The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

March 19, 2011 #4,112 Publisher-Barry Block, DPM, JD

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LA Podiatrist Provides Advice on Preventing Running Injuries

As the running season hits high gear in New Orleans, we asked Dr. Brian Cain, a podiatrist with LSU Health Sciences Center School of Medicine and LSU Healthcare Network, for advice about preventing foot and ankle injuries. "Number one is stretching with a nice warm-up prior to running, and doing a cool-down afterwards to loosen up the muscles, ligaments, and tendons. Secondly, wear the type of shoes that are specific for the sport," says Cain. 

Dr. Brian Cain

 

"For runners, it’s running shoes. Slowly increase your mileage. A runner should really increase 10 percent each week while preparing for a race. Listen to your body. A lot of runners ignore the first signs of injury. At the first sign of injury, use rest, ice, compression (an Ace bandage or wrap just to keep the swelling down), and elevation. If the pain immediately returns upon resuming your activity, you need to seek medical attention," says Cain.

Source: Laura McKnight, The Times Picayune [3/18/11]

Speak to be Remembered

Here  are some tips to have people remember you:

1. Speak in short sentences or phrases.
2. Use pauses appropriately.
3. Repeat your key ideas more than once.
4. Never read your speech.
5. Use stories. Help your listeners to "see" your words.
6. Say something memorable.

Source: Adapted from Patricia Fripp
 

Query: Pain in Hallux Interphalangeal Joint

I have a 52 year old male patient who had a 1st MTPJ fusion about 18 months ago and, now has pain in his hallux interphalangeal joint. 

Pain in 1st hallux interphalangeal joint S/P MTPJ fusion

He tried an OTC orthotic with a met pad, which "did nothing." Any suggestions? 

Jordan Sheff, DPM, Newport, RI
 

Query: Replacement Product for Panafil

I have a diabetic patient who used Panafil ointment (papain-urea-chlorophyllin) a few years ago for a neurotrophic ulceration and had excellent results with healing.  He has currently developed another ulceration that is being appropriately off-loaded - but he is requesting Panafil again for dressing changes. This product is no longer available as Panafil. I wonder if anyone is aware of it being manufactured under a different name. If not, does anyone have suggestions for a similar or better replacement?

Theresa L. Schinke DPM, Appleton, WI

Query: Invoice Required for Dispensing CAM Walker?

Several months ago, I treated a patient with a work-related injury.  Part of the treatment involved CAM walker immobilization, followed by orthotic therapy. The appropriate treatment codes and charges were submitted to the insurance carrier. The patient made a full recovery and was returned to work. We received an EOB from the insurance carrier in reference to the CAM walker and orthotics, stating: "payment for charge is not recommended without an invoice or documentation of cost." Is this legal? Any suggestions on how to approach this issue would be appreciated.

Mark Oslick, DPM, Bensalem, PA

Query: Code for Resecting a Subungual Exostosis

I would like to know the proper CPT code for resecting a hallux subungual exostosis.

Barbara Haik, Office of Brian Shockley, DPM, Vicksburg, MS

Response: I suggest CPT 28124 (partial ostectomy, phalanx) if only the bone is resectioned.

Tony Poggio, DPM, Alameda, CA

Codingline subscription information can be found here APMA Members: Click here for your free Codingline Silver subscription

RE: White Tipped Toes (Gregory Mayer, DPM)
From: G Dock Dockery, DPM

This condition of white tips of the toes after water exposure looks very much like keratolysis exfoliativa (also known as "lamellar dyshidrosis). In most of the cases that I have seen, the palms of the hands are also involved. Treatment is to use topicals and daily use of emollient creams containing urea, silicone, or lactic acid. Steroids typically are not very helpful.

G Dock Dockery, DPM, Seattle, WA, gdockdockery@aol.com

RE: Central Hypotonia (Tip Sullivan, DPM)
From: Jeanne M. Arnold, DPM

I don't know if it is possible in your area, but I would consider referring this patient to a Shriner's hospital. I have found over the years that they are an excellent referral source for neuromuscular disorders in children. The child can be evaluated and treated under one roof, whether it be with physical therapy, orthotics and prosthetics, surgery, or a combination.

Jeanne M. Arnold, DPM, Coeur d'Alene, ID, jarnolddpm3@frontier.com

RE: Pissed Off About Healthcare
From: Wm. Barry Turner, BSN, DPM, Bob Kuvent, RPh, DPM

I agree with Dr. Wm Barry Turner, but I once read where the nuclear energy sector was the most regulated, while healthcare is the second most.
 
Neil A Burrell, DPM, Beaumont, TX, nburrell@gt.rr.com
 
I beg to differ with Dr. Turner. Physicians are allowed to organize as we are doing in Arizona. Podiatric supergroups are forming all over the country. I would urge you to be less "pissed off" and direct your energy toward a collaborative effort with your fellow podiatrists. If anyone is interested in how to get started in your state, shoot me an e-mail.
 
Bob Kuvent, RPh, DPM, Chandler, AZ, ftfixr@gmail.com
 

RE: Sending Patients' Accounts to Collections (David Weiss, DPM)
From: Suzanne Phillips, DPM

I have a follow-up question regarding the doctor writing in about collections. Many responses have been to obtain credit card information from patients in order to secure payments. However, for those of us who accept credit cards, we must be "PCI compliant" as part of our agreement with AMEX, Visa, MC, etc. As I understand it, keeping a copy of the patient's credit card "on file", then means some type of system with which to do this. What systems have others been using? Any recommendations? I am aware of the Heartland Confirm Pay which securely holds patient credit card information, but I do not have experience with it. Are others just making a photocopy and holding onto it? My understanding is that this would be in violation of PCI compliance.
 
Suzanne Phillips, DPM, Richboro, PA, mrsdrphillips@gmail.com
 

RE: The Affordable Healthcare Act of 2010 /Obamacare (Jerry Falke, DPM)
From: Robert Bijak, DPM, Richard A. Simmons, DPM

I read with incredulity the nonsensical reply of Dr. Falke. He missed the point entirely. I said there is no reference to the word HEALTH. I said nothing about the term "general welfare" not being in the constitution! Dr. Falke is in the bubble, not me. As long as we have podiatrists who can't discern a few simple sentences, our hope to become MDs or unlimited licensed DPMs is highly questionable.

Robert Bijak, DPM, Clarence Center, NY rbijak@aol.com

Dr. Bijak's statements, as he wrote them, are correct. The contortions of Dr. Bijak's statements are false and misleading. Dr. Bijak correctly wrote that there is no mention of the word "health" in the United States Constitution. Dr. Bijak correctly asserted, "NOWHERE in the Constitution of the United States of America is HEALTH mentioned AT ALL!"

Richard A. Simmons, DPM, Rockledge, FL, RASDPM32955@gmail.com

RE: Homeopathy is a Safe Way to Complement Treatment Choices: IL Podiatrist (Marc Katz, DPM)
From: Robert Scott Steinberg, DPM

Before modern medicine, there was the pseudo science of homeopathy. I say "pseudo" because, way back then, there were little scientific standards or credible peer-review. To me, homeopathy is an excuse to get around the accepted standards of treatment and is only used for repackaging something as "new" which is very old.

Robert Scott Steinberg, DPM, Schaumburg, IL, Doc@FootSportsDoc.com
 

ASSOCIATE POSITION - TEXAS

Are you looking for a busy, well-rounded practice experience?" Group practice in DFW area looking for a 3-year surgically-trained associate with a sports medicine background. Needs to be as comfortable making orthotics as fixing a complex flat foot. Email CV to crane@faant.com

POSITION AVAILABLE – NEW YORK

Well-established, multi-doctor podiatry practice with offices in Putnam and Westchester counties. Compensation based on productivity. Excellent opportunity for recent residency graduate to build skills and learn practice management. Full-time preferred but right part-time candidate will be considered. Email cover letter and CV to: Podiatry2011@gmail.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 - ST. LOUIS

Multi-location group practice seeks motivated DPM with initiative and leadership skills to contribute to our growth.  Must be board eligible/certified. Practice enjoys strong reputation and name recognition. Established location available for PSR 36+ with incentive comp, benefits, coverage. Please send CV to jmurray@foothealers.com and visit  www.foothealers.com.

PODIATRISTS NEEDED - TEXAS, EASTERN, PENNSYLVANIA

Looking for podiatrists to cover three or four nursing homes in Eastern Texas (Rusk & Tyler) Ft/ Worth/Dallas. Also in Upstate New York (Syracuse and Buffalo) and Pennsylvania (Meadville, Hillsdale, and State College). AVAILABLE IMMEDIATELY. E-mail doconcall02@aol.com  

ASSOCIATE POSITIONS - NW INDIANA, CHICAGO AREA

2 Full-Time positions open - One for Northwest Indiana and one for the Chicagoland area. Must have 2-year surgical residency. Must be motivated and a self-starter. State License required. If interested email: f-massuda@footexperts.com

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

ASSOCIATE POSITION - NYC, NY

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

EQUIPMENT FOR SALE - COOL TOUCH LASER
 
Cool Breeze Cool Touch CT3 plus laser used for ugly, unsightly, toe nail infections. Less than six months old. Great price won't last long. Considering a laser? We also have the Q- Clear Q- switch laser too. This laser is perfect for you. Dr. Zuckerman is in the Fort Lauderdale area and will demo this lasers on your patients. E-mail footcare@comcast.net

PRACTICE FOR SALE - NORTH DALLAS, TX

Reasonably priced. 26 year old solo practice, centrally located. Includes 1 Ritter & 1 Midmark chairs, Excel x-ray, electronic claims submission, website, all supplies and instruments. Retiring owner will stay for transition. Will consider owner finance. dallasfootdr@yahoo.com

PRACTICE FOR SALE - WASHINGTON STATE - SUBURBAN SEATTLE

16 year established part time practice. Includes Midmark 417 (4 position keypad), Excel X-ray, processor, Ritter M9, instruments, bandaids, etc. 1 Day/week $50K gross. Professional Business appraisal at $48K. Asking $35K. Shared office with 2 FP's. Easily expandable. Reply: practiceforsale18@yahoo.com

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

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

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