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The Voice of Podiatrists

Serving Over 17,231 Subscribers Daily

April 01, 2016 #5,633 Publisher-Barry Block, DPM, JD

A partner of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2016- No part of PM News can be reproduced without the
written permission of Barry Block

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PODIATRISTS AND DIABETES

TX Podiatrist Stresses the Need for Daily Foot and Shoe Inspections of Diabetics

For diabetes patients in the Rio Grande Valley, taking a few simple steps – such as checking their feet for abnormalities and seeking early treatment for any wounds – can save them from potential tragic complications, such as having to have an amputation of a foot or leg. This was the message of Luis R. Venegas, DPM podiatrist and Medical Director of the Wound Healing Center at Harlingen Medical Center. His message is particularly timely, considering that April is “National Foot Health Awareness Month.” Dr. Venegas recommends that diabetics check their feet every day, using a mirror if necessary, to look for lesions, abrasions, abnormal calluses, and other signs of trauma and infection.

Dr. Luis Venegas

If a diabetic is not able to clearly see the bottom of his or her feet, Dr. Venegas suggests asking a family member to check their feet on a regular basis for ulcers or other problems. In addition, Dr. Venegas says it’s important for patients to check their shoes each morning, to make sure that a foreign object has not fallen into one of the shoes. Since many diabetics can’t feel sensation in their feet, they may walk around for days — not knowing there is an object in their shoe – whether it be a pebble or piece of metal, such as from a stapler.

Source: The Valley Star [3/30/16]

PODIATRISTS AND POLITICS

NY Podiatrist Says Trump Has Huge Feet

Ted Cruz, yesterday, unleashed an array of sharp attacks on Republican front runner Donald Trump saying that Mr. Trump has “small feet,” and continuing “you know what that means.” Former presidential candidate Marco Rubio had previously commented about the size of Trump’s hands weeks earlier, and Cruz followed suit at a recent town hall. Trump proceeded to release his medical records from his podiatrist, Paul Kesselman, DPM. A letter by Dr. Kesselman stated, in part “If elected, Mr. Trump, I can state unequivocally, will have the largest feet of any individual ever elected to the presidency.”

Dr. Paul Kesselman

Trump, at a rally yesterday responded, “Look at these feet, are they small feet? I guarantee you that there’s no problem with my feet, and no problem elsewhere.” Trump has called upon Cruz to release records from his podiatrist, and said, “Have you seen Lyin' Ted’s feet? I don’t know if it’s true, but some are saying that he has fungus nails.”

Source: April Fool’s News [4/1/16]

INTERNATIONAL PODIATRISTS AND FOOTWEAR

Finally, Sexy Heels You Can Walk In! - UK Podiatrist

So she’s finally admitted it. Victoria Beckham, queen of the towering stiletto, has conceded defeat and admitted what many of us have known all along - that vertiginous heels are simply not compatible with everyday life. So what has changed? Real life it seems. ‘I just can’t do heels any more,’ she recently confided. ‘At least not when I’m working.’ But thankfully, for Posh, and the rest of us, there is now a middle ground between high heels and flats - the low block heel. On spring’s catwalks, these highly desirable (but incredibly practical) shoes abounded.

Margaret Dabbs

Not only are these shoes beautiful to look at, there are clear foot health benefits too. "Lower heels are a kinder option for feet as they offer good support and fit properly," says podiatrist Margaret Dabbs. "High heels put pressure on the back, and shorten the Achilles tendon which can result in long-term feet problems." For those who must wear heels, Dabbs recommends 1.5 inches and the sturdier the better. "A chunkier heel will distribute the body weight better and will be more comfortable as it assists with balance when walking and offers good support to the soft tissues and the arches of the foot."

Source: Clare Coulson, The Daily Mail [3/30/16]

IN THE COURTS

Ex Med Tech CEO Faces Jail Time for Bribing VA Docs

A former med tech CEO is facing jail time for allegedly bribing VA doctors across the country to promote its skinlike dressing for diabetes-related foot sores, marking a dark chapter in the company's legal saga. Advanced BioHealing's ex-leader Todd Clawson recently pleaded guilty to one count of a bribery in a Seattle federal court before U.S. Magistrate Judge James Donohue. Federal prosecutors claimed that Clawson and others in the company paid kickbacks to VA podiatrists and doctors in Washington, California, Arizona, Ohio, Texas, and Georgia to talk up its "biologic" wound dressing device, Dermagraft.

Clawson and others flew a Phoenix VA doctor to Cabo San Lucas, Mexico, for a fishing trip in August 2010. Clawson promised another VA doctor Def Leppard tickets, a Wyoming fishing trip and Las Vegas entertainment, according to a seattlepi.com story. The company flew at least three doctors to Seattle in 2010 to promote its devices. But the bribery didn't stop there. Advanced BioHealing paid doctors as much as $3,000 to come to "speaking engagements" at dinners paid for by the company and attended by VA staff. "These events usually took place at a restaurant where the company, and in some instances the VA speaker, would solicit VA personnel to attend, and the company would pay for their meals," Assistant U.S. Attorney David Reese Jennings said in court papers seen by seattlepi.com.

Source: Emily Wasserman, Fierce Medical Devices [3/28/16]

FROM PM's CURRENT ISSUE

Twice a week, PM News posts an entire article from a recent issue of our partner, Podiatry Management Magazine. Please note that the views expressed in Podiatry Management Magazine do not necessarily reflect the views of PM News or Barry Block.

Today's Featured Article

Click to read this article

PRACTICE MANAGEMENT TIP OF THE DAY

Online Reputation Protection for Physicians - Part 4

4. Help patients understand payment responsibility

Many patients end up confused and angry at the practice when hit with unexpected costs, and they often turn online to voice their displeasure. It's in everyone's interest to be clear about what the patient will be expected to pay at their visit — and of course, it's important for your bottom line that your staff is comfortable collecting in a professional manner.

Source: Joe Capko, Physicians Practice [3/23/16]

QUERIES (CLINICAL)

Query: Gait Abnormality

My patient is a 45 year old mail carrier who six months ago was injured in a car accident. He was hit from behind while stopped in his mail truck. He went to the ER, had extremity x-rays only, and was pronounced without injury. Now, this patient finds that halfway through his mail route, walking with his mail sack, he becomes profoundly universally fatigued such that with trying to “walk it off”, his feet seem to want to invert, sometimes tripping him. I made orthotics that helped only slightly. Examination for orthotics revealed a bilateral and significant diminution of muscle strength of both peroneals. The patient’s employer sent him for a comprehensive neurological exam on my recommendation which included bilateral electromyogram; these studies were NORMAL.

My question is how to proceed: the patient’s PCP and subsequent neurological exam states there are no abnormal findings. I believe that the impact he sustained, which totaled the truck, may have begun a cascade of neurological events such that they are only manifested by exercise or fatigue. Will anyone venture an opinion as to what syndrome may cause this, save (and this I doubt) malingering.

QUERIES (NON-CLINICAL)

Query: Residency and Fellowship CMS Reimbursement

I am trying to find information regarding the reimbursement rates from CMS for podiatric residents in their 4th year. I have read that CMS only pays for the minimum years required to be eligible for board certification, but I know that there are programs that have a 4th year. Do these programs just eat the cost or is there some funding that is paid i.e., .5 FTE. I have a similar question for fellowship funding since I have seen that fellowships for MDs or DOs get funding at .5 FTE. Please post any information.

CODINGLINE CORNER

Query: Tier 1 and Tier2

Recently, insurance companies are designating our practices into Tier 1 or Tier 2 according to our utilization of certain services. Patients who seek a Tier 2 doctor generally have to pay a higher co-pay than if they choose a Tier 1 provider. How can we, as providers, find out what Tier we are in with the various insurance companies?

Sandy, Office of Allan Hetelson, DPM, Bensalem, PA

Response: We currently have two plans that our office deals with which have the tier system. The first plan is pretty simple and has guidelines that we have to follow in order to be a tier 1 (lower co-pay) for patients who present in our office. With this said, we have to provide MU and PQRS to them on a regular basis as well. They put a tracking system in our software to assist in gathering the MU/PQRS data. The second plan is a Highmark plan in the state of Pennsylvania. This plan is specifically a marketplace plan. With this Flex Blue PPO plan, we are also told that we are in the higher co-pay bracket. When I called the insurance company and our insurance rep, all I was told was that we are not enhanced because our doctor is not affiliated with Penn State Health or Pinnacle Health System. As a result, we have new patients presenting with this marketplace plan showing a $120 co-pay.

When I dug as deep as I could to find out how we could be considered part of the Penn State Health plan/Pinnacle, I got no where. All I was told was that they are not adding new doctors to their preferred network at this time. Our doctor is also on staff at our local Penn State Hospital and sees patients at their clinic. Apparently, seeing patients at the Penn State Clinic doesn't grant you the ability to be in the lower co-pay tier. It is important to note that this marketplace plan was tiered this way in 2016 to allow for a lower monthly premium. As a result, patients are finding out that it comes with some restrictions on which doctors they can and can not see. We have encountered many patients who felt that they were misled on this Flex Blue Highmark plan.

Jennifer Fields, Office Manager, Office of Paul LaFata, DPM, West Lawn, PA

RESPONSES/COMMENTS (NON-CLINICAL)

RE: Where are Graduating Podiatry Residents Getting Jobs?

From: Name Withheld

I understand your frustration at not finding an associate; however, that frustration is shared by the new graduates coming out. Unfortunately, of the options available to new graduates (Ortho group, multi-specialty, hospital employment, private practice), I would wager that the majority would say that joining a podiatrist is usually the least enticing option. Salaries are much lower and, whether deserved or not, podiatry has earned a reputation of eating its young.

I experienced this first hand as I was given a much lower than average salary with promises that I would start earning gains very quickly. Almost two years later, I was still earning less than the nursing staff despite the fact that I had worked very hard and built up a large clientele. "Just give it a couple more months" I heard again and again. When the hospital in the area came and offered me a base salary that was 4x what I was making as well as student loan repayment and better benefits, why wouldn't I leave?

Until we can view new associates as partner investments rather than as business investments and cash cows, they will continue to search out other opportunities. The mantra among MD/DO groups is that doctors don't earn money off of other doctors. DPMs would do well to follow suit.

Name Withheld

YOU CAN MAKE THESE THINGS UP

RE: Outrageous Shoes of the Day

Marty McFly was right!

Utilizing the latest in anti-gravity technology, Soft Star Shoes is proud to introduce the world's first fully-functional Hovershoe®! Glide effortlessly over the ground in our flexible, weightless design.

Source: April Fool's News [4/1/16]

MEETING NOTICES

PM PODIATRY HALL OF FAME LUNCHEON

July 15, 2015 – PHiladelphia Marriott

Honoring Bret Ribotsky, DPM and James Lamb

Sponsored by Bako Integrated Physician Services (Silver), PICA (Bronze), and Sammy Systems (Bronze)

PM News subscribers are invited to see Dr. Ribotsky and Mr. Lamb inducted in the PM Podiatry Hall of Fame, including roasts by special guests.

All ticket proceeds go to the APMA Educational Foundation Student Endowment Fund. Reserve your tickets now by sending $75 per ticket to: APMA Educational Foundation, 9312 Old Georgetown Road, Bethesda, MD 20814 or via the APMA Meeting registration form.

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Choose any or ALL from 30+ CME Category-1 articles posted

CLASSIFIED ADS - PART 1 - ASSOCIATE POSITIONS AND FELLOWSHIPS

ASSOCIATE POSITION - CENTRAL VALLEY/SOUTHERN CA/COASTAL

Seeking associates with partnership availability. Must be highly motivated and have good patient skills and personality. Salary excellent with all paid benefits/incentives including malpractice/401k and profit sharing. Compassionate and well-trained for immediate position. Surgery Center and hospital-based with no HMOs/no rest homes. Bilingual in English and Spanish preferred. Offering a permanent position/partnership in a multi-million dollar hi-tech practice with Partnership also in Surgery center. Please e-mail CV and short bio to: Tonya@wetreatyourfeet.com

NEW ASSOCIATE PODIATRIST POSITION – ANNAPOLIS, MD

Immediate position available. GREAT opportunity to join a thriving practice and in-office Ambulatory Surgical Center in beautiful Annapolis, Maryland. The full-time associate role is for an independent thinker who is board qualified or certified ABFAS. Must be licensed in Maryland with two years surgical training. Annapolis offers easy access to both Baltimore and D.C., as well as the incomparable Chesapeake Bay. Staff privileges available at the growing Anne Arundel Medical Center. If you are energetic, self-motivated and ready to hit the ground running, email cover letter and resume to mokane@podiatrygroup.us.

ASSOCIATE POSITION - ST. LOUIS AREA

Newly available position to join a well-established independent practice, associate leading to partnership. Experience preferred, Board qualified/certified. Please call Dr. Edward Stein at (314) 565-2739 and forward your resume to stcpod@att.net

F/T PODIATRIST – PENNSYLVANIA

Expanding, well rounded, multi-site, state-of-the-art group with offices throughout Lehigh County, Pennsylvania. We offer: Competitive salary Benefits Partnership opportunity We're associated with hospitals, wound care centers, and a residency program. Requirements: Hard-working, self- motivated, board qualified/certified, and surgically trained. 2016 graduating residents welcome.Please email CV to: recruiting@foi-solutions.com

ASSOCIATE POSITION - TAMPA BAY

Well established, dynamic multi-doctor practice in the Tampa Bay, high-tech with EMR and digital x-rays. Sports medicine, surgery and potential partnership. No NH/ HMOs. Excellent hospital privileges. Choose an area of practice concentration that you are passionate about & enjoy a lifestyle 2nd to none. CV to floridapodiatrist@tampabay.rr.com

ASSOCIATE POSITION - WESLEY CHAPEL/TAMPA FL

Established practice with expanding and well-rounded patient base in fast growing area, seeking PSR 36 trained individual with strong work ethic. Full EMR/EHR, digital x-ray, ultrasound and laser on site. Multi-hospital privileges, no nursing homes. Salary and benefits package. Must be board qualified and obtain Florida License. Send CV and references to slevin40@gmail.com

ASSOCIATE POSITIONS – MARYLAND (FULL-TIME/PART-TIME)

Are you motivated, personable and enjoy working with the elderly? We are offering part-time positions in Maryland. Podiatry Management Services provides care in Nursing Homes, Assisted Living, Senior Homes, Adult Daycare and other similar facilities. Please e-mail your CV to: drhprosen@verizon.net or fax to 888-241-3302 or call Dr. Herbert Rosen at 410-580-0255.

ASSOCIATE POSITION – SOUTHERN CALIFORNIA

Successful, growing full-scope practice with offices in Oxnard, Camarillo, Ventura and Santa Barbara seeking a full time podiatrist with excellent patient skills to add to our team. Competitive salary and benefits offered including health insurance and 401K. Potential for partnership. Please send CV to Kelly@footsurgeon.com.

ASSOCIATE POSITION – SAN FRANCISCO, CA

Immediate, full-time opening in fast-paced Sports Medicine Center. No wound care. No Medicare. Candidate must have strong biomechanical, surgical and sports medicine background. Applications accepted online at http://www.fdfac.com/z/about-careers.html

ASSOCIATE POSITION - NEW MEXICO

Growing practice in need of F/T podiatrist. Remote clinic requiring hard-working board certified/qualified candidate who is well-trained in rearfoot, ankle trauma, reconstruction, wound care. Call/hospital work necessary. Looking for self-motivated candidate who is interested in partnership. Send CV to nlhuge@gmail.com

ASSOCIATE POSITION - TAMPA BAY

ASSOCIATE POSITION - VANCOUVER ISLAND, B.C

Associate for well establish practice on Vancouver Island, B.C Canada. Reply to dr.cole@shaw.ca

PRECEPTORSHIP OPPORTUNITY IN PHILADELPHIA

Be intimately involved with all aspects of podiatric medicine, rehabilitation, and pain management. Established and diverse practice. Hands-on experience with patient care, practice management training and we will do our best to assist you with obtaining a residency. I am podiatrist to The Pennsylvania Ballet, so if you have interest in sports medicine, a plus. Salary: $15/hour. Please send your CV and introductory letter to: ediamond7@comcast.net

FELLOWSHIP – DIABETIC FOOT & WOUND (TEXAS)

One position for a 12-month TMB-approved Diabetic Foot and Wound fellowship beginning July 1, 2016. Candidate must have completed a podiatric residency/plastic surgical residency/general surgery residency and be eligible for Texas Medical License. Training involves all aspect of diabetic foot management. Curriculum focuses on surgical limb salvage, and medical management of the complex wound patient. Interested candidates should email their CV, personal statement and 3 letters of recommendation to latonya.rosales@utsouthwestern.edu. UT Southwestern is an Affirmative Action/Equal Opportunity Employer. Women, minorities, veterans, and individuals with disabilities are encouraged to apply.

PM NEWS CLASSIFIED ADS REACH OVER 16,500 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 16,500 subscribers. For details,click here or write to:bblock@prodigy.net or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at (800) 284-5451.

CLASSIFIED ADS PART 2 - PRACTICES FOR SALE OR WANTED, EQUIPMENT FOR SALE

PRACTICE FOR SALE- KANSAS CITY METRO

well established, successful practice in prime Kansas community offering great life/work balance. Full array adult, pediatric services with opportunity for additional growth. High level patient, physician referrals. Strong commercial mix. RFC less than 10 percent. Traknet EHR. Owner assist with transition. Contact Mike Crosby at MCrosby518@gmail.com

PRACTICE FOR SALE – WESTERN MASSACHUSETTS

30 year old general podiatry practice. State-of-the-art medical suite renovated 4 years ago Modern equipment, prime location, large physician referral base, full hospital privileges. No house calls, nursing homes or hospital ER call. Established patient base and unique opportunity for surgically-oriented podiatrist in the Berkshires (Western MA) Priced to sell quickly due to personal and medical concerns. Additional info best achieved via conversation. Contact: dross@albany.twcbc.com or cross12@nycap.rr.com

MLS LASER FOR SALE – CUTTING EDGE LASER TECHNOLOGY MPHI 5

The BEST laser on the market for the treatment of inflammation. MPHI 5 Therapy Laser. Wavelength – Dual, equally penetrating Wavelengths to a depth of 3-4 cm. Also can be used for tendon and ligament injuries, degenerative joint conditions, chronic non-healing wounds, arthritis and tendonitis! Excellent operating condition. Used by podiatrist, physical therapist and orthopedist. Only 2 years old. Discounted Price $34,250 Call Beth Brannock @ (781) 979-0919 or email Beth@footdoctorsmass.com.

NAIL FUNGUS LASER FOR SALE - CUTERA LASER GENESISPLUS

The BEST laser on the market for the treatment of Onychomycosis. Wavelength - 1064nm ND YAG. Spot Size - 1mm, 5mm. Also can be used for other cosmetic treatments: Acne scars, enlarged pores, fine lines, keloids, nail fungus, neuroma, rosacea, scar reduction, sun damage, verruca, warts, wrinkles.Excellent operating condition. Discounted Price $40,000 Call Dr. J. Laurie @ (215) 605-2134 or email GenesisPlus4Sale@yahoo.com

SPACE AVAILABLE WITH BILLABLE MRI – MANHATTAN AND LONG ISLAND

Are you letting income walk out your front door? Do you order MRIs but refer them to outside radiology facilities? Why not perform the MRI yourself and keep all the income? At our turn-key facilities on Long Island and Manhattan, rental of the office gives you access to our state-of-the-art equipment, including a fully-functioning extremity MRI where ankles and feet can be scanned. Once you run the numbers, you'll see that the added income to you makes this proposal a no-brainer. Call 516-476-1815 or e-mail podo2345@aol.com for further information.

PM NEWS CLASSIFIED ADS REACH OVER 16,500 DPMs AND STUDENTS

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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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