The Voice of Podiatrists

Serving Over 10,900 Podiatrists Daily

May 15, 2008 #3,246 Editor-Barry Block, DPM, JD

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Most People Suffer From, Yet Accept, Foot Pain: NY & IL Podiatrists

In a recent survey for the American Podiatric Medical Association, 53 percent of respondents reported foot pain so severe that it hampered their daily function. On average, people develop pain in their 60s, but it can start as early as the 20s and 30s. Yet, except for women who get regular pedicures, most people don’t take much care of their feet.

Dr. Andrew Shapiro

“A lot of people think foot pain is part of the aging process and accept it and function and walk with pain,” said Dr. Andrew Shapiro, a podiatrist in Valley Stream, NY. Though some foot problems are inevitable, you can slow the progress of many problems.

Dr. Bart Gastwirth

Obesity adversely affects feet.“Obesity puts a great amount of stress on all the supporting structures of the foot,” said Dr. Bart Gastwirth, a podiatrist at the University of Chicago. It can lead to plantar fasciitis and heel pain and can worsen hammertoes and bunions. It’s also a risk factor for diabetes.

Source: Laurie Tarkan, New York Times, [5/13/08]

OH Podiatrist Appointed to State Medical Board

Governor Ted Strickland has announced that Marchelle L. Suppan, D.P.M., MBA of Orrville, OH has been appointed to a five-year term ending in 2013. Suppan is the Vice President of Medical Affairs at Dunlap Memorial Hospital and serves as Adjunct Faculty at the University of Akron, Wayne College. She is a past president of the Ohio Podiatric Medical Association and a graduate of the Ohio College of Podiatric Medicine. Suppan is an Affiliate member of the American College of Healthcare Executives; Fellow, American College of Foot and Ankle Surgeons; and Diplomate, American Board of Podiatric Surgery. She replaces David Buchan, DPM, who finished 15 years as the podiatric member in December, 2007.

Dr. Marchelle Suppan

Established in 1896, the Medical Board strives to protect and enhance the health and welfare of Ohio’s citizens through effective regulation of more than 55,000 licensees, including: medical doctors (MDs), doctors of osteopathic medicine (DOs), doctors of podiatric medicine and surgery (DPMs), physician assistants (PAs), massage therapists (MTs), cosmetic therapists (CTs), anesthesiology assistants (AAs) and acupuncturists. The Medical Board is comprised of twelve members: nine physicians, and three non-physician public members.

Health Plans Say They'll Risk Losing Members to Protect Profit Margins

The nation's largest publicly traded health plans say they don't plan to temper premium increases for the sake of keeping members on their rolls -- particularly not while they are under pressure from Wall Street over what it sees as their disappointing earnings.

Wall Street analysts were shaken over the long-term prospects of the health plan business after bellwethers WellPoint and UnitedHealth Group, the nation's two largest private-pay plans, reported less-than-expected profits from the first three months of this year.

"We will not sacrifice profitability for membership," WellPoint President and CEO Angela Braly told analysts during a conference call. Coincidentally, WellPoint and other health plans reported their earnings -- and their willingness to sacrifice members to keep them up -- soon before, or during, Cover the Uninsured Week. The project, sponsored by the Robert Wood Johnson Foundation, puts a spotlight on the growing number of uninsured.

Source: Emily Berry, AMNews [5/19/08]

Query: Coding/Billing School

I am looking to send one of my employees to coding/billing "school." I would like it to be podiatry-specific. Are there any online courses available for this?

Larry Best, DPM, Elkhart, IN

RE: Traumeel for Capsulitis/Plantar Plate Injuries
From: Bob Kornfeld, DPM, , Elliot Udell, DPM

Dr. Bates' surprise surprises me. He should know that there are thousands of M.D.'s and D.O.'s practicing integrative medicine and many are using homeopathy in their practices. He should also know that Steven Elias, M.D., the Director of the Dept. of Vein Medicine and Surgery at Englewood Hospital in N.J. has authored a recent article regarding the effects of homeopathic Arnica on post-operative vein patients and reports unequivocally that its efficacy is far beyond that of placebo in reducing post-operative pain, edema and healing time. He should also know that almost every physician practicing integrative medicine today has an M.D., D.O., D.P.M. or D.D.S. degree and was traditionally trained in their specialty.

Bob Kornfeld, DPM, Lake Success, NY, Holfoot153@aol.com

For those of us who decide to choose homeopathic treatments as opposed to medical treatments for our patients, do remember that we are licensed physicians. With that license comes the responsibility to render the latest and most appropriate medical and surgical care to our patients. If we opt to give a patient presenting with a serious infection a homeopathic remedy (which might contain a dilution of some substance that renders it nothing more than sterile water), and that patient gets worse as a result of not using appropriate antibiotics, we could not only be monetarily liable, but maybe even found criminally negligent. We are trained to know better.

The same applies to any other serious condition. We are held to a much higher standard than a homeopathic practitioner, who may have taken a short course on the topic, and can only dispense homeopathic products. I advise all of us, prior to considering homeopathic products for our patients, to visit the websites: homeowatch.org or quackwatch.org and read up on the history of homeopathy and how unscientific and bogus it is.

Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: Univ of Utah Hospital Restricts Podiatry Privileges
From: Multiple Respondents

The precedent set here in Utah should rattle the rest of the country. If this is allowed to go unchallenged, other institutions will tend to follow suit, led by the foot/ankle orthopods as part of their mission to limit our scope of practice. I truly believe that the APMA, along with Utah’s state component, need to legally challenge this decision. If nothing is done, get ready for your own institution or hospital to implement the same policy. Remember we already know that the foot orthopods are actively trying to limit our scope; it doesn’t matter where or how they do it whether through legislation or through individual institutions.

Mathew M. John, DPM, Marietta, GA, footdoc@afcenters.com

APMA, through its State Advocacy Committee and staff, has been actively supporting our members at the University of Utah since first contacted in February. We have provided much needed advice and counsel, including legal counsel to our members and the Utah Podiatric Medical Association (UPMA). APMA remains in regular communication with the doctors and UPMA leadership and staff.

Glenn B. Gastwirth, DPM, Executive Director and CEO, APMA, gbgastwirth@apma.org

Mario Dickens' comment that the hospital is "relying on unfounded information to make their decisions" is, I think, accurate. The orthopaedics community exercised its political power to exclude podiatrists. Perhaps they wanted to avoid the inevitable comparisons of treatment outcomes.

The staffing and credentialing policies of hospitals originate with the medical staffs. These policies are not created to meet the needs of the community or the hospital. It is political power, ego-enhancement and financial gain through elimination of competition which drives the creation of discriminatory credentialing requirements unfavorable to podiatry.

Podiatry has learned this lesson well, and employs it regularly. Many hospitals have credentialing policies that favor ABPS and ABPOPPM members to the exclusion of all other podiatrists. These hospitals, too, rely on rhetoric instead of clinical knowledge, skills, judgment and experience. A highly skilled, widely experienced podiatric surgeon without an ABPS or ABPOPPM certificate may be denied hospital staff appointments and surgical privileges, while lesser physicians having such certificates will have those privileges.

We podiatrists can all recognize when we are the victims of inter-professional discrimination based on our degrees, but we seem blind to the same kind of discrimination exercised within our profession. One’s clinical acumen is not nearly so important as are his organizational affiliations. Inter-professional discrimination may be unfair, but our intra-professional discrimination is purely assiduous hypocrisy.

Howard Lazar, DPM; Bloomfield Hills, MI howardlazar@comcast.net

Query: Faxing Consultations (Jeffrey Kass, DPM)
From: Multiple Respondents

For years, I have been faxing referring physicians and PCP's directly from my EMR after I dictate my note. I use TexTalk MD and it’s great. Other Drs. have been very receptive and appreciate the correspondence and notes for their records in a timely fashion. They have no issue with it coming by fax. I've actually received very positive comments.

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

My office has been faxing all reports, notes and letters for years. I had only one complaint from a physician who wanted his mailed. It's a no-brainer with postage costs so high and so many reports to go out. My office staff faxes throughout the day and re-uses alphabetized fax cover sheets for each doctor faxed and just changes the dates and number of pages faxed as needed. On occasion, I have used the faxing opportunity to report interesting news about my office and the services it provides to the patients the referring doctor sends.

Bruce Krell, DPM, Chandler, AZ, footdoc352@cox.net

I recently began faxing consult reports to PCP’s because of similar reasons. We sent a letter to all referring doctors that we would now be faxing consult reports, and if they had a problem with this, please let us know. I also thought about the non-professionalism, but got past it when I thought about it from my side. I certainly would not think another doctor unprofessional for doing this; moreover, I would think them business-minded and not give it a second thought. We fax to at least 10-15 various docs and have not had any negative feedback. Go for it.

Cynthia S. Ferrelli, DPM, Williamsville, NY, drfoot1@adelphia.net

Query: Accessory Surgical Assistant?

Recently, I performed simple arthroplasty on a patient's left 4th toe and used a pin with a ball for fixation. The next week I had her back in the office for dressing changes. I walk into the room. Her dressings are in the tray, sutures intact, little to no swelling present.....there is also no pin. I questioned her in regard to the pin. She looked very confused. I pulled apart the dressings, but couldn't find it. I asked her to look at home for a pin about 2 inches long with a white ball on it. She paused and then said, "I know what happened. I thought you forgot something in me after surgery so I took it out myself."

Doug Mason, DPM, Freeport, IL

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 skills, please fax your CV with a letter of intent to 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

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