The Voice of Podiatrists

Serving Over 14,000 Podiatrists Daily

April 13, 2013 #4,741 Publisher-Barry Block, DPM, JD

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OH Podiatrist Discusses Transition From Surgical Boot to Street Shoes

According to podiatrist Dr. Danny Morgan, surgical boots are important  after surgery or a fracture. "You don't want those bone to be moving. You want them to be stable." says Morgan.

Dr. Danny Morgan

How does one transition form a surgical boot to a regular shoe after one has been in a boot for a long time? Morgan says post-op patients usually wear boots for about 6 weeks. His suggestion is, "If someone has been in a boot for a longer time, further tests should be done such as an MRI or a CT scan to see any further treatment or surgery is necessary."

Source: Liz Boniz, Local 12 News

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
Have you implemented EMR in your practice?
Click HERE for Results

ASPS Achieves 1,000 Member Milestone

When Dr. David Yeager took on the role of the American Society of Podiatric Surgeons (ASPS) Chair in August of 2012, one of his first initiatives was to have 1,000 members by July of 2013. At the time, ASPS had a little over 700 members, and Dr. Yeager felt that 1,000 members by July was an attainable goal for the organization. ASPS actually met their goal 4 months ahead of schedule. On the April 3rd conference call of the ASPS Board of Directors, the 1,000th member of the association was confirmed; and the total membership of ASPS totaled 1,008. 

Dr. David Yeager

ASPS is the 4-year-old surgical affiliate of the American Podiatric Medical Association, dedicated to advancing the knowledge and skills of podiatrists in the area of surgery of the foot, ankle, and related structures. ASPS’ vision and purpose is to ensure that all APMA members and other physicians who are interested in gaining increased knowledge and skill in the area of foot and ankle surgery shall have access to ASPS.

Hong Kong Podiatrist Discusses Lightweight Running Shoes

The minimalist trend is not for everyone - and may cause injury. Hence, brands are responding by producing more forgiving models while still allowing for the sensory connection between the foot and the ground. The result is the proliferation of the lightweight running shoe, whose market share in the U.S. has more than tripled each year to reach 14 per cent in February last year.

Karlyn Harfoot

According to Karlyn Harfoot, a private practice podiatrist in Hong Kong, "Due to the amount of cushioning in previous running shoes, the natural running style is altered and becomes a habit. Like any habit, it is difficult to break. Some will find it easier to make the changes than others. But due to hard surfaces with no give, such as marble, granite and concrete, we do need some cushioning." Harfoot's advice: find a shoe that fits you, is suitable for your sport, and disregard the brand.

Source: Jeanette Wang, South China Morning Post [4/9/13]

TN Podiatrist Passionate About Food, Photography, Blogging

Dr. Carmen April, a medical/surgical podiatrist, spends her week treating foot and ankle problems, ranging from athletic injuries to amputations. But on the weekends, you can find her exploring some of Nashville’s hottest food spots with her digital camera in tow, capturing local stories with pictures and words, all in the name of her website, Dinner With Nerds (dinnerwithnerds.com).

Dr. Carmen April (Photo: Nathan Morgan)

The Mississippi native opened her Madison-based podiatry practice, the Foot and Ankle Health Care Center, in January 2011. Between office hours at her practice and surgeries at the hospital, spare time is precious. She spends it on maintaining Dinner With Nerds, including setting up interviews.

Source: E.J. Boyer, Nashville Business Journal [4/12/13]

Former GA Podiatrist Indicted in Federal Bankruptcy Fraud Case

Federal grand jurors have indicted a former Macon podiatrist on four counts of bankruptcy fraud, according to the U.S. Attorney’s Office. Dr. George Robert Vito allegedly made false statements under oath by filing documents in his Chapter 7 bankruptcy case in which he intentionally omitted certain financial details, including his financial interests as well as control and ownership of a number of corporations, according to a news release. If convicted, Vito faces a maximum penalty of five years in prison, a $250,000 fine, and a $100 mandatory assessment fee for each count.

Source: Amy Leigh Womack, The Telegraph [4/12/13]

Survey Finds Industry Lagging on Move to ICD-10

Even with a year's grace period, many providers, payers, and health information technology vendors are still running behind schedule in their preparations for the massive conversion next year to ICD-10 diagnostic and procedural codes, according to an industry survey. About half of vendors participating indicated their companies are halfway or less than halfway complete with their ICD-10 product development, a status that is little changed from that in the February 2012 survey. Roughly two-thirds of vendors indicated that they would start beta testing their systems with customers by the end of this year.

“The industry is not where we hoped to be by the timeline,” said Jim Daley, who is chairman of the Workgroup for Electronic Data Interchange and co-chair of the ICD-10 group of WEDI, which conducted the survey, and is director of IT risk and Compliance for Blue Cross and Blue Shield of South Carolina. “There is a lot of work to do.”

Source: Joseph Conn, Modern Healthcare [4/12/13]

Query: EMR Compatibility with Dragon Voice Recognition

I am currently dictating my progress notes into a digital recorder and sending the files to a transcriptionist who logs into my EMR to transcribe. I’d like to use Dragon voice recognition, but find that my EMR slows the whole process down. I must click on the HPI section, click on the relevant section of the foot, place the cursor, dictate that section of the note, then close the HPI section, etc. After a few notes, you begin to justify the cost of a transcriptionist.
 
Are any of the readers using an EMR that functions more like a word document, allowing the user to simply place the curser in different sections of the progress note without opening and closing each section? 

John Scheffel, DPM, Worcester, MA

Query: gSource Instruments

I am interested in purchasing some instruments mainly for palliative care from a company called gSource. I know this company exhibits at some of the podiatry seminars. Has anyone used their instruments? Any input would be greatly appreciated.

Jack Ressler, DPM, Tamarac, FL

Query: Assistant Surgeon Coding

I performed a triple arthrodesis, and had an assistant surgeon (another podiatrist) on the case. How should this be coded?

Kelly Malinoski, DPM, Naples, FL

Response: You would use the same CPT code(s) billed by the surgeon, and, depending on the payer, use modifier "-80" or "AS" (assistant surgeon). Here's a neat link to read that might help:
aaos.org/news/bulletin/marapr07/managing14.asp

"As such, NPP assistant-at-surgery claims billed to Medicare should always use modifier AS. Submission of NPP assist charges to Medicare with modifier 80 will result in claim denials."

Leslie Johnson, CPC, New Rochelle, NY

Codingline subscription information can be found here

APMA Members: Click here for your free Codingline Silver subscription

RE: Competency of APMA Leadership
From: Allen Jacobs, DPM

The letters by Drs. Kiel and Cohen in the most recent PM News both express outrage at what they perceived to be incompetency by our APMA leadership. With respect to Dr. Cohen's letter, I believe that he is correct in his variation of "let he who is without blame cast the first stone."

While I share his opinion regarding the current APMA leadership, and in particular the failures of the executive director, it reminds me of what an orthopedic surgeon said to me over breakfast
recently..."The system makes you steal."

No matter the circumstances, selling...

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

RE: APMA Pinterest Page (Brian Kiel, DPM)
From: Crystal Holmes, DPM

As chair of the APMA Communications Committee (formerly the Public Education & Information Committee) that oversees the development of public education campaigns, I feel compelled to respond to Dr. Kiel's comments about the Pinterest page that is part of APMA's spring Beat Bunion Blues campaign. This is a robust campaign that includes video, posters, tip sheets, print articles, media outreach, and more. Social media also plays a role because it is has proven to be very successful in reaching our target audience, women ages 35-55, the health-care decision makers in most American families--and frequent bunion sufferers.

Pinterest is one of the fastest-growing social media sites and is wildly popular among...

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

RE: Refusing to Hire a Person Who Smokes (Peter Bregman, DPM)
From: Jeff Kittay, DPM

What unbelievable arrogance Dr. Bregman brings to the table regarding his apparent superior will power regarding people who smoke. In one breath he talks about "nicotine addicts" and in the next preaches about how "we all suffer because others are too weak" to give it up.

I lived with a smoker for ten years, and due to her kindness and caring, was never bothered with the smell. She was a chronic heart patient who had had 10 catheterizations and 9 CABGs prior to our meeting in 1995 and 10 more catheterizations and multiple stents in the ten years we had together. She smoked, literally, until the night she passed in 2005, knowing full well the effects, yet despite tremendous will and strength, could not give them up entirely.

Deciding not to operate on smokers "unless I have no other choice" is a clinical decision I cannot argue with. The intolerance bespoken in these disparaging comments, however, is itself intolerable and a poor example of kindness and understanding.
 
Jeff Kittay, DPM, Boston, MA, twindragons2@verizon.net

RE: MI Podiatrist Sentenced to Prison in Healthcare Fraud Scheme (Ted Cohen, DPM)
From: Deborah S. Wehman, DPM,

I take offense that Dr. Cohen suggests that we are all “whores” with regard to insurance billing. I do not charge that much for orthotics ($300) and I do not charge excessively if someone is without insurance. I know plenty of other docs who try very hard to do things correctly. Do we make inadvertent errors?  I’m sure we do but my conscience does not allow me to commit fraud with the government or my patients. Please do not assume that we are all the same.
 
Deborah S. Wehman, DPM, Richmond, IN, DSWehman@comcast.net

RE: MI Podiatrist Sentenced to Prison in Healthcare Fraud Scheme (Ted Cohen, DPM)
From: Lawrence J. Kansky, DPM, JD

Alan Stiebel DPM and Ted Cohen, DPM should be commended for their letters of support of jailed podiatrist, Dr. Anthony Kirk. It is a waste of taxpayer money to jail this man for his alleged misdeeds. Dr. Kirk should have to pay all the improperly received money back with interest, pay a substantial fine, and do much needed community service.  May I dare say, his State Board of Podiatry should even let this first time offender practice podiatry under strict billing supervision so he can remain a productive taxpaying member of society.
 
To those naysaying podiatrists: having defended many alleged criminals in court, there are many reasons innocent defendants take plea deals. Fear of publicity, legal costs, protection of loved ones, not wanting to be subjected to brutal cross examination if they take the witness stand, and facing an unpredictable jury are some of them.
 
There are many podiatrists getting away with doing far worse things than Dr. Kirk such as performing surgical and office procedures that do more harm than good, prescribing orthotics to everyone who walks in the door, using unnecessary and expensive technology, and denying 104 residencies to qualified podiatric graduates. I wish Dr. Anthony Kirk and his family the very best, and pray for peace in his life.
 
Lawrence J. Kansky, DPM, JD, Wilkes-Barre, PA, larry.kansky@gmail.com

RE: 104 Applicants Not Matched for Residency Positions
From: Robert Kornfeld, DPM

There is a character in Chinese that means "crisis" which is composed of two characters that represent "danger" and "opportunity." The Problem: We have 104 unmatched graduates – the crisis. Urgent: These grads need to be placed in a training program and make money – the    opportunity. Pervasive: There is a huge potential for lawsuits if they are not placed – the danger. Reparations: To assist in the “bailout” of our graduates, each licensed DPM, all colleges of podiatric medicine and our state and national associations offer a tax-deductible donation to create a program that can put these unmatched DPMs on the road to being trained.

My Offer: I am offering all the unmatched graduates a “pre-residency” fellowship in integrative podiatric medicine. I propose a one-year program that will thoroughly train them didactically and clinically in understanding the mechanisms of foot and ankle pathology (i.e., why and how patients cross the morbidity threshold), train them to identify these mechanisms, and establish thoughtful, patient-specific protocols to address these issues. This will give them a very strong background in the medical issues they will be called upon to treat as licensed podiatrists - the solution.

Rationale: This opportunity is for the 104 DPMs and an opportunity for us all to commit to supporting this program, the details of which I am already working on. Following the philosophy of collegiality, I welcome your input (DPMs, educators, and administrators).

Robert Kornfeld, DPM, Manhasset, NY, Holfoot153@aol.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. 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 WANTED - CHICAGO

Preceptorship at a State Licensed and accredited Surgical Center in Chicago. Over 2,500 cases annually in podiatry. orthopedics, general surgery, pain management and neurosurgery. Preceptor will be involved in assisting surgeons and scrubbing into cases. Rotations in anesthesiology and 2 months in internal medicine at local teaching hospital. Salary of $ 52,000, plus health benefits and vacation. Housing provided. Do NOT send transcripts or Board scores. Preference will be given to 2013 graduates of the College of Podiatric Medicine. in Chicago.  Send letter of request to: Advanced Ambulatory Surgical Center, Inc. 2333 North Harlem Ave. Chicago, IL 60707. Attn: Dr. Hrywnak

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

BUSINESS DEVELOPMENT MANAGER 

Trulife, a global manufacturer of orthotic, prosthetic, physical rehabilitation and breast care products is searching for a strong business development manager to build the market position of our custom AFO line in podiatry market.  Successful candidate will have experience selling into the podiatry market segment and have established business relationships with podiatrists.  Proven track record of growing sales in podiatry market needed.  C.Ped credential +.  Must be able to develop & manage a sales force consisting primarily of independent sales groups, experienced in B2B podiatry, orthopedic, DME sales.  75% travel. To apply, email resume to lbouchard@trulife.com

EQUIPMENT FOR SALE - PADNET AND MIDMARK 417 PODIATRY CHAIR

Both in excellent condition. Asking $8,000 for PADNET and $3,000 for chair. Inquire (516) 922-0502 or bombbustr7@aol.com

EQUIPMENT FOR SALE - BIOMEDIX PADNET SYSTEM
 
PADnet is clinically valuable, provides fair financial return with medically appropriate testing and seamlessly integrates with the complete suite of BioMedix® products and services. One year old. In Excellent condition. Buyer pays for shipping. Please contact Rhonda Daggs at info@footanklecenters.com

PRACTICE FOR SALE - BROOKLYN, NY

28 year old practice in a desirable part of Brooklyn. EHR certified with stage 1 criteria successfully met. Practice has room to grow. Good mix of Medicare hazardous foot care; surgery and wounds. Low overhead. Priced to sell. Email Inquires to brooklynpracticeforsale@gmail.com.

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 - 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  - MIAMI, FLORIDA

Great opportunity for well trained new or other practitioner wanting to relocate to South FL. Walking distance to three world-class hospitals. Free standing building. Est. 1972. Great terms. Retiring, not looking for an associate. Contact me at draam@att.net

 PODIATRIC MERGERS - CHICAGO AREA 

Weil Foot Ankle & Orthopedic Institute is expanding their presence in the Chicago metropolitan area. We are interested in discussing merger with current  podiatric practitioners in Chicago and surrounding area. Practices that have a minimum of 5 to 25 years of activity are welcome to meet with us and visit our rapidly expanding practice that currently numbers 18 DPMs, a neurologist, a rheumatologist, 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 - SOUTHERN CALIFORNIA COAST

Wanting full-time podiatrist (PSR-24 or greater) in 30+ year established practice situated in coastal community just south of Los Angeles.  Building out a new office near hospital. Compensation is performance based with practically an unlimited earning capability. A possible buy-in is negotiable. Looking for someone to take over practice in the future.  Excellent opportunity for young ambitious doctor.  Send resume to asbf@pacbell.net, titled, "Podiatrist".

POSITIONS AVAILABLE - UPSTATE NEW YORK and CONNECTICUT

Looking for podiatrists to see residents in nursing homes. Syracuse, Schenectady, Albany  Cortland, Little Falls, and Gloversville, and surrounding areas, New Britain and Southport, CT. Great opportunity for supplemental or full-time income. Email inquiries to phasetwopodiatry@gmail.com.

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 - NORTH TEXAS

Associate position available. Located 50 miles from Dallas. All phases of Podiatric care with no ER call. PSR 24 required. Hospital privileges & strong referral base. Practice has EMR, digital X-ray & on site vascular testing. Very competitive salary and benefits. Please send CV to Footdoc3143@gmail.com

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

POSITION AVAILABLE - CENTRAL FLORIDA

Two doctor practice looking for an associate to take retiring doctor's position with partnership opportunity for the right person.  Competitive salary, health insurance and incentives. Two offices serving a diverse number of routine, surgical and wound care patients. Two years surgical residency training and FL license required. If interested in this great opportunity please e-mail CV, surgical log and references to toesrus7@yahoo.com.

ASSOCIATE POSITION - UPSTATE NY

Busy multi-specialty practice of PCPs, general surgeons, OB-GYN, podiatric surgeons looking for a full-time podiatric associate in  Upstate NY, Binghamton, Finger Lake Region. Great Benefits, opportunity for partnership. Must be highly motivated, personable and be Board qualified/eligible. Our podiatrists have over 100 years combined experience. Please send CV to associateinfoot@yahoo.com or fax 607-723-1567.

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 - NORTH CAROLINA

Busy, well established five-office practice in Charlotte, NC looking to fill an associate position leading to partnership for the right person. General and surgical podiatry, wound care. Close to beach, mountains - ideal location for outdoor enthusiast. NC license necessary. Competitive pay with incentives. Send resume to charpodiatry@gmail.com

ASSOCIATE POSITION - PUERTO RICO 

Looking for a well motivated surgically trained podiatrist for a 20 years old hospital based multi office practice . Candidate must be personable, ambitious, and knowledge of SPANISH language a must. Hospital surgical privileges available with heavy load of High Risk Diabetic Foot patients. This position leads to PARTNERSHIP, and eventually ownership. Offices located near San Juan Metro area near Beaches, great schools, and major shopping malls. Please send CV to medicopodiatra@aol.com.

SEEKING FULL OR PART-TIME PODIATRIST - NEW JERSEY

An outstanding practice opportunity! We are searching for a dedicated and caring full time or part-time podiatrist to join our growing endocrinology practice that is devoted to quality patient care and conveniently located in Englewood, NJ. The office is less than ten miles from Manhattan. Competitive salary and benefits package offered. For further details, please call Victoria at (917)655-9009 or email resume to cvsschwartz@aol.com

TWO FOR TEXAS

Desiring to grow our group of successful medical and surgical professionals.  We are seeking an exceptional Podiatric Physician and Surgeon with great interest and talent to serve as 1) Our Diabetic Foot Care Team Leader or 2) Our Sports Medicine Team Leader.  Send CV, letter of interest, and current picture to:  greatdoctors1@gmail.com

ASSOCIATE POSITION - MARYLAND, DC, PA

A podiatrist is needed for the Baltimore, Washington, Pennsylvania area. Partner for the corporation. Surgery center, emergency room call and a hospital location. All areas of podiatry. Established practice. Salary and commission. Fax resume 410-857-4227 or email at butler@qis.net

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

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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