The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

May 08, 2009 #3,540 Publisher-Barry Block, DPM, JD

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Marathoners Learning How to Buy Better Fitting Shoes: NE Podiatrist

For many rational people, mangled feet are the apex of gross thought. But luckily for, well, everybody, toenails don’t seem to be falling off like they used to, even as a record number of entrants have filled up registration for the Lincoln Marathon. “Believe it or not, I have not seen a whole lot of that this year,” said Dr. Torrey Rassfeld, a podiatrist with Capital Foot Center. “I think that probably means that people are doing a good job of finding a good fitting pair of shoes.”

Dr. Torrey Rassfeld

Running and foot experts alike say ill-fitting footwear exacerbates the constant pounding of toe-on-shoe, a battle your toenails cannot win. Make sure your shoes aren’t too short or too wide, Rassfeld said. Either way would result in problematic friction. Also worth remembering is that feet swell, so running shoes should be bought at least a half-size too big. Shop for running shoes late in the day when your feet have been working for at least a few hours.

Source: Cory Matteson, Lincoln Journal Star, [4/30/09]

NY Podiatrist Presents to UN International Diabetes Club

When the United Nations International Diabetes Club reached out to the American Podiatric Medical Association looking for a podiatrist to speak to a group of employees who suffer from diabetes, the APMA called NYSPMA Executive Director Len Thaler who knew exactly the right podiatrist for the job – Dr. Larry Santi.

Dr. Lawrence Santi at the United Nations

Santi, who handles a lot of wound care and limb salvage cases, gladly took the offer and presented to the group on April 22 – the first-ever clinical presentation made by a podiatrist to the U.N. His presentation was centered around the diabetic foot and how it affects quality of life. Santi also recommended ways to prevent foot-related problems.

“I really focused on educating the patients about using a team approach with their other medical specialists when it comes to their healthcare,” said Santi. “It’s very important to have a working partnership on behalf of the patient to ensure that they are receiving the best care possible from all of us.” Santi has been asked to present again in 2010.

White House Budget Aims to Bolster Fraud Control 

The White House said it wants to bolster its oversight of Medicare and Medicaid, proposing a stepped-up fraud and abuse control program that officials estimate could return $2.7 billion to government coffers in five years.

“We estimate that for every $1 we spend to stop fraud in the system, we save $1.55,” HHS Secretary Kathleen Sebelius said at a news conference. In a more detailed report that augments some of the provisions outlined in its February release, the White House has allotted $1.7 billion over the next 10 years in discretionary spending to help better account for dollars lost in the program because of improper or otherwise fraudulent billing.

From 1997 to 2007, the Health Care Fraud and Abuse Control Program has returned more than $11 billion to the trust funds. The program is part of an overall effort to help reshape the healthcare landscape in the U.S. In a conference call with reporters, White House budget chief Peter Orszag again singled out healthcare spending as the biggest drag on the economy.

Source: Matthew DoBias, Modern Healthcare [5/7/09]

Tips of Getting Patients to Read Your E-Newsletter

• Offer Expert Advice - Everyone is an expert in something, says Janine Popick, chief executive of VerticalResponse, an e-mail and direct marketing provider for small businesses. Share your knowledge with others in a "how to" column or "five easy steps to [fill in the blank]." Keep your tips short, sweet, and instructive.
• Stay True to Patient Expectations -"Be specific regarding the frequency of your newsletter and the value you will provide," says Popick. Then, "Make good on your promise." Patients might expect only one newsletter a month. 
• Use Images - Popick advises entrepreneurs to use a healthy mix of images and text in their newsletters, since many e-mail clients will strip out the images and leave only words. Be sure to include a link to your website or to a product mentioned.

Source: Adapted from Carmine Gallo, Newsweek, [5/4/09]

Query: Is this Raynaud’s?

My patient is a 27 yr old healthy woman. She is slim, active, employed and does not smoke or use drugs. She occasionally uses alcohol. I initially saw her in the Fall and felt that she was presenting w/ Raynauds.

Is this Raynaud’s?

She went to a dermatologist, who said she had pernio. The dermatologist gave her nicotinamide  and the sores went away but her feet have continued to turn red/purple. Does anyone have a good idea what is going on and an appropriate treatment?

Debby DeRose, DPM, Fairfield, CT

RE: Brevio Nerve Conducting Test (Lawann Scott, DPM)
From:Elliot Udell, DPM
 
The Brevio is an in-office automated computerized, non-invasive nerve testing modality. The test can be performed by a doctor or technician without neurology training. The Brevio, as well as similar modalities , can generate impressive-looking computerized diagnostic reports.  There is, however, a serious problem with these modalities. The codes that these companies advise podiatrists to use are really the codes that are approved for standard nerve velocity studies combined with EMG studies and interpreted by a neurologist or physiatrist.

The department of Labor of the State of Washington, Cigna and Aetna have all issued reports saying that these modalities are experimental and they will not pay for them and some of these companies will demand restitution if they have paid the doctors for the tests. There is also the possibility of investigation for fraud if a doctor is using a code for what the insurance industry envisions as a completely different test. This does not make the Brevio clinically invalid. You just might not get paid for using it or worse.
 
I spoke with someone at the company that makes Brevio and he told me that they are working on getting separate codes approved that would cover theirs as well as similar diagnostic testing modalities. When this happens, I will strongly consider utilizing Brevio in my practice, but until this happens, I will refer my patients to neurologists and physiatrists in my area when the need arises for neurologic testing. 
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: Venous Stasis Hyperpigmentation (Jeffrey Kass, DPM)
From: Elliot Udell, DPM
 
I have had great success with an age-old method that I learned in school. It's called the venous heart. You take Poron or some similar material. Cut out a heart shaped pad and place it over the area of stasis and then apply an Ace bandage over it. I have always had success with this method. The patients apply it themselves. One must also consider some of the newer surgical treatments for venous disease that are available and make this information available to patients. There are some vascular surgeons who are now specializing in venous surgical cases. 
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com
 

RE: Tail Coverage (Gerald Mauriello, Jr., DPM, MA)
From: Kathy Hasted

Although I won't be helpful in addressing Dr. Mauriello's direct question on how to pay for or go without tail coverage on his previous insurance plan, I would like to take this opportunity to let others know how good we have had it with PICA (and hopefully the same with ProAssurance). Four years ago, I was in the same position as Dr. Mauriello. While at my first employer out of residency, I had been insured by ISMIE for 18 months . When I left that group and joined another, I switched to PICA for malpractice insurance. 

The cost of my tail coverage (issued by ISMIE) was $50,000 -- yes, that is 4 zeros. Since I was not employed for the minimum 2 years, there was no contribution from my former employer and I had agreed to this when I signed the contract with them 18 months earlier. My new group covered the insurance on a draw (I had to pay them back over time). I know $7,500 seems like a lot right now, but hopefully, like in my case, it will be worth the cost in the long run.
 
Kelly J. John, DPM, Rockford, IL, kellyj@rockfordortho.com

Tail coverage was designed for when a doctor retires from practice, leaves the profession permanently or is moving from a "claims made" policy form to an occurrence form. Rather than purchase the tail coverage, the new carrier you will be moving your coverage to should be able to offer prior acts coverage and pick up your current retroactive date. If the carrier only has an occurrence form, then you should contact another carrier that has a "claims made" policy form that you had with PICA.

Kathy Hasted, Medical Malpractice Program Manager, kathy.hasted@rockwoodinsurance.com

RE: CFPM Supports Michener Institute Diploma Change to Include Podiatric Medicine
From: Mario Turanovic, DPM

The information attributed to the CFPM pertaining to changing the diploma name granted to graduates of the Michener Institute's chiropody program is an exercise in Orwellian newspeak. The Michener didn't just "include a reference to podiatric medicine"; it engaged in a wholesale name change from an "Advanced Diploma in Chiropody" to a "Graduate Advanced Diploma in Podiatric Medicine/DPodM." The objective was clearly to obtain the acronym "DPodM", which approximates "DPM", thereby allowing the CFPM and other chiropody organizations to continue blurring the distinction between chiropody and podiatry in Ontario, and to mislead the public into thinking that DPodMs are actually Doctors of Podiatric Medicine (DPMs).

The CFPM claims the decision was made after "significant consultation", yet the CPMA, Ontario Podiatric Medical Association and the Health Professions  Regulatory Advisory Council, which was about to embark on a review of the chiropody and podiatry professions in Ontario were not consulted. 

Even more astounding is that the College of Chiropodists of Ontario , the regulatory body for chiropodists and podiatrists in Ontario was not consulted either. The College has subsequently registered a protest with the Michener Institute, asking it not to refer to podiatry or use the DPodM designation in order to avoid public confusion and breaching the protected title provisions of the Chiropody Act. Other healthcare professional organizations such as the Ontario Medical Association have also expressed concerns about the name change. It appears that the Michener Institute consulted only those organizations such as the CFPM that it knew could be counted on for support. 

As evidence of the CFPM's strategy to blur the distinction between podiatry and chiropody in Ontario, Mr. Hartman refers to these two professions as a single profession in the quote attributed to him.  This is expected from an organization that calls itself the Canadian Federation of Podiatric Medicine, when, in fact, all but four of its members are chiropodists.

Mario G. Turanovic, DPM, President, Canadian Podiatric Medical Association, mgtdpm@telusplanet.net

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.

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

EQUIPMENT FOR SALE - ESWT

High Energy Shockwave Device (NEW);FDA approved as Class 1, payable by Medicare for treatment of Plantar Fasciitis (28890); Payable to surgery centers for Achilles tendinosis; 2 units available; Under $30,000. CONTACT: weil4feet@aol.com

PODIATRISTS NEEDED – DALLAS/ FT WORTH – TEXAS AREA

Texas Home Footcare Associates, a podiatry exclusive company specializing in house calls and visits to facilities for the elderly, is looking to hire podiatrists. We are located in the Dallas area. Full and part-time positions are available. Immediate Openings Available. Must have a Current Texas license. Competitive Compensation Package. If interested fax curriculum vitae to 972 931-4819 or e-mail gjmdpm@tx.rr.com. For further information, call 972-380-8028.

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 - CHICAGO AREA

Join one of the most successful, long-established podiatry practices in the Chicago area, with excellent salary and benefits. We have an immediate opening for a full-time podiatrist in a multi practice location in Chicago. Must have two years of surgical residency. Please e-mail resume to f-massuda@footexperts.com

EQUIPMENT FOR SALE- ALLPRO IMAGING 2010 XRAY DEVELOPER

This processor is only two years old. It is in good working order and has always been regularly maintained. We are in the process of changing to digital films. Will sell for $1300. New Hampshire e-mail wcgcoach@aol.com

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

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

PM News Classified Ads Reach over 11,500 DPM's 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 11,500 DPM's. Write to  bblock@podiatrym.com or call (718) 897-9700 for details. THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451 Ext 110.

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