May 29, 2006 #2,592 Editor-Barry Block, DPM, JD

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Exercise Requires Appropriate Footwear: CA DPM

Avoid any exercise done wearing the wrong shoes. Even if you're doing everything else right, your efforts can be undermined by improper footwear, warns Jodai Saremi, DPM, a podiatrist and editorial staff member of the Aerobic and Fitness Association of America's American Fitness magazine.. Working out with the wrong shoes increases pounding on the joints, and can lead to injuries like plantar fasciitis or tendinitis, she says.

The key, experts say, is to choose a shoe that is specific to your activity and that suits your particular foot. They recommend shopping at stores specializing in athletic shoes, where you can seek advice from a knowledgeable salesperson. And don't forget to replace your shoes when they show signs of wear.

Source: Barbara Russi Sarnataro, WebMD Weight Loss Clinic

Most Insurance Claims Now Submitted Electronically

The proportion of claims submitted electronically to health insurers more than tripled over the past decade, cutting costs and speeding up payments to providers, according to a study by America's Health Insurance Plans. The study found that 75% of all health insurance claims are now submitted electronically, up from 44% in 2002 and 24% in 1995. According to the study, it costs insurers an average of 85 cents to process a "clean" electronic claim, compared with $1.58 for a paper claim.

As a result, the shift to electronic submission saves consumers several billion dollars a year, AHIP President and Chief Executive Officer Karen Ignagni said. The study was based on 25 million claims processed by 26 insurers of various sizes nationwide. It also found that insurers process 98% of clean claims within 30 days of receipt and 57% with seven days.

Source: Laura B. Benko, Modern Healthcare [5/26/06]

Query: EMR Vendors

We are planning to convert to EMR. Has anyone had any experience with Medinotes-e or vendors named Medipro, Cerner, or Microwize? Other EMR's or vendor suggestions are appreciated.

Howard Bonenberger, DPM, Nashua, NH, mailto:HOWARDBON@aol.com

Tattooing Of Nail Bed (Paul R. Shonka, DPM)
From: Elliot Udell, DPM

I can't comment on whether there are any contraindications but can you imagine what would happen if tattooing nail beds catches on? We would be inundated with patients requesting total nail removals of normal nails so that they can tattoo their nail beds. This would create an ethical dilemma.

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

RE: EMR (Fred Fischer)
From: Gary Friend, DPM , J. Kevin Hardison, DPM

There may be good reasons to choose hard wiring over wireless when adopting EMR, but igital imaging is not one of them. Our group practice evaluates x-rays and shows them to atients on wireless laptops. We use the Reina digital x-ray system which works well in a ireless environment.

Gary Friend, DPM, Glenview, IL, drfriend@nspodiatry.com

With all due respect to Mr. Fischer, a properly configured wireless system can perform quite well with digital x-rays. I have used the ScanX system with a wireless tablet PC for 8 months without a single issue. Not to mention the "wow factor" when you hand the patient a tablet PC to view their x-rays.

When the network is configured, you must confirm that signal strength in all areas is "excellent." This may require additional access points. And you will need a powerful tablet PC (preferably a convertible) with at least 1gB of RAM. With this setup, the tablet only requires an additional 1 to 1.5 seconds to access x-rays.

Of course, the drawbacks of a hard-wired system include the added hardware costs. However, the network setup costs alone can be quite excessive if your office is not pre-wired. Also, what if one of the hard-wired PC's in the treatment rooms goes down? I have a less expensive wireless notebook available as a back up in case I have an issue with the tablet. Therefore, there is no down time in any treatment room.

Additionally, because of HIPAA concerns you will need to lock your workstation every time you leave the room and then unlock again once you return. Also, it is also recommended that you install the computer so it faces away from the patient. This can cause major headaches with space layout.

Lastly but most importantly, a fully integrated system is imperative. You will never know what you are missing until you experience full integration. Once you do, you would never consider an interfaced system. Along with Dr. Blake, I chose eClincalWorks. Everyone in the office is extremely satisfied with the decision. How often do you hear doctors say they are extremely satisfied with their EMR decision?

J. Kevin Hardison, DPM, Charlotte, NC,

khardison@archpodiatry.com

RE: Apology/Retraction DMEPOS Competitive Acquisition Program
From: William W. Godfrey DPM

With regards to my recent voiced opinion posted on the issue of potential future 'single sourcing DME for Medicare regions: My statements were misinformed and incorrect; therefore I must retract them. Indeed, upon further research, in the arena of DME for Army medicine, it turns out that we as users and recipients in the Army medical supply chain are in fact saving millions through the use of single source providers of DME.

In addition, my comparison or analogy was faulty; in fact, I jumped to conclusions based on having too few facts and worse- incorrect examples. Moreover, these statements I made were my own personal opinion, albeit now I know to be misinformed (or rather un-informed); and furthermore, these were not the statements nor position of the US Army, nor was I speaking as a representative of it."

In sum, I apologize for misleading & incorrect evidences advanced in the logic of my hasty argument. Therefore, despite my own personal concerns about such a program for the civilian sector, it seems that the reality is that it does in fact work exceedingly well in the arena of Army medicine. Bottom line: It was my mistake and I retract my faulty statements made in my argument; I have learned that this was not a valid comparison or analogy. It was written in haste when I broke my own rule to fully to check the facts and also finally in poor judgment when I mistakenly misrepresented.

William W. Godfrey, DPM, Fort Polk (Leesville), LA,
williamtrekkie@earthlink.net

ASSOCIATE WANTED - MINNESOTA – MINNEAPOLIS SUBURB

Busy, well-established, full-scope podiatry practice, seeking highly motivated podiatrist for a full-time position with buy-in opportunity. Looking for PSR 24/36 trained individual, to help increase surgical volume. Excellent opportunity for long-term growth with unlimited income potential. E-mail CV to employment@associatedpodiatrists.com or fax to (612) 866-5875 Attn. Jennifer.

1st YEAR RESIDENT SLOT AVAILABLE - CALIFORNIA

Sherman Oaks Hospital, in Sherman Oaks CA, has a (PM&S-24 I 1st. year) program available, beginning 7/1/06. Our program offers the Residents a wide variety of cases from ankle fractures, subtalar joint, fusions, & tendon transfers as well as all other podiatric forefoot & rearfoot cases, with very impressive procedure activity numbers at a "C" level. The Residents meet & exceed the requirements for surgical case loads, usually by the first 6 months. Residents will also see an average of 250 to 300 wound patients per month.

The stipend for the 1st year Resident is Thirty Thousand dollars ($30,000) and 2nd year Resident; Thirty- Four Thousand dollars ($34,000). For more information please call Dr. Boghossian at (818) 905-2222 or e-mail him at gbogi@sbcglobal.net

PRACTICE FOR SALE – ARKANSAS

Thriving Ozark Mountains practice in prime retirement area seeks to sell on long term note. Two locations: Mountain Home and satellite office in Harrison, Arkansas, both with established patient base with full range of services and nursing homes available. Hospital privileges. Wonderful Staff. Fully equipped. Priced to sell. (870) 425-1466 orchristinag@centurytel.net

POSITION WANTED - NEW YORK

Non surgical podiatrist with 20 years experience is seeking practice opportunity 1-2 days/wk. ABPOPPM board certified, own malpractice insurance, many insurance plans. Please call (516) 557-6862 or e-mail Joelme@aol.com.

ASSOCIATE POSITION- NEW ENGLAND

Terrific Opportunity Now Available in growing New England practice. Well established and respected practice with new, large office space, latest technology, very helpful staff, loyal patients and solid referral base. Close proximity to hospitals with modern surgical suites. Opportunity for shared ownership. Prefer 24 month PSR with clinical practice experience or an experienced doctor looking to improve their situation. E-mail CV and particulars to NEAFC3@aol.com

EQUIPMENT FOR SALE - ESWT

If you are using or thinking of using ESWT, I have a new machine that has only been used twice. There is no Orbasone in the country priced like this one. Will provide training and installation. Take a look at http://www.orbasone.com Call 1-856-229-2939.

ASSOCIATE WANTED - NORTH CAROLINA

Growing practice in beautiful western North Carolina seeking qualified DPM. Great mix of office and surgery center care. Must have NC license and ABPS qualified/certified. Send cover letter and CV to dpmcareer@aol.com

POSITON AVAILABLE - WASHINGTON, DC

The George Washington University Medical Faculty Associates, a large multi-specialty practice affiliated with a teaching hospital, is seeking a full-time podiatrist. The practice has a diverse population encompassing inpatient and outpatient surgery, as well as a thriving outpatient clinical practice. Must be board certified/board eligible and have experience in diabetic limb salvage. Send CV to cdugan@mfa.gwu.edu or fax to (202) 741-2241.

ESWT MACHINE FOR SALE

I have a DolorClast shockwave machine for sale 60% of cost, call 416-545-1166 or mailto:dracula65@hotmail.com Thank you

PRACTICE FOR SALE - NEW YORK

FOR SALE - Rockland County. Well established, high-volume practice, general and surgical. Gross $500K, hospital privileges; excellent lease. All interested parties reply to: metroNYCpodiatry@aim.com

SURGICAL INSTRUMENTS FOR SALE

Complete Surgical Instruments, Hundreds; Stryker Power Set Electric motor; Reciprocating & Oscillating saw, Roto-osteotomes, also two major bone sets including DePuy osteotomes, several soft tissue sets, etc. Office instruments also. Call for exact items. Art Korbel DPM, (MD) 954 753 7621

ASSOCIATE WANTED - NEW YORK

Associate Wanted - Rockland County, Rockland County. Associate with minimum 5 years experience, high volume established general practice. Reply with CV to nypodiatry111@aim.com

ASSOCIATE POSITION RICHMOND, VIRGINIA AREA

Partnership possible after two years. Two office practice. Palliation; biomechanics/orthotics; woundcare; office/hospital surgery. Must have Virginia license. Associate will do most of the practice’s surgery. PSR24/36/Board qualified/certified in surgery preferred. Available SAP. Send CV to: Dr. Marc Jay Pinsky; 9550 Midlothian Turnpike; Suite 104; Richmond, VA 23235; mjpinsky@juno.com.; FAX: 804-320-6627.

ASSOCIATE POSITON – TAMPA BAY, FL AREA

Two associate positions presently open with a large podiatry group in the Tampa Bay area. Salary and benefits are commensurate with applicant’s qualifications. This is an excellent opportunity for a new practitioner to join a strong, existing group with extensive hospital affiliations and referral patterns. Two-year residency and FL license preferred. zachander@aol.com Fax 813-286-0200 Ph 813-334-2077

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