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The Voice of Podiatrists
Serving Over 15,767 Podiatrists Daily
March 26, 2014 #5,022  Publisher-Barry Block, DPM, JD
A partner of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2014- No part of PM News can be reproduced without the
written permission of Barry Block
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| PM NEWS QUICK POLL | |
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| PODIATRISTS IN THE NEWS | |
NY Podiatrist Discusses Hallux Joint Pain
Never underestimate the power of a little joint to cause big problems. But that’s what can happen to senior citizens suffering from big toe joint pain — often as a result of arthritis — which can not only sour the mood and lessen quality of life, but raise the risk of falling and in many cases proves disabling, according to Alan Berman, DPM, of Somers, NY. Most people associate arthritis with the “big” joints such as the knees and hips. But arthritis, which afflicts an estimated 46 million adults in the United States and 50% of those over age 65, comes in many forms, two of which are specific to the big toe joint and are hardly rare. In a 2009 study in the Journal of Foot and Ankle Research, about 16% of people reporting symptoms of disabling foot pain identified the big or “great” toe as the source of their woes.
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Dr. Alan Berman |
“It’s truly remarkable how much misery can result from big toe joint pain,” explains Dr. Berman, who specializes in podiatry and performs podiatric surgery. “Many patients don’t like to complain and think they can outwait the problem, but seeking professional advice and treatment is the right approach. There’s simply no need to suffer in silence.” No matter what type of arthritis you have, the condition generally includes ongoing joint pain, swelling, stiffness, tenderness, and problems using the joint. But two types of arthritis specifically affect the big toe: gout and hallux rigidus, or rigid big toe.
Source: Wilton Bulletin [3/23/14]
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| PODIATRISTS AND POLITICS | |
DNC Sees Chance for CA Podiatrist to Capture Congressional Seat
While the CA 25th district has been traditionally Republican, there have been signs of a recent shift in the demographics to the point where the Democratic National Committee is looking closely at possibly capturing the seat, said Allan Hoffenblum, publisher of the California Target Book that tracks legislative races. “The one common thing is that people are so angry at Congress that we are seeing these crowded fields of candidates,” Hoffenblum said.
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Dr. Lee Rogers |
For Democrats, most of the attention is being given to Dr. Lee Rogers, who is making his second run for the seat. Two years ago, against McKeon, he was able to capture 47 percent of the vote. With the demographic and voter shifts since then, he is being given a better opportunity, combined with the nonstop campaign he has had since the 2012 election. “I’m not sure if that’s good or bad, having a target on your back,” said Rogers, 36, of Simi Valley, a surgeon at Valley Presbyterian Hospital. “There are a lot of things that are different in this district. For one, it’s one of 16 open seats in the country and I think there is a chance for Democrats here.”
Source: Rick Orlov, Los Angelers Daily News [3/23/14]
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| MEDICARE NEWS | |
SGR Fix Before March 31 Appears Unlikely
The prospects for a permanent doc fix prior to the March 31 deadline are looking increasingly remote. No agreement has been reached on how to pay for a permanent repeal and replacement of Medicare's unpopular sustainable growth-rate formula for physician payments.
The House plans to vote for a patch this week, according to a source familiar with discussions, although it remains uncertain how long a period it will cover. Previously, the House approved a Republican-sponsored bill to pay for repeal by delaying the individual mandate for five years—a non-starter for Democrats. The Congressional Budget Office estimated that the House bill would cost $138 billion over 10 years and result in 13 million fewer people having health insurance coverage.
Source: Paul Demko, Modern Healthcare [3/24/14]
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| QUERIES (NON-CLINICAL) | |
Query: Veriscan 3D Foot Scanner from Envisic
I would like to get some opinions on the advantages/disadvantages of the Veriscan 3D foot scanner. What are some of the pros/cons?
Stephen Musser, DPM, Cleveland, OH
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| CODINGLINE CORNER | |
Query: Medicare & Ankle Braces
For the Medicare patient who presents with ankle sprain, what DME products are typically payable by Medicare?
Craig Sapenoff, DPM, West Palm Beach, FL
Response: There are a myriad of devices which may be used. The AFO LCD does not provide diagnostic limitations. If you read the LCD, you will see there are specific requirements for the products. Listing specific products here would be inappropriate. The use of these products would be subject to medical necessity. Your documentation should meet the standards of care in addition to any requirements of your carrier.
Paul Kesselman, DPM, Woodside, NY
Codingline subscription information can be found here
APMA Members: Click here for your free Codingline Silver subscription
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| RESPONSES/COMMENTS (CLINICAL) - PART 1 | |
From: Arnold Ross, DPM, Michael DeBrule, DPM
A very effective treatment for night cramps has been soaking feet in a Jacuzzi or very warm bath.
Start with gastroc stretching, which is supported by some recent studies. You might already have stretching diagrams from a plantar fasciitis handout. I have used gabapentin with some success, but there isn't much evidence to support this practice yet. The most recent reviews on magnesium that I have come across suggest it is likely just a placebo. Consider vitamin E if your patient is on dialysis. Medications that are strongly associated with leg cramps include intravenous iron sucrose, estrogens, raloxifene, naproxen, and teriparatide. The risks of using quinine (hypersensitivity or thrombocytopenia) are no longer acceptable.
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| RESPONSES/COMMENTS (CLINICAL) - PART 2A | |
From: Keith Sklar, DPM
The question asked, “Has Laser Nail Fungus Removal Been Proven Effective?” I think this is a confusing question. The question should be, “Does the laser play an effective part in clearing dystrophic nails?” In my experience, the answer is a definitive YES. I have treated hundreds of patients with my laser and have achieved impressive results.
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Before and After Photos Supplied by Dr. Keith Sklar |
In a previous post, I shared my experience on the treatment of dystrophic nails. The laser is only a part of my treatment plan to clear and maintain a healthier ...
Editor's note: Dr. Sklar's extended-length letter can be read here.
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| RESPONSES/COMMENTS (CLINICAL) - PART 2B | |
From: Dennis Shavelson, DPM
My position is that dystrophic toenails present a complex diagnostic and treatment scenario that will never be solved by one magic bullet like a pill, topical, laser, or orthotic. To start with, eyeballing dystrophy as fungal must end, as repetitive microtrauma may be as or more important than whether hyphae are etiological. Shoe scuffing from tight toe boxes and underlying biomechanical foot type-specific pathology plays a major role as a precursor to both primary disease and recurrence.
An initial history gathering health state, biomechanical, vascular, and neurological data followed by a biopsy sent to a lab seeking multiple etiologies, and a custom treatment plan will lead to better short- and long-term outcomes. I have a prescription pad, a dispensary, a laser, a biomechanical compensation plan, and a guarantee to my patients that I will try my best to affect short- and long-term cure for their “ugly toenails” if they are willing to assume a role in their care.
Anecdotally, I find that my success rate before and after I had 1064 lasers in my practice has improved, but the number one addition to my pathogenesis-oriented care these past years has been foot centering orthotics, muscle engine training, and shoe wardrobe and lifestyle adjustments, especially when it comes to reducing recurrences.
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| RESPONSES/COMMENTS (NON-CLINICAL) | |
From: Robert Kornfeld, DPM
There is more than one way to do this. Concierge practices can also be "pay at the desk for services" instead of a yearly fee. This is what I do. About 90% of our patients pay for services at each visit. 10% of our patients are assignment for out-of-network benefits, and then the patient pays the difference.
When developing a concierge practice, you need to have a compelling reason for patients to come to you, so a good niche and good marketing is the key to success.
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| RESPONSES/COMMENTS (NON-CLINICAL) - PART 2 | |
From: Leonard A. Levy, DPM, MPH
Three-year programs leading to MD or DO degrees at U.S. medical schools are a reality, and plans for others are in progress. For 15 years as Associate Dean for Education, Planning and Research at Nova Southeastern University College of Osteopathic Medicine, I have been editing Medical Education Digest, published six times yearly, requires reviewing articles from major U.S. medical journals on developments in medical education. Several medical schools in the U.S. and Canada offer the medical degree in 3 rather than 4-years. Some are New York University, Mercer, Louisiana State University, Texas Tech, Lake Erie College of Osteopathic Medicine, University of Calgary, and McMaster University.
A JAMA March 21, 2012 article advocates shortening the medical school curriculum. It indicated that years have been added to the curriculum without evidence of enhanced clinical skills or quality of care, and shortening the length of medical training does not compromise physician competence. With medical education (including podiatric medical education) having at least 3-years of residency, shortening medical school a year reduces financial burdens on medical graduates and decreases health costs, states Ezekiel Emanuel, MD, PhD, Provost, University of Pennsylvania School of Medicine.
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| RESPONSES/COMMENTS (OBITUARIES) | |
RE: Passing of Keith Springer, DPM
From: Juan Goez, DPM
Dr. Springer was a no-nonsense surgeon and teacher who always put the patient first while allowing his residents to make the most of every surgery. Compassionate always, he strived for perfection. Our prayers are with his family. May God provide them the strength to honor his life.
Juan C. Goez, DPM, Bellmore, NY
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MEETING NOTICES - PART 1
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| YOU CAN'T MAKE THESE THINGS UP | |
RE: Wedding Catastrophe Narrowly Averted by Quick Thinking Podiatrist
Jeff Kittay, DPM
In what could have been a complete disaster, a daring DPM from Boston leaped into action and turned a near fiasco into a romantic fairy tale ending. Weddings in the Jewish faith are traditionally concluded, and the drinking begun, when the groom crushes a glass beneath his shod heel, driving out any evil spirits, and ensuring a peace-filled life for the newlyweds.
On Sunday January 16th of this year, in the sleepy township of Verona, New Jersey, events conspired to bring such an idyllic ceremony to a dramatically different conclusion. A new bridegroom, who shall remain nameless except...
Editor's note: Dr. Kittay's extended-length story can be read here.
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MEETING NOTICES - PART 2
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| CLASSIFIED ADS |
ASSOCIATE POSITION - ATLANTA SUBURB
Immediate associate position available. PSR 24/36, ABPS certified/qualified for high volume surgical practice. State of the art practice with on-site accredited surgical center, physical therapy and MRI. Full hospital privileges available. Send inquiry and CV to: glewis@mariettapodiatry.com.
FULL-TIME ASSOCIATE POSITION - SOUTHERN CALIFORNIA
Well established 65 year old practice looking for full time associate upon completion of a 36-month residency. Salary and full benefits including medical and malpractice included. Purchase opportunity available after probationary period. Full scope modern practice with 2 office locations. Great opportunity. Please email your CV to bkatzman2@verizon.net
PODIATRISTS WANTED – NORTHERN CALIFORNIA
Podiatrists wanted for fully managed practice in skilled nursing facilities in the following areas: 1. Chico and Meadowood 2. Sacramento 3. Fresno – local and up to one hour south. Send CV and area of interest to: ZBUBBLESZ@aol.com
ASSOCIATE POSITION - SOUTHERN CALIFORNIA
Very busy, two location group practice seeking a full-time, self-motivated and hard-working podiatry associate. Competitive salary offered. Please email CV to: podiatrists@icloud.com
ASSOCIATE POSITION - NORTH CAROLINA - GREENSBORO/TRIAD AREA
Busy, state-of-the-art group practice seeking full time associate. PSR 24 or above training preferred. Excellent opportunity for a highly motivated and ethical applicant. Competitive income and benefit package. Hospital privileges available. Board certified/qualified applicant, send CV and letter of interest to triad.podiatrist@yahoo.com
FULL-TIME ASSOCIATE POSITION – FLORIDA PANHANDLE
Immediate position available for hard-working, motivated individual in a well-established practice. Equal mix of primary care and surgery. Excellent opportunity to get on all insurance panels. Board qualified/Certified with ABPS preferred. Competitive salary and benefit package. Please email CV and letter of interest to kmoore@feetareneat.com.
ASSOCIATE POSITION - HUDSON VALLEY REGION, NY
Hudson Valley Foot Associates has a great opportunity available! We’re a high-volume, diversified, multi-office group practice utilizing state-of-the-art modalities. Great growth for a personable and motivated DPM. Please visit www.hvfa.com and forward cover letter with CV to info@hvfa.com.
ASSOCIATE POSITION - CENTRAL FLORIDA
Associate wanted for well-established practice in central Florida. Multi Physician Practice – Multi Practice Locations Competitive Salary and Benefits. Experienced support staff. Excellent opportunity for a promising future. To apply please go to www.yourcareerinpodiatry.com
ASSOCIATE POSITION - KENTUCKY
Immediate opening for palliative/general podiatric care provider in established clinics, nursing home and assistive living settings in beautiful Southern Kentucky. Travel involved, but transportation provided along with ability to provide a wide range of clinical care including DME. Board certification not mandatory, but must be eligible for KY state license. Base salary with incredible bonus opportunity/full benefits. Join Kentucky’s largest and most respected podiatric group. Email CV and letter of interest to: jonkim12000@yahoo.com
ASSOCIATE NEEDED - CONNECTICUT
Position available for a board certified or qualified individual who has an emphasis on DM foot care and is comfortable with all surgical aspects of forefoot, rearfoot and ankle surgery. Excellent opportunity for a surgeon. Competitive salary and benefits offered and a perfect community to raise a family. fax resume to bfsoffice@4udr.com
PRACTICE FOR SALE - SOUTHWEST FL
Multilocation multidoctor practice in beautiful Southwest Florida. Practice has grossed over seven figures consistently and currently shows 10-15% growth in revenues with increase in new patients and patient visits. EHR is already implemented with meaningful use criteria met. Practice has been professionally evaluated by Provider Resources. Only serious inquiries to this email address. This is a great practice in Paradise and a good opportunity for the right doctor or doctors. Email to: practiceforsaleswfla@gmail.com
PM News Classified Ads Reach over 15,500 DPMs and Students
Whether you have used equipment to sell or are offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 15,500 DPMs. for details, click here or write to: bblock@podiatrym.com or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at (800) 284-5451
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| Disclaimers |
Acceptance and publication by this newsletter of an advertisement, news story, or letter does not imply endorsement or approval by Barry Block or Kane Communications of the company, product, content or ideas expressed in this newsletter. Podiatric Medical News does not represent the views, and is a separate entity from Podiatry Management Magazine and Podiatry Management Online. Any information pertaining to legal matters should not be considered to be legal advice, which can only be obtained via individual consultation with an attorney. Information about Medicare billing should be confirmed with your State CAC.
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ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS
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