The Voice of Podiatrists

Serving Over 10,900 Podiatrists Daily

May 14, 2008 #3,245 Editor-Barry Block, DPM, JD

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William Thomas Holt, DPM, 89

Dr. William Thomas Holt of Knoxville, TN passed away on 5/6/08. He was a graduate of Illinois College of Podiatry, and a Knoxville podiatrist for over 50 years. He was past president of the Tennessee Podiatric Medical Association, past president of the Tennesse Board of Podiatry Examiners, and served on the National Board of Podiatry Examiners.

Dr. Holt was a member of the Downtown Rotary Club and the Elks Lodge. He was also active in the Arthritis Foundation for many years, where he served as President. Dr. Holt, who was a Veteran of WWII, served in the Army Medical Corps. One of Dr. Holt’s sons, Dr. William P. Holt, is a practicing podiatrist in Knoxville, TN.

PM News policy is to request that memorial donations be made to the APMA Education Foundation Student Scholarship Program, 9312 Old Georgetown Rd. Bethesda, MD 20814.

Source: Knoxville News Sentinel from [5/8/2008]

Summer Heat Bad For Feet: WA Podiatrist

Summer's heat is usually associated with afflictions ranging from sunburn to heat exhaustion, but foot pain? That's right. Heat causes the entire body to swell and retain fluid, and the feet are no exception. That means tighter shoes and sweatier socks are the perfect recipe for a host of foot problems.

Dr. Donald G. Hovancsek

To begin with, warm weather can turn a pair of shoes into a virtual petri dish for bacterial growth, causing a number of skin-related ailments, explains Dr. Donald G. Hovancsek, an Olympia, WA podiatrist. "The warmth not only makes your pores open up more, but you perspire more, and that can result in fungus and yeast problems," he explains. "That ingrown toenail, for instance, that wasn't so bad in the winter may in the summer incubate and get infected faster." Athlete's foot is another fungal condition that thrives in warm environments.

Source: Daily Sentinel Via HealthScoutNews [5/12/08]

AL Podiatrist Receives Scholl’s President’s Award

Walter D. Clark, DPM, of Birmingham, AL, received the Dr. William M. Scholl College President’s Award of Rosalind Franklin University of Medicine and Science at the recent 2008 Midwest Podiatry Conference in Chicago, IL. The President’s Award, the highest award given by the Scholl College, is bestowed upon an individual who has demonstrated outstanding professional leadership and has contributed to the advancement of the college.

Dr. Walter Clark

Dr. Clark is a 1976 graduate of the Illinois College of Podiatric Medicine, the forerunner of the Scholl College. He is a past president of the APMA. “Dr. Clark has distinguished himself as a remarkable leader in podiatric medicine and the Scholl College as well as in his military career and community service,’ says Terence B. Albright, DPM, dean of the Scholl College. “He represents a model of excellence for our students.”

Forbes Lists Podiatry in Its 25 Best-Paying Jobs List

Podiatrists
Mean Annual Wage: $118,500*
One-Year Change: 6.5%
No. In Employment: 9,020
Top-Paying Industry: Outpatient Care Centers ($129,310*)
Top-Paying State: Oregon ($176,740*)
Top-Paying Metro: Orlando-Kissimmee, FL ($184,780*)

* Mean annual wage

Source: Forbes 5/12/08

Editor's note: PM's Annual Survey showed a median net income of $116,000.

Query: Faxing Consultations

With the last few increases in postage, I have been contemplating sending consultations, reports, etc. via fax. I am curious how others feel about this. Is this less professional than a letter by mail? One benefit would be that the primary docs would get the report much quicker (1-48 hrs).

Jeffrey Kass, DPM, Forest Hills, NY

Query: CPT 97597 versus CPT 1104x Debridements

Recently the biller at the hospital where I perform wound care in a wound care center stated that physicians should be billing the CPT 97597 - CPT 97598 (active wound management) codes for sharp debridement of ulcers. She contends that the initial visit can be billed using the appropriate CPT 1104x code, but subsequent "maintenence" or follow-up to the same wound needs to be billed using the CPT 97597 - CPT 97598 series codes. Have there been any new updates that I am not aware?

Alan Pittle, DPM, El Paso, TX

Response: TrailBlazer Medicare will allow you to use either the CPT 1104x series or the CPT 9759x, depending on the type of debridement you did, the depth of the debridement, and what was removed during the debridement.

If you are excising necrotic, and, truly, non-viable tissues via sharp sugical debridement, you should use the CPT 1104x series of codes. Remember those codes are based on the depth to which you went to remove whatever it was you removed.

If your taking off fibrin, and the like via sharp debridement, then the CPT 9759x codes are the best to use. Those codes are not based on the depth to which you debrided tissue. If there is any question about what you removed and the depth, it is probably best to err using the CPT 9579x codes. There is a specific TrailBlazer LCD on "Wound Care" that can be found here.

Paul Kinberg, DPM, Dallas, TX

Codingline subscription information can be found by clicking here

RE: Univ of Utah Hospital Restricts Podiatry Privileges
From: Kelly Hamblin, DPM,

This article reported on the "turf battle" between orthopedists and podiatrists at the University of Utah Medical Center. The podiatrists have lost out because we are not able to provide the same level of quality foot and ankle care that a "board certified physician can," according to University officials. The podiatrists who are employed by the university are now not able to perform surgery at their facilities or on their patients, so they can maximize surgical experiences for the orthopedic residents and students.

I am a recent graduate of the podiatric surgical program at the University of Utah. I believe I received excellent training, although most of my experience came from outside of the university. I am very disappointed at the self-serving decisions that have been made at the University of Utah. The orthopedic department has put their own agenda ahead of quality patient care by board certified foot and ankle specialists.

Kelly Hamblin, DPM, Kelly Hamblin, DPM, hamkel@grangermedical.com

Why are we as a profession being so diplomatic with the AOA?I admire the APMA's decision to take the 'high road' with this scope of practice battle. However, I think it's time for 'the gloves to come off'! Since the AOA wants to question our qualifications to practice foot and ankle surgery, we should do the same to them. What qualifies them to question our abilities? It seems like the hospital is relying on unfounded information to make their decisions rather than regarding a podiatrist's credentials. While we're "playing the nice guy" our profession is being hunted like prey.

Mario Dickens, DPM, Kingwood, TX, mariodickens@hotmail.com

Editor’s Note: To read the entire newspaper article click here.

RE: Bilateral Tarsal Tunnel Syndrome (H. Ashley Ledger, DPM)
From: Gregory Mowen, DPM

I personally like the Neurowrap product a lot for recurrent tarsal tunnel syndrome. If your recurrence was due to scar tissue, then certainly a case can be made for a "pre-emptive" use of it on the contralateral side as well. One note though, most often bilateral TTS is going to be associated with an underlying neuropathy, maybe in a very early stage, so look closely.

Gregory Mowen, DPM, Ventnor, NJ, gregmowen@comcast.net

I have seen about 40 cases of recurrent tarsal tunnel syndrome as a result of previous open surgeries. If anyone has re-operated on these patients, it becomes difficult to visualize the normal anatomy due to fibrous tissue (scar) that occurs as a part of the healing process. I would recommend using the Neurowrap on both sides to limit any tissue adhering to the nerve that may potentially cause the same problem.

Steve Goldstein, DPM, Royal Palm Beach, FL, stevefootdt1@cs.com

RE: Traumeel for Capsulitis/Plantar Plate Injuries (Neil Levin, DPM)
From: Dwight L. Bates, DPM, Bob Kornfeld, DPM

One of the M.D. Family Residents at UTSW/Parkland has completed a residency in general surgery at another institution in the USA. When asked why he changed specialties, he answered that he was interested in homeopathy. I was surprised!

Dwight L. Bates, DPM, Dallas, TX, dlbates04@yahoo.com

Editor’s Note: An extended-length letter by Dr. Kornfeld appears at: http://www.podiatrym.com/letters2.cfm?id=19526&start=1

Re: Competitive Bidding Phone-In PowerPoint
From: Paul Kesselman, DPM Woodside NY

For those registered for the competitive bidding phone-in, or for those wishing to review the presentation who could not participate in the phone-in, you may download the PowerPoint registration by clicking here.

Paul Kesselman DPM, Woodside, NY, pkesselman@pol.net

RE: Medical Crocs (Elliot Udell, DPM)
From: Steve Kominsky, DPM, Steve Goldstein, DPM

We have been selling the "medical crocs" for about a year. Being a Crocs wearer myself, I can tell you that they feel great. I wore Birkenstock sandals in the operating room for years but made the change to Crocs last year. They are very supportive and extremely comfortable.

Our patients have responded very well to them in terms of sales, and we continue to place sizeable orders, but truth be told, you're not going to make a mortgage payment on the profit. Do it for the convenience to your patients, and to have something else to "discuss" with them while they are in the office.

Steve Kominsky, DPM, Washington, DC, sjkom120@aol.com

There are some many knockoffs of "Crocs" that I have seen them at Kmart, Target, and even at rest stops along the highway, especially here in Florida. The average consumer today will buy these knockoffs because they usually cost less. I am not sure what makes the medical-based Crocs different from the regular ones. I heard something about them being impregnated with silver as a defense against bacteria. You will not become wealthy selling these. I think if you started selling Crocs when they first hit the market when the demand was great, you could have made some decent money. Today, you’re just going to be providing a service. I am not knocking the product at all; it is just a matter of good business sense to realize you will most likely not make a lot of money selling these.

Steve Goldstein, DPM, Royal Palm Beach, FL, stevefootdt1@cs.com

ASSOCIATE POSITION - SOUTHEAST MICHIGAN

Seeking a quality-oriented, patient-focused RPR-trained associate for a fast paced, established group practice in Southeast Michigan. This is a secure, long-term position. Emphasis on diabetic foot and wound care. Gain surgical experience while earning an excellent living. Our outstanding staff allows you to concentrate on optimal patient care without the responsibilities of practice management. Partnership possibility for the right individual. If you are highly motivated, ethical and have good communication and clinical skill, please call (734) 981-0487.

ASSOCIATE POSITION - SAN ANTONIO, TEXAS

Seeking three-year trained resident for associateship, hopefully leading to partnership. Competent in all phases of podiatry particularly reconstructive rearfoot surgery. Outstanding opportunity for the right individual. Reply to Richard Pollak at 210-692-0279, or fax resume to 210-692-0028 or e-mail drpllk@hotmail.com

CASE CONSULTING

Dennis Shavelson, DPM is now accepting referrals of difficult cases involving biomechanics, surgical complications, non-healing wounds diagnostic and treatment dilemma’s and subtalar stenting from DPM’S. Full reporting with second opinion only, rapid return after care and assumption of care options. Medicare and Out-of-Network Only. (212) 288-3668 or drsha@lifestylepodiatry.com

PODIATRISTS NEEDED - CHICAGO --NORTHWEST INDIANA

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists. We are located in Chicago and Northwest Indiana. 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

SOUTH CENTRAL PENNSYLVANIA-PM&S 36 ASSOCIATE WANTED

Large, busy podiatry group looking for associate interested in future partnership. Practice facilities and technologies include: Surgical Center, Physical Therapy Department, 6 appointment locations, EMR, MRI, Clinical Trials and Digital X-ray. Full compensation and benefit package offered. Mail CV to Martin Foot and Ankle, 1203 S. Queen St. York, PA 17403 or email johnreitzelmfa@aol.com

ASSOCIATE POSITION – MANHATTAN & QUEENS

Seeking new Residency graduate for growing three-office practice in Manhattan and Queens, start 07/08/08. Must be PSR-24 trained minimum. Must be ethical, well-trained, vibrant personality and ambitious. Willing to work hard and be a team player. Good base salary plus bonus incentive plan. Guaranteed partnership after one year. No long term employee. Apply only if interested in partnership and if you meet the outlined criteria. Please e-mail resume and cover letter to: hansfeet@aol.com

ASSOCIATE WANTED - KNOXVILLE, TN AREA

Busy multi-doctor, multi office practice heavily weighted in surgery. PSR-24 + experience preferred. Part-time also available. Area consistently ranked in top five areas of country to live, work or retire. Ranked third in country 2008 Boaters magazine for boating destination. First year guarantee $150,000 plus bonuses and benefits. Send cover letter an c.v. to davidphawk@adelphia.net

SEEKING RESIDENT FOR PSR-24 - BALTIMORE, MD (MERCY MC)

Position for a highly motivated individual with completed non-surgical residency or one desiring additional surgical training in well-established Podiatric Residency Program. Busy metropolitan hospital with high surgical numbers and inpatient care. Resident is integral member of multidisciplinary team. Begins mid June 2008. Includes competitive salary/benefits. Send inquiries to rsher18@yahoo.com

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