The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

April 02, 2011 #4,124 Publisher-Barry Block, DPM, JD

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CA Podiatrist Receives APMA Award of Excellence

Lester J. Jones Jr., DPM  recently received the APMA Award of Excellence which is given to members in recognition of outstanding national accomplishments in scientific, professional, or civic endeavors. Nominees for the Award of Excellence also demonstrate outstanding service to APMA and unimpeachable character.

Dr. Lester Jones

Dr. Jones has been an instrumental diplomat for podiatric medicine. He has forged lasting ties with allopathic medicine through his service at the Greater Los Angeles VA, where he reorganized the Division of Podiatric Medicine and Surgery and markedly expanded its scope of practice, while simultaneously rebuilding its residency programs. He has helped podiatric medicine reach educational parity with allopathic and osteopathic medicine through his many leadership roles with the Council on Podiatric Medical Education and now as Executive Associate Dean for Academic Affairs at the College of Podiatric Medicine at Western University of Health Sciences.

Doctor Specified Socks Receives Coveted APMA Seal

The American Podiatric Medical Association has announced that it has awarded Doctor Specified Health and Lifestyle Socks its coveted Seal of Acceptance to use on all of their current styles. The original six Doctor Specified styles have carried the seal for the last three years. When the line was expanded to include the new categories of Leisure, Comfort, and Support, the new styles were submitted and approved as well.

Doctor Specified Socks

"We are very proud that our dedication and focus on quality have resulted in every style we offer being granted the APMA Seal,” explains Rob Zellmer, General Manager. "When we began Doctor Specified, it was our goal to provide people with a unique product that is not only comfortable, stylish, and pleasurable to wear but one that also promotes quality foot care health."

CMS Enacts Face-to-Face Rule for Home Health, Hospice

The CMS today enacted a new Medicare requirement that physicians meet face-to-face with home health and hospice patients, a move that was strongly opposed by providers in the industry.

Under a provision of the Patient Protection and Affordable Care Act, home health patients must be seen by a physician within 90 days before care begins or within 30 days after it starts, according to a CMS statement. Hospice patients must be seen in the 30 days before the start of the patient's third benefit period.

Source: Paul Barr, Modern Healthcare [4/1/11]

CDC Releases Guidelines to Prevent Infections

The Centers for Disease Control and Prevention and the Healthcare Infection Control Practices Advisory Committee have released new evidence-based guidelines for preventing infections related to intravenous catheters. More than a quarter of a million bloodstream infections occur annually in hospitals, resulting in more health complications for patients, longer lengths of stay, and increased costs, the CDC said in the report.

In their recommendations, which replace guidelines drafted in 2002, the CDC and HICPAC emphasized education and training, use of maximum sterile barrier precautions during insertion and specific antisepsis preparations. In addition, the report also stressed the benefits of bundled improvement strategies and monitoring.

Source: Source: Maureen McKinney, Modern Healthcare [4/1/11]

Query: Painful Callus, 5th Metatarsal

This 55 y.o. patient had a stroke years ago, but is otherwise fairly health He has tried AFOs. He puts so much weight on the outside of his foot that it causes a thick painful callus at the base of the 5th metatarsal. Also, his foot functions terribly in varus because of overpowering by his inverters, resulting in an altered, cumbersome gait. He has been struggling with this for years.

Painful Callus, 5th Metatarsal

I thought of doing a transfer of the posterior tibial tendon to the lateral foot by passing through the interosseous membrane and back down onto the lateral cuneiform and doing a closing Dwyer laterally and a gastroc recession (as was presented at the ACFAS Meeting). Any other ideas or thoughts?

Stephen S. Pirotta, DPM, Bentonville, AR

Query: Designing an Exam Room from the Ground Up

I have the opportunity to design and build a podiatric examination room from the ground up. I would like to query the readership as to how they would design "the perfect room." Assume a 10' x 11' room size. For example, where would the exam chair be in relation to the door? What kind of door? Where would the cabinets be positioned?  What instruments would you keep in the room and how/where would you store them? What type of lighting would you use?  

What type of hard surfaces would you use? What would be the best arrangement for doctor/patient/family traffic flow? Carpet or tile floors? Sink or no sink? Mobile supply carts or fixed counter tops?  What video, audio, or electronic devices would you have built-in?  The preceding are just a few examples of things to consider. We have some room to really custom-fit this new construction, so feel free to be creative!

Nat Chotechuang, DPM, Bend, OR, natchot@hotmail.com

Query: Non-Invasive Vascular Exam

I have billed and gotten paid on non-invasive vascular exams done in my office. A colleague recently told me that it was required to have a vascular lab interpret the results in order to be paid. The code I am using is the technical code of CPT 93922. I am interpreting the results myself. I do have a hard copy printed and document my assessment on that hard copy, I keep a copy in the chart. Any thoughts on this - if it is correct or not?

Stephen S. Pirotta, DPM, Bentonville, AR

Response: You are allowed to perform and interpret the results. The test performance and report must be of a quality comparable to that of a vascular lab.

If you perform and read the test (1-2 levels), bill CPT 93922.  If you only perform the test, and have someone else interpret the findings, then you would bill CPT 93922-TC for performance of the technical component.

Tony Poggio, DPM, Alameda, CA

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

RE: DME Supplier Enrollment Fee Follow-Up (Paul Kesselman, DPM)
From: Joseph Menn, DPM

I am one of a four doctor group with one main office and three satellite offices. According to Dr. Kesselman's statement, and our schedule, we would need to pay an extortion fee for eleven licenses ($5,555.00) in order to buy the privilege of dispensing an ankle brace to my nice little lady who sprains her ankle on the way to church on Sunday, thereby gaining a profit of about a buck and a half. Is this correct? Are they out of their minds?  If so, good luck to all those "Super Groups" out there! 200+ doctors and 75+ locations and some with rotating schedules! Think they'll actually pay it? What a windfall for Medicare. Maybe this is how they won't have to raise taxes to pay for all of our uninsured.
    
Joseph Menn, DPM, Myrtle Beach, SC, jmenn@coastalpodiatry.com

RE: Focused Review of Palliative Care in a Hospital (Name Withheld)
From: Thomas Clark, DPM
 
In response to the focused review question, Name Withheld should request a copy of the policy: Medical Staff Professional Practice Evaluation from the medical staff office. Read the section on focused review. Although there are many reasons that the committee may request a focused review, if you are competent in the area of concern, you will not have a problem with the process.

The difficult part will be mostly arranging a time with the reviewing doctor that will be mutually acceptable to both of you. The fact that they are reviewing "palliative care" may have to do with your privileges being  somewhat limited within this specific hospital. This process is a part of the function of assuring medical staff oversight of individual staff members, which is required by different accrediting agencies.

Thomas Clark, DPM, Lebanon, PA, twclark918@gmail.com

RE: Obesity and Podiatry
From: Evan F. Meltzer, DPM, Robert Bijak, DPM

News flash: West Virginia now outweighs Mississippi as the most obese state in the nation (source: CBS News, 3/31/11). It’s nice to know that Mississippi is not in first place in all negative categories for a change (although it is still the leading state in the rate of diabetes in the U.S.).

Evan F. Meltzer, DPM, Jackson, MS, Evan.Meltzer@va.gov

I find it incredulous that podiatrists are advocating a "professional" role in weight management.  Are these the same podiatrists who won't treat gout or diabetes because it's systemic? Are these the ones who say, "if you wanted to practice medicine, you should have gone to medical school"?

Those advocating nutrition and counseling probably never took a formal course in nutrition, and I hate to tell you, endocrine problems are quite prominent in obesity. Most podiatrists never took an individual course in endocrinology. I actually have graduate credit in an endocrinology course, and knowing the complex interactions of the systems. I wouldn't presume to treat obesity. Again, most podiatrists don't know what they don't know. Even if you formally rotated through endo as a podiatrist, you are not trained or licensed to treat this systemic disease. Once again, your limited license keeps you legally below the ankle, and in some states, the tibial tuberosity. Do what all podiatrists are supposed to do with systemic diseases, refer to a fully licensed physician. If you want to treat obesity, vote for a degree change.  

Robert Bijak, DPM, Clarence Center, NY  rbijak@aol.com

RE: Answering Service (Bela Pandit, DPM)
From:  Ellen Wenzel, DPM
 
We are a two-physician practice, and we also use the $0 approach; just a little differently. At the end of each day, the front office forwards the phones to the cell phone of whomever is on call (check your landline carrier for how it works). Cell phone numbers remain private and the voicemail message never has to be changed. The patient, ER, or floor are in immediate contact with us. Our patients love it, and the ER and referring physicians always comment on how great it was to get us on the line without delay. Yes, I do get an occasional early am or late night call from a patients believing that they are just going to get the voicemail. But, after the surprise wears off, they are usually apologetic and call back at a more reasonable hour.

I even take the time for patients who call in with unexpected needs for scheduling via LogMeIn.com. It's free from home.

Ellen Wenzel, DPM, Vancouver, WA, wenzeldpm@gmail.com

RE: MD Podiatrist Discusses Price of OTC vs. Custom Orthotics
From: Richard Gosnay, DPM
 
I find it hard to believe that Dr. Christina said that the major difference between OTC orthotics and custom orthotics is price. I suspect sloppy journalism on the part of Ms. Braff at the Chicago Tribune.
 
Richard Gosnay, DPM, Danbury, CT glabroushead@gmail.com

Editor's comments: Dr. Christina did not say what you infer; Ms. Braff did. There are no quotation marks in the article to indicate that Dr. Christina did. Dr. Christina only provided the cost differences between OTC and custom orthotics.

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 - 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

ASSOCIATE POSITION - MICHIGAN

Entry level DPM needed to join an established, full service, group podiatry practice in Monroe, MI. A generous salary and future partnership opportunity will be offered to the right applicant. Check out our website at www.monpod.com Send CV and cover letter to info@monpod.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

Part/time, full/time associate for busy, well established multi-doctor, multi-office NYC group. Seeking motivated, ethical, NYC licensed DPM with excellent office management and clinical skills in all phases of Podiatry. Board Qualified/Certified preferred. Salary plus incentives, pension/medical/dental. Partnership potential. E-Mail CV to urbebe78@aol.com

ASSOCIATE POSITION - MANHATTAN

Podiatrist wanted full/part time for busy midtown Manhattan practice. Must participate in the networks Aetna, BlueCross, Oxford, and United Healthcare. Please respond to 44footcare@gmail.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

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

EQUIPMENT FOR SALE- MIDMARK CHAIR

Midmark 647 podiatry procedure chairs, x2, condition new (only 1 yr.) , wired & wireless foot controls, block screen, base rails, light and dark blue upholstery with matching stools, under warranty. Other pod. equip., large modern curved reception desk. Midtown Manhattan, contact NYCfoot@aol.com for further information.

 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

PRACTICE FOR SALE - HOUSTON, TEXAS

28 year old busy, progressive practice for sale with an excellent reputation and well established referral base. Well-trained, dedicated, supportive staff. Excellent cash flow $475K income after overhead. EMR, digital x-ray, diagnostic ultrasound. Free standing building also available with large outdoor sign. Also available are two transferable surgical center partnerships(with distributions). Owner retiring and willing to stay part time during transition. Cover letter/CV to softechpodiatrist@gmail.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

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