The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

May 23, 2012 #4,469 Publisher-Barry Block, DPM, JD

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Diabetics Must be Proactive to Prevent Amputations: OH Podiatrist

Perhaps the most dreaded complication arising out of diabetes is a foot wound that leads to amputation. “Even though many diabetics breathe a sigh of relief, thinking that is the end, that they have handled the problem,” said Dr. Steven D. Gross, of Perry Township’s Stark County Foot and Ankle clinic, “often it is just the beginning. At first, it may be a toe or toes, but if great care is not taken, further amputations can follow.” 

Dr. Steven D. Gross (Photo: Scott Heckel)

Gross’s observation, he stressed, is not intended to frighten diabetics, rather to underscore the importance of managing their disease and being proactive in the care of their feet.

Source: Diana Rosetti, Massillon Independent [5/21/12]

GA Podiatrist Uses Laser to Treat Plantar Warts

10 year old Janelle Florence noticed a plantar wart on her toe about two years ago. It was more than just an annoyance. “I was very self-conscious about it,” says Janelle. And try as she might, she couldn’t get rid of it.  “We tried all the methods, over-the-counter products, and nothing seemed to work," says Janelle's mom, Aslean Florence. It started to spread. She heard about the laser treatment. She saw podiatrist Dr. Georgina Asante who has seen plantar warts get out of control.

Dr. Georgina Asante

“In my practice, I’ve treated mosaic warts, which covered the entire bottom of the foot and were extremely painful to walk on,” says Dr. Asante. Instead of surgically removing it, Janelle is having the laser treatment. It took less than 5 minutes. The treated growth will gradually separate from the skin and slough off, leaving healthy skin.

Source: Teresa Whitaker, WRBL News 3 [5/20/12]

MI Podiatrist Named New Chief of Staff of Major Detroit Hospital System

Brian G. Loder, DPM, has been elected Regional Chief-of-Staff at Henry Ford Macomb Hospitals. He is the first podiatrist to hold this important leadership position. During his 2-year term, Dr. Loder will be responsible for representing the opinions and concerns of more than 700 staff physicians at the two-campus, 500-bed teaching hospital located in southeast Michigan.

Dr. Brian Loder

Dr. Loder has been an active staff member at Henry Ford Macomb Hospitals for 16 years. His past leadership experience includes memberships on the Credentials, the Operating Room, and the Medical Education Committees. He previously received Henry Ford Macomb Hospitals' “Physician of the Year” award. In addition to his busy private practice, he also serves as the Medical Director of the Henry Ford Macomb Hospitals' Wound Treatment Center and is the Director of the Podiatric Surgical Residency Program.

Dubai Podiatrist Introduces Portable Foot Toning Device

Today, at the first day of the Arab Health Exhibition and conference, Dubai Podiatry Centre announced immediate availability of the Footerella, a discreet portable electronic device which tightens and tones women’s feet. The Footerella device is the first of its kind worldwide to use electrical muscle stimulation technology to easily tone women’s feet, resulting in a decreased foot size with tightened and toned arches, more able to withstand the rigors of stiletto use.

Michelle Champlin

“There has been an unprecedented level of interest and excitement amongst our existing patients at our Dubai clinic,” said Michelle Champlin, Founder and Chief Podiatrist of Dubai Podiatry Centre and inventor of the Footerella device. “The device has shown considerable measurable results in clinical trials, with notably tightened and toned long and transverse arches and, in many cases, a decrease in shoe size by ½ to one full size. Aesthetically, the appearance of the foot is also much improved by tightening and toning the muscles.”

Source: Bio-Medicine

Former Medicare Chiefs Say SGR Must Be Eliminated

Four former Medicare administrators told a panel of senators that the sustainable growth rate budget mechanism and fee-for-service payment system must be replaced. Unfortunately, however, there is no replacement plan for the current system, which is scheduled to cut Medicare rates by more than 30% in 2013 if Congress doesn’t prevent it. “There is no alternative ready for prime time right now,” said Gail Wilensky, PhD, who led the Medicare agency during the George H.W. Bush administration.

The Senate Finance Committee heard testimony from past leaders of the Centers for Medicare & Medicaid Services and its predecessor agency, the Health Care Financing Administration, on May 10. Senators questioned the witnesses on how the SGR and fee-for-service came about and how Congress should act to move past a broken system.

Source: Charles Fiegl, AMNews [5/21/12]

Query: Recopia/DrFirst EHR

As I approach retirement, I have been looking for a system that would allow me to qualify for meaningful use and the Medicare financial incentive. I do not wish to get a full EHR program due to the expense and the impact that the learning curve would have on my solo practice. I have been using the Recopia/DrFirst e-prescribing. Recopia has approached me with their "MU" program which is an enhancement to their e-prescribing that would gather the data for meaningful use without the EMR portion. An additional benefit is that they have an interface that is compatible with my existing office management/billing program. My question: Are there any podiatrists who are using/have used the program that can give me any info, good/bad/ugly on the software, training, and usage issues?
 
Leonard F Pinto, Jr, DPM, Hanover, MA

Query: A2D2 Digital X-Ray Machine

I was wondering if anyone had any thoughts about the A2D2 digital x-ray machine?

Sean Rosenblum, DPM,  Bronx, NY

Query: Debridement & Contact Cast Application

I would appreciate guidance regarding billing selective debridement (CPT 97597) and application of a contact cast (CPT 29445) for a Medicare patient. I reviewed the CCI edits on the CMS website, and it appears that application of a contact cast is bundled into the debridement code, so only the debridement code would be allowed. We, however, have been advised that both codes can be used to treat one wound. However, given the CCI edit restrictions, I don't see how this is possible unless I am misinterpreting those edits. Any enlightenment would be greatly appreciated.

Lynne Njirich, Office of Steve C. Jensen, DPM, Sonora, CA

Response: Checking the CCI edits, CPT 29445 (application of a total contact cast) (column 2 component code) is bundled into CPT 97597 (selective debridement) (column 1 code). The indicator is "1" which means that, if appropriate, with a "-59" modifier on CPT 29445, the edit can be unbundled so both can be paid.

Appropriateness is based on 1) medical necessity, 2) standard of care, and 3) any payer guideline limitations.

Tony Poggio, DPM, Alameda, CA

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RE: Lamisil, Tamoxifen Drug-to-Drug Interaction (Craig Herman, DPM)
From: Charles Morelli, DPM

This topic is a perfect one to segue into one closely related and that is "anti-rejection drug-to-food" interaction. Having recently received a kidney transplant, I am acutely aware of these hazards and, as podiatrists, we all need to be aware of them.

Being that we treat thousands of diabetics each and every year, I can guarantee you that a substantial number of them have had, or are in need of a kidney transplant and if that is the case, they are undoubtedly taking meds that need to be taken not only at a specific time interval, but also not in the presence of any foods that can inhibit the P450 enzyme.

For kidney patients, grapefruit juice and...

Editor's note: Dr. Morelli's extended-length letter can be read here.

RE: Hyperpigmentation of African-American Women After Using Corn Remover Pads (Janet McCormick, MS)
From: Shelley Gath, DPM

Links to cancer were published after rats were given high doses of hydroquinone. Hydroquinone does show dramatic results and is still prescribed by many dermatologists and plastic surgeons on a limited basis. With all products, results may not become evident for several months, if at all. Also, if results are seen, continued maintenance of the product is necessary to prolong the desired look. So yes, hydroquinone use would be limited to 8 weeks.

Kojic acid as well as alpha hydroxy acid have caused irritation and redness in some patients, which may cause the area to become darker than the original pigment. With all products, a test area is recommended first. Like my mother used to tell me, put lemon on it, which has natural bleaching properties and VItamin C which regenerates the skin. Avoid sun exposure to the area when using. 

Shelley Gath, DPM, Arcadia, CA, footdoc.gath5@gmail.comshellgath@hotmail.com

RE: Konica SRX 101 X-Ray Processor (Jack Ressler, DPM)
From: Sean S. Ravaei, DPM

I used to have an SRX 101. In the five years that I had it, it did not break down once. It worked great. The only reason that I sold it was to upgrade to a digital one.

Sean S. Ravaei, DPM, Beverly Hills, CA, drravaei@866866feet.com

RE: Nail Polish Can Mask Nail Diseases: DC Podiatrist
From: Janet McCormick, MS

Nails are dead, so they do not breath. They are made up of dead epidermal cells pushed forward from the live matrix, so they do not breath. They are keratin, a horn-like non-nucleated protein and are a similar material to hair. The nail bed below is alive. As for nail polish eating the nail surface of the toenail, nail polish is not an acid. It is an acrylic that cures (dries). The very most it can do is turn the surface of a nail yellow when dark polish is used for a long time. That is the discoloration that Dr. Osterman is referring to and it is not a medical issue.

Usually, the stain can be removed easily, but most people who wear polish change it often and don't really care if their toenails are stained on the surface.  One might note, also, that those who wear polish look at their toes very often, much more often than those who do not wear polish. For that reason, they will see changes very early, much faster than the women (and men) who do not polish their toenails.

Janet McCormick, MS, Medinail Learning Center, Frostproof, FL, janet.mccormick.info@gmail.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. Also availability E 22nd between 2nd and 3rd and E 70th off 3rd. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM

PRACTICE FOR SALE — BROOKLYN, NY

This practice has been in the same location for 31 years, seeing 80-100 pts/week, working 4.5 days/week. Grossing $350K and netting close to 70%. All surgery referred out. Low rent, option to buy the building in future. Asking $225K, doctor willing to finance. Call 800-983-4194, or email:contactus@podiatrypracticeconsultants.com

PRACTICE FOR SALE - BALTIMORE, MARYLAND

Established 40+ year old well-rounded practice of both surgical and non-surgical care with special emphasis on sports medicine. Medicare and BS/private insurance base, no Medical assistance. Needs to transition to a confident well trained individual. Purchase can include building. Contact:podiatrypracticesale@gmail.com

ASSOCIATE POSITION - NYC

Full and part-time opportunity available in 40 year old practice in downtown Brooklyn. State-of-the-art office with EMR and digital x-rays. Must be experienced, highly motivated with good clinical skills. Competitive salary. Possible buy-in opportunity available. please email resume to dpm10019@yahoo.com

ASSOCIATE POSITION - MANHATTAN

Podiatrist needed for busy state-of-the-art offices in Manhattan. Offices are located near Penn and Grand Central Station. 10+ years experience only and an out-of-network doctor for most insurances. Please forward your information and CV to: roni@myfcny.com

ASSOCIATE POSITIONS - MULTIPLE STATES

Podiatrist Needed in Arkansas, Kansas, Missouri, Nebraska, Iowa, Minnesota, North Dakota, South Dakota, Texas, Colorado, Wisconsin, and Oklahoma. Expanding multi-state medical practice seeking podiatrists to service long-term care community residing in nursing homes and assisted living facilities. We offer an established patient base, scheduling, equipment allowance and cover travel expenses. Provide generous compensation, bonus opportunities, disability, health insurance benefits, malpractice coverage and flexible scheduling. Looking for a podiatrist with excellent skills, able to provide expert and compassionate care to patients. Email CV to: careers@aggeus.org or call 773-770-0140 x300/x305. www.aggeus.org

ASSOCIATE POSITION - OH

Join a well-established modern practice in Dayton, Ohio. Excellent reputation and referral base. Base salary $120,000, benefits and bonus structure. EMR, diagnostic ultrasound, Padnet vascular studies, CO2 lasers, all aspects of DME. We seek a surgeon that is well-trained and personable to join our group of 4 podiatric surgeons. Would like to have this individual buy in to the practice eventually. Please send CV and to Ohiodoctors@aol.com

ASSOCIATE POSITION - CALIFORNIA

Office and hospital-based podiatry group in Bakersfield, CA seeks highly-trained surgical associate to join us. Prefer surgeon with trauma and Charcot reconstructive experience. Staff privileges with 5 local hospitals. Offering health insurance, CME allowance and competitive salary. Must be PSR 24/36 trained, ethical and thoughtful when treating patients. Please forward CV to: aghams2@aol.com

ASSOCIATE POSITION - BEAUTIFUL LONG ISLAND

Business-oriented, mature Board eligible/certified podiatrist who is not just looking for a job, but a secure future. Buy-out of practice will be available. Practice does in excess of $500K. 2 hospitals available. No nursing homes, no Medicaid. Competitive package. Please fax CV to 631-581-0857.

ASSOCIATE POSITION - NEW JERSEY

Immediate opening for a full-time podiatrist in a rapidly expanding multi-office practice in central New Jersey. Well established referral base with full admitting hospital privileges. Availability to become part owner of a multi-room, multi-specialty ASC. Excellent opportunity for the right doctor with potential to achieve $200K in the first year. Wonderful working conditions. Applicant must have at least PSR-24 surgical training. Valid NJ license and Medicare number is required. Applicant should also be familiar and competent in biomechanics, trauma, ESWT, PRP, wound care, and ultrasound diagnostics. Participating insurance #'s a plus. Please fax resume to:(609) 259-6637.

ASSOCIATE POSITION - ILLINOIS

Full and Part-time opportunity to provide conservative, ethical podiatric care to residents in long-term care throughout Illinois . Full time position includes health, disability, 401, auto/travel expenses. Ideal Full-time candidate would be willing to travel 2-3 days per month, or be located in central or downstate IL. We have a 30 year history of providing exceptional care and service, with appropriate reimbursement. Please email queries or resumes to: gh@podiatryplus.net.

ASSOCIATE POSITION - CALIFORNIA

We are hiring podiatrists for part-time positions in California: San Francisco, San Diego, San Jose. Duties: Diagnosis and treatment of Onycomycosis using Pinpointe laser in our facilities (training at the clinic); flexible schedule. Qualifications: Valid DPM California license; active medical liability insurance. email CV to: ofer@lasernailtherapy.com

ASSOCIATE POSITION - WORCESTER MASSACHUSETTS

Podiatry practice in Worcester Massachusetts is looking for an associate podiatrist. Busy 2-person practice. High surgical numbers. No nursing homes. Call to hear free recorded message for more information. Call 641.715.3800 Access Code 32299 and message 4 to learn about the practice. Visit our website www.centralmasspodiatry.com

ASSOCIATE POSITION - KANSAS CITY, MISSOURI

Kansas City may be the perfect move for you and your family. I am looking for an entrepreneurial minded associate who wants to grow and then own part of an already successful practice. If you are the right candidate for this associate position, you will enjoy a competitive compensation package and you will be working with a doctor who is as committed to your success as he is to his own. Go to:www.YourFutureInPodiatry.com for full details.

ASSOCIATE POSITION - FLORIDA

Looking to hire an associate who is caring, friendly, and holds a patient in the highest regard. I am a single practitioner with a large podiatry practice in Tampa, FL. Will provide an outstanding salary with additional incentives, excellent healthcare benefits, retirement and cell phone. Please email resume toHeliodiety@aol.com or fax to 813-854-6105.

Very busy, two location group practice seeking a full-time, self motivated and hard working podiatry associate. Competitive salary and benefits are offered. Please email CV to: footcare4all@aol.com

ASSOCIATE POSITION - NORTHWEST IOWA

A well-established, midwest multi-physician practice with strong hospital affiliations seeking FT podiatrist. Applicant should be well trained surgical physician, completed a 24-36 month residency, & board eligible. Practice offers high surgical volume, advanced wound care and good mix of general podiatry. Competitive salary, excellent benefits. Fax resume: 712-258-9977

EQUIPMENT FOR SALE

Retiring from practice. Equipment For sale. Mini x-ray. One year old Ultrasound with MS arterial/venous X-ray plates. Great condition Ritter chairs. Drills, surgical tools. So much. Just ask, I probably have it Footcare@comcast.net

EQUIPMENT FOR SALE: EPAT 

(Extracorporeal Pulse Activation Treatment) for sale. D-Actor 200. This machine is still new. Purchased in late 2011.( new machines>30K). It is the conservative alternative to surgery. Treats Plantar Fasciitis, Heel spurs, Achilles Tendonitis, Joint pain. Great Buy. $19,995. Please call 713-541-3199 for more information. or email contactus@houstonfootankle.com

PM News Classified Ads Reach over 13,500 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 13,500 DPM's. Write to bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $115 for a 50-word ad. 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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