The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

March 16, 2012 #4,411 Publisher-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2012- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

TX Podiatrist is New A&E Celebrity

A&E has expanded its popular Storage Wars series into the Lone Star State with an all new cast of Dallas area bidders trying to turn the contents of abandoned storage units into a profit. Though it’s impossible to replicate the lovably quirky rock star collector Barry Weiss from the original series, A&E did find another off-the-wall eccentric for Storage Wars Texas in the form of the garishly garbed podiatrist Dr. Morris “Moe” Prigoff. Yes you read that right, Moe is a podiatrist (or foot doctor to you and me). And when I say “is,” that’s exactly what I mean, because by all accounts Dr. Morris Prigoff is still doing his foot doctorin’ at Oak Cliff Podiatry Centre and North Dallas Podiatry Centre.

Dr. Morris "Moe" Prigoff

Prigoff  received his Doctor of Podiatric Medicine degree in Cleveland from the Ohio College of Podiatric Medicine and completed his surgical residency at the Cleveland Foot Clinic and Brecksville Veterans Hospital. He is a Fellow of the American College of Foot and Ankle Surgeons, and a Diplomate of the American Board of Podiatric Foot and Ankle Surgeons. In addition to his medical background, Moe has also been a furniture collector for more than 30 years, and a reseller for more than a decade. He currently owns “River Regency Modern,” an antique furniture and art store located in Dallas.

Source: Asa Hawkes, Starcasm.net [3/14/12]

Early Screening of Diabetics Leads to Lower Amputation Rate: UK Podiatrist

Amputation rates for Isle of Wight diabetes patients are among some of the lowest in the country, according to a new study. The study, published in the March edition of medical journal Diabetologia, compared lower-leg amputation rates for Primary Care Trusts over three years. Head of Podiatry Services at St. Mary’s Hospital, David Shields said: "Around 10 years ago, together with Dr. John Rivers, an Island GP, we designed a pioneering new service to ensure that patients with diabetes were screened early for possible problems with their feet."

Linked with this, a specialist foot service has also been set up in the past few years at the Diabetes Centre at St Mary's Hospital, where a consultant in Diabetes, Dr. Victor Lawrence works together with David Shields, Stephanie Stanley (Deputy Head of Podiatry) and the multidisciplinary team for patients who have developed ulceration which can all too easily lead to amputation if not rapidly treated.

Source: Isle of Wight County Press [3/14/12]

PA Podiatrist Appointed to Bethlehem Police Civil Service Board

Dr. Joseph S. Saka has been appointed to the Bethlehem Police Civil Service Board. The police civil service board meets 4-5 times per year to discuss eligibility into the police force as well as eligibility and nomination for lieutenants.   

Dr. Joseph Saka

Dr. Saka graduated from the New York College of Podiatric Medicine in 2004 and completed a three-year residency at Hoboken University Medical Center (formerly St. Mary's Hospital). Saka is the first podiatrist ever appointed to the Board.

Late TX Podiatrist and Wife Honored at College Dinner

Some people who supported the mission and philosophy of Tyler's Texas College were honored Friday during the school's fourth annual Legacy Dinner, featuring actor and humanitarian Danny Glover as master of ceremonies. Honorees included Lizzie Willis and the late Dr. I.E. Willis. Dr. Willis served on the Texas State Board of Podiatry Education, American Board of Podiatric Surgery, Texas State Board of Podiatric Medical Examiners, and Texas College.

Dr. I.E. Willis

Mrs. Willis, a community volunteer, taught elementary school in the Longview Independent School District and served the National Podiatry Association Women's Auxiliary and other organizations. "My late husband served on the trustee board, he believed in Texas College," Mrs. Willis said. "When I lost my husband, they (college) came to my rescue. They were there when I needed someone."

Source: Jacque Hilburn-Simmons, Tyler Morning Telegraph [3/14/12]

Query: Malpractice vs. RRG

I am seeking current malpractice insurance. Please explain the difference between an insurance carrier and a risk retention group (RRG). Which is better?

Wayne Odinsky, DPM, Brooklyn, NY

Editor's Comment: PM News does not supply legal advice. A Risk Retention Group (RRG) is a form of self-insurance. An RRG is formed and owned by its policyholders, and covers specific liabilities and actions, which most traditional insurance companies won't insure. RRGs are common practice for law enforcement officers, doctors practicing emergency medicine, contractors, medical product manufacturers, and a variety of other professionals in high-risk industries. Medical Protective (Medpro.com/podiatrists) is an RRG operating in NY. PM News does not endorse any product or service.

Query: Keeping Track of Inventory for Separate Offices
 
Besides looking at your shelves and realizing you are out of a certain product or item, what other ways (computer programs specifically), are available that will not only keep track of inventory, but let you know how many items are left?  I also want to be able to have one database (on a server) that can separate offices without having to enter everything multiple times for different office locations.
 
Charles Morelli, DPM, Mamaroneck, NY

Query: EMR Bamboozle

Has anyone else's yearly EMR fee for updates and support gone up? My EMR yearly fee has gone up another $220. I just wonder where is the ceiling for these fees? The more that is required of us, the more we will have to pay because, like it or not, they have us over a barrel. It's not like all these hi-tech and meaningful use requirements are just going to go away. I miss the good old days when we could be doctors and government didn't have us jumping through hoops like trained monkeys.

JM Cortez, DPM, Simi Valley, CA

RE: Atypical Forefoot Pain (Gary Bjarnason, DPM)
From: Gino Scartozzi, DPM

I read the many posts concerning the clinical presentation of this patient and would like to add my "few cents" to this issue. The patient has a positive "Mulder's Sign" and paresthesias only when shifting and braking while driving his truck rig. There is no pain elicited with normal daily activities. The pain seems centered on the plantar aspect of the first to third metatarsal-phalangeal joints. Despite the views of some that these are "just neuromas," the presentations and findings are NOT consistent with neuromas from anatomic etiology and factors that elicit such pain. This may be "neuritis" secondary to metatarsalgias (excess weight loading), but not "neuromas."

There is a question as to whether the clinician should obtain a foot MRI. I strongly suggest an MRI of the foot AND lower back. The fact that the chiropractor feels there is no lower back radiculopathy will not...

Editor's note: Dr. Scartozzi's extended-length letter can be read here.  

RE: Lapidus or Fusion (Carl Solomon, DPM)
From: Dennis Shavelson, DPM

I would like to comment on Dr. Solomon’s case. His procedure reduces the IM, but if one looks closely, the first metatarsal position and the girth of the foot have not changed post-op. In reality, the IM angle is reduced due to a 2nd met adductus deformity. His procedure will not produce shoe fit improvement as would be expected from a reduced IM angle.

Also, the fusion eliminates first ray function, increasing lesser metatarsal tissue stress (and the 2nd ray deviation) and prevents selection of varied heel heights in shoes, while shortening stride. In cases like these, when I was operating, I would perform a Keller bunionectomy with an aggressive EHL “Z” plasty and a purstrung capsular “soft tissue plasty”, along with post-op compensatory rehab and optimal functional positioned orthotics, foot type-specific. The removal of the proximal phalanx base allows the IM angle to reduce. The 1st MP joint remains functional, and often stride length, step length, and cadence are upgraded, not reduced.

Since there is minimal lateral transfer of tissue stress and a level of 1st ray function, patients can wear more stylish, higher heeled shoes. They can upgrade their lifestyle habits, not reduce them.

Dennis Shavelson, DPM, NY, NY, drsha@lifestylepodiatry.com

RE: Changing Banks for Medicare Direct Deposit (Joe Borden, DPM)
From: Thomas Neuman, DPM

Everything with Medicare is a problem.  I sent in my forms to change bank accounts for EFT. I'm still waiting six months later for them to deposit money in the new account. Consequently, I have two different bank accounts still open for one office.

Thomas Neuman, DPM, Northridge, CA, footguy1@pacbell.net

RE: ICD-10 Preparation (Edmond F. Mertzenich, DPM, MBA)
From: Harry Goldsmith, DPM, Michael Rothman, MS, DPM

"What bothers me is that for a coding system that has been used internationally for many years, there are so few sources in this country to get the actual codes, let along information on how to code properly. It seems to me that there are a few proprietary companies out to make a good profit from this doom and gloom."

CMS has for several years now offered not only the complete draft ICD-10-CM database (currently 2012), but also ICD-10-CM guidelines, GEMS (sort of crosswalk), and a whole host of ICD-10-CM information…for free on its site.  What you get from commercial products is the same thing in a prettier, more convenient (maybe) package along with expert commentary, pointers, etc.
 
Go to cms.gov/ICD10/ for a tremendous amount of free information.
 
NOTE: My previous response listing the estimated costs for implementation of ICD-10 and how those costs are broken down is still relevant. It will be a costly transition for practices.
 
Harry Goldsmith, DPM, Cerritos, CA, hgfca@verizon.net

Ah, another government conspiracy, just like that foreign metric system thing. Just because every country in the world uses ICD-10 and it's backed by the WHO doesn't mean the good old USA has to. 

Michael Rothman, MS, DPM, Skokie, IL, michael.rothman1@gmail.com

RE: ABPS Name Change (Mark Wolpa, DPM)
From: Narmo L. Ortiz, Jr., DPM, Raef M. Fahmy, DPM

With all due respect to Dr. Wolpa's very informative post, the name "American Board of Podiatric Foot and Ankle Surgery" is a misnomer that would not make sense.
 
Let's move forward with the plans for a name change. I would even suggest that the "new Board" should also invite orthopedic foot and ankle surgeons to apply for certification: MDs and DOs alike. That way it would become a unification board and not a divisive one. Aren't we looking for parity anyway? We are already collaborating together (DPMs, MDs and DOs) in private practice, hospital institutions, textbooks, journals, academic institutions, and specialty seminars.
 
Narmo L. Ortiz, Jr., DPM, Marietta, GA, nlortizdpm@embarqmail.com

"Perception is everything." The universal marketing phrase does have some truth. The environment of healthcare in our country is transforming quite rapidly. It is our responsibility to educate and inform the public, governmental agencies, and the multitude of healthcare providers about what we do and how well we do it. Outcomes and competency is the name of the game no matter what your degree. We need to be clear and respectful to the talented, well-trained and clinically competent foot and ankle surgeons representing our profession now and in the future. Foot and ankle surgery is a clear concept for all. This may be a chance for us to lead a discussion on a single standard board for all foot and ankle surgeons, regardless of degree. Let's keep evolving.

Raef M. Fahmy, DPM, Manchester, NH, fahmyman@pol.net

RE: ABPS Name Change (Craig Breslauer, DPM)
From: Andrew I. Levy, DPM

We have always moved forward as a profession and a society. Without those who moved boldly forward before us, we who practice now would not be able to be where we are today. It is therefore incumbent upon us to move forward as a profession and as a society.

Andrew I. Levy, DPM, Jupiter, FL, rcpilot48@gmail.com

The ABPS name change to ABFAS represents exactly that—only a name change as it was presented. One would expect that the ABPS would deal with the required paperwork to place the name change in effect but only if we, the membership, desire for this to happen. We have been discussing such a change for several years and are finally on the brink of seeing it come to fruition.

The name change is by no means meant to be exclusionary and would not change in any way the individual state’s scope of practice or privileging for hospitals. On the contrary, it could help states struggling with these efforts by ...

Editor's Note: Dr. Cohen's extended-length letter can be read here.

Codingline & PM News
In conjunction with AAPPM Present
The Greenbrier Coding & Practice Management Workshop - August 20-22
(Following the 2012 APMA Annual Scientific Meeting in Washington, DC)  

The Greenbrier, White Sulphur Springs, WV

Speakers: Harry Goldsmith, John Guiliana, Barry Block, Michael Brody, Paul Kesselman, Jonathan Moore, Rem Jackson, Chad Schwarz, and other nationally-known authorities. 

Earlybird Bonus Until April 1 - Save $50 

Click Here for information or to Register

PRACTICE FOR SALE - JACKSONVILLE, FLORIDA

Gross income >600K. Selling real estate (1,200 sq ft office, 3 treatment rooms) and practice including all equipment, (digital x-ray ultrasound, EMR, etc.) Asking Price is $350K for everything. Can be a turn-key transfer. Averaging over 100 new patients/month with strong referral base. Excellent opportunity!! Reply to Pesplanus1@gmail.com

PRACTICE FOR SALE - BROOKLYN, NY

A large, busy practice is for sale in Brooklyn, NY. This practice has been in the same location for over 50 years. Average 150 pts/week, average gross 730K, most surgery is currently being referred out. Financing available. Please call 800-983-4194, or email contactus@podiatrypracticeconsultants.com

PRACTICE FOR SALE - BALTIMORE, MARYLAND

Established 40+ year old well-rounded practice of both surgical and non-surgical care with special emphasis on sports medicine. Medicare and BS/private insurance base, no Medical assistance. Needs to transition to a confident well trained individual. Purchase can include building. Contact:podiatrypracticesale@gmail.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. Also availability E 22nd between 2nd and 3rd and E 70th off 3rd. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM

EQUIPMENT FOR SALE - SHOCKWAVE MACHINE 

D-Actor 200 by Storz Medical. High Frequency Extracorporeal Pulse Activation Treatment (EPAT) System. A little over a year old, excellent results for plantar fasciitis and Achilles tendonitis. Must sell;  practice merger. Selling for 18,000 (new machine >30K) Email: footdoc21@gmail.com

ASSOCIATE POSITION - NORTHWEST IOWA

A well-established, midwest multi-physician practice with strong hospital affiliations seeking FT podiatrist. Applicant should be well trained surgical physician, completed a 24-36 month residency, & board eligible. Practice offers high surgical volume, advanced wound care and good mix of general podiatry. Competitive salary, excellent benefits. Fax resume: 712-258-9977 Diane Coulter, Office Manager.

ASSOCIATE POSITION - SEATTLE, WA AREA

Established podiatric clinic looking for an associate to join our team, 5 offices located around the greater Seattle, WA area. Great base salary, benefits and friendly work environment. Please send resume to:seattlefootdoctor@yahoo.com

ASSOCIATE POSITION – ALBANY, NEW YORK

Solo practitioner looking to wind down after 29 years. Immediate position available in a well- established diversified practice. Must be ethical, hardworking and committed to quality patient care. Must have good communication and surgical skills. Patient base established with additional growth present. Excellent salary & benefits. Please send cover letter and resume to McBride719@aol.com

ASSOCIATE POSITIONS - MULTIPLE STATES

Podiatrist Needed in Missouri, Nebraska, Iowa, Minnesota, North Dakota, South Dakota, Ohio, Texas, Colorado, Oregon, Washington, Arizona, Massachusetts, Rhode Island, Wisconsin, Indiana, Oklahoma, Connecticut and Vermont. Expanding multi-state medical practice seeking podiatrists to service long-term care community residing in nursing homes and assisted living facilities. We offer an established patient base, scheduling, equipment allowance and cover travel expenses. Provide generous compensation, bonus opportunities, disability, health insurance benefits, malpractice coverage and flexible scheduling. Looking for a Podiatrist with excellent skills, able to provide expert and compassionate care to patients. Email CV to: careers@aggeus.org or call 773-770-0140 x300/x305. www.aggeus.org

POSITION AVAILABLE – CENTRAL WYOMING

Well established solo practitioner looking for an associate leading to partnership at a busy, modern practice in a great location. Friendly personality and good communication skills a must. Competitive salary and benefits. Please send letter of introduction and CV to: wyofootdoc@gmail.com

ASSOCIATE POSITION - NEW YORK

WORK SMARTER NOT HARDER. Join a modern, well-established 42-year-old podiatric medical/surgical practice within a multi-specialty office. Located just 20 minutes from NYC. Must be responsible, compassionate, driven, and self-starter. Enjoy cross-referrals from other specialists and support of medical assistants, office managers, and medical billers with over 50 years combined experience. Utilize modern technology: state-of-the-art diagnostic ultrasonography, fluoroscopy, ESWT (machine is owned by practice), physical therapy, x-ray, circulation testing, NCV, and in-office operatory suite. Very strong and effective advertising/marketing program. No nursing homes, No HMOs, No Medicaid, No Medicare. Must be licensed for podiatry in New York. Send cover letter/CV to: linchpindpm@yahoo.com

ASSOCIATE POSITION – BROOKLYN NY

Busy multi-specialty Medical office in Brooklyn, NY is seeking an experienced podiatrist. We are offering great compensation, flexible schedule and great office environment. Our Requirements: Must have Experience Must have Medicaid & Medicare provider. Please respond by email to:  ddpropertymgmt@gmail.com

ASSOCIATE POSITION – MIAMI, FLORIDA

Associate with potential for partnership. All phases of foot and ankle care. Bilingual in Spanish helpful. Send Resume and Letter of interest to miamifootandankle@gmail.com

SOUTHEAST GEORGIA- SAVANNAH & SURROUNDING AREAS

Beautiful weather year round & near the Coast. Opportunity for Early Buy-in. Seeking podiatrist looking to build a career & long-term relationship. Either established practicing physician or new residency graduate. Must be PSR-24/36 trained. Multiple locations. Full range of services with new facilities. E-mail cover letter & CV to melissafoot@pol.net

ASSOCIATE POSITION - MANHATTAN

Podiatrist needed for busy state-of-the-art offices in Manhattan. Offices are located near Penn and Grand Central Station. Along with CV, please provide medical plans that you are currently participating in. Please forward your information to roni@myfcny.com

ASSOCIATE POSITION - LOS ANGELES

Multi-specialty group seeking part time podiatrist. Opportunity to transition into full time position. Required: 3 years or surgical residency, including Charcot reconstruction, fellowship or interest in biomechanics, and ability to train surgical residents. Send CV to podiatricri@yahoo.com

PM News Classified Ads Reach over 13,500 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 13,500 DPM's. Write to bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $115 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.

• 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.