The Voice of Podiatrists

Serving Over 9,000 Podiatrists Daily

February 22, 2007 #2,816 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.

OH Podiatrist Provides Tips on Winter Foot Care

You may not be going barefoot in February, but you still need to care for your feet. Some tips from podiatrist Kristin Titko, owner of Cincinnati Center for Footcare:

Dr. Kristin Titko

After wearing fur-lined boots, towel-dry between toes to avoid athlete's foot.

If shoes or boots get wet, loosen the laces and open them wide so shoes will dry well. This helps prevent fungal infections.

Moisturize the bottom of your foot twice daily to prevent dryness and calluses.

Source: Cincinnati Enquirer [2/21/07]

Samuel Hoffman was Podiatrist By Day, Hollywood Musician By Night

Samuel Hoffman, the foot doctor, who played an unusual instrument called a theremin, defined the sound of ghosts, goblins, and space invaders. He started his musical career as a violin player in New York at the age of 14. Hoffman became the youngest musician to play at Loew's New York Roof Garden, and later formed his own orchestra. He studied podiatry at Long Island University and became a foot doctor by day and band leader by night (under the stage name Hal Hope).

Dr. Samuel Hoffman

He obtained his theremin in a barter with another musician and integrated it into his act as a novelty. In the 1940's Dr. Hoffman transferred his medical practice to Los Angeles. In keeping with his habits as a union musician, he registered as violinist and, under "other instruments," as thereminist. When film composer Miklos Rozsa was looking for a thereminist to play in Hitchcock's Spellbound (1945), Hoffman was the only one listed and he was hired on the spot when Rozsa heard him quickly sight-read his developing score. Hoffman went on to play theremin in dozens of Hollywood films in the 1940's and 1950's, (including The Ten Commandments) usually for scenes of fear, madness, drunkenness, and emotional distress. He performed on three successful record albums for composer Harry Revel, concertized in Los Angeles, and appeared on The Tonight Show with Johnny Carson.

Source: Scott Marshall, IMDB

GAO Says Administration Lacks Patient Privacy Strategy for EHRs

The Bush administration has no overall strategy to ensure patient privacy as it promotes expanded use of electronic health records among insurers, doctors, hospitals and other health care providers, according to a recent Government Accountability Office report, the New York Times reports. In 2004, President Bush said every U.S. resident should have an EHR by 2014, which could prevent "dangerous medical mistakes, reduce costs and improve care."

However, according to the Times, the report found that the Bush administration "had a jumble of studies and vague policy statements but no overall strategy to ensure privacy protections" would be built into a national EHR system. Sen. Daniel Akaka (D-HI), who requested the GAO investigation, said the report indicates that the Bush administration is "not doing enough to protect the privacy of confidential health information." He added that "more and more companies, health care providers and carriers are moving forward with health information technology without the necessary protections."

Source: The New York Times via American Healthcare [2/20/07]

Query: Perioperative Analgesia

For many years I have used the same old method for post-op pain management: NSAIDS and opioids, along with RICE. I have been reading recently about “the multimodal analgesia” approach (Outpatient Surgery, Feb 07) and have tried continuous local pumps into the posterior tibial nerve, popliteal nerve with ropivicaine in the past with okay results. I always have given those patients narcotics for breakthrough pain, and so far they seem to use less. I have read about adding “small doses” of pregabalin along with the cox-2 antagonists/NSAIDS pre-op as well as post-op. I wonder how many others are using this approach, and what type of cases are they using them on, what their regimen is, and how they think it is working?

Tip Sullivan, DPM, Jackson, MS

Query: Non-Expert Coding Postings on PM News

I understand that the "experts" are entitled to get paid for their knowledge, and for that there is Codingline. Why can't the un-experts discuss these issues in PM News? No one forces the experts to weigh in, and I personally would love to know what my colleagues in the trenches think about billing issues.

Peter Smith, DPM, Stony Brook, NY

Editor’s Response: When PM News started 13 years ago, we let everybody discuss billing issues. The problem was that “un-experts” often offered incorrect coding information. This caused both confusion and problems for podiatrists who read this wrong information and, as a result, billed incorrectly.

When Codingine.com, experts in coding and billing, was established, we realized that having them first post the message would limit the amount of wrong information.

RE: Cosmetic Foot Surgery
From: Martin V. Sloan, DPM

This phrase "Cosmetic Podiatry" is quite an attention-getter. It's being discussed more prevalently these days. Like it or not all podiatric surgeons practice "cosmetic podiatry" to some degree. All of us ostensibly seek to attain excellent cosmetic results as well as excellent functional results in our surgical endeavors. We all try to be purists even as we see reimbursements shrinking. And herein lies the problem. I suspect these individuals marketing themselves as cosmetic podiatrists are the new charlatans on the block, vis a vis the minimal-incision surgeons of yesteryear. They offer nothing new, and don't do anything unique that can't be done by most board certified surgeons and charge apparently exorbitant fees as they somehow bypass the ubiquitous RBRVS coding umbrella.

Interestingly, they practice primarily in the upscale sections of their chosen metropolis. Perhaps this provides some degree of anonymity for their snake-oil tactics. Or perhaps they have discovered a truly marketing bonanza as they go about re-inventing the wheel. In either case, consumers beware!

Martin V. Sloan, DPM, Abilene, TX, mvs321@cox.net

RE: APMA State Leader as an Expert Witness (Bryan Markinson, DPM)
From: Paul J. Liswood, DPM, Tip Sullivan, DPM

I think we can all agree that it is important to have a strong APMA and state associations. We pay dues and elect our leaders to represent our interests. Because of this, I feel it is inappropriate for a APMA leader to act as a plaintiff witness. Membership looks to the APMA and state associations for help during challenging times. I do not think any of us would want to be a party in a malpractice case and have the president of your association testifying against you, while informing the jury of his/her elected position.

Why would you want to continue being a member in that case? Membership has to know that the association will be there to help them. This is how you build a stronger association. I am proud that my division introduced a resolution to the NYSPMA to limit leadership from acting as expert witnesses. It is a start. I agree with Dr. Rampino and Dr. Block that there are many other capable doctors to fill this role in an ethical manner.

Paul J. Liswood, DPM, Brooklyn, NY, dr.liswood@verizon.net

Elected APMA officials are suppose to be respected, ethical practicing podiatrists. We all know that this is not the total truth 100% of the time. I say, that the decision to offer expert testimony for or against anyone in court is a personal choice! It is a lawyer’s game - who has the most credible opinion? Our associations do not need to go there. If you have ever really been there you know that when you are on the stand it is not your credentials that sway the jury it is how you present yourself to them. I have seen some very unethical as well as surgically challenged podiatrists as expert witnesses that have presented themselves well I also know some very ethical as well as talented podiatrists that although they are great podiatrists do not come across well in court.

There should be and are penalties for those who choose to misrepresent themselves or mislead a jury in a court of law, but I do not support the notion of any of our associations attempting to limit who can and cannot participate in our judicial system. I guess that, being from Mississippi, I am still a rebel-unnecessary rules and regulations have plagued us for decades. There will always be people that do not “do the right thing” –those who choose to be unethical will hang themselves in our current court system given time. Our associations can take action on them AFTER they have been found guilty of some unethical or illegal action. As long as one testifies in good conscious and based on the evidence of a given case I believe that any professional has the right, not the responsibility, to do so.

Tip Sullivan, DPM, Jackson, MS, tsdefeet@msfootcenter.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

ASSOCIATE WANTED - MICHIGAN-DETROIT AREA

Great opportunity-must be hard-working, reliable, responsible and good with patients & staff-surgical training a plus-partnership after 1 yr. Michigan license required fax resume to 248-478-1370

SOUTH CENTRAL PENNSYLVANIA-PM&S 36 ASSOCIATE WANTED

Large, busy podiatry group looking for associate interested in future partnership. Practice facilities and technologies include: Surgical Center, Physical Therapy Department, six appointment locations, EMR, MRI and Digital X-ray. Full compensation and benefit package offered. Mail CV to Martin Foot and Ankle, 1203 S. Queen St. York, PA 17403 or email business administrator, johnreitzel@comcast.net.

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 -MINNESOTA – PRIME MINNEAPOLIS SUBURB

Busy, well-established, full-scope podiatry practice, seeking highly motivated podiatrist for a full-time position with potential partnership opportunity. Looking for PSR 24+ individual. Excellent opportunity for long-term growth with unlimited income potential. E-mail CV to employment@associatedpodiatrists.com or fax to (612) 866-5875 Attn. Jennifer.

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

ASSOCIATE POSITION – WASHINGTON, DC

Associateship leading to full purchase or immediate sale. 25 Year old practice located in a hosp. w/ full surg privileges. Large number of diabetic patients and referrals. Fully equipped with x-ray, topical hyperbaric oxy units, 4 tx rooms and more. $400K on only 3 days a week. Will finance with generous terms and stay to introduce. Owner leaving area. Contact R. Benjamin, DPM jhallux@yahoo.com or 202-841-5545

SEEKING RESIDENT FOR PSR-24 POSITION: BALTIMORE, MD

Mercy Medical Center -Position for a highly motivated individual with completed non-surgical residency or one desiring additional surgical training in well-established Podiatric Residency Program. Busy metropolitan hospital with high surgical numbers and inpatient care. Resident is integral member of multidisciplinary team. Begins mid June 2007. Includes competitive salary/benefits. Send inquiries to rsher18@yahoo.com

ASSOCIATE POSITION – NY & CONNECTICUT

Opportunity to be a part of a prestigious and well-established large Orthopaedic and Rehabilitation practice, with locations in Stamford, CT and West Harrison, NY. Looking for a Podiatrist to join an already busy practice with opportunity to build. We have state-of-the-art offices with MRI, digital x-ray, paperless charts, physical and occupational therapy. Applicants should be Board Certified or Board Eligible. Competitive salary and benefits. For further information on the practice, log onto WWW.NYCONNORTHO.COM Interested candidates should forward their C.V. to: Cliff Katz, Executive Director ckatz@nyconnortho.com

PART-TIME ASSOCIATE POSITION - BRONX, NY

Part-time associate position with real potential for full time. Two days a week (one day-in office; one day-house calls). Associate will have an opportunity to work with a very ethical and hard-working podiatrist. Competitive salary + incentive compensation. Please email CV to scottdeis@aol.com

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

• To Post a message, send it to:    bblock@podiatrym.com
• Notes should be original and may not be submitted to other publications or listservs without our express written permission.
• Notes must be in the following form:
  RE: (Topic)
  From: (your name, DPM)
  Body of letter. Be concise. Limit to 250 words or less). Use Spellchecker
  Your name, DPM City/State
• Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.