The Voice of Podiatrists

Serving Over 10,700 Podiatrists Daily

February 29, 2008 #3,181 Editor-Barry Block, DPM, JD

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CLEAR's Armstrong, Rogers Contribute to EWMA Wound-Healing Position Statement

The European Wound Management Association (EWMA), under the direction of Pisa's Professor Marco Romanelli, has completed a position statement for wound healing. Designed to provide critical information regarding standards of care, definitions of success and economic burden to national economies and health care providers, worldwide, the document is set for release in the weeks preceding the EWMA symposium May 14-16 in Lisbon, Portugal.

Dr. David G. Armstrong

"The document is both digestible and informative", notes Professor David G. Armstrong, of the Scholl College’s Center for Lower Extremity Ambulatory Research (CLEAR) at Rosalind Franklin University of Medicine and Science. Armstrong served as one of two podiatrist members -- along with CLEAR's Dr. Lee C. Rogers, Chief of the Broadlawn’s Amputation Prevention Center in Des Moines -- on the blue ribbon team of authors.

Godfryd to Receive DSC

Thomas S. Godfryd, DPM of Birmingham, AL has been selected to receive the American Podiatric Medical Association’s highest honor, the Distinguished Service Citation (DSC).

Thomas S. Godfryd

Dr. Godfryd is a past president of the Alabama Podiatric Medical Association and has been a member of the Board of Directors of the Podiatry Political Action Committee since 1989, serving as its Vice Chairman from 1993 to 1996 and as its Chairman from 1996 to 2007.

Dr. Godfryd will receive his award at the APMA House of Delegates Meeting in Washington, DC (April 4-7th).

Few Docs Reported Quality Data For Bonus in 2007

A relatively small number of physicians participated in a voluntary program last year that provides a small bonus payment to practices that report on quality measures, according to data released by the CMS. Preliminary data on the Physician Quality Reporting Initiative, or PQRI, show that 99,000 physicians, nonphysician practitioners or therapists—16% of the eligible professionals who could have reported quality data on 74 quality measures—submitted this data at least once in 2007.

Several specialties: anesthesiology, ophthalmology and emergency medicine, had higher than average rates of participation in the PQRI. Physicians who successfully reported a designated set of quality measures on claims during this period were eligible for a bonus payment, subject to a cap, of 1.5% of total allowed charges for covered Medicare physician fee-schedule services.

The 2008 PQRI reporting period—which spans the entire calendar year—will offer the same bonus payment for reporting on 119 measures.

Source: Jennifer Lubell, Modern Healthcare [2/27/08]

Query: Non-painful Click after Sclerosing Alcohol Injections

I have a patient in her 50's who has received a series of 6 scleroising alcohol injections for a Morton's neuroma between her 3rd and 4th metatarsal on her right foot. Prior to starting the injections she had a palpable Mulder's sign in this interspace. After the 6th injection she reports no pain, but still at times can feel the click that used to be painful. X-rays are negative except for a tight interspace. I have not done any advanced imaging such as an MRI or ultrasound. Does anyone have any experience with this as far as whether these clicks resolve or just remain non-painful.

Bob Sage, DPM, Beloit, WI

Query: Ethical Dilemma

I have been hired as an expert witness in a malpractice case against on orthopedic surgeon living 90 miles away. His patient had a severe diabetic foot infection. The orthopedist surgically incised an deep abscess near the 1st met head. He sewed it up with no drain. The abscess progressed to bone. The patient sought me for a second opinion. The infection was so bad it required a transmetatarsal amputation. I was asked by the patient's attorney to be the expert witness.

The orthopedist's attorney happens to be a past patient of mine. I performed bunion surgery on both her feet over a year ago with great results, thank goodness. She has scheduled a deposition with me for this Friday. I ran into her last week at a restaurant where she told me to be careful what I say because "they (meaning the ortho group) are gunning for me." I felt bullied and pressured by her. To make matters worse, the orthopedist is employed by a hospital that my hospital just acquired, so we technically work for the same large employer. Do I continue as the expert witness? Do I give in to her bullying tactics? My patient truly has a legitimate malpractice claim that needs good representation. Advice would be appreciated.

Name Withheld

Editor’s comment: PM News does not provide legal advice. Given the circumstances of this case, the appropriate thing to do is to pass on being an expert witness. There is no shortage of expert witnesses who will be more than willing to serve in this case. Be aware that you still could be subpoenaed to testify.

Given the behavior of the attorney, she could be subject to professional discipline.

RE: Bunion Shield for Infant (Tom Silver, DPM)
From: Steven Goldstein, DPM

A company called Liquid Rubber Appliance in West Orange, NJ (973) 325-0174) makes custom made appliances. You take a plaster impression of the hallux and first MPJ. It will cost you about fifty dollars, so price it accordingly.

Steven Goldstein, DPM, Royal Palm Beach, FL, stevefootdr1@cs.com

RE: Are Those Orthotics Really Custom-Made? (Susan L. Boren)
From: Carl Ganio, DPM, Paul Kesselman DPM

How many times have we all seen devices such as "pelvic stabilizers" or "levelers" ... and asked the same question. Chiropractors have been taking impressions, and dispensing these to patients for the 20 years I have been in practice. To date, I have never seen one shaped like the patient's foot. I have never seen their production facility, and would appreciate any feedback from someone who dispenses or fabricates these devices.

The photo above shows one of my leather devices compared to the same patient's chiropractic counterpart. Tell me which one is custom?

Carl Ganio, DPM, Vero Beach, FL, drcarlganio@bellsouth.net

I would certainly agree that one should thoroughly investigate the orthotic laboratory you are considering switching to, as much or more so than the laboratory you may have become accustomed to using. Heightened competition surely has invited more cut-throat marketing schemes, some of which have resulted in the scenario posted by Ms. Boren. It behooves all podiatrists to be sure that they are receiving what they are prescribing and that what they are dispensing is accurately described by the HCPCS codes they are submitting for reimbursement.

If providers don’t police this issue, then the insurance carriers will, resulting in the eventual denial of orthotic payments for all providers. Stay tuned for a future issue of Podiatry Management where I provide some other situations of, “If it’s too good to be true…..”

Paul Kesselman DPM, Woodside, NY, pkesselman@pol.net

ASSOCIATION POSITION - MONTANA

Two Doctor group seeks individual with three years of surgical training with emphasis on the forefoot. Diabetic foot fellowship desirable. Practice includes two physical therapists that work on site. Rural setting with excellent outdoor activities. Competitive salary and benefit packages with opportunity for partnership. Respond to: jclough@sofast.net or Fax to: 406-761-7219

PRACTICE FOR SALE - DALLAS TX

10 year old general podiatry practice, including, geriatric care, diabetic care, surgery, biomechanics, etc. Grossing approximately $185,000 part-time, can be made full-time. Hospital privileges available. Will stay for transition. Please reply to: footdoc8390@yahoo.com

P/T ASSOCIATE POSITION - QUEENS, NY

10 yr old practice seeks motivated, surgically-trained individual. Fax CV with hours available to (718) 458-0053.

ASSOCIATE WANTED – NEW YORK IMMEDIATE OPENING

Busy multi-dimensional practice; 70 miles north of New York City . Currently four (4)-doctor practice. looking to expand – all phases of podiatric medicine. contact: (845) 454-8308 EXT: 106

ASSOCIATE WANTED -BOCA RATON-DELRAY BEACH AREA

Great opportunity-must be hard-working, reliable, Responsible and good with patients & staff-surgical Training a plus-partnership after 1yr. Florida License required fax resume to 561-865-2225.

ASSOCIATE POSITION - NEW YORK CITY

Excellent opportunity for foot/ankle surgeon, Manhattan and Brooklyn Associate position leading to possible partnership. Requirements: Two years enrollment in a surgical residency program Qualities of self-motivation and impeccable skills in forefoot and rear-foot surgery. Package Includes: Malpractice insurance, Health Insurance plus salary, Incentives. Terms negotiable Email CV to Manfootcare@aol.com 212-349-7676

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 - NEW YORK STATE

ASSOCIATE Wanted To Be fast tracked into PARTNERSHIP. 6 doctor group with one partner anxious to retire. DON'T MISS THIS OPPORTUNITY. Check out our website www.footcaregroup.com then e-mail me to arrange a visit mhudes@footcaregroup.com

PRACTICE FOR SALE - PORT ST LUCIE, FLORIDA

The office is 0.2 miles away from the hospital. Good mix of Medicine, Surgery, Wound care, and general podiatric care. Wound care center privileges available. No HMO's. Please call 1-772-475-7920 or derrico@pol.net for details

Connecticut- Part time or Full time position available for a PSR 24 trained Podiatrist in the New Haven Area. We are seeking a hard working, ethical, charismatic practitioner for a well rounded established office Please email resumes to Surgeonseven@aol.com. Position available ASAP or July.

ASSOCIATE POSITION - FLORIDA , NAPLES

Great opportunity for PSR- 24/36 BE/BC podiatrist with strong surgical skills to join multi-office practice. Hospital privileges available at 648 bed hospital system, 200 bed hospital system and multiple surgical centers. Candidate should have the skills and desire to perform rearfoot surgery including Charcot reconstruction and ankle surgery. Florida has a great scope of practice law and we rotate for ER call at all 4 hospitals. Candidate needs to be ethical and motivated. Established practitioner or new practitioner OK. Base salary, percentage, benefits including 401K. Fax CV to (239)566-8778 or Email CV to Drgordon@gulfcoastfootcare.com

PRACTICE FOR SALE - AUSTIN, TEXAS

15 year established practice with good mix of surgery and clinical patients. Nice office condo for sale with practice or lease. Current podiatrist will transition the practice. 300-400K yearly gross. Flexible payment options MRobsonDPM@aol.com

CASE CONSULTING

Dennis Shavelson, DPM is now accepting referrals of difficult cases involving biomechanics, surgical complications, 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

PODIATRISTS TO SHARE OFFICE SPACE - BROOKLYN, BRONX

Office space to rent on busy 737 Nostrand Avenue, Brooklyn. New Bronx building and offices at 1250 E 223 St. Bronx. PRIVATE OFFICE, 3-4 treatment rooms, separate receptionist area, waiting room and 2 bathrooms.CALL CRISPIN ADAMS: (917) 301-6284

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