The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

March 01, 2011 #4,096 Publisher-Barry Block, DPM, JD

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NY Podiatrist Dies in Vintage Military Crash

The pilot of a private vintage military jet that crashed into the Hudson River near the Kingston Rhinecliff Bridge has died, according to the state police. Police divers Sunday morning will resume searching for the body of 38-year-old Dr. Michael Faraldi of Germantown, a Rhinebeck podiatrist and father of two. Faraldi was the only person aboard the jet, which crashed into the ice in the Hudson River Saturday just north of the bridge and was partially submerged.

Dr. Michael Faraldi

Faraldi was a podiatrist on the staff of Northern Dutchess Hospital and with a private practice in Rhinebeck, said Dr. George Verrilli of the hospital staff.

Source: John W. Barry and John Davis, Poughkeepsie Journal [2/26/11]

International Task Force Reports Consensus on Treatment of Charcot Foot

An international Task Force on Charcot arthropathy, supported by unrestricted educational grants from Small Bone Innovations, Inc.  and other orthopedics companies, has reached agreement on new recommendations for the effective treatment of diabetic Charcot foot. The Task Force, comprising experts in diabetic foot disorders and Charcot arthropathy was convened on January 31, 2011 at the Pitié-Salpêtrière Hospital in Paris by the American Diabetes Association (ADA) and the American Podiatric Medical Association (APMA). The Task Force reported that it reached a consensus on the definition, pathophysiology, diagnosis, and recommended treatment of Charcot foot. 

Dr. Lee C. Rogers

Lee C. Rogers, DPM, co-chair of the Task Force and Associate Medical Director of the Amputation Prevention Center at Valley Presbyterian Hospital in Los Angeles, CA said: “Our 18-member Task Force representing six nations, discussed our frustration with the misdiagnoses, delayed diagnoses, and poor treatment of the Charcot foot. The Task Force is excited about newer developing treatments, but first, we need to combat things like lack of symptom recognition, ignorance of the consequences, and reluctance of doctors to prescribe effective treatments.” Other podiatrists on the task force were Drs. David Armstrong, Robert Frykberg, and Lee Sanders.

Editor's Note:  PM News is proud to present excerpts from Meet the Masters

Bret Ribotsky: If you had a wish for the profession, what would it be? 

Dr. Allen Jacobs

Allen Jacobs: My wish would be that podiatrists would appreciate the profession for what it is, what it has become, and just do what is right for the patients. If podiatrists would not worry about manipulating patients for financial gain, I think everyone would be just fine. I think that our profession offers wonderful and valuable services, whether it is palliative care or total ankle replacement, and everything in between. I just wish that the profession would have a bit more pride in itself and have the realization of the wonderful services we provide people on multiple levels.

Dr. Joseph Agostinelli

Meet the Masters is broadcast each Tuesday Night at 9 PM (EST). The next segment  will feature retired Air Force Colonel Joseph Agostinelli, DPM, . You can register for this event by clicking here

Conflict Resolution

Conflict is unavoidable, but conflict can be addressed, managed, and even resolved succesfully. Here are 5 steps that you can take before problems arise that will help you when they do:

• 1) Start by asking yourseld some very basic questions: Why are you in practice? What is your mission?
• 2) Recognize your limits - what you can and cannot control.
• 3) Recognize what is truly at stake. The presenting issue is rarely all that is involved, and most frequently just pretext.
• 4) Solve the patient's problem, and you can solve your own.
• 5) Do not wait for a problem to address it.

Source: Martin Ellin 

Query: Purging Medical Records for Deceased Patients   

Does anyone know of a way to find names of deceased patients? I have my staff on a project of weeding through charts. I know you have to keep charts for seven years,  but I am looking for a way to identify those who have passed more recently, so the records can be filed separately.

Cynthia Ferrelli, DPM, Buffalo, NY

Editor's comment: PM News does not provide legal advice. Googling a patient's name often brings up an obituary notice. Note: The fact that a patient is deceased does not eliminate the need to maintain that patient's chart. Legally, the heirs of the patient could theoretically commence a lawsuit against you. In that instance, the defense that you no longer have the chart would not serve you well.

RE: Consent for Lasering Fungal Nails (Sean Ravaei, DPM)
From: Lowell Weil, Sr, DPM

Low energy lasers may not need a consent because there is no danger to injury, however the lasers that are being used for "fungal nail treatment" are all high energy devices that have the potential for injury (burn) if the settings are not correct or if a malfunction would occur to allow a burst effect.

In addition, I think that  a consent should also include a statement that "I have been informed that not all fungus nails are able to be cured using laser technology and resistant fungal nails may not be respond to this treatment." This may save a false advertising claim.
  
Lowell Weil, Sr, DPM, Des Plaines, IL, weil4feet@aol.com

RE: Aetna Discrimination Against Podiatrists in New Jersey‏
From: Jonathan Michael, DPM

For the past three years, I have been trying to participate with Aetna Health Care in New Jersey, but the panel is always closed for podiatrists. I was told by the Aetna rep that Aetna feels that they have enough podiatrists, and they limit the number of podiatrists to one per county! I am a young member of the profession with over $250,000 in student loans. My referring MD sources stated that I have to accept all insurances in order for me to get referrals, as their staffs do not have the time to pick and choose which patients to refer to me.

I feel this is discrimination to podiatrists and to the patients because the choice Aetna patients have is to see the podiatrist who is appointed by Aetna. I am seeking any DPMs in the same situations to email me as I will file a class action lawsuit against Aetna. Any advice is appreciated.

Jonathan Michael, DPM, Bayonne, NJ, njfootdr@hotmail.com

RE: MD-Logic (Jack Ressler, DPM)
From: Scott Shields, DPM

I have been using MD-Logic for years and have recently converted to EMR. I am VERY happy that I did. We are still scanning charts and this transition is long and on-going, but not as disruptive as I thought that it would be. I have a computer in each treatment room and for me this has worked out well. I recommend MD-Logic and would do it again. I do not have any financial arrangement with MD-Logic.

Scott Shields, DPM, Enid, OK, shields1@suddenlinkmail.com

RE: MD-Logic (Jack Ressler, DPM)
From: Will Parker, DPM

I have been using MD Logic for just three months now, and I am happy to say I love it. First of all, training was well done (3 days on-site). They worked with each staff member on individual roles. On day 4, we were flying solo and and were 100% implemented.  MD Logic was easy for the staff to get excited about. The learning curve was short. It is a touchscreen system. You do not have to navigate drop down boxes with a mouse or stylus pen. You just need your finger, and this makes charting fly. 

I previously dictated with Dragon Dictate and printed for paper charts. The three main selling points for me were: 1. Fastest system I have seen with easiest interface 2. Documentation is robust and podiatry-specific (you can customize to your liking if you choose) 3. My staff (mostly older ladies with limited computer skills) loved it after a live demo.

My advice to anyone looking at EMR is to take into consideration the way it will impact your staff. You may love it, but if it terrifies your people, there will be problems. Also, customer/technical support has been very good (and seldom needed). I have no financial relationship with the company. I am just a very happy guy with a whole lot of extra time on my hands these days. No more mountains of charts.
 
Will Parker, DPM, Conway, SC, wlparker@conwaypodiatry.com

RE: EHR/EMR Gouging (Donald Brann,DPM )
From: Jeffrey Kass, DPM, Marc Katz, DPM

Dr. Brann makes an interesting point about "collecting physician information". However, he should not differentiate a "free EMR" from a paid one. In each instance, insurance companies will be acquiring physician data. In fact, a lot of people are running out to get EMR in order to qualify for this $44,000 incentive. And again, no one is handing you out money for nothing. This data that is collected will undoubtedly be used against us in due time.
 
Jeffrey Kass, DPM, Forest Hills, NY, jeffckass@aol.com

Of course, there has to be a reason that a company provides a program for free. It has to be supported somehow. These are not philanthropists; they are business people.

Don't you think that the insurance companies see everything we do when we submit claims and send them notes? They know exactly what is going on. Practice Fusion does not put your name on the data that is sent. And we already know, with some certainty, that reimbursement and medicine will soon look  very different than it does today.  Changes are on the horizon and we need to be ready. Practice Fusion is hardly my biggest worry. I think they have put together a strong company and good product.

I've been "trialing" the program and think that it is superior to many of the costly programs available today. I would imagine if many of the programs had the opportunity to make some money selling  anonymous data, they would all be lined up. And finally, many of the companies selling programs will be out of business. Their models are not sustainable. Practice Fusion looks like they have a unique sustainable model.

Marc Katz, DPM, Tampa, FL, dr_mkatz@yahoo.com

RE: H&P's for Podiatrists (Robert Bijak, DPM)
From: Jon Purdy, DPM, Elliot Udell, DPM

There is a saying, "Be careful what you wish for." Can you imagine what the practice of podiatry would be like if Medicare and insurance companies were to take a 180 degree turn and  insist that in order for a podiatrist to get paid for treating a case of onychomycosis, plantar fasciitis, or even a verruca, he or she has to perform a complete physical exam on the patient? Could you imagine what a busy practice would be like, if in order to be paid for treating a minor foot problem, you had to listen to a patient's chest, take their blood pressures, palpate their bellies, examine their throats and ears, do a breast exam or prostate exam, take an EKG, etc. We would all become as adept at doing these tests as the family practitioner down the block, but after the novelty would wear off, the time consumed in doing these tests would send the best of our practices to hell in a handbag.  

Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

At one time, I felt very qualified to perform H&P’s. In school, I went through our H&P course and was tested with “actors” faking symptoms.  In residency, I rotated through many months of neurology, ER, and other specialties where I performed H&P’s. I did three months of internal medicine where we podiatrists did the full admission, presented cases in morning rounds, and followed and managed patients through discharge. 

While a resident, I witnessed other specialties (orthopedics comes to mind) that did their own pre-operative H&P’s which were a fraction as good as mine. I recall rounding in the ICU with the attending orthopod who looked at his consult and asked the nurse what all the wires and tubes coming out of the guy were about. Dumbfounded, she had to inform him that his patient was in the ICU which should be self-explanatory. 

I guess the point is that we take risks every day and operate within our comfort zones of training. Doing an H&P on an otherwise healthy patient, and being sued for missing that one in a million this or that, is no more risky than not biopsying that little melanoma or having the infection go bad. We are multi-system clinicians and surgeons. There’s always going to be that “expert” to tear you apart. Although I don’t do my own H&Ps anymore, and not because I don’t have my IM friend to pay $20 to do the rectal exam for me, I just lost my touch. I certainly don’t begrudge those competent to do them. 

Jon Purdy, DPM, New Iberia, LA, podiatrist@mindspring.com

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/PARTNERSHIP - CHICAGO

Chicago Podiatric Surgeons, one of Chicago’s leading podiatric practices, is searching for a FT podiatric surgeon. Applicant must be a personable and confident surgeon with ability to manage surgical patients independently and be at least board qualified. High compensation. Will be working in new 7000 sf state of the art office in AN upscale Chicago neighborhood. Ownership/partnership opportunities. Send letter of intent and CV to drcarr@chicagopodiaty.com

ASSOCIATE/OPPORTUNITY - PHOENIX 
 
Established practice seeking motivated min. PSR24+ personable, ethical, motivated person to join state-of-the-art multi-office locations. Partnership/Ownership opportunity in practice, real estate, surgical center. Also interested in existing practitioner to merge or work part time. Contact AZPODAssociate@aol.com  Must be pursuing or have AZ license.

ASSOCIATE POSITION - MARYLAND

IMMEDIATE Associate needed to join a multi-office podiatry practice in the Baltimore MD Region. Desired candidate should be surgically trained with Board Eligible/Certification. You must be hard-working, ethical, compassionate and confident in your abilities to deal with pathology, patients, staff and fellow physicians. Patient base is already established. Excellent income and growth potential for the right associate. Please forward a cover letter, resume, and surgical log (if a current resident) and availability to FootDocMaryland@Gmail.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

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 - NE GEORGIA SUBURB

Immediate opening for PSR24/36, ABPS Qualified or Certified individual. Hosp/Amb. Surg. Ctn privileges available. Good chance of partnership or practice purchase in foreseeable future. Send resume/CV to gramps395@yahoo.com

TWO ASSOCIATE POSITIONS - WEST CENTRAL FLORIDA

One in general podiatry, second with surgical residency. Good diagnostician, compassionate, hard-working individuals needed for high-tech group practice. flpodiatrist@tampabay.rr.com

ASSOCIATE POSITION - KENTUCKY
 
Very well-established podiatry practice in Louisville, KY seeks a motivated, ethical practitioner trained in all phases of podiatry including routine care, surgery and wound care to join 2 other podiatrists. By joining our practice you will receive a competitive salary with a bonus structure and benefits. Our practice is equipped with DME, PadNet, Gait Scanner and on site retail store. There is a huge potential to grow your practice with our ideally located facility that has strong affiliation with leading area hospitals as well as 2 local residency programs. For immediate consideration, please forward CV to Samuel10530@yahoo.com

ASSOCIATE POSITION AVAILABLE - NY

Busy Midtown Manhattan state-of-the-art practice with 2 locations seeking part time/full time associate. Must be in-network Empire BC/BS. Looking for a personable doctor with immediate availability. Residents Need not apply. DrB@myfcny.com

ASSOCIATE POSITION - WEST CENTRAL FLORIDA

A great opportunity to join a very busy, well-established, diversified practice in Clearwater, FL. Seeking an associate who has the drive and desire to work hard, has strong work ethics, and is very personable. BC/BE and minimum PSR24 +. We offer competitive salary and benefits. Send resume to Jaye@fdn.com

FELLOWSHIP OPPORTUNITY
 
Applications are being accepted for the Central Kentucky Diabetes Management Fellowship. Dr. Jonathan Moore, former UTHSC Diabetes Fellow, OCPM adjunct faculty, AAPPM board member and national lecturer and author on diabetes and practice management related topics is director and founder. Don't miss out on the most unique, dynamic fellowship in Podiatric medicine. Learn latest advances in Diabetes management/surgery along with knowledge to run and grow a successful practice. Generous stipend, full benefits and free housing in resort setting. Email CV and letter of interest to: jmoore@aappm.org  Visit our website

PRACTICE FOR SALE - MARYLAND, DC SUBURBS

Great opportunity. Well established and equipped practice for sale. Office includes state licensed Ambulatory Surgical Center. Present owner is retiring but will stay on as needed for smooth transition. Average gross over past 3 years is $575 K. dpmpracticeforsale@yahoo.com

PRACTICE FOR SALE - BOSTON SUBURB

A 12+ year practice, including all equipment is for immediate sale. Average gross is $100K while being open only one day weekly. The ability for increased growth potential is obviously excellent with increased hours. Doctor is looking for serious offers only. Reply to shop@thefootdoctor.com

SPACE AVAILABLE- NYC & LI

Office to sublet and share - 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

PM News Classified Ads Reach over 12,500 DPM's and Students

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