The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

March 13, 2009 #3,492 Publisher-Barry Block, DPM, JD

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Lebrija Re-appointed to MN Board of Podiatric Medicine

Dr. Edward (Alex) Lebrija of  Morris, MN has been reappointed to the Board of Podiatric Medicine by Gov. Tim Pawlenty. He will serve a four-year term that expires Jan. 7, 2013. Lebrija has been a licensed Minnesota podiatrist since 2000. He practices at Stevens Community Medical Center in Morris and at Ortonville Area Health Services Medical Center in Ortonville and was appointed as a podiatrist member of the board.

Dr. Edward (Alex) Lebrija

Dr. Lebrija is board certified in both Foot Surgery and in Rearfoot Reconstruction and Ankle Surgery by the American Board of Podiatric Surgery.  He received his D.P.M. degree from Barry University School of Podiatric Medicine in Miami, Florida. Dr. Lebrija completed three years of surgical residency at Millcreek Community Hospital in Erie, Pennsylvania.

Source: St. Paul Legal Ledger [March 12, 2009]
 

Podiatric Presence Felt at Nail Council Scientific Meeting 

The annual scientific meeting of the Council for Nail Disorders was held on Thursday, March 5th, as part of the American Academy of Dermatology Annual Scientific Sessions and Exhibits in San Francisco.  Bryan C. Markinson, DPM, a board member of the council, reports that the meeting was the largest in its history in terms of attendance, not only by the international community of dermatologists interested in nail diseases, but by doctors of podiatric medicine. 

Dr. Bryan Markinson

Dr. Markinson reports that the podiatric physicians in attendance contributed greatly in both the question and answer sessions and open panel discussion that concluded the meeting. The podiatrists in attendance also got to see first-hand the complete open door policy to members of our profession as well as their appreciation for what we bring to the table in this growing scientific area of investigation.  

At a board meeting immediately following the scientific session, a major point of reflection was on the increase in attendance by podiatrists and their contribution to the success of the meeting. In total, it was a great day and a home run for podiatry.

Be Prepared To Sacrifice, Official Tells AMA

With healthcare costs skyrocketing, all players in the healthcare industry “are going to have to give something up” to achieve comprehensive reform, a White House official told physicians at the American Medical Association’s 2009 Seventh Annual National Advocacy Conference.

Ezekiel Emanuel, special adviser on healthcare with the Office of Management and Budget, issued a challenge to doctors during his presentation. “This is not about what you want, but what you’re going to contribute to make sure that healthcare reform goes forward,” he said, adding that he’s posing the same challenge to payers and other providers. In achieving this goal, the easy way out would be to just to spend more money in an effort to cover all Americans, Emanuel said. Instead, “we need to focus on quality and efficiency such as bundling payments, and pay-for-performance” measures to improve care and reduce utilization of services, he said.

AMA President Nancy Nielsen acknowledged that parties in this debate were bound to disagree, but asked that the administration treat doctors respectfully. Physicians do need some assistance on some issues, such as meaningful tort reform and antitrust relief, she said. President Barack Obama’s fiscal 2010 budget blueprint does target physicians in some of its healthcare cost-saving measures , yet it also offers a 10-year reprieve to Medicare physician payment cuts.

Source: Jennifer Lubell, Modern Healthcare [3/11/09]

Survey Finds Doc Use of IT Up; Money Still Key Issue

Compared with a similar survey five years ago, information technology use has almost doubled among members of the American College of Physician Executives, but money remains the primary reason why some have not implemented an IT system. About 1,000 of the Tampa, FL.-based organization’s 10,000 members participated in the survey that was posted online in November and December of last year, and 64.5% said that they have an electronic medical record system in place—compared with 33.1% five years ago. Almost 10% in this year’s survey said they were testing a system, compared with 14% in the 2004 survey. Only 5.9% said they haven’t started planning for EMR implementation, vs. 15.1% five years ago.

In terms of computerized physician-order entry, 43.8% said they were already using it while 13.9% said they were testing a system. In 2004, 23.3% said they had implemented CPOE and 15.8% were in the testing phase. The percentage of members who had no CPOE development under way decreased to 13.7% from 22.4% in 2004. At 32.9%, reducing liability and medical errors was the prime reason given for adopting IT, while lack of money and resources was the top reason for not doing so. This was cited by 40.9% of the respondents compared with 45.9% in 2004.

Source: Andis Robeznieks, Modern Healthcare [3/11/09]

Query: Scope of Practice in Australia

What is the scope of podiatry practice in the land down under? As I recall, the scope in the U.K. is rather limited compared to the U.S.A. If the scope in Australia is broader than the U.K., why would anyone want to leave Australia to practice in the U.K.?

Al  Kanegis, DPM, Westbury, NY
 

RE: Council for Nail Disorders Meeting
From: Jeffrey A. Stone, DPM

The Council for Nail Disorders was held last Thursday at the American Association of Dermatology meeting in San Francisco. It was the 13th Annual Meeting and is the most prestigious assembly of international investigators, physicians, and scientists concerned with nail pathology.
 
The purpose of the annual Council meeting to update the physician community on any advances in  the evolving science. The Council brings together physicians and researchers to acquire awareness, knowledge, and skills in nail disease. The spirited audience included basic scientists, dermatologists, podiatrists, hand surgeons, primary care physicians and industry personnel.
 
The faculty was a living "Who's Who" in nail dermatology and any reader of texts and articles concerning nail disorders got to see each author personnally.  This included C. Ralph Daniel, M.D., Richard K Scher, M.D., Antonella Tosti, M.D., Boni Elewski, M.D. and Phillip Fleckman, M.D. All of these physicians are the editors and assistants editors of the hallmark text, Nails, Diagnosis, Therapy, Surgery." Also speaking was Dr. Robert Baran who wrote the reclassification of Nardo Zaias' model for onychomycosis presentation. He was an intellectual hoot.
 
I was extremely pleased  to see the professional parity displayed between these gentlemen and Bryan Markinson, D.P.M.  Dr. Markinson has been as active member of the Nail Council and is clearly perceived as an equal by these luminaries.  He was also reappointed to the Council Board. Kudos to Dr. Markinson. I recommend that any podiatrist interested in onychomycosis (and who isn't?) or other nail pathology join the Council for Nail Disorders, and get active on of both your patients and your profession.
 
Jeffrey A. Stone, DPM, Goodyear, AZ, Desert1doc@aol.com
 

RE: Voice Recognition Software (Tom DeBenedictis, DPM)
From: Marc Garfield, DPM, Larry Kosova, DPM

Dragon has the best software, but beware of the pitfalls: 1) the new addition (V10) will not work with an EMR unless you have the medical version.  It has coding to specifically block out EMR programs, so you cannot even use a text box, then cut and paste. If you do, you will get errors. Version 9.X works well at the preferred level ($100), most reviews do not substantiate the professional or medical versions--the vocabulary is almost the same. 2) Computer dictation can be flawed, expect to review your dictations in great detail for several months. 3) Rushing voice dictation will yield poor results. 4) Some errors can be downright embarrassing if not caught. 5)Your computer should have a 2.0 G duo-core and 3 g RAM minimum. 6) Expect to spend $150 on a good wired microphone and $300 on the wireless. The benefit over a $30 microphone is actually very small but 5% more errors can lead to lots of time in corrections or missed subtleties, "uhhh...rectus" may type, well you get the picture. 

Vista Dictation comes with all new computers and works almost as well--for free, but has no medical diction built in and has to be cut and pasted into your notes, it will not connect directly into an EMR, but cut/paste and all other computer functioning can then be fully and accurately voice-controlled. emicrophones.com has free tools to facilitate VISTA VOICE dictation into med records or EMR. 

Marc Garfield, DPM, Williamsburg, VA, mgarfield1@cox.net

As Mark Johnson suggested, the only game in town is really Dragon. If you are new to speech recognition, then start with version 10. Some will suggest the preferred version, but I recommend Medical for new users. It will just make the program easier to use and more accurate for the doctor’s language that we use. YES, you can add words you need later, but it works very well out-of-the-box. I would suggest a very fast computer, and yes dual or quad core since this program and Windows Vista use a lot of resources.

Buy a real speech microphone for anywhere from $50-150. I use a modified Sennheiser 835 head set (about $150). This will cut down on errors. You need to use a device called a USB pod (Andrea pod about $45.00 external soundcard) as the ones in laptops/computers tend to create noise and are less accurate. You can also use the speech system that is already in Vista, but it is not very good for what we do. It is designed for a high school student writing a paper.
 
I would suggest using a speech EMR, since talking into a computer does not prevent your notes from being altered. This issue has been a hot topic in recent lawsuits.

Larry Kosova, DPM, Chicago, IL, lkosova@yahoo.com

RE: Podiatry Must Speak With One Voice (Judith E. Rubin, DPM)
From: Jeffrey Kass, DPM

Editor’s note: Dr. Kass’s extended-length note can be read at: http://www.podiatrym.com/letters2.cfm?id=25117&start=1

RE: Roger Buehler, DPM 

Roger was probably the classiest, nicest, and most "good-hearted" colleague I have ever met. For those of you who know Yiddish, he was the quintessential mench. Podiatry has lost one man who typified what our profession should be all about.
 
Michael Z. Metzger, DPM, MBA, Houston, TX

ASSOCIATE POSITION – NAPLES, FL

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. 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-SOUTHEAST MICHIGAN-BRIGHTON

Outstanding opportunity. Eleven year established-earn 200K. Excellent location in mid to high income growth area.  Turn-key, all equipment and furniture included. High quality 1,350 sf build-out. Large illuminated sign on busy main road, convenient parking. Must sacrifice due to illness. Priced to sell. Call (248) 565-5266.  Docpod@aol.com 

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 

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

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 -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

ASSOCIATE POSITION – HOUSTON, TX

Associate needed for 30 Year Houston practice. 2 offices, each located in growing medical center. Heavy surgical/office practice with minimal RFC. Tremendous opportunity for personable self starter. English & Spanish would be a big asset.PM&S-24 and PM&S-36 graduate welcome. Texas license required. Reply to ssssmosk@aol.com

PRACTICE FOR SALE - CENTRAL FL

Practice sale, in beautiful, high quality of life, growing area; 2000 sf bldg. fully equipped/ designed for podiatry; excellent location, features & exposure; near hospital, wound and HBO center. Great opportunity for expansion; good insurance climate. 352-357-7499 / E-mail: windnwave@earthlink.net

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

PRACTICE FOR SALE or ASSOCIATE WANTED – SOUTHEAST OHIO 

Well-established, two-office practice in Southeast Ohio for sale. Seller currently works 3.5 days per week. Gross >$300K, Net ~$140K.  Excellent locations and growth potential. All equipment and furniture included. Seller is willing to help with transition, Ohio Licensure. Contact seller at bjadpm@hotmail.com for more information.

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