The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

May 21, 2011 #4,166 Publisher-Barry Block, DPM, JD

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WA Podiatrists Present at Eye Surgeon Conference

On May 18, 2011, Anthony Lo, DPM and Susan Scanlan, DPM teamed up to give a presentation on common foot problems among patients with diabetes to the Northwest Eye Surgeons at their annual conference. Dr. Lo is a partner in the large multispecialty practice of Minor and James Medical in Seattle and Dr. Scanlan is the executive director of the Washington State Podiatric Medical Association. 

Drs. Anthony Lo and Susan Scanlan

About 135 eye doctors were present, as  Drs. Lo & Scanlan stressed the "team approach" to addressing the literal "head to toe" conditions that can occur. They also practice what they preach as USTA competitive tennis partners, and as husband and wife!

MI/VA Podiatrists Present at Indian Diabetic Foot Conference

Two American podiatrists recently made presentations at the Amrita Diabetic foot conference, held May 6 and 7, 2011 in Cochin, India. Sarnarendra Miranpuri, DPM from Troy, Michigan was the keynote speaker and David L. Nielson, DPM from Roanoke, Virginia spoke on skin grafting and external fixation. 

(L-R) Sarnarendra Miranpuri, DPM. Christy Sankoorikal, MD, and David L. Nielson, DPM

India has a very high (second only to China) number patients with diabetes, and there is high interest in understanding the disease process. This was the 2nd annual foot conference in this region and was attended by 200 surgeons, orthopedists, and primary care doctors.

CPME Continues Moratorium on College Admissions 

At its April 2011 meeting, The Council on Podiatric Medical Education (CPME), based on a recommendation from the Accreditation Committee and review of statistical information related to class sizes and available residency positions, continued a moratorium on increasing the number of spaces for entering students. This decision was based on the belief that no significant change had occurred in the previous six months in the relationship between college enrollment and authorized residency positions to warrant a change. This moratorium has been in place since 2007.

At its October 2010 meeting, the Council also elected to eliminate temporarily the 10 percent enrollment buffer provided each college of podiatric medicine, effective with the class of 2012-2013. Consequently, each college's maximum enrollment will be the number identified in CPME 100, Accredited Colleges of Podiatric Medicine. Temporary elimination of the buffer will be revisited at the Council's October 2011 meeting; the decision will be based on the availability of residency positions.

Query: Idiosyncratic Reaction to a Foot Injection

Has anyone had a patient with the following unusual reaction to a foot injection of .25 cc dexamethasone and 2 cc of lidocaine plain? The following day after each injection the patient develops a rosacea-like redness on her cheeks which she describes as feeling like a sunburn. It begins roughly 12-18 hours after the injection and lasts a day and goes away. The redness is not present on any other part of her body.

Elliot Udell, DPM, Hicksville, NY

Query: Cortex EDI or Claim Shuttle?

When submitting Medicare DME, has anyone had experience with Cortex EDI or Claim Shuttle? Any input would be appreciated.

Paul Stepanczuk, DPM, Munster, IN

Query: Cerner EMR in a Clinical Setting

Has anyone used the Cerner EMR in a clinic setting? The hospital I am associated with is offering a very affordable lease option. 

Lea Elliott, DPM, Marrero, LA

Query: Diabetic Shoe Refund Demand

We supplied diabetic custom shoes and innersoles to a Medicare patient in February, and we received payment in March. This week we got a letter requesting we return the money paid because the patient resided in a skilled nursing facility (SNF) at the time of service.

We will return the money, but we were not aware of the situation until we got this letter. In the meantime, the shoes were dispensed, and we paid our suppliers. Is there another way to bill for the shoes to get reimbursement? Can we get the SNF to pay us? What is the protocol?

Allan Hetelson, DPM, Bensalem, PA 

Response: I do not have a suggestion on how to get reimbursed for this particular pair of shoes, but we have begun having patients sign an advance beneficiary notice (ABN) for their diabetic shoes/inserts. We then bill Medicare with the "GA" modifier. If Medicare denies, then we can bill the patient.

Candace Scudday, Office Manager, Office of Bruce A. Scudday, DPM, El Paso, TX

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Query: Unidentified Fixation (Richard Jaffe, DPM)

The device shown on his x-rays is "Hallu-X", Intramedullary Fusion Device. This device is marketed by Extremity Medical, (extremitymedical.com). Having "a problematic encounter" during removal seems like a possibility.

Bruce R. Lawrence, DPM, Oceanside CA, brldpm@cts.com

RE: Vacuum System With an Umbrella Burr? (Ivar E. Roth DPM,MPH)

I use a Promed Filestream system. It uses whatever burr you choose, and it does do a good job controlling the dust.

Jeanne M. Arnold, DPM, Coeur d'Alene, ID, jarnolddpm3@frontier.com

RE: Substitute for Colchicine (Robert K Hall, DPM)
From: Marc Garfield, DPM

Colcrys is a generally available form of colchicine. It is considered a “brand name” with now no competing generic equivalent. Colchicine does not work for everyone, but works for most cases of acute gout. I disagree with the 24 hour reference. Being red, warm and/or swollen with pain is good enough. Check patients' med lists for diuretics, particularly HCTZ, and check their vitamin lists for niacin. Fresh or frozen cherries work remarkably well.

Marc Garfield, DPM, Williamsburg, VA, mgarfield1@cox.net

RE: Podiatrists' Responsibility When Taking Patients' Blood Pressures (Peter Harvey, DPM)
From: Thomas Graziano, DPM, MD

Blood pressure is a linear phenomenon and not an on-off switch. There exists a blood pressure threshold at which morbidity and mortality begin to rise more rapidly and take on significance. The current definition of hypertension is systolic blood pressure >140 mmHg OR diastolic blood pressure >90 mmHg on TWO occasions separated by at least a week. This means that one can NOT genuinely make the diagnosis of hypertension on a single visit, although the higher the initial reading, the more suspicious one becomes that subsequent readings will also be high.

As we know, 90% of hypertension in adults is essential hypertension (idiopathic) and 10% is caused by renal involvement. Of that 10%, 5% have renal parenchymal disease, and 5% have renovascular disease. So what is our role as podiatrists? We should be taking blood pressures on all of our patients because it should be part of our comprehensive examination. We should then be making the appropriate referrals when necessary, just as we would do if we suspected any other condition beyond our scope of practice. Period.

Thomas Graziano, DPM, MD, Clifton, NJ, TGrazi6236@aol.com

ASSOCIATE POSITIONS - TEXAS

Texas licensed podiatrists needed in San Antonio and Austin. Great paying positions for full or part-time. Well established, unique mobile podiatry practice servicing senior living facilities. Business office locations in both cities with excellent support staff for your assistance and scheduling. Check us out before looking elsewhere. Find us at www.footmobile.com Reply with cover letter and CV to doctor.cohen@yahoo.com with a cc: to lisa.schulze@yahoo.com or call us at 210-495-6477.

ASSOCIATE POSITION - MARYLAND

Looking For The Best. Busy practice. F/T associate possibly leading to partnership. Seeking sharp, honest and hard-working associate who is extremely personable. Board Certified or eligible. Exceptional surgical skills and training needed, but is just as important to diagnose accurately. Excellent salary and benefits. Email CV to Marylandfootcare@live.com

ASSOCIATE POSITION - SOUTHERN MI (NOT DETROIT AREA)

Leading to partnership for rapidly growing 3-physician group practice. Must be residency trained and willing to learn and follow our very successful business model. Salary plus incentive. If you're unhappy with where you're at now this may be the answer! If, interested send CV to: paulapmac@me.com

ASSOCIATE POSITION- NEVADA

Well established 22-year practice in Las Vegas/Henderson, Nevada seeking full-time associate. General podiatric care with moderate amount of surgery to be done in local hospital or surgery center. Competitive salary and benefits. Modern office in new area. Please respond by email to lvfootandankle@gmail.com

ASSOCIATE POSITIONS - NW INDIANA, CHICAGO AREA

2 Full-Time positions open - One for Northwest Indiana and one for the Chicagoland area. Must have 2-year surgical residency. Must be motivated and a self-starter. State License required. If interested email: f-massuda@footexperts.com

ASSOCIATE POSITION – NEW YORK

Great opportunity to share “state-of-the-art” offices and equipment in mid-town Manhattan and White Plains with Board Certified podiatrist. Out-of-network or participating providers welcome. Please call 212-704-4310 for additional information and fax your CV to 212-704-4311

ASSOCIATE POSITION – IOWA CITY AREA

Modern practice seeking a well-trained (PSR 24/36) associate. Excellent opportunity for an energetic, hardworking individual with strong surgical and medical skills. Solid referral network and 13 years of growth. Come live in the Iowa City area and enjoy the quality of life and stability of a Big Ten University community. Competitive salary and benefit package available. If interested, fax CV to 319-354-1014 or e-mail to dave@341foot.com

ASSOCIATE/OPPORTUNITY - PHOENIX (EAST VALLEY)

Established practice seeking motivated min. PSR24+ personable, ethical, motivated person to join state-of-the-art multi-office locations. Partnership/Ownership opportunity in practice, real estate, surgical center. Also interested in existing practitioner to merge or work part time. Contact AZPODAssociate@aol.com Must be pursuing or have AZ license.

ASSOCIATE POSITION - SW FLORIDA

Huge opportunity. Are you an outstanding person? Would you like the freedom to utilize your talents to the max? Opportunity awaits right candidate. Excellent mix of office/surgery motivated/experienced staff. Full Time Associate PSR 12-36. Great Salary/Benefits, Bonus Package, Unlimited Potential, Buy-In Opportunity. Email resume to podiatry22@yahoo.com

ASSOCIATE POSITION - TAMPA BAY, FL

Associate with PSR 24+, needed for a dynamic practice. Well-established high-tech with specialties in sports medicine, surgery, and wound care. No nursing homes or HMOs. E-mail: flpodiatrist@tampabay.rr.com

ASSOCIATE POSITION - WA (KIRKLAND, SEATTLE, EVERETT, AND REDMOND)

Join one of the fastest growing podiatry practices in Washington state. Must be motivated to grow practice. Competitive salary and benefits. For more information go to seattlefootdoctor.com. Send resume to seattlefootdoctor@yahoo.com

ASSOCIATE - POSITION - SOUTHEAST GEORGIA & SOUTH CAROLINA

Seeking recent residency graduate to join practice. Must be PSR-24/36 trained. Multiple locations. Full range of services with new facility. E-mail to melissafoot@pol.net

ASSOCIATE POSITION - NEW YORK CITY & QUEENS

One of the fastest growing podiatry practices in New York City and Queens seeks a podiatrist who participates with HealthFirst, Fidelis, and other Medicaid plans. Preferably a Spanish speaking podiatrist. Contact me at Podocare@aol.com

SPACE AVAILABLE- NYC & LI

Office to sublet and share - East 60th Manhattan, and Plainview long island. access to an MRI, Joint Commission certified operating rooms, digital x-ray, diagnostic ultrasound, and access to a multi-specialty ambulatory surgical center. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM

PRACTICE FOR SALE - SOUTH CAROLINA

$800,000+ gross, single location practice needs well trained, energetic podiatrist. Confidential inquiries carpodpract@gmail.com

PRACTICE FOR SALE - HOUSTON, TEXAS

28 year old busy, progressive practice for sale with an excellent reputation and well established referral base. Well trained, dedicated, supportive staff. Excellent cash flow $475K income after overhead. EMR, digital x-ray, diagnostic ultrasound. Free standing building also available with large outdoor sign. Owner retiring and willing to stay part time during transition. softechpodiatrist@gmail.com

PRACTICE FOR SALE - MISSION VIEJO, CA

Relocating to Tulsa. Great opportunity to buy my office. Located on Mission Regional Hospital Campus. Gross income 2010 was $340,000. Approximately 1300 sq ft with 3 treatment rooms, digital x-ray and fully computerized. Only 3 years old. Will consider all offers. 949-702-1052. David Stoller, DPM (Family Footcare) david@missionviejofootcare.com

PRACTICE FOR SALE - MARYLAND, DC SUBURBS

Great opportunity. Well established and equipped practice for sale. Office includes state licensed Ambulatory Surgical Center. Present owner is retiring but will stay on as needed for smooth transition. Average gross over past 3 years is $575 K. dpmpracticeforsale@yahoo.com

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