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| PM News | |
The Voice of Podiatrists
Serving Over 17,290 Subscribers Daily
April 29, 2016 #5,653  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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| PM NEWS QUICK POLL | |
Final Chance to Vote
Quick Poll
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What percentage of your bunion surgeries are done in-office? |
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| PODIATRISTS IN THE NEWS | |
NY Podiatrist Discusses Bunions
Dr. Stewart Kamen, a podiatric surgeon at NewYork-Presbyterian/Lawrence Hospital Bronxville, explains, “A bunion is a protruding ‘bump’ on the side of the big toe. The visible bump actually reflects changes in the bony framework of the metatarsal bone. This bone can move over time from its original position, causing the bulge.”
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Dr. Stuart Kamen |
Dr. Kamen advises: “If bunions interfere with activities, are consistently painful, or the deformity is causing problems in the rest of the foot, surgery should be considered. Although some people feel they can live with the discomfort, if left untreated, bunions can lead to other problems, such as hammertoes, inflammation in the ball of the foot, or painful bursitis.”
Source: Lower Hudson Daily News [4/26/16]
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| PODIATRISTS AND ACCIDENTS | |
NY Podiatrist Accidentally Shot in Foot by Patient
A retired NYPD officer accidentally shot his Long Island podiatrist in the foot at the doctor’s office Wednesday morning, Nassau County police said. The 77-year-old retired cop was showing off his .10-mm. semiautomatic pistol to Dr. Matthew Nester, 46, at about 10:30 a.m. in the office in Oceanside when the gun went off, police and a witness said.
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Dr. Matthew Nester |
The bullet went through the ex-cop’s thigh, and hit Nester in the right foot, police said. Both men were taken to a local hospital and expected to survive.
Source: Joseph Stepansky and Graham Rayman, New York Daily News [4/27/16]
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| MEDICARE NEWS | |
CMS Unveils Quality, EHR Measures that Frame New Medicare Payment System
The CMS on Wednesday took steps to explain how physicians will be paid under the Medicare Access and CHIP Reauthorization Act, which was passed last year as part of the overhaul of the controversial sustainable growth-rate formula. The agency unveiled the Quality Payment Program, which will replace the current patchwork of incentive plans that reward doctors for delivering lower-cost, higher-quality care. It consolidates three existing programs: the Physician Quality Reporting System, the Physician Value-based Payment Modifier, and the CMS' incentive program for adopting electronic health records.
The program will offer two paths when it goes into effect in 2019. Physicians can choose from the Merit-based Incentive Payment System, or MIPS, or the Advanced Alternative Payment Models. The CMS expects that in the first program year, at least, most physicians will choose the MIPS path. Physicians will select six outcomes-oriented measures to track, and the budget-neutral program will carry upside and downside risk.
Source: Beth Kutscher and Adam Rubenfire, Modern Healthcare [4/27/16]
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| E-HEALTH NEWS | |
CMS Reveals Successor for Meaningful Use Program
As part of the proposed rule on the implementation of the Medicare Access and CHIP Reauthorization Act (MACRA), the meaningful use electronic health records (EHR) incentive program will be folded into the Merit-Based Incentive Payment System (MIPS), effective January 1, 2017, Andy Slavitt, acting administrator of the Centers for Medicare & Medicaid Services (CMS), announced at a news conference today. The successor to meaningful use, known as Advancing Care Information, will include fewer measures than the current program, will provide more flexibility in meeting those criteria, and will stress the use of information technology to improve patient care, Slavitt said.
Eligible professionals (EPs) will no longer have to meet every requirement, as they do under the current program, he emphasized. The proposal allows physicians and other EPs to get 50% credit just for reporting on the measures, which no longer include clinical decision support or computerized physician order entry. The other 50% of the score will depend on the EPs' performance on those measures, and clinicians can choose the metrics that are most meaningful to their practices. The number of measures has been reduced to 11 from the current 18.
Source: Ken Terry, Medscape News [4/27/16]
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| CODINGLINE CORNER | |
Query: Debriding a Cutaneous Horn
Is debridement of a cutaneous horn-type hyperkeratosis that protrudes from the tip of the toe about 6 mm on a diabetic who's on Medicare covered? How about if the patient has qualifying diagnoses and class findings? The gentleman has a rigid hammertoe which has caused this callus on the tip of the toe about 5 mm from the nail. Can I bill for the nail debridement as well?
Joseph Borreggine, DPM, Charleston, IL
Response: This is a covered service, CPT 11055, if the patient meets the criteria for callus debridement under your routine foot care LCD. Same rules apply with the diagnosis and class findings.
Jeffrey Lehrman, DPM, Springfield, PA
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| RESPONSES/COMMENTS (NON-CLINICAL) - PART 1 | |
RE: Solo Practice is Doomed
From: Tip Sullivan, DPM
It is awesome that our profession has progressed so far that a 30 something year old person with 4 years of experience can make a half million dollars in one year! This makes me feel very old at 60 and stupid as a solo practitioner. Why would anyone choose to be in a solo practice when they could make that kind of money working for a hospital? Then I think about all the effort and love I have put into building my practice. The building and single specialty surgical center that took years and blood, sweat and tears to plan and build. My employees and friends who depend on me. The patients who call me at home about concerns. The battles fought for our profession in an area which is podiatry poor. The independence to do what I want as well as the responsibility that goes along with it. I feel better when I look back on the journey. I feel sad that the days of the solo practitioner are coming to an end.
Tip Sullivan, DPM, Jackson, MS
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| RESPONSES/COMMENTS (NON-CLINICAL) - PART 2A | |
From: Brian Kiel, DPM
Let's see - $750,000 gross charges means approximately 55-58% will be allowed, which is $430,000. Of that $430,000, approximately 55% goes to overhead which includes malpractice, meetings, etc. That leaves $193,500. Dr. Withheld makes about $150,000. Is his malpractice paid? Without the exact $ amount involved, I can't be absolute, but based on this, his "non-salary" is not way out of line. A bonus system would obviously be indicated and not having paid vacation is unacceptable, but the salary is not outrageous. Also, why would surgery be paid any differently? When you are in the OR, you are not in the office producing income; and in today's environment, you are probably making less in the OR than in the office.
The key to being successful is increasing the utilization of services such as ultrasound, EPAT, Topaz, and DME such as braces and AFOs, and increasing the volume of patients seen. Based on this, I can't imagine that the volume of patients you could see is maxed out. If one is unable to do these things and/or is unable to increase their income to their satisfaction, looking for another position is the best thing to do.
Brian Kiel, DPM, Memphis, TN
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| RESPONSES/COMMENTS (NON-CLINICAL) - PART 2B | |
From: Dan Klein, DPM
I have come to learn that any profession works like a business. As such, businesses are in the business of making money, even at the expense of its employees. When I began my life as a podiatrist, I agreed to join an existing practice. I was offered a buy-in to the practice at a certain dollar figure, to which I couldn't afford. I was given the option of 'sweat equity'. I agreed to a nice salary with bonus after meeting baseline income for the practice. The sweat equity was 25% of buy-in costs over the next 4 years. This agreement was not in writing, but by a handshake, a naivety I deeply regretted years later.
After 2 years, I felt that since I was generating a lot more money, I would ask for a small increase in my percentage bonus. I was denied this and was told that my services would no longer be needed. When I asked about the 2 years of sweat equity I was entitled to, the owners denied ever making this agreement. I was angry and realized if it isn't written, it doesn't exist. So much for trust.
In today's practices, a new resident must utilize a lawyer to review contracts and ensure that, over time, what you expect... i.e. raises, etc. are written in the contract. Don't be intimidated and don't sell yourself and your self-esteem to the devil.
Dan Klein, DPM (retired), Fort Smith, AR
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| RESPONSES/COMMENTS (NON-CLINICAL) - PART 2C | |
From: Dieter J Fellner, DPM
First, I want to thank the anonymous poster for instilling a sense of reality, common sense, and hope, with his contribution to this debate. Now, on to Dr. Sullivan. Please be assured I was wide awake when I read your response. And I am sorry that you seem to struggle so much in making ends meet towards the end of your career. It is possible, perhaps, that you might have benefited from the advice of our anonymous poster.
As for the source of my data, I will refer you back to my original posting. Seemingly, you found yourself in a state of indecent haste, and hurried to pen your righteous rebuke, but failed to read and/or comprehend the...
Editor's note: Dr. Fellner's extended-length letter can be read here.
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| YOU CAN'T MAKE THESE THINGS UP | |
RE: Outrageous Shoe of the Day
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Built from an erector set? |
Source: Jayda Hany via Virtual Shoe Museum
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MEETING NOTICES
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NEED CME CREDITS FAST?
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Partial required credits can be taken online for AZ, CT, FL, GA, ID, KY, IL, IA, MO, MT, NE, NH, NY, NC, OK, PA, PR, TN, TX, VT, WA, and DC
Choose any or ALL from 30+ CME Category-1 articles posted
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| CLASSIFIED ADS - PART 1 - ASSOCIATE POSITIONS AND FELLOWSHIPS |
TEMPORARY PODIATRY POSITION IN ILLINOIS
During June and July temporary (may lead to a permanent full or part time) position available in Central Illinois servicing nursing homes within 90 miles of Springfield. Excellent pay and bonus for this short period! Lodging and travel stipends available. Join our great team. Please email GH@Podiatryplus.net
ASSOCIATE POSITION – MANHATTAN
Unique opportunity. Upscale, Park Avenue Manhattan. Need an experienced, motivated, caring doctor with excellent podiatric surgical skills to see in-network patients and to cover out-of-network patients. Salary based on experience with performance bonuses if earned. Part or full time. Partnership a possibility if qualified candidate exhibits outstanding performance and skills. Send CV to: institutebeaute885@gmail.com.
ASSOCIATE POSITION - CENTRAL VALLEY/SOUTHERN CA
Seeking associate with partnership availability. Consider this position if you want to be financially independent after only several years. The practice will supply enough patients to satisfy board certification very quickly. As a partner you can be compensated up to 7 figures or more as a dedicated partner. Don’t pass up the opportunity to join a very progressive practice, great opportunity in all ways. No disappointments, one of the best practices in California. All paid benefits/incentives including malpractice/401k and profit sharing. Bilingual in English and Spanish preferred. Please e-mail CV and short biography to: Tonya@wetreatyourfeet.com
ASSOCIATE POSITION - HUDSON VALLEY REGION, NY
Hudson Valley Foot Associates has a great opportunity available for a personable and talented DPM. Visit hvfa.com for more information about our practice. Send CV, with cover letter, to info@hvfa.com
ASSOCIATE POSITION - EAST ORANGE, NJ
Associate wanted for practice in East Orange NJ PSR 24-36 trained. Must be motivated to grow practice, especially wound care and surgical services. Looking for the right person who will start the buy-in process. Send CV to Drfoot44@gmail.com
ASSOCIATE POSITION - SOUTHEAST CONNECTICUT
Looking for a well-trained associate to join a 60+ year old multi-doctor, multi- location practice. Walk in to an established patient base and full schedule on day 1. No nursing homes or house calls. Competitive salary and benefits. Send CV to lakesidenh@att.net.
ASSOCIATE POSITION – SAVANNAH, GA
Thriving, seven location, podiatry practice is seeking a family-oriented associate podiatrist to build career and long-term relationship. Associate will have full range of services and access to surgical center along with access to all of the latest diagnostic and therapeutic technologies. Please email CV with cover letter to hr@atlanticfeet.com
ASSOCIATE POSITION - ST. LOUIS, MISSOURI/SURROUNDING AREA
Well-established practice seeking experienced, highly skilled associate. Partnership opportunity. Board qualified-certified, PSR-36 trained. State-of-the-art office, Digital X-Ray, EHR, Laser, EPAT. Send cover letter, CV/Resume to stcpod@att.net or call 314-565-2739.
ASSOCIATE POSITION - JACKSON, NJ
Well-established practice serving Monmouth and Ocean County is looking for highly motivated associate. Modern office that is rapidly growing with a second office opening soon. Must be willing to provide care for all aspects of podiatry including sports medicine, biomechanics, palliative care, wound care, surgery, and several nursing homes. Send CV to: podiatrynj1212@gmail.com
ASSOCIATE POSITIONS- HOME FOOT CARE, INC
We are looking for podiatrists to visit home patients in these areas: Los Angeles, CA, Ventura County, CA, Santa Barbara, CA, Lancaster/Palmdale, CA, San Bernardino/Riverside, CA, Palm Springs/Palm Desert, CA, Las Vegas, NV, Honolulu, HI. Full/part time, independence, excellent compensation, dedicated support staff, electronic billing/medical records. email CV to: homefootcare@hotmail.com
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.
ACADEMIC POSITION - WESTERN UNIVERSITY OF HEALTH SCIENCES
Western University of Health Sciences College of Podiatric Medicine is seeking podiatrists interested in the education and training of future doctors of podiatric medicine. Applicants must be at least board-qualified in either ABPM or ABFAS with preference for dual board certification. Academic rank will be commensurate with scholarly and clinical credentials. To be considered, please send letter of intent, curriculum vitae, 3 references, and salary expectation to (http://apptrkr.com/784853). Western University of Health Sciences is an Equal Opportunity Employer. The University embraces diversity and is committed to attracting qualified candidates from historically underrepresented groups.
ACADEMIC PODIATRIC PHYSICIAN AND SURGEON
The new College of Podiatric Medicine and Surgery located in Illinois and leading to a degree of DPM/MD, is seeking licensed podiatric physicians to become part of the clinical teaching faculty where, under a new curriculum, students will begin clinical training their first year. Applicants need to be licensed and their academic rank will be that of clinical professor which will also include student rotations through their offices. For additional information please send your CV to: Dominic@ColPodMedSurg.com The new College of Podiatric Medicine and Surgery is an equal opportunity/affirmative action employer.
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.
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| CLASSIFIED ADS PART 2 - PRACTICES FOR SALE OR WANTED, EQUIPMENT FOR SALE |
PODIATRY PRACTICE FOR SALE - PITTSBURGH SOUTH (BROWNSVILLE), PA
33 yr established, successful practice. All phases of podiatry, laser & cash services in place. Hospital and Sx Center. Turn-key ready with strong client base. Contact pa.footdoctor@gmail.com
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.
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| Disclaimers |
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.
THIS MESSAGE IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR
ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS
PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE.
If the reader of this message is not the intended recipient or an
employee or agent responsible for delivering the message to the
intended recipient, you are hereby notified that any dissemination,
distribution, or copying of this communication is strictly
prohibited. If you have received this communication in error, please
immediately notify me and you are hereby instructed to delete all
electronic copies and destroy all printed copies.
DISCLAIMER: Internet communications cannot be guaranteed to be
either timely or free of viruses.
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