The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

April 29, 2009 #3,532 Publisher-Barry Block, DPM, JD

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First DPM Fulbright Scholar to be Hosted by Medical School in Slovakia

Leonard A. Levy, DPM, MPH is the first podiatric physician to be designated a Fulbright Specialist. Dr. Levy is Associate Dean for Education, Planning and Research at Nova Southeastern University College of Osteopathic Medicine (NSU-COM) in Fort Lauderdale, Florida.  He also is Director of the Center for Bioterrorism and All-Hazards Preparedness as well as Professor of Family Medicine and Professor of Public Health.

Dr. Leonard Levy

His assignment includes spending about a month at Comenius University Faculty of Medicine in Bratislava, Slovakia beginning September 29. Comenius is one of two medical schools in that Eastern European nation which previously was part of Czechoslovakia until 1993 when it was split into two separate nations, Czech Republic and Slovakia. During his service as a Fulbright Specialist, he will be instructing Comenius medical school faculty in contemporary medical education concepts as well as introducing the faculty to the public health and biomedical informatics programs conducted by NSU-COM.

Additionally, he will be providing an overview of podiatric medicine including physical diagnostic procedures and basic principles of podiatric medical care for common foot and ankle disorders.  Development of a liaison between NSU-COM and Comenius University Faculty of Medicine is one of the objectives of the activities in which he will be engaged. Dr. Levy hopes to create exchange programs for Comenius and NSU-COM medical students as well as in the masters in biomedical informatics and masters of public health (MPH) programs.

40 Podiatrists Volunteer at Boston Marathon

On Monday April 20th, the 113th running of the Boston Marathon took place, with over 28,000 runners participating in this event. Over the course of the race, there are hundreds of volunteers, with 40 podiatrists working at the medical tent at the finish line. Even with almost perfect weather, there were still over 600 runners treated in the medical tent for various aliments, from hypothermia to tendonitis to blisters.

Podiatric Medical  Team Photo Boston Marathon 2009

The captain of the podiatry team is Dr. Jonathan Kaplan, who has been volunteering for this event for over 15 years. His first Boston Marathon was as a volunteer student from NYCPM and he has continued volunteering for the race since he moved to Boston in 1991.  He became the Chief Podiatrist for the Marathon and was selected to the core medical team committee in 2004.

The Medical tent consists of MDs, physical therapists, athletic trainers, nurses and podiatrists. This year, the podiatry team consisted of students from NYCPM and TUSPM and practicing podiatrists, both local and as far away as Iowa and California. Long-standing members of the Podiatry team include Drs. Howard Palamarchuk, Richard Cullen, Richard Baker, Paul Heffernan, Lori Lundberg, Paula Marella, Kirk Neustrom, Joel Segalman and Neal Zomback.

Shortage of Doctors an Obstacle to Obama Goals

Obama administration officials, alarmed at doctor shortages, are looking for ways to increase the supply of physicians to meet the needs of an aging population and millions of uninsured people who would gain coverage under legislation championed by the president.

One proposal — to increase Medicare payments to general practitioners, at the expense of high-paid specialists — has touched off a lobbying fight. Family doctors and internists are pressing Congress for an increase in their Medicare payments. But medical specialists are lobbying against any change that would cut their reimbursements. Congress, the specialists say, should find additional money to pay for primary care and should not redistribute dollars among doctors — a difficult argument at a time of huge budget deficits.

Source: Robert Pear, New York Times [4/26/09]

Query: Ingrown Nails in 3 Month Old

I have a 3 month old patient with ingrown nails on both halluces. I tried trimming them back, but they continue to return and the tissue is growing over the nail quite extensively. Unfortunately, the child would not sit still for a clear photo.

Ingrown hallux nail with overlapping skin in infant

I am planning on removing the nails, but am not sure if I need to do a matrixectomy on a patient this young. Has anyone ever done this? Were there any long-term problems?

Rick Burnell, DPM, Camden, SC

Query: Hypoallergenic Shoes

I have a young female patient with a bilateral contact dermatitis. It clears with the use of topical steroids and returns in the exact same locations when she stops using the meds. I sent her to an allergist who did testing for common chemicals in shoes and he found that she is allergic to nickel and maybe other chemicals not found in the traditional shoes. Does anyone have any experience with any companies that make hypoallergenic shoes?
 
Elliot Udell, DPM, Hicksville, NY

Query:  Independent Contractor Arrangement

We have started working with an independent contractor doctor who is managing our nursing home patients. We have a formal agreement set up, and currently structure her reimbursement for the services are based on a per patient charge (x dollars), paid regardless of the CPT code(s) billed with the encounter. The doctor has been seeing the majority of patients billing CPT 11719 code which reimburses just enough to cover her cost. This does not account for my billing staff.

My question is whether it would be appropriate/legal to pay this independent contractor based and depending on the CPT code that she submits to our office to bill?

Daniel C Albertson, ARNP, Bluegrass Regional Foot & Ankle Associates, London, KY

Response: In general, it is better to pay a contractor either an hourly wage or a set percentage of billings (assuming that fee-splitting is allowed in your state). Paying based on a particular CPT is problematic, at best. It opens a whole can of worms, including the potential of over-utilization. Medicare and other carriers tend to frown on compensation which might incentivize a practitioner to bill for a particular code for any reason other than because it is the correct code to bill.

Barry Block, DPM, JD, Forest Hills, NY

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RE: On-Line Podiatry Listing Services (Frank Graham, DPM)
From: Marc Katz, DPM

I don’t recommend localpodiatry.com. Here is the reason. They want you to pay 30 dollars for each person who calls your office. So, if three patients call and one makes an appointment, that’s great. But what if the other two decide that they will not make an appointment because you are out-of-network or too far from their home, etc.? Then you've basically paid 90 dollars for one patient. If you use this service, you will need to monitor this closely to ensure that you are getting an acceptable return on investment.

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

RE: Red Flag Rules Go Into Effect May 1, 2009
From: Michael Brody, DPM

Red Flag Rules are an Identity Theft Prevention Program mandated by the FTC that are designed to detect the warning signs – or "red flags" – of identity theft in their day-to-day operations. The original date for compliance was November 1, 2008, but the FTC extended the deadline to May 1, 2009.

How do Red Flag Rules apply to physicians' offices?

The Red Flag rules apply to any entity that regularly extends, renews or continues credit. If you do not collect payment IN FULL from your patient at the time of the visit, you are extending the patient credit. Even if you collect the co-payment or co-insurance in full, and bill the insurance company the balance, you are extending credit to the patient for the amount due from the insurance company. The FTC has defined this as.......

Editor's note: To read Dr. Brody's complete extended-length note click on: http://www.podiatrym.com/letters2.cfm?id=26022&start=1

PRACTICE FOR SALE - FLORIDA—CENTRAL/SOUTH

Turn-key operation grossing $570,000 annually based on one full-time doctor. Great opportunity for growing the top-line. Surgery is only 14% of the professional man-hours; it can significantly increase income. Medicare makes up 64% of revenues. Seller will assist with transition. Call 863-688-1725, ask for Chas.

ASSOCIATE POSITION – ILLINOIS 
 
Quality Podiatry Group provides quality services to residents at long term care facilities. We are currently offering full-time or part-time positions for motivated ethical podiatrists. Immediate openings available. If interested, fax curriculum vitae to 312 225-9366 or e-mail feetwork@aol.com

EQUIPMENT FOR SALE

MIN-x-ray Mobile system Model PM200R40. Brand new less than 1 year old. never used at all. I was opening a new location that fell through. Completely brand new. paid $11,000 Will sell for $8,500. Located in the Bronx, NY- call 914-714-0667.

ASSOCIATE POSITION - CONNECTICUT

Nice community outside of New Haven. Well-established, busy practice seeking part-time or full-time associate. Excellent opportunity for a highly motivated and ethical professional. Must have good patient skills. PSR-12 or higher with excellent skills required. Send resume and cover letter to fax # 203-439-7916.

ASSOCIATE WANTED - FLORIDA

Associate needed for a dynamic multi-doctor practice in the Tampa Bay area. Partnership opportunity for the right candidate. Preference given to a PSR 24+ resident completing their education this spring/summer, and must have a Florida license. Well-established practice, high tech with EMR and digital x-rays, with specialties in sports medicine, surgery and wound care. No nursing homes or HMO's. Excellent hospital privileges available. Choose an area of practice concentration that you are passionate about and enjoy a lifestyle for yourself and your family that is second to none. E-mail: kimvelez@tampabay.rr.com

OFFICE SPACE/ MRI RENTAL – NYC, LI   
 
Turn-key space available, daily, monthly; East 60th off Park Ave, East 22nd St. off 3rd Ave, and Plainview Long Island. JACHO-certified operating rooms available, as well as all surgical equipment and anesthesia. Extremity MRI Rental. Stark compliant. All exams read by board certified radiologist. Call for details. 516 476-1815

NEEDED CHICAGO -- NW IND & BALTIMORE/WASHINGTON, DC PODIATRISTS

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists in Chicago, Northwest Indiana, and Baltimore, MD. Full and part-time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com Visit our website

ASSOCIATE POSITION AVAILABLE-MIDTOWN MANHATTAN

Looking for Full-time associate to work in well established practices in midtown Manhattan and Forest Hills. Immediate opening for PSR 24-36 surgically trained Podiatrist. Great opportunity with competitive salary along with malpractice benefits. Please send CV to slurie@papapc.net

EQUIPMENT FOR SALE

Used Acoustic Imaging Diagnostic Ultrasound. Comes with 10 MHZ linear probe. Printer included. Unit is a console on wheels and cannot be shipped, must be picked up. Price includes 3 hours of hands-on and didactic material on podiatric ultrasound. See website www.hurtheel.net for more details. Price: $4,750 Contact Information Henry Slomowitz  E-mail hslomowitz@gmail.com Phone 973-479-6305.

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