The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

March 03, 2011 #4,098 Publisher-Barry Block, DPM, JD

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Moisture is the Enemy of the Feet: NY Podiatrist

Foot scourges like athlete's foot and plantar warts thrive in water – so you should do your best to keep your feet protected and dry. If you take a shower after your workout at the gym, try to remember to bring flip flops with you. But even if you don't, don't despair: You can wipe your feet down with a little alcohol to make sure all is clear, says Manhattan podiatrist, Dr. Johanna Youner. 

Dr. Johanna Youner

When you're wearing shoes, make sure your feet stay dry, she urges. "The best protective thing is just to put some cornstarch in your closed shoes," says Dr. Yourner. "It protects you from all sorts of things that can break down your skin." This is especially important with boots.

Source: Melanie Lefkowitz, Stylist

Flat Feet Often Lead to Knee, Hip, and Back Problems: TUSPM Professor

Parents and pediatricians have historically ignored signs and symptoms of flat feet, but new evidence suggests this oversight has created a large number of patients with foot problems that crop up in adulthood. According to Philip J. Bresnahan, DPM, assistant professor of podiatric medicine at Temple University School of Podiatric Medicine in Philadelphia, the foot is a series of interlocking bones that, when working well, can support the full weight of a grown man or woman who walks 10,000 steps a day. 

Dr. Philip Bresnahan

“But when those bones are not connected well, it’s like standing on a bag of marbles, which provides no support and flat feet occurs,” he said. Left undiagnosed and treated, flat feet often lead to knee, hip, and back problems.

Source: Rockford Register Star [2/28/11]

APMWA Announces 25th Annual Student Writing Competition

The American Podiatric Medical Writers Association has announced its 25th Annual Student Writing Competition.

• All papers MUST be non-technical in nature. Appropriate subjects include practice management, ethics,or any topic that would be suitable for a lay publication.
• There is no word limitation. Papers will be graded for content, style, grammar, neatness, and overall impact.
• First prize will be one thousand dollars ($1,000.00), sponsored by an APMA Educational Foundation endowment from Dr. and Mrs. Steven Berlin, and recognition in the APMA NEWS and the APMWA Newsletter. Honorable Mention Certificates may also be awarded.
• This competition is open to ANY enrolled podiatric student.
• Entries must be received by 4/1/11 via e-mail at bblock@podiatrym.com
• Entries become the property of APMWA, which may arrange publication of the entry.

Entitlement Spending Next on Agenda: Cantor

As House leaders prepare to vote on a short-term spending bill to avert a government shutdown, the No. 2 Republican in that chamber told hospital executives that the House will next address entitlement spending. “It will likely be the first time you see a House have a prescription for Social Security, Medicare, and Medicaid,” House Majority Leader Eric Cantor (R-VA) said to attendees Tuesday morning at the Federation of American Hospitals' annual public policy conference and business exposition in Washington.

The so-called continuing resolution for the remainder of 2011 that is the center of debate on Capitol Hill this week deals with discretionary spending, but not entitlement programs. House and Senate Republicans recently chided President Barack Obama for not tackling entitlement reform in his budget, which he released Feb. 14. The House will release its budget this spring, and Cantor's comments suggest entitlement reform will be a part of that financial framework.

Source: Jessica Zigmond, Modern Healthcare [3/1/11] 

Call for Nominations - Podiatry Management's 2011 VIP List

Every five years, Podiatry Management Magazine publishes its "Most Influential Podiatrists" list. This list is compiled by the editorial board of PM. We invite nominations of individuals for this prestigious honor. Please send nominations along with a brief statement of why this podiatrist belongs on the VIP list to bblock@podiatrym.com. Self nominations will be accepted. 

Query: Twitter

Does anyone have their patients following their office using Twitter? What has been your experience using it? I think this would be a neat way to keep patients apprised of things happening at the office, as well as to keep in touch with them. It would be just an office e-mail attached to the account, so messages would also be sent to the main desk if appointments were needed.

Charles R. Oehrlein, DPM, Hoover, AL  

RE: Fraud and Abuse (David Gurvis, DPM)
From: Multiple Respondents

I would like to thank Dr. Gurvis for bring up this vital topic of providing nail care as a covered service when you know it is not. I have a practice in the Midwest and frequently have patients without qualifying conditions mad that they cannot get their podiatric services for “FREE.” It is time-consuming to explain that there are specific rules and that they do not qualify. The mass majority are not even remotely close to qualifying.

I tell them that I would not like to go to jail, and that I will not lie to get their desired services covered. Some will decline the services if not covered, but most request care as an out-of-pocket expense.

I have a podiatry friend who told me that he was billing for services when he knew that they were not covered. His excuse was that the patient deserved the care. I think that this is true, but are you willing to go to jail so that the patient does not get the bill? I am not. We should clean our own house.

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

With all due respect to Dr. Gurvis' frustration, the input staff of the office should be trained to screen out patients such as these.  Questions should be asked when the patient first calls the office (if the potential patient states they need toenails trimmed, the phone-screener should ask questions that will certify routine foot care).  The input questionnaire should be very clear as to what constitutes routine foot care. When the staff reviews the questionnaire and does not see routine foot care qualifiers, the patient should be informed of that. In my opinion, those not eligible for Medicare's covered foot care can be screened out during the initial phone call. There is no sense having the doctor go on a hunting expedition trying to find a reason to qualify a patient for routine foot care.
 
Richard A. Simmons, DPM  Rockledge, FL,  rasdpm32955@gmail.com

If what you say is true, the previous podiatrists are stealing money from you. Document the good health of the patients, and encourage them to file qui tam lawsuits against the podiatrist thief.   

Dwight L. Bates, DPM, Dallas, TX, dlbates04@yahoo.com

RE: Fraud and Abuse (David Gurvis, DPM)
From: Multiple Respondents

There is no reason NOT to explain to patients or potential patients why Medicare, etc. will not pay for nail care on healthy patients. What these doctors are doing is illegal and fraudulent and should be rooted out. I have always told those patients who tell me that other podiatrists they went to did this to return to them because there was no way I would commit fraud for anyone and subject myself to prosecution. Trust me, any patient you lose because of that is not one you really want in your practice.
 
Brian Kiel, DPM, Memphis, TN, Footdok4@gmail.com

I couldn't be more proud of a podiatrist than I am with Dr. Gurvis.  I have dealt personally with this issue in my past business relationships. In fact, thanks to PM News, we read weekly of podiatrists who are bring fined significant amounts of money for Medicare fraud - one recently in my own professional back yard.  For what? Toenails? Some of our seasoned colleagues just can't grasp the fact that it is okay to bill a fee for service. Is trimming nails worth a large Medicare sanction or jail time?  Medicare has invested significant resources in their waste, fraud, and abuse department. No longer is the "little guy" immune.

Podiatrists who sympathize with the old sweet lady in his practice for years find it hard to be honest regarding nail care, so they justify and rationalize their billing and document pain when it doesn't exist, etc. As long as these podiatrists continue to put money above integrity, we all suffer. I find that my patients understand Medicare cuts and, when explained correctly to them, will pay cash if they truly appreciate the service, or leave...in which case, it relieves me of a patient relationship built on gaming the system.  A win-win for me.

Randall Brower, DPM, Peoria, AZ, footdoctor33@yahoo.com

Dr. Gurvis hits the nail on the head. I have ascribed to the "black and white" theory of it is or is not covered. When the patient gives me the "free" line, I respond by saying that it is not free, and we are all paying for this service. I do not and will not play the game, and I too explain to patients that this is not a covered service by Medicare and the fee is $XX, cash, check or credit card. I tell them that I will not commit fraud and do not look good in stripes, and they are welcome to return to their other podiatrist. I can't wait until Medicare continues to reduce the value and reimbursement of the service even more, or better yet, deems any kind of trimming or debridement of toenails to be statutorily non-covered. At that time, the treating podiatrist will find out whether or not the patient who liked "free" service will place a value on the service rendered.
 
Greg Amarantos, DPM, Chicago, IL, amogreg@aol.com

RE: Purging Medical Records for Deceased Patients (Cynthia Ferrelli, DPM)
From: Susan M. Weeks

I suggest scanning deceased patients' charts into a separate sub-folder. We file ours by last names and are always able to access the patient record. Oftentimes, there are still unpaid financial obligations so charts are not scanned until all debts are resolved.

Susan M. Weeks, PMAC, Knoxville, TN, weekssusan@bellsouth.net

RE: Aetna Discrimination Against Podiatrists in New Jersey (Jonathan Michael, DPM)
From: James Sang, DPM

Unfortunately, the denial of any new solo DPM practitioner or new DPM group joining Aetna due to a closed panel is not unique in New Jersey. This also occurs in the Philadelphia, PA area. To make matters worse, in the Philadelphia area, our local Blue Cross/Blue Shield provider, Independence Blue Cross, is currently not accepting any new solo DPM practitioner or new DPM group due to the panel being closed to podiatrists.

In essence, the only way a new DPM practitioner can get onto the Aetna or Independence Blue Cross panel is...
 
Editor's note: Dr. Sang's extended-length letter can be read here.

RE: Practice Fusion (Donald Brann,DPM)
From: Joe DeTrano

Practice Fusion is very clear about our ad-supported business model. Information about our ad program is posted on the website for anyone to see. They do not share information about providers or patients with the insurance industry. Not only would it violate company privacy policy but also HIPAA regulations. Any questions can be happily answered at support@practicefusion.com

Disclaimer: My firm is a licensed partner of Practice Fusion.

Joe DeTrano, CPC Medical/Medical Data Resource, joe@medical-billing.com

RE: Bakotic to Be Inducted into the PM Podiatry Hall of Fame
From: Jeffrey Kass, DPM

I would like to congratulate Dr. Bradley Bakotic for his well-deserved induction into the PM Podiatry Hall of Fame. Dr. Bakotic's commitment to the profession is tremendous. I would reach out to anyone who currently does not use his pathology lab to use it. The service and quality of their work is excellent, and the dividends received by using the lab are revealed in the generous philanthropic work that Dr. Bakotic and Bako Labs perform. We must support those who support us.
 
Jeffrey Kass, DPM, Forest Hills, NY Jeffckass@aol.com

RE: GA Podiatrist Discusses Diabetic Neuropathy
From: Michael Brody, DPM

In reference to this article, a patient's PHI has been released.Unless there is written permission from the patient to release his name in this manner, this article is a HIPAA violation on the part of the podiatrist.

Each day new HIPAA violations and fines are making the news. We need to be ever vigilant on protecting the confidentiality, integrity, and security of our patients' information. It is of interest that PM News is not in violation of HIPAA since PM News obtained this information from a news source, PM News and the source cited are not considered a covered entity under the HIPAA regulations.

Michael Brody, DPM, Commack, NY, mbrody@tldsystems.com

Editor's comment: PM News does not provide legal advice. Two of the exceptions to the HIPAA privacy rules is when patients 1) consent to release of PHI or 2) Patients waive this right by disclosing PHI in public.

PM News generally prints excerpts of published articles. Had we printed the entire article, it would have been oobvious that the patient (as well as the doctor) was interviewed, and thereby he waived his right to privacy. For example, if a professional athlete reveals that he is being treated for an injury, that injury is no longer privacy-protected PHI. 

RE: Manipulating Patients for Financial Gain? (Jeffrey Kass, DPM)
From: Allen M Jacobs, DPM

Maybe Dr. Kass needs to read the letter from Dr. Gurvis regarding fraud and abuse which preceded his letter in PM News on March 1, 2011.  It would answer his own question.

Allen M Jacobs, DPM, St. Louis, MO, allenthepod@sbcglobal.net

ASSOCIATE OPPORTUNITY - FREDERICKSBURG, VA

Progressive, busy practice seeks personable, ethical, confident associate interested in future partnership. Lucrative opportunity for self-starter with strong work ethic. State-of-the-art office in rapidly growing community with two new hospitals and new surgery center. Practice has excellent reputation with well established referral base. Cover letter/CV to: fredfeet@verizon.net

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

ASSOCIATE POSITION - SOUTH/CENTRAL PENNSYLVANIA

PSR-24/36 trained individual for busy practice in family-friendly college town. Seeking personable, ethical, motivated individual to join our well established practice providing all aspects of podiatric care. Competitive salary and benefits package. Reply with letter and CV to Jagerone@aol.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

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

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

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 - 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

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 12,500 DPM's. Write to bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $109 for a 50-word ad THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451.

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