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May 28, 2008 #3,257 Editor-Barry Block, DPM, JD

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Daniel Joseph McCarthy, Jr., D.P.M., Ph.D

Daniel Joseph McCarthy, Jr., 78, passed away Saturday morning, May 24, 2004 at the Hospice Care Center in Akron, Ohio. He graduated with a Doctor of Podiatric Medicine from The Ohio College of Podiatric Medicine in 1951 and maintained podiatric practices in Elkart, IN and Manistee and Bay City, MI, from 1951 to 1973.

Dr. Daniel J. McCarthy, Jr

During that time, McCarthy earned three more degrees: Master of Arts in Biology (Indiana University), Master of Christian Education (Grace Theological Seminary), and a Ph.D. in Biology from the University of Windsor, Canada. He taught at The Illinois College of Podiatric Medicine and The Pennsylvania College of Podiatric Medicine from 1976 to 1980.

A winner of numerous awards in medical research, Daniel was an internationally renowned scholar in podiatric dermatology. He served as President of The American Podiatric Dermatological Association for many years. He was named “Podiatric Practitioner of the Year” by The American Podiatric Association and later headed a Podiatric Section for the Baltimore Veteran’s Administration Hospital where he trained many Podiatric Interns and Externs.

PM News policy is to request that memorial donations be made to the APMA Education Foundation Student Scholarship Program, 9312 Old Georgetown Rd. Bethesda, MD 20814.

NH Podiatrist Keynotes at Australian Podiatry Association Meeting

Howard Dananberg, DPM presented the Keynote Address, "A 25 Year Prospective on Sagittal Plane Theory" at the Annual meeting of the Australian Podiatry Association, NSW, in Sydney, held between May 14-16, 2008. Dananberg's lecture was a discourse on the history of Sagittal Plane Theory starting with the revelations visible via the initial in-shoe pressure measurement device, the EDG. He described how these findings led to the understanding of how gait style and chronic lower back pain are related.

Gary Donnelson, Executive Director of the APodA (L), Jenny McConnell, and Dr. Howard Danenberg

"In our 1999 JAPMA article, there was only a 16% recurrence of lower back pain episodes in the study subjects using foot orthotics", stated Dananberg, "and this can go a very long way to relieving the dollar strain on the healthcare systems of the world, as the known back pain recurrence rate is 71%." "Ending the treadmill cycle of these patients can be a major contribution that podiatry provides to the entire healthcare system" he continued.

As founding member of the Vasyli Biomechanics Think Tank, Dananberg, along with Jenny McConnell (the physiotherapist who developed the world famous, McConnell knee taping technique), David Armstrong, DPM, Trevor Prior, a UK podiatrist, and Bill Vicenzino, a professor in sports physiotherapy at the University of Queensland, in Australia, are committed to developing concepts to further improve biomechanically-based treatment methods.

IA Podiatrist Survives Deadly Tornado

When Chris Considine and his family ventured upstairs from the concrete cellar of their rural New Hartford home, the tree blossoms fluttering on the carpeting were the first clues that the damage was severe. Considine said he looked outside and saw that his neighbors’ house was flattened. But his neighbors were standing on the cement slab. “They were devastated, but they were all there,” said Considine, a Waterloo podiatrist and married father of three.

Dr. Chris Considine

Cell phones weren’t working, so the neighbors waited for rescue workers to come down 325th Street. It took about an hour because the rescuers had to cut through downed trees. “I was just feeling that I wished (the neighbors) had come to our house,” he said. “I guess planning ahead for stuff like that would be better, but obviously, nobody had time to prepare for it. I just wish we would’ve called them to come over to our house.”

Chris and Susan Considine didn’t have a flashlight, so they held the children in their laps as the tornado ravaged the floors above them. The air pressure caused their ears to pop; they couldn’t hear each others’ voices, Considine said. The power blinked off. When the winds died down, the family emerged to find the roof over their kitchen caved in. Windows were broken. The entire east side of the house had disappeared. Both of their cars were totaled. Thirty mature evergreens and a 100-year-old blue spruce had been ripped out of the ground. Considine said he heard his neighbor, the woman he stayed with until emergency crews arrived, later died at a nearby hospital.

Source: Jennifer Jacobs, Des Moines Register [5/26/08]

How To Respond to an Awkward Question

When someone asks you an awkward question, offer a question of your own answer such as: “That’s an interesting question. Why do you ask?” or “I have never been asked that before. What do most people say?”

Reason: You gain time. And you may push your questioners to reveal exactly what they want to know—and why.

Source: Adapted from Shawna Shuh, “Get Out of the Hot Seat!”

Query: Multiple Joint Fusions - One Toe

If I perform a digital fusion on both the proximal interphalangeal joint and the distal interphalangeal joint of the same toe for chronic arthritic changes and subluxations to those joints, what would be the proper CPT coding? Can I bill CPT 28285 twice?

Robert Lee, DPM, Los Angeles, CA

Response: CPT 28285 is the correct CPT code to use for interphalangeal joint fusions. It is billed once per toe, not once per joint, so you can only bill it once.

Mark Schilansky, DPM, Catskilll, NY

Codingline subscription information can be found by clicking here

RE: Skin Lighteners (Chuck Langman, DPM)
From: Mathew M. John, DPM

I prescribe hydroquinone 4% cream bid-tid for at least 3 months. It also comes in a gel form. There are brand names out there but the generic has been around for years. Most insurance companies will not cover hydroquinone though because they consider it as cosmetic.

Mathew M. John, DPM, Marietta, GA, footdoc@afcenters.com

RE: Conflicts of Interest
From: Irv Kanat, DPM

The 2007 House of Delegates of APMA adopted Resolution Number 11, which had been submitted by no less than 29 state societies. The subject was “ETHICS PRESENTATIONS.” The Resolution outlined the importance of increasing the amount of information and direction that appropriately and ideally should be provided to members of the profession at every opportunity. The Resolution stated, in part -

”RESOLVED that the Annual Scientific Meeting of APMA, officially designated regions of APMA, component societies and their divisions, APMA affiliated and related organizations, and other podiatric educational seminars, be encouraged to include at least one (1) continuing medical education (CME) credit annually on the subject of “Ethics in the Delivery of Health Care Services,” based on the APMA Code of Ethics.”

Further, APMA is directed to report annually to the House of Delegates the results of a National Annual Survey of the presentations that are provided as a result of this Resolution. As a result, APMA continues to gather those statistics and report its findings every year, as it did in 2008.

Hopefully, those entrusted with the development of podiatry meetings all across the country will be reminded of the importance of this concept,and will assure that this most timely and important suggestion is taken into consideration during all future meeting planning sessions.

Irv Kanat, DPM, West Bloomfield, MI, ikanat@maxai.com

RE: Conflicts of Interest (Barry Mullen, DPM, Michael M. Rosenblatt, DPM)
From: Multiple Respondents

Although I do not usually respond to folks who comment about my writings here, there is an important teaching point that needs to be made. With all due respect to Dr. Mullen, whom I respect as an ethical and moral doctor, the mere fact that treatment is appropriate, medically necessary and in the patient's best interest DOES NOT resolve the conflict of interest inherent in referrals to self-owned surgical facilites. All three of those requirements should be answered in the affirmative before a surgeon recommends ANY treatment, no matter where it is to be done.

Dr. Rosenblatt got it absolutely correct. He gets a gold star. The key to a knowing waiver (by the patient) of the conflict is (a) disclosure of the interest and (b) the offering of an alternative venue (or perhaps alternaive modality) for the treatment. The conflict inherent in the owned surgical facility is one which can be knowingly waived by the patient, but only after after full disclosure.

Finally, I must say I find it interesting that no one wanted to discuss my comments about the conflict inherent in covenants not to compete.

Richard W. Boone, Sr., Fairfax, VA, RWBoone@aol.com

Editor's note: Extended length letters by Dr. Oloff and Kalker appear at: http://www.podiatrym.com/letters2.cfm?id=19809&start=1

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