The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

May 19, 2010 #3,861 Publisher-Barry Block, DPM, JD

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DC Podiatrist Provides Tips on Avoiding Athletes Foot and Blisters

Wear light, moisture-wicking, synthetic (not cotton) socks, says Stephen Pribut, DPM, a sports podiatrist in Washington, D.C. After you run, change out of your soggy socks and shoes and slip into dry after-sport shoes before you go for coffee or run errands. Don't stash your sweaty pair inside a dark gym bag or your trunk where they can't air out. You can also sprinkle antifungal powder on your feet before running.

Dr. Stephen Pribut

Buying properly fitted running shoes may sound like a no-brainer, but consider this: "Studies show that fewer than half of people's running shoes were fit correctly," Pribut says. Because your feet can expand a half size over a day, shop in the late afternoon or evening. If you've been on a running hiatus, don't assume you can jump into your old pair. As you age, your feet flatten and lengthen, so you may need to go up a size.

Source: Karen Asp, Runner's World [June 2010]

Dallas Supergroup Launched

Podiatric Medical Partners of Texas (PMPT) - Jay Lifshen, President has partnered with Integrated Physician Systems (IPS) - Jeff Walker, CEO, to facilitate the merger of 15 practices with 24 physicians in the greater Dallas area. This model allows the doctors to receive the rewards of being a large group while keeping their individual autonomy and control. IPS is providing all merger integration, process re-engineering, revenue cycle management (billing services), CCHIT 2011 certified software (fully integrated PM & EMR software), employee management oversight, credentialing, managed care negotiations, human resources, financial management services, company benefits, and all other back office operational support services. 

Dr. Jay Lifshen

Jon Hultman, DPM, MBA, Chairman of the IPS Board has stressed the need for supergroups for more than a decade. "IPS was the ideal partner to assist us in becoming a supergroup and managing the PMPT infrastructure," said Lifshen.

Cambridge Health Alliance Names a New Chief of Podiatric Surgery

The Cambridge Health Alliance, Cambridge, MA, has announced that Adam Landsman, DPM, PhD has been appointed to be the Chief of Podiatric Surgery, and will join Harry Schneider, DPM, who has been named as the Director of Residency Training. The Cambridge Health Alliance, which includes The Cambridge Hospital, Whidden Hospital, and Somerville Hospital are affiliated with Harvard University, School of Medicine, and offers advanced podiatric surgical training for six residents.

Dr. Adam Landsman

According to Dr. Landsman, "This progam already has an outstanding reputation for the podiatric services provided. We hope to expand on that strong foundation with new research and residency training opportunities." Prior to this position in Cambridge, Dr. Landsman served as an attending physician and co-director of fellowship training at Beth Israel Deaconess Medical Center in Boston.

Editor's Note: PM News is proud to present excerpts from Meet the Masters.

Bret Ribotsky: What tips or pearls you can offer to somebody who is  thinking of starting a business outside of podiatry?  

Dr. Dennis Shavelson

Dennis. Shavelson: I think you have to be analytical. You have to be much more business-like. You have to look for something that you are passionate about. Stay in an area that you can control and be an expert in.  

Don Canada and Mary Feeley

Meet the Masters is broadcast each Tuesday Night at 9 PM (EST). This week's show features two well-known APMA state component executive directors: Don Canada for TXPMA and Mary Feeley from IPMA . You can register for this event by clicking here

Query: EMR and Stimulus Money

If EMR/EHR is free (Practice Fusion), does one still qualify for the $44,000 incentive? When do the reimbursement checks start to flow? If it is a group practice, does everyone in the practice qualify for $44,000 or is it one incentive per practice?

John Moglia, DPM, Berkeley Heights, NJ

Editor’s Comment:  Any software that meets the meaningful use standard qualifies for stimulus money under the American Recovery and Reinvestment Act (ARRA), regardless of what the software costs. Every practitioner who utilizes this software can qualify for up to $44,000, regardless of how many are in a group practice.

Reimbursements are scheduled to start in 2011 for those who submit qualifying Medicare claims for 80% of all patient encounters during a 90-day reporting period. You will need to submit Medicare billings of $24,000 in 2011 to receive the maximum first year payment of $18,000.

Query: Coding a Tarsal Tunnel Release

I performed a tarsal tunnel release, as well as debridement of an extensive amount of tenosynovitis from the flexor digitorum longus and flexor hallucis longus tendons. There was also a very large and multi-lobulated ganglionic/synovial cyst which seemed to emanate from the flexor hallucis longus/medial facet of the subtalar joint which I excised. The total operating room time was over 2 hours. How should the above procedures be coded?

Richard M. Maleski, DPM, Arnold, PA
 
Response: The tarsal tunnel release should be billed as CPT 28035 - release, tarsal tunnel (posterior tibial nerve decompression).

The debridement and removal of unrelated cysts of the tendons, if done at the ankle level, should be billed using CPT 27630 (excision of lesion of tendon sheath or capsule, i.e., cyst, ganglion, leg or ankle). If the tendon debridement and or cyst removal was done at the foot level, bill CPT 28090 (excision of lesion tendon sheath or capsule, including synovectomy, foot).

Howard Zlotoff DPM, Camp Hill, PA

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

RE: Minimal Important Difference (MID) and  Outcome Measures
From: Michael Turlik, DPM
 
When evaluating the results of a clinical trial, the clinician needs to make a decision if the intervention will result in a clinically important benefit for the patient. This is easiest if the primary outcome is a validated patient-oriented instrument rather than a surrogate outcome. Although most studies will report if a statistically significant difference was found, it is more important if the intervention is shown to be clinically significant as well. Many times, the authors of podiatric articles may not include a minimally important clinical difference in their publication, which causes problems in interpretation of the study.

In a recent publication  (Journal of Foot and Ankle Research 2010, 3:7) Landorf, et al. calculate the minimally important difference (MID) for two commonly employed outcome measures used for heel pain. This aids readers in evaluating efficacy as well as helping researchers to determine the correct sample size calculation. 
 
Michael Turlik, DPM, Cleveland, OH, mmturlik@aol.com

RE: Professor David Armstrong
From: Michael M. Rosenblatt, DPM
 
Hardly a week goes by when I don't notice another contribution Professor David G. Armstrong makes for our profession. Each and every one of us owes Dr. Armstrong a note and vote of thanks for the fine, favorable publicity he provides for podiatric medicine and surgery. This is far and above his own outstanding scientific and personal achievements. How can we clone him? He is truly a remarkable man. 
 
Michael M. Rosenblatt, DPM, San Jose, CA, Rosey1@prodigy.net

RE: Podiatrists and the Term “Physician”
From: Dan Klein, DPM, Bob Kornfeld, DPM

I don't understand the vast confusion about podiatrists using the term "physician." The fact is that podiatrists should not use this term, since they are not physicians. I believe there is an identity crisis by the young podiatrists who go through residency training and truly believe that this qualifies them to use the term. I see this a lot, especially by podiatrists who have gone through 3-year surgery residencies, and who distance themselves from the term podiatrist by using the description "reconstructive foot and ankle surgeon" on their white coat. Listen, my fellow podiatrists - you are not physicians in anyone's eye but your own. You are an allied health professional with advanced training. Until you have taken the appropriate conventional medical doctors or osteopathic medical licensing exam and passed the state's requirements, you are not a physician.

I believe that podiatrists need to revise their training to be commensurate with standard medical school or osteopathic school curricula and residency training, and then apply for recognition as a physician. Granted, there are certain exceptional states that have given recognition to the term “physician” used by podiatrists, but these are exceptions, as the term is not universally recognized in all states. So, be happy about who you are, and if not, get your MD or DO degree and license.  
 
Dan Klein, DPM, Fort Smith, AR, toefixer@aol.com

Sometimes, reality hits us in the face. My little 8 year old niece was playing outside and apparently fell, hurting her left thigh. She was screaming and crying from the pain. My wife, her aunt, said, "Let Uncle Bob look at your leg," to which my niece replied, "No!, He's just a foot doctor.  I need a real doctor."
 
My experience as a podiatrist has been great. I truly enjoy going to work every day and have been blessed with a great living. But reality is reality. We are not considered "real doctors." Even our own families do not think of us as "physicians." Is the MD degree going to undo this unfair and uneducated attitude toward our profession? I believe yes, but not as fast as we all would like to believe. There will be built-in prejudices that will last for a generation or two. I think what it will accomplish for most of the podiatrists whom I have spoken with is a much needed ego boost. There are many podiatrists who do not like to describe themselves to others as podiatrists. They would rather say, "I am a foot and ankle surgeon." It doesn't really matter what you call yourself. Being a DPM for most means not being an MD. It just makes sense for this profession to end the confusion about who we are and what we do. 
 
I, myself, would love to have an MD degree. It isn't going to change the way I practice and I do not know if it will be a source of increased income. However, it would be nice to be regarded by family and society as the real doctor that I already am.
 
Bob Kornfeld, DPM, Manhasset, NY, Holfoot153@aol.com

RE: Practice Fusion EMR (Michael Brody, DPM, Larry Kosova, DPM)
From: Multiple Respondents

The world lives on interfaces! There are even issues with the programs that Dr. Brody represents, as they must have interfaces for all of the extra modules that you will need to purchase. Even their EHR and PM have to interface behind the scenes. I highly doubt that each of us will need our own IT departments to debug our interfaces. Let's get away from the tech lingo. That comment is unrealistic and a scare tactic. I happen to be a computer programmer and have taught systems architecture, and I don't buy it.

Since Dr. Kosova has no interest in any of these companies like Dr. Brody, I believe his research and comments are excellent points with a good initial evaluation of the software. The bottom line is that you need to do what is best for your practice.  You cannot just support someone because they support podiatry if it is not the best solution. Some of these programs mentioned have major problems and are too small to survive.

Let's hear from some people that don't have ties to these companies so that we can get some real information please!

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

I am compelled to enter my opinion once again regarding running one’s office using EHRs that work in the “cloud.” My two offices have been paperless since October 2009 when we began using Office Ally for appointment scheduling, inter-office memos, comprehensive notes, complete patient records, electronic prescriptions, lab scheduling and results, etc. We have done our billing through them for the last four years. It has been seamless. I have a computer (I use "all-in-ones" to save space) in each treatment room. There was a learning curve, and we input podiatry-specific macros, etc. It costs about $70 per month for everything.  The cost is so low because Office Ally is also a clearinghouse, and your billing, for the most part, goes through them and the insurance companies pay them a few cents for each claim...you may still print your own statements. Over 6,000 physicians use their service.

Would you rather put out $25,000 dollars just to get some back from Medicare/Medicaid or would you rather just buy your computers, modems, etc. and spend less than $1,000 per year to have a comprehansive system?

Disclaimer: I use this product but have no financial interest in it. My theory is simple...the more doctors who use it, the stronger it becomes.

Martin R. Taubman, DPM, MBA, San Diego, CA, mtaubman@san.rr.com

I have just read Dr. Kosova's response to this thread with great interest. This thread is getting quite interesting and those following it will have the opportunity to learn a fair bit about EMR in general.

I asked a number of similar questions of Sabas when speaking with him regarding back-ups and retrieving data. My take away from that conversation is that…

Editor’s Note: Dr. Brody’s extended-length letter can be read here.

PRACTICE FOR SALE - MINNESOTA

Practice Grossing over $500K yearly. Good mix of surgery, orthotics, DME, diabetic care, general podiatry. Commute < 5 miles to work. Friendly Midwest lakes area with arts, good schools, affordable living, restaurants, shopping. Option to purchase building. Will consider associate to buy-in/ buy-out. Midwestpractice@gmail.com

EQUIPMENT FOR SALE -  PODIATRY CHAIR (5X)
 
Midmark model 114 power podiatry chair, rose color, debris tray with matching stool. In perfect condition. Like new. Rarely used. $4000.00.  Contact: richard.dpm@sbcglobal.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

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 – 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 - 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 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

ASSOCIATE POSITION -

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

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.

ASSOCIATE POSITION - MARYLAND

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

PODIATRISTS WANTED BALTIMORE/CHICAGO/NORTHWEST INDIANA

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 Jake Shimansky, Director of Physician Recruitment. Phone 773-342-5221 FAX 773-486-3548 E-Mail jshimansky@homephysicians.com www.homephysicians.com

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

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

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 

PM News Classified Ads Reach over 12,000 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 12,000 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.

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