May 19, 2006 #2584                                     Editor-Barry Block, DPM, JD

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Grief Healing Center Named For MI DPM Aids Children and Adults

Lisa Bartoszek is program director of Lory's Place, a grief healing and education center founded by Hospice at Home Inc. Lory's Place was named for Dr. Lory Schults, a St. Joseph, MI podiatrist who died in a traffic accident in January 2004. While helping Lory's husband, Ron Schults, and two small children to deal with their loss, Lisa Bartoszek, expressed her desire to start a center.

It opened in November 2004 in St. Joseph, IN  There are active peer support groups for children ages 3 to 18, adults and anticipatory grief (to anticipate the grief from the death of a loved one) with facilitators that meet twice a month. "Each room has a different purpose. The adults have a place to grieve and learn why their kids are acting they way they are," Bartoszek said.

"We educate the kids why they are grieving certain ways and they can learn to live again." With no fee for services, there are two fundraisers a year. The first is Lory's Place Run, Walk and Rock at 8:30 a.m. Saturday. The second is the Dr. Lory Schults Memorial Lady Skipper Regatta on Aug. 26.

Source: Sherry Van Arsdall, South Bend Tribune [5/17/06]

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Query: Website for NPI

Does anyone know of a website that can be searched for the new NPI number to see if doctors have registered for a number?

Arnold Beresh, DPM,   Hampton, VA 

Editor's comment: PM News does not provide legal advice. While E- mail is a tremendous vehicle for communication, it is generally not a secure method for transmitting personal health information (PHI). It is inadvisable to send PHI unless you are sending encrypted E- mail through a secure server.

RE: Ultrasonic Instrument Cleaners (Thomasin Hammer, DPM)

From: Elliot Udell, DPM

I too use a Branson 200 in my office. Yes, it is mainly marketed as a jewelry cleaner, but it does not say anything of the sort on it. It is a very professional looking machine. Most instruments will not totally fit in the unit. If we are cleaning nail clippers or hemostats, only the portion of the instrument where there is debris must be inserted into the water. After it goes through the cycle, the instruments are then bagged and put into the autoclave for sterilization.

I acknowledge Dr. Hammer for cleaning and sterilizing all podiatric instruments. This is quickly becoming the standard of care. Seeing news reports of MRSA infections spreading, AIDS, Fungi and Hepatitis, it behooves all of us to make sure that help and do not harm our patients.

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

From: Bob Kornfeld, DPM , Bret M. Ribotsky, DPM

I have done live radio shows for about seven years as well as advertising with 30 - 60 second radio commercials. There is no question that doing live interactive radio is by far the best marketing tool I have found. My experience with commercial spots is that they rarely get anyone's attention and the ROI is dismal. My advice is to get yourself on a talk radio station and do a live interactive format and you will be amazed at how many patients will flock to your office. As long as your on-air persona is relaxed, confident and informed, you become an instant celebrity/expert in your field and they will respond well.

Bob Kornfeld, DPM, Lake Success, NY,    holfoot153@aol.com

I would suggest you reconsider advertising new or "experimental" medical treatments. Radio advertising is a proven winner and I have used it very well to recruit patients for research studies..... Just choose your demographic wisely.

In my area, plaintiff attorneys listen to the radio from their golf carts, and private planes, just looking for their next target. Be real careful about advertising on radio station WIIFM  (What's In It For Me).  It needs to be about the listener for it to work.

Bret M. Ribotsky, DPM, Boca Raton, FL,   Ribotsky@doctorbret.com

From: Howard R. Fox, DPM, Michael M. Rosenblatt, DPM

I don't have patients sign a consent for P&A's, removal or warts, or other minor procedures. If I were to get sued on one of these, there would be a claim of lack of informed consent regardless of whether a consent form was part of my records. But I am very careful to explain exactly what I am going to do, what the risks are, including the biggest one (recurrence), and what's involved with healing, aftercare, etc.

"Informed consent" is not a patient or guardian signing a form; it's the conversation the doctor has with the patient and the understanding the patient has from that conversation, including answering all questions concerning the proposed procedure. The signed consent form is symbolic that such a conversation took place, but it obviously doesn't PROVE any such conversation took place.

As far as dentists go, I'm not so sure they should be the gold standard here. I had root canal last week by an endodontist. I am hypertensive and take two medications to treat this, and this was disclosed on the history form I completed. Despite doing a superb job, there was no consent, my blood pressure was never taken once, and epinephrine was used in the local anesthetic. I'm having the tooth capped tomorrow, and I am certain there will be no consent, no blood pressure check, and probably epinephrine in the local. Of course my FAVORITE part of the whole experience is that I'm paying exactly what they are charging, up front, despite having dental insurance. Hmmmm... maybe they ARE the gold standard!

Howard R. Fox, DPM, Staten Island, NY,   foxhr@yahoo.com

Dr. Jeffrey Kass asked about the necessity of having a written, signed consent form by a patient for very small procedures, like biopsies, even though dermatologists rarely do. The Editor wisely suggested that it is always better to "err on the side of safety and have the patient sign."

But there are other reasons why it is essential, even though complications almost never ensue from a biopsy. The patient will receive a statement from Medicare or the insurer describing that a billing for a "surgery" had been done. It is highly unlikely that the patient will actually "remember" the biopsy, especially from deep tissues of an insensate ulcer, which can be painless. Then, your patient will complain to the insurer that you committed a fraud. Having the signed consent form for the biopsy on file, as well as the pathology report will stop this immediately. I know. It happened to me.

This is just another incidence where the value of documentation stood up to defend you and helped provide a decent night's sleep in a very tough World.

Michael M. Rosenblatt, DPM, San Jose, CA,   Rosey1@prodigy.net

 From: David Secord, DPM

I completely agree with Dr. Rosenblatt on this one. In 1999, I was working for a podiatrist in North Texas as an associate. His practice was busy and the schedule full. His wife was the office manager and his sister-in-law was the billing clerk. It didn't take me very long to figure out that the reason the waiting room was full of patients was because they were follow-ups, ad infinitum, for nail procedures. After being chided by the owner's wife for not seeing my post-op nail patients often enough, she informed me that "the insurance companies don't pay us enough for a procedure, so we have to make it up with follow-up visits and co-pays, so you have to see these people at least 12 times after the global period".

She was also instructing all patients to start using the herbs and vitamins she was hawking from the front desk as a rep for Rexall. She would review all the patient's medications lists and tell them that they "needed to get off all this junk and start taking herbs and vitamins." The medications discontinued included insulin, Lasix, Norvasc, Dilantin, Lipitor and the like, none of which were prescribed initially by our office.

As this constituted practicing medicine without a license, I confronted the owner of the practice. He informed me that he "knew of and gave his blessing to the activity, as it was important to the bottom line of the practice." I had to leave the practice at that point, even though I had no where else to go and no place to practice. I was simply not going to share a jail cell in Huntsville with this guy and his wife. If the practice is doing illegal stuff, you have to extricate yourself from this situation.

David Secord, DPM, Corpus Christi, TX,  David5603@pol.net

PRACTICE FOR SALE - COLUMBUS, OHIO AREA

Fully furnished practice, open ONLY 14 hours a week with an average
yearly gross of 235K. 75% primary care, 20% surgical, 5% Nails.
Plenty of opportunity for growth and surgery. Changing locations.
Financials available upon request.    Kyle_DPM@Yahoo.com  

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