The Voice of Podiatrists

Serving Over 14,000 Podiatrists Daily

March 30, 2013 #4,729 Publisher-Barry Block, DPM, JD

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OH Podiatrist Discusses Long-Term Problems From Wearing High Heels

A survey conducted by the American Podiatric Medical Association showed that 73 percent of U.S. women have shoe-related foot problems. "High heels increase the pressure on the bottom of the foot, change the center of gravity, affect most of your joints -- hips, back, knees," said Dr. Carly Robbins, a podiatrist in Marysville. "They cause a risk of having ankle instability and sprains, especially in Ohio ice and snow."

Dr. Carly Robbins

"A lot of women will lose the fat pad on the bottom of the feet," Robbins said. "Less fat can be more painful. Over time, women might develop arthritis (or) hammertoes -- which can also make (high heels) more painful."

Source: Robin Davis, The Columbus Dispatch [3/28/13]

PM News has begun a new weekly feature called Quick Poll. Each week, we will post a new poll based on some of the controversial issues discussed in our Comments/Responses section. Straw polls are not scientific and do not represent standards of care. This is the last day to vote.

Quick Poll
Assuming additional residencies are not added, which is the better way to ease the residency shortage ?

PA Podiatrist Discusses Monofilament Test

The monofilament is essentially a short piece of nylon fishing line, says Lee Sanders, DPM, of the VA Medical Center in Lebanon, PA. The doctor asks you to close your eyes and then presses the monofilament to the foot, often starting with the toe and then moving to other spots. “If you are unable to feel the application of the monofilament, you have some loss of sensory perception,” says Sanders.

Dr. Lee Sanders

“People may not feel it at the level of the toes, but they may feel it at the ball or the arch or the heel.” Testing at multiple locations gives the doctor a sense of how far the condition has progressed.

Source: Erika Gebel, PhD, Diabetes Forecast [April, 2013]

CA Podiatrist Elected to AAWC Board

The Association for the Advancement of Wound Care (AAWC) announces the newly elected members of the 2013 AAWC Board of Directors. The new board members will join with 2012 elected members and will serve a 2-year term. Among those elected was Podiatrist Physician Representative, Brandon J. Hawkins, DPM, CWS from Bakersfield, California who replaces Desmond Bell, DPM, CWS from Ponte Vedra Beach, Florida.

Dr. Brandon Hawkins

Dr. Hawkins is Owner/Partner of Stockdale Podiatry Group and Sequoia Foot Care Group. He also serves on the Boards of The University of Utah Alumni Association and the  Dr. William M. Scholl College of Podiatric Medicine Alumni Association.

Source: Association for the Advancement of Wound Care

FL Podiatry Group Sues for Defamation and Contract Interference

Central Florida Foot and Ankle Center is accusing Jay Care Medical Center and its chief executive officer of defamation and contract interference. Its lawsuit against Dr. Japinder Singh and Jay Care, filed in February, hinges on Central Florida Foot and Ankle's role in the physician network of Physicians United Plan, a Medicare Advantage HMO. Physicians United often is called PUP.

The lawsuit contends Singh, while on a PUP committee that checked physician credentials, caused PUP to terminate Central Florida Foot and Ankle from PUP's network in November 2011. Singh told PUP the foot and ankle center "runs too many tests" and said he "could run them himself," the current lawsuit contends.

Source: Robin Williams Adams, The Ledger [3/27/13]

Most Physicians Concerned About Future of Profession

Nearly 6 in 10 physicians in a Deloitte Center for Health Solutions survey said they are concerned about the future of medicine, pointing to declining clinical autonomy and income. Pessimism among physicians resulted in nearly 75% agreeing that "the best and brightest" may avoid a career in medicine. That number increased from 69% the year before.

Still, 7 in 10 physicians reported they were satisfied with their careers. The most satisfied groups were the non-surgical specialists (67%) and physicians aged 25 to 39 (80%). Primary care physicians were the least satisfied division, at 59%.

Source: Marcia Frellick, Medscape News [3/28/13]

Query: Night-Time Pruritis in Pregnant Patient

A 30 year old healthy female who is 16 weeks pregnant complains of severe pruritis only at night to mainly the feet, but also the hands. She states that it is waking her up at night because it is so uncomfortable. Her OB has run numerous tests and ruled out gestational diabetes and other pregnancy linked disorders. He has told the patient that it is early in the pregnancy to experience any of these serious syndromes. She has had three other pregnancies without problems and has never experienced this before.

Her skin is pristine and she denies any rash or changes to her skin. Her dermatological, vascular, and neurological exams are all normal. She has tried multiple topical preparations from antifungals, to drying powders, to BENGAY. Nothing has helped relieve her symptoms. I am open to any suggestions.

Christine Dalrymple, DPM North Andover, MA

Query: Coding the Dispensing of Crutches

I dispensed a pair of crutches to a patient and billed Blue Shield E0114 (crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips) x2 units. They paid $0.48, stating that they provide benefits for rental up to purchase price. I'm not sure how to code this or what modifier to use to tell them it is not a rental. I would appreciate some help.

Ara Kelekian, DPM, Montebello, CA

Response: Using modifier "NU" tells the payer the crutches are purchase vs. a rental.

David J. Freedman, DPM, CPC, Silver Spring, MD

Codingline subscription information can be found here

APMA Members: Click here for your free Codingline Silver subscription

RE: Podiatric Certification of Nail Techs (Jeanine Jones Moss, DPM)
From: Janet McCormick, MS

The certification Dr. Moss  was mentioning is probably from the  Medical Nail Technician Program written by Robert Spalding, DPM, and Janet McCormick, MS of Medinail Learning Center. Its purpose is to train nail technicians to work appropriately for podiatrists. As we all know, nail techs are not properly trained, and if they are to perform well in podiatry offices, they must be appropriately trained.

The podiatrist does not certify the technician, though Medinail Learning Center (medinails.com) does seek podiatrists who are willing to offer the internship the students must take before being certified as an MNT. The graduates of this program will also be eligible for the new Clinical Podiatric Medical Assistant Program from the ACFAOM. Many podiatrists are employing nail technicians to perform aseptic pedicures on their patients.

Janet McCormick, MS, Frostproof, FL, janet.mccormick.info@gmail.com

RE: How Long Does it Take to Receive EMR Stimulus Check? (Kurt Meier, III, DPM)
From: Robert Wunderlich, DPM

I'm confused by Dr. Meier's response to this topic. He states that last year (2012), "I attested on February 2 and received the funds in my account on March 23.  This year, I filed on February 15 and have not received the check yet."

The initial reporting period for Stage I of Meaningful Use is 90 days, is it not?  That would mean the earliest one could have attested last year would have been March 30th, 2012, or thereabouts. For the 2nd year of Stage I, there is a 90-day reporting period AND a full year reporting period. I began my own 90-day reporting period for 2013 on January 1st, and as of today (3/28/13), I'm still 3 days away from completing that.  How was Dr. Meier able to attest on February 15th of this year?  Am I doing it wrong?

Also, will the EHR stimulus for the 2nd year of Stage 1 be paid after the 90-day attestation, or the full year attestation?

Robert Wunderlich, DPM, San Antonio, TX, rwunder@gmail.com

RE: Dr. Scholl's Marketing Campaign (James Petko, DPM)
From: Marc Katz, DPM, Gino Scartozzi, DPM

Seriously, we are going to sit and worry about Dr. Scholl's? Stop complaining and do something about it! Write a blog on the superiority of orthoses made by podiatrists compared to an over-the-counter device. When your patients come into the office, educate them. Do an eblast to all of your patients about your orthotic devices. Let all of your patients know that YOU are the expert when they need an orthotic. 

It's not Dr. Scholl that's holding you down and getting you frustrated - it's YOU doing it to yourself.

Marc Katz, DPM, Tampa, FL, dr_mkatz@yahoo.com

I simply do not agree that one should tolerate Dr. Scholl's method of marketing their OTC insoles. In my opinion, overlooking a misrepresentation of providing "custom" orthotics to the general public simply because they "bailed out" the former Illinois College of Podiatric Medicine is not best representative of this profession's and the public's interests. Such "altruism" was rewarded in having the Illinois School of Podiatric Medicine renamed in that corporation's name which I remember created quite a bit of controversy then with current and former alumni.

In the past few years, other than some of their products carrying the APMA Seal of Approval, I have failed to see...

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

RE: 104 Applicants Not Matched for Residency Positions (Lawrence Oloff, DPM)
From: Bryan Markinson, DPM, Michael Marcus, DPM

At last year's APMA Annual Meeting, the COMEDIAN, of all people, told a packed room at the conclusion of his act that the expected surge in diabetes in the United States, (perhaps a quadrupling in 20 years) is staring us right in the face. He stated that we would be fools to squander that opportunity. I felt bad that something so obvious to him had eluded our consciousness.

The federal government two years ago, highlighted a study that indicates a severe manpower shortage in podiatric medicine that could not be met by even tripling the current admission numbers to our schools. At the same time, Vision 2015 was...

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

About six years ago, a college grad called my office and asked me if he could shadow me. He spent several weeks with me. In time, he became turned on to our profession. He applied to the colleges, was accepted to Scholl, and did satisfactory in his didactics. As March 20th approached, I spoke to him and wished him luck. At the same time, a student from Temple is rotating in my clinic. He too was anxiously awaiting the big day. The fourth year student from Chicago didn't get a match.

My present student was fortunate to get a good solid program. He was ranked in the top...

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

RE: 104 Applicants Not Matched for Residency Positions (Jeanne Arnold, DPM)
From: Philip Radovic, DPM, Joseph D. Pasquino, DPM

The residency shortfall crisis requires immediate attention. An instant impact might be made in generating more entry-level positions by having CPME rescind the requirement that a hospital be a sponsor/co-sponsor for residency approval. This would bypass much of the burdensome red tape required by hospitals for sponsorship. The vast majority of podiatric surgery is performed in outpatient surgery centers across the country. Many surgery centers have the resources to financially support a residency and can affiliate with a hospital for inpatient training and trauma rotations, etc. (the hospitals can still obtain GME dollars).

Shifting first year residents to these entry level positions for a two-year certificate would allow for state licensure in most states. Those seeking further training could obtain it through the limited 3-year programs or fellowships. I have asked CPME to consider this avenue.

Philip Radovic, DPM, San Clemente, CA, phil@feetfixer.com

In an answer to certain of the concerns about the residency shortage raised in the letter from Dr. Arnold, I direct PM News readers to Resolution 13-13 presented to the March 2013 APMA House of Delegates by the Pennsylvania Podiatric Medical Association and seconded by the New Jersey State Podiatric Medical Association. This Resolution is on the APMA website and it contains the most up-to-date facts concerning residency development that we could determine.

If the current programs in development are authorized, we are told that will...

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

ASSOCIATE POSITION - HAMPTON ROADS VIRGINIA

Needs to be highly motivated, INDEPENDENT and surgically-trained to join a successful 40+ year practice surrounded with water sports, beaches and hiking. PSR24/36 ; well versed in forefoot and rearfoot surgery, diabetic wound care, sports medicine and diagnostic ultrasound. Please email CV & cover letter to feetloveus@gmail.com

ASSOCIATE POSITION - ORANGE COUNTY, NY

Looking for a highly motivated surgical trained podiatrist in the Orange County, NY (West Point area). Hospital, wound center and surgical center affiliated. It is a busy practice that covers hospital inpatients, Wound Center, and takes ER call. The applicant has to be trained in all foot surgery and be able to handle advanced diabetic wound care. The practice is a 1 hour car ride from NYC and is close to hiking, fishing ,skiing and state parks. Please Email a CV and contact info to clsp4@yahoo.com

ASSOCIATE POSITION - NORTH CENTRAL, NJ

Well established busy solo physician seeking a well trained podiatrist (PMS 36) to join our growing practice. Bilingual English Spanish a big +. Competitive salary/benefits package. Send CV to email: njpod2013-1@yahoo.com

POSITION AVAILABLE - WEIL FOOT ANKLE & ORTHOPEDIC INSTITUTE- CHICAGO

Weil Foot Ankle & Orthopedic Institute is expanding their presence in the Chicago metropolitan area and suburbs and is recruiting qualified podiatric surgeons. A three-year residency is required and a podiatric fellowship is preferable. Current practicing podiatric practitioners in Chicago and surrounding area are also welcome to join our rapidly expanding practice that currently numbers 16 DPMs, a neurologist, an orthopedic surgeon, and a primary care sports medicine physician. For more information contact: info@weil4feet.com or call Stephanie Spiegel, COO at 847-390-7666.

ASSOCIATE POSITION – HACKENSACK NEW JERSEY

Full-time podiatrist PSR 24 or greater, board eligible needed for traveling between offices in Northern NJ, Saturdays. Slow to start but great potential – high end location. Personality a must, Not routine care shy, Multilingual a plus, base salary and malpractice. Info to anklefootdoc@optonline.net, please no attached files.

ASSOCIATE POSITION – NORTHERN CALIFORNIA/SF BAY AREA

We’re expanding, seeking podiatrist to join multi-office practice. Must have great people skills, bedside manner, and positive demeanor. California license required. No nursing home visits. Prefer private practice experience. Send CV and cover letter to:ebpod2008@gmail.com

ASSOCIATE POSITION - SUBURBAN PHILADELPHIA

Full time, PSR 24-36 month trained podiatrist needed for busy suburban Philadelphia group practice. Multidimensional, multi-office group treating a wide range of patients including forefoot, rearfoot & ankle surgery, diabetic wound care, sports medicine, and workrelated injuries. Office & diagnostic equipment state-of-the-art. Full benefit package included with bonus incentive. Position available starting July, 2013 excellent opportunity leading to partnership. Please email to: bailliemw@gmail

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 12/24 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.

ASSOCIATE POSITION - WASHINGTON, DC/ MD SUBURBS

Prominent, established two office practice seeking well rounded, personable, ethical individual with sharp medical and surgical skills. Must be 24/36 month trained, ABPS qualified or certified. Partnership opportunity with ownership potential. Competitive salary with benefits package. Please send CV to ponyrunner66@gmail.com

ASSOCIATE POSITION - SOUTHWEST FL

R U a PM&S36 or PSR24 graduate looking for a bright future in podiatry BUT cannot be afraid to work hard to achieve. Nail care to reconstructive ankle/leg trauma. Attitude & God complexes need not apply. Frames / IM nails, must be comfortable applying. Work hard for exciting future. Superstars only. Send info mny1029@gmail.com

ASSOCIATE POSITION – TAMPA BAY AREA

Multi-location practice seeking individual with balanced medical and surgical training. Practice is well established with growing new patient visits. Offering competitive salary and benefits along with bonuses commensurate with performance. EMR already in place with well-trained assistants. Please Send cover letter and CV to office@fitfeetflorida.com

ASSOCIATE/PARTNERSHIP  MIAMI/KENDALL FLORIDA

Podiatrist with interest in foot and ankle surgery and comprehensive foot and ankle care. Pathway to partnership/ownership available. Send CV and information: ibaumdpm@bellsouth.net

ASSOCIATE POSITION – LEXINGTON, KY

Associate needed at fast growing, practice in beautiful Lexington, KY. All new office structure with gait analysis, med spa and heel pain center in prime location. Amazing benefits and chance to work alongside a forward-thinking podiatrist. Email emenold8@gmail.com with your resume.

ASSOCIATE POSITION - N.E. INDIANAPOLIS (FISHERS/ANDERSON)

Full or Part-time associates to join board-certified podiatrist in diverse, modern podiatry practice in hospital and office settings. EHR, digital x-rays, PADnet, Cutera Genesis Plus laser, Pinpointe Laser, ESWT, mini-C-arm, all aspects of DME, and hospital affiliations with three networks. Limited wound care. No nursing homes. Current Indiana podiatrists welcome. Tremendous potential for individual(s). Send C.V. with salary and benefit expectations: john.lloyd@lloydpodiatry.com

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

Requiring full-time podiatrist (PSR-24 or greater) in established Practice situated in a foothill community of Southern California. There is an existing patient base and a strong support team. Compensation is performance based with practically an unlimited earning capability. A possible buy-in is negotiable. Send resume to office@uplandpodiatry.com , titled "podiatrist."

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 PODO2345@AOL.COM 516-476-1815

PRECEPTOR POSITIONS - PHILADELPHIA

(3) Preceptor Positions available in Philadelphia and possibly (1) or (2) more in NY/NJ. Practice is diverse with a strong offering in podiatric rehabilitation, sports medicine and pain management. Two preceptors successfully completed this past year and gained tremendous hands-on experience. Please send resume to: ediamond7@comcast.net. To learn  more: www.philadelphiapodiatrist.com.

PRECEPTOR POSITION – TAMPA BAY AREA

Multi-location practice offering paid preceptorship. You will learn great patient care techniques along with nuisances that go into running a successful practice. We had a positive experience with a preceptor this past year and want to repeat this. If interested please send CV to office@fitfeetflorida.com

EQUIPMENT FOR SALE - USED Q-CLEAR LASER

Still under warranty. New laser head just added. First Best Offer. Marketing and training included. Dr. Zuckerman will train you. e-mail with questions to footcare@comcast.net

ACADEMIC POSITIONS - SCHOLL COLLEGE

The Dr. William M. Scholl College Podiatric Medicine is seeking up to three full-time academic podiatrists to train and lead the next generation of podiatrists in an interprofessional, multicultural learning environment. Applicants must be board qualified with preference for board certification in foot surgery and reconstructive rearfoot/ankle surgery. Salary and academic rank will be commensurate with scholarly credentials. Contact Robert Joseph DPM, PhD at Robert.joseph@rosalindfranklin.edu or (937) 479-1793. Rosalind Franklin University of Medicine and Health Science is an Equal Opportunity/Affirmative Action Employer. The administration, faculty and staff embrace diversity and are committed to attracting qualified candidates from historically underrepresented groups.

PRACTICE FOR SALE - SIOUX CITY, IA, TRI-STATE

Solo practice, established over 40 years. High volume, general care with surgical and orthopedic mix. Surgical privileges at 2 major hospitals. Deferred financing available. Contact: Medical Office, PO Box 4516, Sioux City, IA 51104.

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

PRACTICE FOR SALE - LOS ANGELES, CA

Practice is in Boyle Heights area since 1998. 70%MM the rest consist of Cash/PPO/HMOs. Last 4 years grossed between 200-350k in a down economy. Constant referrals from PCPs in the area. Includes Padnet, and all podiatry equipments. Asking 130k. Please email me only footdoc525@yahoo.com

PM News Classified Ads Reach over 14,000 DPMs 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 14,000 DPMs. Write to:bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $115 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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