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March 27, 2012 #4,420 Publisher-Barry Block, DPM, JD

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FL Podiatrist Treats Toronto Pitcher for Plantar Fasciitis

Dustin McGowan's status for the start of the regular season is in doubt after he was diagnosed Sunday with a case of plantar fasciitis in his right foot. Toronto's right-hander was forced to leave a Minor League game during the second inning on Sunday afternoon with pain in his foot. He was later examined by podiatrist Dr. Glenn Copeland and received the preliminary diagnosis. 

Dr. Glenn Copeland

Plantar fasciitis is the inflammation of the connective tissue that begins at the heel of the foot and extends towards the sole. It can be very painful and often becomes a nagging problem that is difficult to treat. It's the same ailment that former Toronto outfielder Scott Podsednik experienced last spring. The difference between the two is that Podsednik's connective tissue was completely torn and McGowan's is just inflamed, which should help ease the recovery process.

Source: Gregor Chisholm, MLB [3/25/12]

Barry Faculty and Students Provide Treatments for Homeless

In a long-running and ever-growing pre-Holy Week tradition, church volunteers emulated the biblical example of Jesus Christ, who humbled himself before his Apostles by washing their feet on the eve of the Passion, by washing the feet of the homeless in the church's open-air courtyard. The symbolic act has also proven a good, practical opportunity to alleviate some of the ills of homelessness, which is hard on mind and body. Especially feet. 

Barry University Faculty and Students Treat Homeless (Photo: Peter Andrew Bosch)

Participants received foot exams from podiatric students and faculty at Catholic-affiliated Barry University. About 20 students and doctors provided treatment for foot ailments, from the commonplace — ingrown toenails and calluses —, to thornier medical issues like fungus, ulcers, and infected wounds. After cleaning those out, health workers sent the patients directly to the nearby Camillus House clinic. "They really need the help," second-year podiatric student Scott Boynton said. "A lot of times, this is the first time they've been seen."

Source: Sun Sentinel [3/24/12]

MPMA to Participate in Diabetes Alert Day on Tuesday

The American Diabetes Association has designated Tuesday as Alert Day. The day is set aside to ask the public to take a diabetes-risk test to find out if they are at risk for developing type-2 diabetes. The Michigan Podiatric Medical Association joined the ADA in calling attention to the disease and the life-changing complications that can surface without proper care. 

Dr. Jody Sengstock, MPMA President

Individuals are encouraged to visit their local podiatrist to receive a comprehensive diabetic foot exam. The exam is recommended for individuals at any risk level of developing diabetes. Even if the test does not identify early stages of diabetes, it gives each patient necessary information that can be used as a baseline record for testing in later years.

Source: Livington Daily [3/25/12]

CA Podiatrist Speaks at Belgian Podiatry Conference

An international podiatry conference celebrating 20 years of podiatric education in Flanders, Belgium was held at the Artevelde University College in Ghent on March 22-23, 2012.  

(L-R) Simon Spooner and Dr. Kevin Kirby

350 podiatrists, physiotherapists, and biomechanics researchers from 7 different countries were provided with lectures on the most recent biomechanics research and therapies. Keynote speakers included Drs. Kevin Kirby (USA) and Simon Spooner (UK), who lectured on subjects ranging from the history and evolution of foot orthosis therapy to the latest research on barefoot running.

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

Bret Ribotsky: What are your feelings about using scribes in a podiatry office? 

Dr. Kathleen Toepp-Neuhoff

Kathleen Toepp-Neuhoff: I have used scribes in my practice for almost 15 years. I have not been charting for all that time because of my training and my belief that as the doctors, we do medicine, and that does not include charting. I have to review and sign the chart, but my best scribe goes in with me and charts. Years ago, we did it on paper. Now, of course, we do it on the computer, but the scribe goes in and does all the charting. I sit down and talk to the patient.

There are all sorts of studies that show that we’re really at an advantage in podiatry because people communicate better with somebody who sits at their level instead of standing up above them, which happens in some doctors' offices.

Dr. D. Scott Malay

Meet the Masters is broadcast each Tuesday night at 9 PM (EST). This week's guest is podiatric surgeon and editor, Dr. D. Scott Malay. You can register for future events by clicking here

Take Listening to the Next Level

Even a good listener can become better. Elevate your listening skills with these best practices:

•  Pause. Not interrupting the speaker is the first step. Wait a few seconds before you respond, in case the other person has more to say. A person often will clarify a point or revise a statement when allowed a few extra moments to think. And a speaker who has completed what he or she wanted to say will be ready to listen to you.
•  Jot notes. Withholding your comments allows you to listen carefully and not rush to speak. But do write down questions you want to ask or points to make so you don’t forget them when it’s your turn to speak.
•  Follow up. End the conversation by committing to what you will do as a result. Develop a system for filing your conversation notes so that you always follow up promptly. Example: Immediately add tasks to your to-do list.

Source: Adapted from “Hotel Management Tips—the Power of a Good Listener,” Jack A. Turesky, Hospitality Net via Communication Briefings

Query: Summit LifeDop 300

Does anyone use the Summit LifeDop 300 hand-held Doppler system for arterial waveform and ABI calculations? Is the system easy-to-use and reliable for basic arterial flow evaluations? Are there any issues with reimbursement?
 
John Scholl, DPM, Lady Lake, FL

Query: Viztek Opal II CR Digital System

I am currently considering the the purchase of the Viztek Opal II CR digital system. Has anyone had any experience with this system as it relates to quality of images, reliability of the scanner, etc.?  Any input would be appreciated.
 
David E. Gurvis, DPM, Avon, IN

Query: Issues with Cerner Billing Software

I've recently had great difficulty with my Cerner billing software since the update in December regarding the zip codes for secondary insurances/HIPAA. It has been three months since I've received a payment from Medicare due to the delays and continued changes required by Cerner. I'd like to know if my situation is unique or if others have had similar problems. If so, what are other doing about it?
 
Scarlett Kinley, DPM, Clearwater, FL

RE: ICD-10 Preparation (Edmond F. Mertzenich, DPM, MBA)
From: Marc Garfield, DPM
 
ICD-10 is delayed. ICD-11 will probably be released before or close to when a conversion to ICD-10 occurs, but we are not expected to implement ICD-11 until around 2020.
 
The biggest costs are in retraining courses for staff and doctors and productivity losses, a readiness analysis, and code conversion tools.  Another cited cost is “increased documentation.” The expectation is that the doctor will have to learn how to document in such a way that a coder can translate a few statements and turn those into a specific and appropriate ICD-10 code, as ICD-10 is being referred to as the “new language of medicine.” This is not just adding another digit to an ICD-9. It is a new system and the documentation in your software will have to be standardized to produce an ICD-10 code rather than converting your coding capture tied to a diagnosis in your chart now. At least that is what is supposed to happen.
 
Here is a link to one of several ICD-10 cost breakdowns. They are all similar, from what I have seen.
 
Marc Garfield, DPM, Williamsburg, VA, mgarfield1@cox.net

RE: Taking X-Rays on Patients with Ingrown Nails (Ivar E. Roth DPM, MPH)
From: Michael M. Rosenblatt, DPM

Dr. Roth is against x-raying all ingrown nails and feels it's a rip-off of patients. In many cases, that is true. However, there are some patients who have greatly incurvated nails where at the distal aspect there is a strong possibility of a bony exostosis. Most ingrown nails are only incurvated at the medial and/or lateral sides, but some actually appear to be pointed upwards dorsally. Those may actually demonstrate pain on squeezing the toe downwards.
 
These situations receive extra-pressure from the  footgear. Appropriate treatment of this situation may require treating the bony exostosis in order to allow the nail plate to flatten out. If you believe your patient has this situation, x-rays are appropriate. That should be documented in your chart notes. You would certainly not x-ray all ingrown nails. I suppose it is up to you if you choose not to bill for a negative film. But my point is that it is sometimes appropriate to x-ray a patient who has a complaint of ingrown nail(s).
 
Michael M. Rosenblatt, DPM, San Jose, CA, Rosey1@prodigy.net

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