The Voice of Podiatrists

Serving Over 14,000 Podiatrists Daily

April 24, 2013 #4,750 Publisher-Barry Block, DPM, JD

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WesternU LPC Holds Grand Opening    

The grand opening of the Limb Preservation Center (LPC) at Western University of Health Sciences drew more than 50 people to the University’s Patient Care Center (PCC) on Friday, April 19, 2013. The LPC, which was established to prevent amputation, enhance mobility, and preserve quality of life in the growing population of high-risk patients with chronic disease, is located within the Foot & Ankle Center.

(L-R) Dr. Jonathan Labovitz; Keith Mintun, Novadaq regional sales manager; and CPM Founding Dean Dr. Lawrence Harkless (Photo: Jeff Malet)

Dean Lawrence Harkless, DPM, of the College of Podiatric Medicine welcomed guests -- including Pomona Valley Hospital Medical Center staff, regional podiatrists, elected officials’ representatives, and WesternU students and faculty – and led tours of the facility. The LPC also was presented with certificates of recognition and congratulations by the offices of Congresswoman Gloria Negrete-McLeod, D-35th District, and state Rep. Norma Torres, D-52nd District.

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.

Quick Poll
Is your office handicapped accessible?
Click HERE for Results

NY Podiatrist Lectures at Forensic Conference

New York forensic podiatrist, Bryan B. Kagan, DPM recently lectured at the 2013 Spring Educational Conference at the Chesapeake Bay Division of the International Association for Identification in Dover, Delaware on "Pedal Evidence-An Overview" to an audience of law enforcement officials, forensic scientists, and security analysts.

(L-R) Dr. Bryan Kagan with Seminar coordinator, Jeff Barnes

Kagan is scheduled to present the results of his research, "A Comparison of Barefoot Foot Impressions with Shod Foot Impressions" at the Annual Conference of the IAI in August. He also recently published a study of Foot/Hand Dominance in the January 2013 issue of the Journal for Forensic Identification. Kagan practices in White Plains, NY. He is a member of the American Podiatric Medical Association, the International Association of Identification - Forensic Podiatry Discipline, and the American Society of Forensic Podiatry.

FL Podiatrist Added to Online Mediation Portal

Dr. Richard Polisner will be working closely with Mediation.com to launch his website and advertising campaign to reach new clients in Ponte Vedra Beach, Florida and surrounding areas. After practicing podiatry and foot surgery for over 30 years as a Board Certified Foot and Ankle Surgeon, Dr. Polisner received his Master's Degree in Jurisprudence (Health Law) from Loyola Law School and is uniquely qualified as a mediator based on his own career path and experiences as a participant in the mediation process.

Dr. Richard Polisner

After running his own multi-million dollar medical business and working with many professionals, clerical employees, and private contractors, Dr. Polisner learned the nuances involved with contractual negotiations, labor and employment disputes, and employee/employer relations. He also worked closely with attorneys representing injured patients and served as a liaison between the physicians, the attorneys, and the healthcare regulators in various claims.

Source: Financial Content [4/1/7/13]

AMA Initiative to Target Diabetes, Heart Disease

By working with ongoing national campaigns and “galvanizing America's physicians,” the American Medical Association will be seeking to reduce the deaths and healthcare costs associated with cardiovascular disease and type 2 diabetes. Dr. Jeremy Lazarus, president of the AMA, said the organization has earmarked $6 million for the first year of its multi-year Improving Health Outcomes initiative, which could continue for a decade or more.

The AMA will also partner with YMCA of the USA and the Centers for Disease Control and Prevention to target adults whose blood sugar is higher than normal but not yet diabetic. The AMA will support the CDC's National Diabetes Prevention Program. It will also work with physicians to direct their pre-diabetes patients to YMCA diabetes-prevention programs.

Source: Andis Robeznieks, Modern Healthcare [4/22/13]

Query: Mobile Credit Card Processing

I would appreciate hearing about PM News readers' experiences (good or bad) with mobile credit card processing such as Square.

Philbert Kuo, DPM, Chesapeake, VA

Query: Office Visit Billed with an Injection

Can anyone explain why you can't bill both an office visit and an injection (e.g., CPT 20550) in the same visit?

Amanda Bartell, DPM, Jacksonville, FL

Response: You should be able to bill both, presuming the E/M service meets "significant, separately identifiable evaluation and management service" guidelines, and you append the E/M service code with a "-25" modifier.

So, on the initial work-up, one should expect the injection and the E/M to be payable. On a follow-up visit where an injection is again given, there may not be enough interval changes to warrant a separate payable E/M service. The work-up on that second visit may in fact be very minimal or unchanged from the previous encounter (as well as the decision to provide another injection).

Not only does the E/M service need to stand-alone, but the documentation in your records must clearly evidence relevant history, exam and/or decision-making (2 of 3) in order to qualify for payment.

Tony Poggio, DPM, Alameda, CA

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RE:  Post-Op Hallux Varus (Kel Sherkin, DPM)
From: Keith L. Gurnick, DPM

1) It looks to me more like the surgery performed was an opening wedge with a bone graft, not a closing base wedge. The bone graft is still visible and looks like it was the patient's own bunion bone placed in the opening wedge which was most likely too much bone, and thus an overcorrection of the IM angle with resultant hallux varus. The osteotomy site at the base does not even look like the bone went on to union from the x-ray shown.

2) Your best chance of a correction to make the toe less straight without the potential ramifications of future surgeries would be a 1st MPJ fusion.

3) You could go back to the base and cut through and remove some bone at the base wedge site. Then also do some work at the head, but 1 1/2 years post-op, there will be joint changes. It is a much more difficult and exacting procedure to try to preserve the joint, and if this surgery fails, the patient will require a third surgery.

Keith L. Gurnick, DPM, Los Angeles, CA, keithgrnk@aol.com

RE: Post-Op Hallux Varus (Kel Sherkin, DPM)
From: Ira Weiner, DPM

Based upon the x-ray findings and history, I feel a closing Aiken osteotomy is in order. Since she states that the MPJ has a pain-free ROM, I would not address that. It appears she does not have the classic "staked" metatarsal. If a fusion procedure is warranted in the future, there is plenty of good bone left to support that procedure using any fixation method of choice.
 
As a side note, the question of cosmesis only is brought up. I feel if she has difficulty finding the shoes she wants, it becomes her call as to whether or not she wants this corrected. I don't feel there is a single surgeon among us who does not strive for good cosmesis in an elective procedure. Salvage procedures are a little different. If the patient is unhappy with the way the procedure looks, then we have a duty to correct the problem if it's something we are able to do.
 
Ira Weiner, DPM, Las Vegas, NV, vegasfootdoc2005@yahoo.com

RE: Podiatry's Secret Problem (Steven Moskowitz, DPM)
From: Don R Blum, DPM, JD

With all the comments and observations regarding DPMs who do not follow the rules as to routine foot care and exclusions, especially when we identify this related to a parent and/or family member, how many DPMs have then contacted the appropriate license board or insurer and complained?

Don R Blum, DPM, JD, Dallas, TX, donald.blum@yahoo.com

RE: Podiatry's Secret Problem (Steven Moskowitz, DPM)
From: Lynn Homisak, PRT

I too would like to say "BRAVO!" to Dr. Moskowitz for speaking up! I have also seen this kind of manipulation going on in way too many offices...ever since the rules came out from Medicare about specific nail care coding (way back when.) Sadly, there are still offices that continue to work the system by manipulating codes and documentation in order to get paid and/or retain patients. It makes it bad for those who make the effort to code properly.

The doctor I worked for in NJ called 'em like he saw 'em, and like Dr. Moskowitz did not submit claims for non-covered nail services. Patients were informed what was and wasn't covered, signed an ABN, and paid cash. Period. As a result, we may have lost some patients to DPMs down the street who we were told submitted (erroneous/fraudulent) claims for them, but we never had problems sleeping at night! It's always better to do the right thing.

Lynn Homisak, PRT, Federal Way, WA, lynn@soshms.com

RE: Parts for Whitehall Whirlpools (George Jacobson, DPM)
From: Jeffrey Kass, DPM

I bought the toggle switches at Home Depot.
 
Jeffrey Kass, DPM, Forest Hills, NY jeffckass@aol.com

RE: 104 Applicants Not Matched for Residency Positions (J. Marshall Devall, DPM)
From: Brian Kiel, DPM

Dr. Marshall Devall recently posted from the perspective of one of the programs and he made an excellent point. Some of these graduates do not qualify for a residency. I am not saying all of them, but a certain percentage just don't have what it takes to be a 3-year resident. Perhaps they, the profession, and the public are better off if some people don't become surgeons.

I searched "options for unmatched medical students" and guess what, there is lots of information about not getting matched after graduating from medical school. There are numerous articles that advise unmatched students in alternatives to a residency including but not limited to getting a secondary degree, taking time to volunteer or work at a job that will strengthen your application for the following year, or even realizing that perhaps medicine was not for you. I do not pretend to think this is a simple problem with simple answers. My point is merely that this situation is not unique, and that perhaps there are some answers that don't involve self-condemnation of the entire profession.

Brian Kiel, DPM, Memphis, TN, Footdok4@gmail.com

PRACTICE FOR SALE - VIRGINIA

62 years consecutive private podiatry practice, excellent referral base, busy, modern equipment; X-Cel Xray machine, digital Tigerview scanner, Traknet EMR, and 3 new Midmark chairs for the doctor and patient. Virginia license is required. Please contact Dr. Fine at drmichaelfine@aol.comor 703-582-5999.

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.

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 – MARIETTA, GA
 
An associate is needed for a dynamic practice located in Marietta, GA, a suburb of Atlanta. We are looking for a well trained, motivated and personable candidate. This is a great practice opportunity. 2 years or more of a surgical residency is required and practice experience is a bonus. Our office has a licensed and certified surgical center. This is a modern practice with ultrasound, digital x-ray and EMR. We offer a competitive salary and benefits along with potential for partnership. Please e-mail your cover letter, curriculum vitae, letter of references and picture to light@eastcobbfoot.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 - 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 - 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.

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 DETROIT SUBURBS

Multi-location practice seeks individual with excellent surgical training.  Practice is well established for over 30 years.  EMR’s available, ultrasound, Doppler & circulation testing, digital x-ray.  Buy in opportunity as owner plans on retiring in 2016 or sooner.  Please send cover letter with CV to footlaw@hotmail.com

PODIATRIST NEEDED - VAN NUYS, CA
 
Looking for reliable, honest and motivated podiatrist to assist with house calls to patients home residence and various health facilities.  Candidate must be willing to drive throughout the San Fernando Valley and the greater Los Angeles areas. Flexible schedule. If interested, please email resume to homefootcare@hotmail.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."

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

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 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

ASSOCIATE POSITION – CENTRAL VIRGINIA

Two office practice, well established, modern offices. ED trauma call, good mix of medicine and surgery. Excellent compensation package. Please email letter of intent and CV to jdisabato@vfasa.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 - 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.

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

FT OR PT ASSOCIATE - SOUTH JERSEY

Great opportunity for FT or PT associate starting July 2013 in established practice in South Jersey. EMR, FDA-approved Lasers for fungus. Will work with Board Certified/Qualified podiatrist. Must have New Jersey License. Diverse practice in a nice area with a pleasant environment. e-mail CV at hhfootdoctor@gmail.com

ASSOCIATE POSITION - NEW JERSEY

Immediate opening for a full time podiatrist in a rapidly expanding multi-office practice in central New Jersey. Well established referral base with full admitting hospital privileges. Compensation is performance based with patients scheduled from day 1. Wonderful working conditions. Applicant must have at least PSR-24 surgical training. Valid NJ license and Medicare number is required. Applicant should also be familiar and competent in podiatric surgery, biomechanics, trauma, PRP, wound care, and ultrasound diagnostics. Participating insurance #'s a plus. Please fax resume to: (609) 259-6637

ASSOCIATE POSITION - SUBURBAN WASHINGTON

Busy 4 office practice in suburban Washington, DC seeing highly motivated individual for full time associate position leading to partnership. Minimum PSR 24. Competitive salary and benefits.  Respond to mlmltm@aol.com

ASSOCIATE POSITION- HUDSON VALLEY REGION, NY

Hudson Valley Foot Associates has a great opportunity available!  We’re a high-volume, diversified, multi-office group practice utilizing state-of-the-art modalities. Great growth for a personable and motivated DPM.  Please visit www.hvfa.com and forward cover letter with CV to info@hvfa.com.

ASSOCIATE POSITION - SOUTH CAROLINA

South Carolina's largest provider of foot care is a multi-doctor, multi-location practice currently seeking a highly skilled, personable, and hardworking physician to join our TEAM. South Carolina License is necessary. Above average salary and benefits. Please send Letter of Interest and CV to scdpmjobs@gmail.com.

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".

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

EQUIPMENT FOR SALE - FOX YAG LASER

Mint condition, still under warranty. Unit is portable & includes all the accessories. $14,500.00. Call 727 586-3668 or 727-321-310.

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

 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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