The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

May 15, 2010 #3,858 Publisher-Barry Block, DPM, JD

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Trauma Center Named After PA Podiatrist and Her Husband

Lehigh Valley Hospital and Health Network today named its trauma center the Mattioli Trauma Center in recognition of a $1 million gift from Joseph and Rose Mattioli, longtime owners of Pocono Raceway in Long Pond, PA. To honor the Mattiolis' generosity, hospital officials invited NASCAR legend Bobby Allison to stop by. Allison spent six weeks at the trauma center after the June 19, 1988 crash that left him seriously injured and ended his driving career.

Drs. Joseph and Rose Mattioli

The Mattiolis -- Joseph is a dentist and Rose a podiatrist -- said they believe the 72-year-old Allison is alive today because of the care he received at Lehigh Valley Hospital 22 years ago. Besides their friend Allison's treatment, the Mattiolis said, their twin great-granddaughters received care at the hospital's neonatal intensive care unit when they were born prematurely six years ago. Each weighed three pounds at birth. "It's a miracle that they lived," Rose Mattioli said. "We had the right people to take care of them. We call them our miracle babies."

Source: Lehigh Valley News-Express Times (PA) [5/13/10]

CA Podiatrist Lectures at Orthopedic-Podiatric Seminar in Rome, Italy

Kevin A. Kirby, DPM, Clinical Associate Professor of Biomechanics at the California School of Podiatric Medicine, recently lectured at a three day foot surgery, biomechanics and sports medicine conference held in Rome, Italy on May 6-8, 2010. Kirby gave 10+ hours of lectures and workshops on topics ranging from open and minimal foot surgery techniques, biomechanics, and treatment of various sports injuries, and biomechanics and treatment of flatfoot deformities in children and adults. 

Drs. Kevin Kirby and Francesco Albo, Program Chairman of Rome Foot Seminar 2010.

The 400+ registrants for the seminar, which  included orthopedic surgeons, podiatrists, physiotherapists and orthopedic technicians from around Europe and the U.S. were treated not only to lectures and workshops, but also to live foot surgery. This very well-attended seminar marked the first time that the Italian orthopedic surgery and podiatry communities have held a joint conference of such scope and size.

Query: Juvenile Cartilage Replacement
 
I have read of the use of juvenile cartilage replacement for treatment of chondral defects in the ankle and first metatarsal head. If anyone has used this product, I would like to hear about your outcomes and rationale behind using this product? 
 
Syed Ahmed, DPM, Louisville, KY

RE: Large-Sized Women's Dress, Casual, and Basketball Shoes

I have a woman basketball player who has been wearing men's shoes that don't fit well. Does anyone know where she can purchase size 14 or 15 women's shoes for sports, casual, and dress wear?

Jan David Tepper, DPM, Upland, CA

Query: Comprehensive Diabetic Foot Exam

We have been told that when doing a Comprehensive Diabetic Foot Exam (CDFE) that we should bill CPT 99213, but it is to have a particular modifier. Is this information correct? Does anyone know the modifier?

Walter Warren, DPM, Seymour, IN

Response: There is no specific modifier for the "Comprehensive Diabetic Foot Examination."  The specific evaluation/management (E/M) code you choose should be determined by the same complicated formula as any other E/M services (including the option to base the coding on time - as long as over 50% of the time spent during the encounter was medically necessary counseling).

Having performed many CDFEs in my practice, CPT 99213 appears to be the most appropriate and predictable code for my work-ups - based on time. This may or may not be the appropriate code for your patient.

More information on E/M service coding and documentation may be found in the "Evaluation/Management Primer" located on CMS MedLearn Matters website.

Paul Kesselman, DPM, Woodside, NY

Codingline subscription information can be found at:
http://www.codingline.com/subscribe.htm

RE: AFO for Driving Post-Achilles Tear (Jeffrey Kass, DPM)
From: Simon Young, DPM, Robert Scott Steinberg, DPM

I don't know how an Arizona brace, even if  9 inches above the malleoli, can help in this situation. Usually the tendonomuscular junction is more proximal than 9"  and will not do anything to stabilize her tendoAchilles since symptoms seem to be more associated with the gastrocnemius. An Arizona brace might irritate the tendonomuscular junction.

Dr. Kass should consider a custom ankle foot orthotic brace that might have a hinge, which would allow her to dorsiflex past 90° or have a custom ankle foot orthotic brace at 90°. This might allow her to be able to drive, but still support the tear.

Simon Young, DPM, NYC, simonyoung@juno.com
 

You should not be giving your patient premission to be driving, at least not until she has regained significant strength and flexibility. It is difficult for me to imagine that she should be driving, and if you give her permission, you could be liable for any accident she might cause.  Her desire to drive should not be your concern. Her injury and return of function should be the only thing on your mind. Send her to a physicial therapist, and when s(he) indicates that your patient can resume driving, then, and only then should you give her your okay.
 
Robert Scott Steinberg, DPM, Schaumburg, IL, doc@footsportsdoc.com 

Practice Fusion EMR (Justin H. Sussner, DPM)
From: Michael L. Brody, DPM

I recently had a conversation with a representative from Practice Fusion in my capacity of developing a Health Information Exchange.  Health information exchanges are an important part of the whole network of EMR's that we will all need to work with.  From what I understand, the 'totally free' part has MAJOR strings. There are features that you will need in order to qualify for the stimulus checks that are add-ons and will cost extra. In addition, they told me that the software displays advertisements to your patients when they access the patient portal. The person whom I spoke with did not demonstrate a good understanding of meaningful use, or what is needed to qualify for the stimulus money.  After the phone call, I felt that this was not a company that I wanted to be involved with.

Finally, I have strong reservations about integrating one company's EMR with another company's PM system. If the communication is not working properly and the data ends up in the wrong place, you have major problems, and each company will point the finger at the other. Nobody will take responsibility for the interface.  No matter whom you use, you are much better off with an integrated PM /EMR system.

Disclaimer: I provide consulting services on meeting the requirements for achieving the stimulus checks to: ICS - Sammy Software, Biomedix - Trak Med Software, IPS Physicians Systems, and Quicknotes.

Michael L. Brody, DPM, Commack, NY, mbrody@tldsystems.com

RE: Nurses to Take USMLE Exam in 2012 (Bryan C. Markinson, DPM, Steve Wan, DPM)
From: Simon Young, DPM, Robert Bijak, DPM

Physicians assistants and nurse practitioners are usually trained under the direct auspices of medical doctors. Medical doctors like to deal with people whom they train.  Although we are affiliated with hospitals, we are a distinct group. Physicians assistants, after their initial academic year, do another year of clinical training under medical supervision. Once they graduate, they are given the same autonomy.

Our residents need to be trained by medical doctors with much less influence from podiatry.  CPME rules and regulations don't work any longer. We need a new game plan and it requires much more medical (not podiatric) input and training.

Simon Young, DPM, NYC, simonyoung@juno.com

First to Dr. Wan: While the California Board might recognize USMLE and COMLEX equivalency to NBPME (probably because the USMLE is more comprehensive), is the converse true? If it were, then podiatrists would de facto have proven to have passed the USMLE 1 and be allowed to start medical clinical, like any student who passes the USMLE1. I doubt if podiatrists in California can do this.
 
Next to Dr. Markinson: Why shouldn't we blame the APMA? Do they not represent us in influencing change? The majority of podiatrists have indicated a desire to change degrees and/or license. As for his claim that there is an increase in medical school seats, according to the American Association of Colleges of Medicine, there has been no significant increase in 35 years. As to Dr. Markinson’s statement referring to those who chose and love podiatry, I don't doubt that there's a percentage who enjoy limited responsibility and want to continue the status quo.

The need for increased training (viz a viz project 2015) for a minimum of 3 years of residency, is precisely the wrong thinking. Three years will not change our license, and residents will be trained to do procedures that most states will not let them perform, and so will have wasted their time. The license is everything, and frankly, without an unrestricted license of an MD, you're still a limited licensed podiatrist no matter how many years residency you do. Degree change and/or plenary license change is the only obvious direction for podiatric evolution. Everything else is simply rhetoric and continued zero inertia.

Robert Bijak, DPM, Clarence Center, NY, rbijak@aol.com

RE: The Media Impression of Podiatry (Doug Richie, Jr., DPM)
From: Dennis R. Frisch, DPM

As a member of the APMA Board of Trustees and Advisor to its Public Education and Information Committee, I would like to comment on the recent string of posts on PM News. First, it must be noted that APMA creates millions of media impressions every year. Although the focus of the recent discussion has centered around the “lifestyle” issues, APMA’s public education extends far beyond “lifestyle” alone.
 
Public education is both a passive and active exercise. APMA is recognized by the media as the source of information on foot and ankle health, although that does not mean that every issue will come to our association for comment. However, on an almost daily basis, APMA receives requests for information from print, Web, television and radio media around the country. The media generate questions that they deem relevant to their audiences. The other aspect of media relations is “active”. Active communication is the development and dissemination of messages that are generated by APMA directly to the media. APMA’s messages are relevant and timely, and designed to position our members in the best possible light.
 
APMA’s Today’s Podiatrist Campaign is a perfect example of an active media campaign. This campaign is an integral part of advancing the mission of APMA’s Vision 2015 Project. This multifaceted public education initiative is designed to educate the public about the education, training, experience, and scope of the practice of modern day podiatric medicine and surgery. The campaign tagline is simple and to the point. Today’s Podiatrist is a physician, surgeon, and specialist. The success of this campaign will not only be measured by what APMA does, but on how the campaign materials are utilized by our component societies and members. As today’s podiatrist, your participation in this campaign is essential to its success!

Dennis R. Frisch, DPM, Boca Raton, FL, DRFrisch@apma.org

RE:  Medicare Fraud Risk Created by Billing Loophole (Paul Kesselman, DPM)
From: Michael M. Rosenblatt, DPM

As usual, Paul Kesselman, DPM is on-target regarding his complaint about OIG, and a possible OIG finding that could lead to Medicare fraud charges. It is important to understand that OIG is first and primarily a political organization, run by bureaucrats whose only interest is protecting their own funding. Their studies are frequently based upon completely erroneous assumptions, and they do a very poor job of collating and evaluating cohorts. I can paraphrase the results of many OIG studies in a single phrase: “Garbage in equals garbage out.”

While I cannot speak for APMA, I can report that APMA has been misled by OIG more than once. OIG is not above “using” APMA for their own political purposes and stabbing them in the back as soon as those resources are obtained. I strongly urge anyone confronted by OIG to limit co-operation with them, and first obtain legal advice before even considering a stance of co-operation with them. In this case, Dr. Kesselman points out that OIG is dead wrong. Combined APMA and MD/DO legal counsel may be required to set them straight. 
 
Michael M. Rosenblatt, DPM, San Jose, CA, Rosey1@prodigy.net

ASSOCIATE POSITION - SW FLORIDA, BEAUTIFUL GULF COAST AREA 
 
Well-established podiatry practice with excellent mix office/surgery seeking full-time associate PSR 12-36. Excellent salary & benefits for the right hardworking, personable candidate. Email resume to pudos@aol.com or fax to 239-573-9201.

LOOKING TO PURCHASE PRACTICE IN TEXAS
 
Experienced, surgically-trained podiatrist looking to purchase successful full-time practice in Texas, preferably within 1 hour of Houston. Serious inquiries only. Please send email to faajobs@mail.com.

ASSOCIATE POSITION - TAMPA BAY, FL

Associate needed for a dynamic practice in the Tampa Bay area. Preference given to a PSR 24+ training and must have a Florida license. Well-established practice, high-tech with specialties in sports medicine, surgery and wound care. No nursing homes or HMOs. E-mail: drcosentino@tampabay.rr.com

ASSOCIATE POSITION - MARYLAND

IMMEDIATE Associate needed to join a multi-office podiatry practice in the Baltimore MD Region. Desired candidate should be surgically trained with Board Eligible/Certification. You must be hard-working, ethical, compassionate and confident in your abilities to deal with pathology, patients, staff and fellow physicians. Patient base is already established. Excellent income and growth potential for the right associate. Please forward a cover letter, resume, and surgical log (if a current resident) and availability to FootDocMaryland@Gmail.com

CANADIAN PODIATRISTS COME BACK HOME!

An Edmonton, Alberta group of DPM’s requires an additional Podiatrist. Interest in biomechanics essential. Given Canadian visa restrictions, this position is open only to Canadian Citizens or permanent residents. Very attractive compensation package. Fax C.V. or letter of interest to: (780) 483-5796.

PRACTICE FOR SALE – MAINE

25 year full scope in medical building, podiatrist friendly hospitals, appreciative and cooperative patients, excellent expansion potential, physician referrals. Wonderful place to raise a family. Retiring seller will stay for transition. mainefootdoc@yahoo.com

FUNGAL NAIL LASER FOR RENTAL-  NYC, LONG ISLAND AREA ONLY

Our trained technician comes to your office to treat your patients. Pay only for patients treated, no up-front costs. Laser is FDA-approved for general podiatry use, FDA pending for onychomycosis. Call 516-242-7540

EQUIPMENT FOR SALE – PAD NET 
 
5 month old PAD Net device for sale. Very lightly used with 7 months of the warranty left and an extra set of toe cuffs. Serious calls only. 928-774-4825

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

Busy practice with offices in Pomona and San Bernardino is looking to expand and bring on a part-time or full-time podiatrist. Spanish speaking is helpful, but not imperative. For full-time position, a six figured starting salary with benefits and bonuses is offered.  Office work is needed, and must be willing to do house calls. NO NURSING HOMES, HOWEVER! If interested, please send CV to scpodgroup@gmail.com

ASSOCIATE POSITION - NAPLES, FLORIDA

Great opportunity for PSR- 24/36 BE/BC podiatrist with strong surgical skills to join multi-office, multi-doctor practice. Hospital privileges available at 648 bed hospital system, 200 bed hospital system and multiple surgical centers. We rotate for ER call at all 4 hospitals. Candidate needs to be ethical and motivated. Established practitioner or new practitioner OK. Salary and percentage based on skills and experience, benefits including 401K. Current Florida license a plus. This a wonderful world class community. Fax CV to (239)566-8778 or Email CV to Drgordon@gulfcoastfootcare.com

ASSOCIATE POSITION – NEW YORK

Great Opportunity NY podiatric practice – multiple locations – seeks well-trained, ethical DPM per diem and full-time positions available. Competitive salary. Send resume and CV to: info@advancedfootcare.org

ASSOCIATE POSITION - LAS VEGAS, DALLAS, HOUSTON, AND SAN ANTONIO AREAS

Seeking well trained ABPS board rearfoot/ankle certified/qualified foot surgeons for surgical practice with national foot/hand/orthopedic surgery group. Excellent salary/benefits. Email CV and cover letter to: slb99@pdq.net

1 YEAR PODIATRIC SPORTS MEDICINE FELLOWSHIP  - MONROVIA, CALIFORNIA

Applicants must have completed a podiatric residency program and must have or be eligible for a California license. Annual stipend: $48,000 and $60,000. If interested, please e-mail your resume with cover letter to the Program's management company at victoriamanagers@gmail.com

ASSOCIATE POSITION – MANHATTAN

Part-time, in-network Board Certified or Board Eligible Podiatrist wanted for busy Manhattan practice. Please email CV to parttimepodiatrist@gmail.com

ASSOCIATE POSITION - CONNECTICUT (FAIRFIELD AND NORTH HAVEN)

Great opportunity. Join one of the largest podiatric groups in Connecticut. Associate position leading to partnership. Well-established and progressive offices. Electronic medical records, digital x-ray, diagnostic ultrasound, Padnet vascular studies, nerve conduction studies, pinpoint and CO2 lasers, electrical stimulation and ultrasound therapies. Seeking a well-trained, personable, and highly motivated individual. Please send resume and current photo to dr.kassaris@yahoo.com 

PRACTICE FOR SALE - TENNESSEE

Established 30-year full-scope podiatry practice. Excellent hospital and surgery center privileges with investment opportunities. Fully equipped 2200 sq.ft. office across from hospital. High volume of new patients, DME, and local referral base. Great community for a family and the outdoorsman. Reply to tnfootdr@gmail.com

ASSOCIATE POSITION - PENNSYLVANIA

Western Philadelphia suburbs. 2-Office, Multi-Practitioner Practice ,has full-time position available. Must be ABPS Qualified or Certified. PSR-36 Preferred. Looking for hard-working, well-rounded, personable individual who is interested in all aspects of Podiatry including foot surgery and wound care. Please e-mail Resume to: pod1593@gmail.com

ASSOCIATE POSITION - PRINCETON, NJ

Looking for a full-time associate in a very high volume 2-office practice in the Princeton area in routine/sports/pediatric/surgical podiatric care. Excellent opportunity for a hard-working, ethical, individual with good personal and clinical skills. Candidate needs minimum PSR 24-36, board qualified/certified, and an active NJ state license. Send résumé’s – princetonpodiatry@yahoo.com

ASSOCIATE POSITION NORTH CAROLINA - ASHEVILLE/MOUNTAINS

Well established, multi-doctor, multi-office diverse practice has immediate need for associate doctor leading to partnership. Associate doctor will be very busy from day one. Attractive compensation and benefits. Buy-in potential after one year. Contact at smfc2@charterinternet.com or 828-734-1535

PRACTICE & BUILDING FOR SALE - MIDDLE TENNESSEE

Two locations each with 3 exam rooms, x-ray room, large waiting room, and ample parking. Excellent locations and growth potential. All equipment and furniture included. Website and marketing material included. Seller happy to assist with transition. Grossed 350K last year, priced to sell with financing available 200k. Call 931-446-5724.

SEEKING EMPLOYMENT - SOUTH FLORIDA

Board Certified Foot Surgeon. Had own practice in Texas for twenty years. E-mail:  ehe2852341@yahoo.com

ASSOCIATE POSITION - MINEOLA, NEW YORK 
 
Full-time or Part-time associate position with future partnership potential available with busy multi-office practices on Long Island. Must be proficient in all phases of podiatry with emphasis on surgery, biomechanics and RFC. Minimum standards include either a three-year PSR, or board qualified/certified status with ABPS. Existing hospital privileges with a NY-based facility helpful. Interested doctors are encouraged to e-mail their CV to mets724@gmail.com

ASSOCIATE POSITION - MARYLAND

Podiatrist needed for Maryland practice. Fax resume to 410-749-6807.

ASSOCIATE POSITION – GREATER MILWAUKEE, WI

Great opportunity: our busy multi-physician, podiatric group practice, with multiple locations, strong hospital based affiliations and clinical appointments, with teaching faculty positions at PM&S-36 residency programs, is seeking a full-time RRA BQ/BC, PM&S-36 surgically trained doctor. Position will be available for July/August, 2010. Applicant should be well trained in all aspects of conservative care and surgical forefoot, rearfoot, reconstructive surgery, trauma, wound care and limb salvage. Candidate should be ethical, hard working, outgoing and a self-starter. Commensurate pay, income guarantee, with incentives and full benefit package. Definitive plans will be discussed leading to partnership tract. Contact: Daniel Hellman, M.D. @ 414.831.0512 or by e.mail @ hellmandr@gmail.com

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