The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

March 30, 2011 #4,021 Publisher-Barry Block, DPM, JD

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MN Podiatrist Demonstrates Efficacy of MEDIHONEY®

The following poster presentation by was made by Steven Kavros, DPM, Mayo Clinic, Rochester, MN at the annual Diabetic Foot Global Conference (DFCON), held in Los Angeles March 24-26: "The Clinical Use of Leptospermum Honey on Neuropathic Forefoot Ulcerations in Patients with Diabetes Mellitus"

Dr. Steven Karvos

The purpose of this study was to evaluate the healing of forefoot ulcerations with the use of MEDIHONEY® in the setting of diabetic neuropathy. The study found that the MEDIHONEY® group healed at a significantly faster rate than the control group; the mean healing time was 77 days (95% CI, 73.1 – 80.89 days) versus 96 days (95% CI, 91.3 – 100.89 days) for the control group. There was a significant healing rate with the use of MEDIHONEY® versus the control (p< 0.0001).

Source: Morningstar.com [3/29/11]

Call for Nominations - Podiatry Management's 2011 VIP List

Every five years, Podiatry Management Magazine publishes its "Most Influential Podiatrists" list. This list is compiled by the editorial board of PM. We invite nominations of individuals for this prestigious honor. Please send nominations along with a brief statement of why this podiatrist belongs on the VIP list to bblock@podiatrym.com. Self nominations will be accepted.

FINAL NOTICE - APMWA Announces 25th Annual Student Writing Competition

The American Podiatric Medical Writers Association has announced its 25th Annual Student Writing Competition.

• All papers MUST be non-technical in nature. Appropriate subjects include practice management, ethics,or any topic that would be suitable for a lay publication.
• There is no word limitation. Papers will be graded for content, style, grammar, neatness, and overall impact.
• First prize will be one thousand dollars ($1,000.00), sponsored by an APMA Educational Foundation endowment from Dr. and Mrs. Steven Berlin, and recognition in the APMA NEWS and the APMWA Newsletter. Honorable Mention Certificates may also be awarded.
• This competition is open to ANY enrolled podiatric student.
• Entries must be received by 4/1/11 via e-mail at bblock@podiatrym.com
• Entries become the property of APMWA, which may arrange publication of the entry.

AMA Launches Coding Mobile App

The American Medical Association unveiled a coding application for use on Apple iPhones, iPads and iPod Touches, according to a news release from the association.

The CPT coding app is free on iTunes and is designed to help physicians find appropriate evaluation and management billing codes—known as E/M codes—which apply to patient-physician encounters.

Source: Paul Barr, Modern Healthcare [3/29/11]

What Would Your Patients Say if Surveyed?

An outpatient survey from the Williamsport Hospital in Williamsport, Pennsylvania asks, "Have you used Williamsport Hospital Services before? If yes, has the quality of the services improved, remained the same, or declined?

The first principle in the quest for quality is recognition that quality is what the patient perceives it to be, not what you or I say it is (or what it should be). How would your returning patients answer such a survey?

Source: 201 Secrets of a High Performance Dental Practice by Bob Levoy (Elsevier/Mosby Publishers)

Use Web Videos to Attract Your Ideal Patients           

Produce and post videos to your website that are targeted to your ideal patients. For example, if you specialize in wound care, let prospective patients know about your approach to treating wounds and the collaborative relationships you may have with other physicians in your area. Be sure to place a link to this video prominently on your homepage, Facebook wall, and Tweet about it. For maximum impact, upload your videos to Youtube and syndicate them across as many search engines as possible using keywords that include the topic of the video, your name, practice name, and the location of your practice. 

Query: Answering Service

Has anyone had great success and can recommend a good answering service that is in a reasonable price range. I need one that can distinguish when to actually page me when it's important and be able to e-mail the other messages. Online scheduling would be a plus. I have been using Answernet for several years, and although they seem to be okay service-wise, the price is very high. I am in solo practice, and I only get a few emergency/urgent calls a month. The rest are for appointments, RX refills, etc. Maybe, I just think the price is high? I would love to get some feedback on what anyone else is paying and any recommendations.

Bela Pandit, DPM, Chicago, IL

Query: Medicare Paying for Orthotics?

I recently billed Medicare L3020 for custom foot orthotics (expecting a denial) in order to send the bill to the patient's secondary insurance. The claim, however, was paid. The same thing happened multiple times. I thought Medicare didn't pay for these codes. Was there a recent change?

Mike Rosenblum, DPM, Fair Lawn, NJ

Response: This unfortunately was a mistake. In the future, be sure to bill the foot orthotic codes with a "GY (statutorily not covered) modifier, and not, just in case you did, with a "KX" modifier. You want to make sure you get the "correct" denial.

If you bill L3020 with the "GY" modifier, the claim will be denied reimbursement, with the fee the patient's responsibility. If there is a cross-over to a secondary payer, they will receive the Medicare denial for statutory reasons and process the claim under their policy. In your case, you should contact your Medicare carrier, and request instructions on voluntarily refunding the money, as well as on how to re-bill a corrected claim.

Tony Poggio, DPM, Alameda, CA

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

Obesity and Foot Pain (Scott Shields, DPM)
From:  Robert Creighton, DPM

Dr. Shields asked a very important question. According to the Centers for Disease Control and Prevention, 72.5 million Americans are defined as obese, and this doesn’t include the millions more who are not obese by strict definition, but are substantially overweight.  Along with an increased body mass index come increased metabolic-related pathology and increased biomechanical stresses that have well-known effects on the lower extremities. Podiatric medicine needs to incorporate a more public health oriented weight-management interaction than it has historically provided. This is especially true with the growing problem of diabetes and metabolic syndrome; two hallmark diseases of the obesity epidemic.  

We have a tremendous role to play in this area of healthcare, and I do not believe we are living up to it. There have been some disjointed efforts toward this role, with sponsorship of walking programs and more discussion and articles addressing areas related to this topic, but it’s time to bring it all together, formalize it, and take it to the next level. Our colleges and CPME seminars should include education on diet, nutrition, and exercise principles.  With the proper knowledge-base this is an area where podiatry could shine.

Robert Creighton, DPM,  St. Petersburg, FL, rcreightonjr@hotmail.com

RE: Obesity and Foot Pain (Scott Shields, DPM)
From: Robert Creighton, DPM

After reading all of the posts concerning the subject of obesity in America, one movie comes to mind: Wall-E, which painted a pretty accurate prediction of what could happen to humanity. How many people literally fight over the parking spot that is the closest to the store door, and how many kids are sedentary video game fanatics? Just like the big oil companies that put a stop to the development of electric cars for general use, do you really think for one minute that the major pharmaceutical companies, fast-food restaurants, and processed food manufacturers would want a healthy, slim, and fit population?

To the developers of high fructose corn syrup, which is one of the main ingredients in most of the foods that we consume, thank you for increasing America's girth!

Narmo L. Ortiz, Jr. DPM, Cape Coral, FL, nlortizdpm@embarqmail.com

RE: Obesity and Foot Pain (Scott Shields, DPM)
From: Elliot Udell, DPM

At two past APMA conventions, the American Society of Podiatry Medicine along with the APMA sponsored programs on the role of podiatry in the management of obesity. Obesity plays a role in pedal pathology, either directly as a result of excessive pressure on the foot and/or  indirectly by causing type II diabetes. At the APMA conventions, Dr. Lisa Jung, a professor of nutrition at NYU discussed portion control as a method of controlling obesity, and we had a bariatric surgeon discuss surgical approaches to weight loss.
 
Attendees came out of those  sessions realizing that weight loss is not a "walk in the park" for many patients. Some can attain their goals with professional counseling, either one-on-one with a nutritionist or in group settings such as Weight Watchers or Overeaters Anonymous. For others, bariatric surgery combined with counseling is their only hope of avoiding metabolic, cardiac, and musclo-skeletal problems.
 
In our office, we regularly recommend support groups, nutritionists, and bariatric surgical services. One advantage I have is that since I personally belong to Weight Watchers, it is less intimidating for patients when I extend my hand to them and invite them to join me at local support meetings.
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: Basic Website Cost (Thomas E. Silver, DPM)
From: Alec Hochstein, DPM

Let's start by first establishing that a website is a necessity. Obviously, it is not essential to provide quality care, as we as podiatrists have been doing that way before Al Gore " invented the Internet" . A website is a showplace or a source of information for your potential patient, current patient, or referral sources. In short, it is the first stop for many when deciding on where they want to seek treatment and/or send their patients.

To answer the question - it really "depends". It depends on what you would like the functionality of the website to be. Do you want video? Do you want ability to schedule appointments? Do you want to...

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

Re: Oregon Podiatrist Favors "Less Is More" in Running Shoes
From: Patrick J. Nunan, DPM
 
The urban myth of Born to Run has made one shoe manufacturer a lot of money.  The book which is a best-seller is fictional for the most part. Read the endorsements on the cover and the book, talking about a great piece of fiction. The author has made an incredible amount of money.  Most of us do not weigh 100 lbs like the tribe mentioned in this book, nor do we run on soft, forgiving services. While I respect Dr. McClanahan's overall work in sports medicine, I disagree with anyone who feels there is only one way to treat someone, or in this case, recommend the same shoes for everyone.  Barefoot running is a training tool but not for everyone.  Talk about the true science out there, not a fictional novel. 
 
Patrick J. Nunan, DPM, Huntington, WV, pjndpmrun@aol.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

ASSOCIATE POSITION - CT - (FAIRFIELD AND NORTH HAVEN)

Join one of the largest podiatric groups in Connecticut. Well-established and progressive offices, including EMR, digital x-ray, vascular and NCV studies, Pinpointe and CO2 lasers, diagnostic ultrasound and electrical stimulation therapy. You can expect a full schedule of patients the day you start, and a very competitive salary. For more info www.greatfootcare.com. Send resume to Dr.Kassaris@yahoo.com

POSITION AVAILABLE – PHOENIX, ARIZONA

Full-time or part-time position available for an associate to join a modern, well established practice. Needed is a motivated, hard-working, well-rounded, surgically-trained podiatrist to complement our office. Excellent income potential with possible partnership opportunity available. Arizona license required. Email CV to Foot.doctor@hushmail.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

Associate position for podiatry office on Maryland’s Eastern Shore. Certified ambulatory surgery center on-site. Please fax letter and CV to 410-749-6807.

ASSOCIATE POSITION - EAST TEXAS, DELAWARE

Looking for podiatrist to see patients in Nursing Home Facilities in East Texas and Delaware. AVAILABLE IMMEDIATELY. Please contact me at doconcall@aol.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

ASSOCIATE POSITION - NYC, NY

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. Also a used Lumix 2 laser, best price today Dr. Zuckerman is in the Fort Lauderdale area and will demo this lasers on your patients. E-mail footcare@comcast.net

EQUIPMENT FOR SALE - DOPPLER, SURGICAL INSTRUMENTS

Koven Technology Smartdop 45 hand-held bi-directional vascular ultrasound Doppler with real-time waveform LCD - like new in carry case. all attachments for ABI and Digital PPG & PVR. AC charger and computer cords included. Also available are surgical hand instruments, rasps, Weitlanders, stats, needle holders, retractors, and more. Email. Podassociate@aol.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

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

PM News Classified Ads Reach over 12,500 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 12,500 DPM's. Write to bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $109 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.

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