plantar skin irritation by reducing the vertical force as well as the shear stress that people notice as causing blisters. It is an exciting combination that has never happened before," explains Armstrong, a member of the Vasyli Think Tank who also serves as co-director for the annual Global Diabetic Foot Conference. "A National Institute of Health-funded scientific study and an independent clinical trial suggest that the Vasyli-Armstrong insole reduces the risk of someone developing foot ulcers."

Source: Health Insurance Week [February 15, 2009]

Alleged Unnecessary Surgery in Unsterile Environment (Kentucky)

Facts: Sue Blevins, then age 62 and a church janitor, underwent a surgery on her ankle on 8-9-04 to remove a cyst. It was performed by a podiatrist and followed a course of conservative care. On a post-operative visit several weeks later, the defendant removed the sutures with an instrument. Blevins recalled that the deendant continued to use the instrument even after dropping it to the floor. Thereafter on a subsequent visit, there were signs of an infection. Two days later she was admitted to a local hospital with a significant infection. She remained hospitalized and underwent a skin graft repair surgery.

Plaintiff alleged negligence by the defendant in several regards, (1) the surgery was not needed to begin with, her problems being related to tendon dysfunction, not the cyst, (2) a delay by the defendant in sending her to the hospital, and (3) maintaining an unsterile environment by using the dropped instrument.

The podiatrist defended that the surgery was properly indicated and followed a lengthy course of conservative care. Thereafter, while there was an infection complication, defendant postured that he responded to it properly and ultimately it was controlled. The court's instructions asked if defendant violated the reasonably competent podiatry standard. The answer was no and Blevins received nothing nothing.

Result: A defense judgment was entered.

Plaintiff’s Expert: David Widom, DPM, Palm Coast, FL.
Defendant’s Expert: Alan Catanzariti, DPM, Pittsburgh, PA

Source: 13 K.T.C.R. 1

Federal Appeals Court Clarifies When Doctor Conduct is Reportable

A federal appeals court for the first time spelled out what constitutes an investigation under the Health Care Quality Improvement Act in a decision experts say could guide physicians in disciplinary and reporting actions.

The federal statute generally requires hospitals to report physicians to the National Practitioner Data Bank if they have been reprimanded for quality or conduct issues, or if they surrender privileges while under investigation.

A panel of the 1st U.S. Circuit Court of Appeals clarified that an investigation remains ongoing until the hospital's decision-making process runs its course, and the medical executive committee either takes final corrective action or formally closes the probe.

Source: Amy Lynn Sorrel, American Medical News [2/16/09]

Find the Time to Do Your Best

The workplace battle cry may be “More! More! More!” However, sometimes doing a little less is the best strategy. Here are some tips for smart slackers:

• Let e-mail wait. Unless you are waiting for an urgent message, designate time to check e-mail messages. Limit your distractions so you can focus on other important tasks.
• Say “No” when you can. If you already are drowning in work when someone asks you to take on one more thing, let that person know that you cannot agree to that request right now. Tactfully explain that you would like to help but that you have too much on your plate right now, and you fear that you would not be able to do quality work.
• Quit multitasking. It may seem like a compulsory tactic these days, but it often leads to poor results. A better approach is to plan to spend chunks of time concentrating on a single task.
• Make an appointment with yourself. Block off some “me” time on your calendar every month. Use that time for planning, catching up and wrapping up loose ends. Treat the appointment as you would any other, and don’t let anyone else’s priorities draw your attention away.

Source: Adapted from “The Right Way to Slack Off at Work,” Anthony Balderrama via Communication Briefings

Query: Reason to Dismiss?

I have a patient, usually nail care only, who is habitually rude, impatient and ill-natured. Last visit, as I checked her chart to be sure I hadn't missed any problems, she said, "You're such an ass."  Outside of my bruised feelings, she's never disrupted the office in any major way. She obviously has no respect for me, but is that a reason to dismiss her as a patient? I've been seeing her about 2 years.

Larry Aronberg, DPM, Lake Worth, FL
 

RE: Dancer’s Foot Revisited (Seth Rubenstein, DPM)
From: Multiple Respondents

Please evaluate the fit of the ballet shoes on her broad forefoot. The smaller the shoe, the more crushing the effect.

Robert Schwartz, C. Ped, NY, NY, rss@eneslow.com

Have you thought about  perniosis (chilblains)?
 
Marta Losa Iglesias Ph.D. (Spain), marta_losa_iglesias@hotmail.com

I was trying to be helpful giving everyone the diagnosis on Dr. Rubenstein's patient. I have to admit that I had an advantage that no one else had that helped me be so sure that the diagnosis was acrocyanosis. I saw multiple pictures of his patient including her hands that show the exact same changes in her fingers that were seen in her toes.  She has classic changes in her hands and feet consistent with acrocyanosis. Additionally, I personally spoke with Dr. Rubenstein for additional history.

Mike Boxer, DPM, Woodmere, NY, MCBDPM@aol.com

RE: EMR Pricing (Brad Shollenberger, DPM, Reading, PA)
From: Richard A. Simmons, DPM

I am not an expert, but I do use an EMR. From the description Dr. Shollenberger has given, he would be overpaying for a very inefficient system. First, imagine that only two people in your office could access your patient charts and other records. As he describes it, you start with this huge handicap and then you try to make this system work in your office.

The interface to the lab is nice, but the better interface would be access to a medical records database. It sounds to me like Dr. Shollenberger is getting a free-standing EMR, but paying the price of a sophisticated integrated system.

I remember when the PC came into the medical marketplace. Many physicians overspent tens of thousands of dollars purchasing inefficient computers and incompetent software. Regretfully, I think the same will happen with EMR hardware and software.
 
Richard A. Simmons, DPM, Viera, FL, RASDPM32822@aol.com

RE: In-Office Physical Therapy (Lynette Thomas, DPM)
From: David Zuckerman, DPM

A new physical therapy device I have been using in my office for the past year is a device  called the NEO GEN EST device. It delivers two types of physical therapy modalities at the same time without  the need for any physical therapists or physician required to supervise the therapy.

The doctor can bill and receive over $500 dollars per treatment session. The total revenue with just five patients per months can be in the tens of thousands of dollars. I see no need for the expense of having a physical therapist in your office. Disclaimer: I am a paid consultant to Outcome Medical, who is the distributor for this product.

David Zuckerman, DPM, Woodbury, NJ, footcare@comcast.net

OFFICE SPACE/ MRI RENTAL – NYC, LI    

Turn-key space available, daily, monthly; East 60th off Park Ave, East 22nd St. off 3rd Ave, and Plainview Long Island. JACHO-certified operating rooms available, as well as all surgical equipment and anesthesia. Extremity MRI Rental. Stark compliant. All exams read by board certified radiologist. Call for details. 516 476-1815

ASSOCIATE POSITION – BRONX, NY
 
NYNJ Foot & Ankle Associates www.nynjfootandankle.com is a rapidly growing practice that was started 12 years ago. All aspects of foot and ankle services are provided including large surgical volume, diabetic wound care, trauma and general podiatry. We are now hiring part-time for our Bronx, NY location. Excellent salary opportunity for the proper candidate.  A partnership track is available for the proper candidate. Fax CV to 718-547-9232

ASSOCIATE POSITIONS - CALIFORNIA

Three podiatrists needed for busy North Hollywood office.  Full-time Monday-Friday 8am-2:30pm.  No weekends and no call. Pay negotiable. New podiatrists are encouraged to apply. Please email resume and salary request to Coasttocoastpodiatry@yahoo.com

OFFICE SPACE FOR RENT - SEATTLE, WA

Full-service, state-of-the-art podiatry office is offering office space for an independent podiatrist or podiatry group. We have digital X-ray, PADNET, physical therapy equipment, all podiatry equipment and staff to assist you to make the most out of your podiatry practice. Our office is conveniently located close to North West and Stevens Hospital right across from North Gate Mall. You can send your letter of interest to: seattlefootdoctor@yahoo.com or call 425-223-9588

ASSOCIATE POSITION – CINCINNATI, OHIO

This is your once-in-a-lifetime opportunity to join one of the most successful practices in the United States. No seniority system. If you are motivated and have completed a PSR24-36 residency, your income is limited only by your enthusiasm and desire to achieve. Fax resume to: 513-577-7261 or E-mail resume to Kroesch4poh@aol.com

ASSOCIATE POSITION -SOUTHERN NEW JERSEY

I’m looking for podiatrist who wants additional practice hours. Perfect for combining your own practice with an additional income. Must be on Aetna Insurance, Horizon Blue Shield, Medicare, and most commercial carriers. I am looking for someone who has a desire to learn how a very successful practice is run, so that I will be able to have time away from my practice. Payscale to be discussed. Could lead to partnership or sale. E-mail contact information, CV, and why you would be perfect for this opportunity. Contact foot.care@verizon.net

CASE CONSULTING

Dennis Shavelson, DPM is now accepting referrals of difficult cases involving biomechanics, surgical complications, non-healing wounds diagnostic and treatment dilemma’s and subtalar stenting from DPM’S. Full reporting with second opinion only, rapid return after care and assumption of care options. Medicare and Out-of-Network Only. (212) 288-3668 or drsha@lifestylepodiatry.com

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.

NEEDED  CHICAGO -- NW IND & BALTIMORE/WASHINGTON, DC PODIATRISTS

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists in Chicago, Northwest Indiana, and Baltimore, MD. Full and part-time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com Visit our website

ASSOCIATE POSITION – SOUTHERN CALIFORNIA 
 
FLEXIBLE, Part-Time or Full-Time opportunity with growing podiatric medical group in a busy office in Los Angeles. CURRENT DME supplier number a plus. No nursing homes. Most days are available with flexible hours available. If interested, e-mail scpodgroup@yahoo.com.
 

PRACTICE FOR SALE – ANDERSON, INDIANA

Well established office in Anderson Indiana for sale. Seller currently works 3 half-days per week and gross over $200K. Excellent locations and growth potential. Very podiatry-friendly community. All equipment and furniture included. Seller is willing to help with transition. Contact seller at mddpm@sbcglobal.net for more information.

PODIATRY ASSOCIATE WANTED – NJ

Northern NJ. Bergen County Must be well-trained. No nursing homes or house calls. Modern well-equipped office. Digital x-ray and ultrasound. Excellent pay and opportunity. Must have NJ license. Call 973-472-4700.

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

PRACTICE FOR SALE - CENTRAL FL

Practice sale at bargain, in beautiful growing area; 2000 sf building fully equipped/ designed for podiatry; excellent location, exposure; near hospital& wound center. Great opportunity for expansion; good insurance climate. 352-357-7499 / E-mail windnwave@earthlink.net

 
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