The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

March 20, 2012 #4,414 Publisher-Barry Block, DPM, JD

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OH Podiatrist Has Family Float in St. Patrick's Day Parade

Cleveland enjoyed a record-setting Saturday -- a record number of participants in Ohio's oldest St. Patrick's Day parade, a record crowd to watch it, and a record temperature. The parade contained 245 units, a record. The 2012 edition even had a float simply called "The Corrigan Family." On board were Dr. Thomas Corrigan, a Westlake podiatrist; his wife, Deb; and their children, 3-year-old twins Tom and Steve, and Grace, 2.

The Corrigan Family Float

The float also carried mannequins representing distant relatives, the doctor said, including Wrongway Corrigan. Corrigan claimed that he made an unauthorized flight from New York to Ireland in 1938 because his compass was broken. Another relative is Capt. Jack Corrigan, a heroic New York firefighter who died in the 9/11 terrorist attack on the World Trade Center. Tom Corrigan is the seventh consecutive Thomas in the clan that originated in Ireland's County Mayo.

Source: James Ewinger, The Cleveland Plain Dealer [3/17/12]

NYCPM Emil Rose Scholorship Winners Announced

Each year, NYCPM hosts the Emil Rose Scholarship. The sophomore, junior, and senior classes are each presented with a 100 question exam based on all the subjects they have studied at the institution in their previous years. The student with the highest overall grade is given the scholarship. 

(L-R) Karim A. Badawy, Kelly Whitenack, and Mathew Yagudayev

This year from the class of 2013, it is a tie between Karim A. Badawy (the 2011 winner) and Kelly Whitenack. The winner from the class of 2014 is Mathew Yagudayev. The winner from the graduating class of 2012 is still to be announced this year.

NY Podiatrist Organizes Fundraiser for Colorectal Cancer Research

Praise. Prayer. Party. Sometimes there are events that do only one, or even two of the three, but seldom are all three done in one event. The vision for a Praise Party, was the dream of Rev. Dr. William Holley, who wanted to raise awareness of colorectal cancer which affects a greater percentage of African-Americans than other demographics every year, and the numbers are steadily increasing. On Friday, March 23rd, Dr. Holley and friends will host the first ever of its kind, a Praise Party.  

Dr. William Holley

This event of purpose is a collaboration between Holley, WUFOAM1080 and Soul 2 Sole Ministries. It also aims to donate partial proceeds from the event to the medical fund for Shannon Smith, a young woman with a resilience, courage, and a beautiful smile, who tragically lost her limbs as a result of illness.

Source: WUFO

Diabetic Foot Experts Attend Global Meeting to Share Ideas on Amputation Prevention

Diabetes and diabetic foot experts from around the globe met March 15-17, 2012 at the tenth DFCon Global Diabetic Foot Conference in Los Angeles to share ideas on how to prevent lower limb amputations due to the complications of diabetes. Specialists from 39 U.S. states and 35 foreign countries attended DFCon 2012 at the Renaissance Hollywood Hotel at the site of the Academy Awards®. Corporate interest in the meeting was strong, with 68 pharmaceutical, medical device makers, and other companies exhibiting. 

DFCon conference co-chairmen Drs. David G. Armstrong, DPM, MD, PhD and George Andros, MD lead a panel discussion on the opening day of DFCon 2012.

Lee C. Rogers, DPM, and Joseph L. Mills Sr., MD, were course directors. More than 30 internationally known experts from eleven countries served on the DFCon faculty. Noted physician, educator, and international expert on the diabetic foot and wound management, Jan Apelqvist, MD, PhD, received the 2012 Edward James Olmos Award for Advocacy in Amputation Prevention. The next DFCon meeting is set for March 21-23, 2013, again at the Renaissance Hollywood Hotel in Los Angeles.

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

Bret Ribotsky: What are your thoughts about when VAC treatments should be used? 

Dr. Peter Blume

Peter Blume: We’ve done both basic science and clinical research on negative-pressure wound therapy. Not only have we published studies on outcomes, but we’ve looked at these in a vascular surgery lab. I think you’ve got to have enough perfusion to support  negative pressure. If you have cutaneous oximetry of 20 and no outflow with necrosis, I think you’re wasting your time. However, I think negative-pressure therapy is a phenomenal adjunct therapy as a peri-operative tool. The definition of that is pre-wounding, open amputations, waiting a couple of days, putting on negative-pressure therapy, and then going into a skin graft, the flap, and secondary closure.  

Dr. Kathleen Toepp-Neuhoff

Meet the Masters is broadcast each Tuesday Night at 9 PM (EST). This week's guest is podiatric surgeon and veterinarian Dr. Kathleen Toepp-Neuhoff. You can register for future events by clicking here

Free Employees from Actions that Waste Their Time

Strike this deal with your team members: If they identify three management actions that waste their time, you will remove those roadblocks. However, they also must identify three ways they waste time and eliminate those actions.

Source: Adapted from “How Managers Can Improve Employee Productivity,” Peggy Duncan, suiteminute.com via Communication Briefings

Query: Traknet vs. Medisoft for In-House Billing

We are looking at Traknet billing vs. Medisoft 17/18 systems for in-house billing in anticipation of the ICD-10 "storm." Any feedback will be appreciated.

Mark K. Johnson, DPM, West Plains, MO

RE: Failed Hallux Implant (Alan Berman, DPM)
From: Eric Edelman, DPM

Consider ordering an MRI to see if the flexor hallucis longus tendon is still present and accounted for. If the tendon is still there, I would consider removing the implant, anchoring the tendon to whatever is left of the proximal phalanx, and then collecting as much of the capsule as you can to make a spacer, like you'd do for a Keller arthroplasty. Have him work with physical therapy for a month or two and see if the toe purchase comes back.

If the tendon isn't there, I would fuse the joint, and I'd probably skip the bone grafting and just tell the patient to expect a shortened big toe. He's 67, he's already had surgical complications, why tempt fate more than necessary? When I've removed these implants in similar cases to yours, I get a rotary burr and debride away some bone in the canal where the implant sits. It always seems to be that grayish-green color that just doesn't look healthy, so I try to get rid of it. It's the same theory as debriding an ulcer down to bleeding tissue.

Eric Edelman, DPM, N. Syracuse, NYericedelman@gmail.com

RE: Do First MTP Joint Fusions Reduce the IM Angle? (Ed Davis, DPM)
From: Carl Solomon, DPM

I support Dr. Davis’ contention that the degree of hypermobility at the Met-cuneiform joint does have some bearing on this, which is why I commented anecdotally that hypermobility seems to make 1st MTP fusions even more capable of reducing IM angles. But my position that the procedure effectively reduces the IM angles is NOT just anecdotal. I tried to illustrate that and was criticized both here as well as in personal emails. So instead of taking my word for it, look at some studies (both orthopedic as well as podiatric) on your own. Please search key words “1st MTP joint arthrodesis + metatarsus primus varus.”

Among the many results is the following, which makes a rather compelling statement: “A separate proximal osteotomy for...

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

RE: Medicare Guidelines for AFO Use (Doug Ritchie, DPM)
From: Marc Katz, DPM
 
Fall prevention is a goal that is accomplished by bracing, physical therapy, and the use of assistive devices. These patients may have lateral ankle instability with joint abnormality, mild drop foot, abnormal unstable gait, muscle weakness, etc. These diagnoses are no different than those used for any AFO.
 
When a person comes in with a weak lateral ankle, and we put them in a Ritchie brace, are we not ultimately using the brace for ankle sprain prevention? So how can you say that these don't meet Medicare guidelines? I would imagine that if you told Medicare that you've developed the Ritchie brace for ankle sprain prevention, they would say that it is not covered.
 
It's all semantics here, and we are all trying to help patients by preventing further injury and allowing for stabilization of the foot/ankle.
 
Marc Katz, DPM, Tampa, FL, dr_mkatz@yahoo.com

RE: All Scripts vs. Practice Fusion EMR (Howard Shapiro, DPM)
From: Brandon Macy, DPM

I’ve used Allscripts MyWay online for the past 8-9 months. There are some things I like and other features I wish were better. As it is a general medical program (although one reseller has podiatry-specific content that I’m not certain is necessary), there is some customization involved on your part. But shortcuts are easy to do, once you learn the logic of their program. The help buttons are actually pretty good too.
 
Brandon Macy, DPM, Clark, NJ, bmacydpm@comcast.net

RE: ICD-10 Preparation (Joseph S. Borreggine, DPM)
From: Robert Kornfeld, DPM

Here is another great example of the hoops you will have to go through to get paid for services. Why? Simply because the AMA is going to make windfall profits from the sale of ICD-10 books, software, and seminars. Why? Simply because insurance companies will have greater leeway to either downgrade your reimbursements or deny claims based on improper coding specificity. Why? Because EMR companies are going to be able to charge you tons of money for implementation of updated coding. Why? Because the government (Medicare) will be able to more easily audit and demand money back. Why is everyone freaking out? Just because it is going to cost you a few hundred thousand dollars to cooperate with everyone above who is going to be making a lot of money off of your losses? What's wrong with that? Seems fair to me.
 
The truth is none of this can happen if no one cooperates with the insanity. You are the enablers in this. Wake up to what is going on around you. Denial is not going to make things better. Cooperating is not going to make things better. How many times do you want to get run over before you get out of the street? The Greek government saw the disaster coming and did nothing. History shows that complaining with "non-action" nets zero change. This is NOT a time for protest. This is a time for action. What are you willing to do to protect your practices, your livelihoods, your families?
 
Robert Kornfeld, DPM, Manhasset, NY, Holfoot153@aol.com

RE: ABPS Name Change (M. W. Aiken, DPM)
From: Richard Gosnay, DPM, Tip Sullivan, DPM

I am quite happy to be a podiatrist. I am often dumbfounded by the belittling euphemisms that some of my colleagues use for our profession, as if there is something about our specialty that is inferior. So, I answered the first question on the ABPS questionnaire, "Yes, I am satisfied with the name American Board of Podiatric Surgery." I also answered the later question in the affirmative. I am strongly in favor of the name change to the American Board of Foot and Ankle Surgery.

Podiatry includes many facets. One of them is foot and ankle surgery. This board certifies competence in foot and ankle surgery. There is nothing pejorative about recognizing this. And there is no particular reason why the word, podiatric, needs to be in the name. The proposed name is descriptive and honest. I am mostly in favor of the name change because if we do not use this name, how would we feel if another profession takes it? Suppose there comes a time when nurse practitioners decide to emphasize nail procedures, orthotics, skin biopsies, wound care, and fracture care. And suppose their profession certifies their new-found niche with a board. How would you feel about practicing in the same building as a nurse practitioner who is certified by the American Board of Foot and Ankle Surgery? I think that the proposed name change is prudent and would protect the interests of our profession.

Richard Gosnay, DPM, Danbury, CT glabroushead@gmail.com

As a profession, we had better be more concerned about our own members rather than what we call ourselves. I have recently learned of a 3-year residency program in Rancho Cucamunga, CA that has had to close down for financial reasons, leaving the residents there in a bad way. These people are our future regardless of what we call ourselves. I think we have sorely misplaced our priorities when we can debate and discuss issues like a name change while our residents and our programs, who in essence are our future, are not getting our attention and support!
 
Tip Sullivan, DPM, Jackson, MS, tsdefeet@MSfootcenter.net

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

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

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

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

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

PM News Classified Ads Reach over 13,500 DPM's and Students
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