The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

May 30, 2011 #4,173 Publisher-Barry Block, DPM, JD

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Funding Cuts Leading to Amputations: BC Podiatrist

A Vancouver podiatrist says provincial healthcare cuts are to blame for two amputations her patients have undergone over the past year, and she is calling on the government to restore funding. Dr. Tammy Gracen says when the province stopped funding orthopedic shoes and orthotics for cases where amputation wasn't deemed a risk in March of 2010, she had to switch from helping patients in pain, to leaving them in pain because they can't afford proper treatment. 

Dr. Tammy Gracen

Since then, she has had one patient lose a toe, another had three amputations, with the last, below the knee, Gracen said on Friday morning at her Vancouver office. She believes the amputations would have been preventable if treated earlier with preventative measures, but by the time orthopedic shoes were approved, it was too late.

Source: CBC News [5/26/11]

OR Podiatrist is Pioneer in Forensic Podiatry

Pioneers in the field of forensic podiatry are helping law enforcement track criminals using the trail they leave behind, even as they flee the scene of a crime. Bandon podiatrist Dr. John DiMaggio is one such leader in forensic podiatry. He is co-author of the first book-length work on the subject and a founding member of the American Society of Forensic Podiatrists. 

Dr. John DiMaggio

Forensic Podiatry Principles and Methods, published this year by Humana Press, offers a detailed look at the standards established to date by the best forensic podiatrists here in the United States and abroad. For DiMaggio, the publication lends credibility to the emerging forensic field and provides a text book for podiatrists now studying and practicing medicine.

Source: Geneva Miller, Bandon Western World [5/26/11]

SALSA Garners $2M to Fight Diabetic Amputation by Playing Video Games and Wearing Smart Sox

Two separate $1.1 million research grants awarded this week will help the University of Arizona Department of Surgery's Southern Arizona Limb Salvage Alliance (SALSA) continue their battle against diabetes-related amputations. The two proposals are characteristic of the "simplicity in technology" approach for which SALSA and its collaborative teams at Scholl's Center for Lower Extremity Ambulatory Research (CLEAR) and the Hamad Research Unit in Doha, Qatar, have become known. One proposal uses a "game-based" approach to allow patients to use sophisticated video game-style therapies to play their way to improved balance, reduced falls, and reduced risk for complications. As Dr. David Armstrong puts it, "It's like a Nintendo Wii for Diabetes-- Wii Feet, rather than Wii Fit, if you will." 

(L-R) Drs. Joseph Mills and David Armstrong

The other project uses state-of-the-art "smartsox", wearable technology that can use microscopic woven fiber optic sensors to predict skin breakdown and warn the patient and caregivers well in advance.The two studies, both funded on the same day, were funded by the Qatar National Research Foundation (QNRF) and will be conducted over the coming four years.

NY Podiatrist Sentenced to 6 Months Jail For Medicare Fraud

A podiatrist who filed phony claims for reimbursement to cheat healthcare insurance providers was sentenced to six months in federal prison Thursday by U. S. District Judge Richard J. Arcara. Dr. William Holley, 48, of Buffalo, also was ordered to pay $36,868 to victims. He pleaded guilty in January to theft in connection with healthcare. Holley submitted false claims to Medicare and Univera, prosecutors said.

He initially was charged with 28 counts of health fraud and was allowed to plead guilty to one count. His attorney said Holley is an ordained minister who is devoted to helping poor people with foot problems.

Source: Buffalo News [5/27/11]

Eliminate Interruptions

If you will need more than a minute or two to act on or respond to a phone or e-mail message, add it to your to-do list instead of dropping everything to respond to it immediately.

Source: Adapted from “Minimizing Distractions,” Mind Tools, via Communication Briefings

Query: Rem Jackson's Top Practices

I was wondering if many people out there have had experience with Rem Jackson's "Top Practices" seminar or his group in general. Has it been helpful and worthwhile?

Stephen Pirotta, DPM, Bentonville, AR

RE: Touch Screen Notebook  (Laura R Lefkowitz, DPM)
From: Benjamin Elgamil

Unfortunately, there is not a wide selection of 12"+ screen size tablet PCs. My biggest advice is not to skimp on the essential features to save money. Look for PCs with an Intel Core 2 Duo, i3, or i5 processor with at least 2GB of RAM. I recommend researching the Fujitsu Lifebook T900 or T901 (13.3" screen).

Benjamin Elgamil (TUSPM '13) Baltimore, MD, belgamil@gmail.com

RE: SC Medicaid Elimination of Podiatry Services (Robert Bijak, DPM)
From: Lee C. Rogers, DPM, Jeffrey Kass, DPM

I feel badly that Dr. Bijak has lived with the "embarrassment" of having the "tarnished DPM degree." I, on the other hand, am proud to be a DPM and joined "mainstream medicine" when I graduated.

Lee C. Rogers, DPM, Los Angeles, CA, lee.c.rogers@gmail.com

I am a little perplexed with Dr. Bijak's comment that "podiatry's redundancy was ascertained" - I was wondering if he could expound on that. If there is a degree change and podiatry is "mainstream", would not the redundancy he speaks of still be present? So, instead of a redundant podiatric DPM, there would be a redundant podiatric MD.

When I first graduated, I always questioned why there was podiatry? We overlap with many disciplines. If there is a problem on the skin of the foot - you can see a dermatologist. If there is a broken bone, you can see an orthopedist. If there is a problem with circulation, you got to the vascular doctor. My opinion has changed over the years. I can honestly say, we know feet, and we know feet better than most.

Jeffrey Kass, DPM, Forest Hills, NY, Jeffckass@aol.com

RE: EHR Certification Charges (Richard A. Simmons, DPM)
From: Marc Garfield, DPM

The problem with Dr. Simmons' approach is that it is unlikely to meet the government definition of “Meaningful Use.” Therefore, you would not be eligible for stimulus funding. Unless, from within Practice Fusion, you open the note, enter the vitals, write the prescriptions, import the labs as structured data via an HL7-compatible interface, track tobacco usage, create a visit summary within 48 hours of the patient visit, etc. Then create, cut and paste your CC, HPI, exam and plan from Medinotes back into Practice Fusion.

In order to substantiate your attestation, all of the required MU criteria need to be...

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

RE: Is Surgical Follow-Up Payable? (Ron Werter, DPM, Bruce Block, DPM)
From: Jeffrey Kass, DPM

While Dr. Block offers Dr. Werter sound advice, the question was not directly answered. Dr. Werter did not mention which insurance company he had this problem with and so I don't know their particular policy. If you feel you did nothing wrong outside of the policy - I would fight the claim. Take them to task. More on more, it seems, insurance companies deny procedures or visits on a "whim." Out of nowhere - there is policy change, certain procedures all of a sudden needed prior authorization. Unfortunately, dealing with insurance companies has become a game. They decide that they want to make more money, so it becomes easy to change a policy and catch someone off guard.

In my opinion, if they denied you on the surgery, I see no problem with your billing for post-op visits. I still would fight them on the surgery if there are no clear guidelines anywhere. I do think it is prudent, however, in the future, when doing any surgery, or DME to ALWAYS pre-certify. It's a terrible feeling when you devote time, energy, and money, and then get screwed.

Jeffrey Kass, DPM, Forest Hills, NY, jeffckass@aol.com

RE: Inflationary Feet

A patient presented in my office with swollen feet. I asked her how long her feet have been like this. She told me that her feet "inflated” about one month ago. 

J E Schiller, DPM, Euclid, OH

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 - 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 - NORTHERN NJ

Well established, part-time practice is for sale in Northern NJ. Digital X-rays, EMR, located in a medical condo building. Surgery 35%, Routine 30%, Average Gross is 130K on 2 half days per week. Practice is expandable to full time with increasing hours and marketing. Real estate available for purchase. Financing available. Please call 800-983-4194, or email contactus@podiatrypracticeconsultants.com

PRACTICE FOR SALE - BROOKLYN, NY

A large, busy practice is for sale in Brooklyn, NY. This practice has been in the same location for over 50 years. Average 150 pts/week, average gross 730K, most surgery is currently being referred out. Financing available. Please call 800-983-4194, or email contactus@podiatrypracticeconsultants.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

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 - CANADA

Beautiful Victoria, B.C. Canada on the ocean, fast growing area. Associate for multi-office full scope practice. Reply to dr.cole@shaw.ca

ASSOCIATE POSITION - SOUTHERN NEW JERSEY

Seeking personable, ethical, motivated individual for a growing, well-rounded practice with potential for partnership. Must be PSR 24-36 trained. Competitive salary, incentive and benefits. Email CV to orin915@comcast.net

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 - 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

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 - 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 - CENTRAL NORTH CAROLINA

Well-established, busy podiatric practice is seeking highly motivated, well-trained and personable associate for full-time position. Competitive Salary and Benefits, Buy-in Opportunity. Interested persons must be actively pursuing or have NC license. Send resume and letter of intent to gpagpa530@yahoo.com

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

Southern California practice looking for highly motivated podiatrist for very busy, two location practice. Excellent salary and benefits offered. Please email resume to mrsmcmackin@aol.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 POSITION – NEW YORK

Well-established, multi-doctor podiatry practice with offices in Putnam and Westchester counties. Compensation based on productivity. Excellent opportunity for recent residency graduate to build skills and learn practice management. Full-time preferred but right part-time candidate will be considered. Email cover letter and CV to: Podiatry2011@gmail.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

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

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