The Voice of Podiatrists

Serving Over 14,000 Podiatrists Daily

June 01, 2013 #4,785 Publisher-Barry Block, DPM, JD

A partner of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2013- No part of PM News can be reproduced without the
written permission of Barry Block

NJ Podiatrist Receives APMA Meritorious Service Award

Hal Ornstein, DPM was presented with the Meritorious Service Award (MSA) at the Region III APMA meeting held earlier this month in Atlantic City, NJ. The MSA is awarded to members in good standing in recognition of their exceptional accomplishments on the local, state, or regional level in scientific, professional, or civic endeavors that have had a profound impact on podiatric medicine.

(L-R) APMA President Dr. Matthew Garoufalis presents NSC to Dr. Hal Ornstein (Photo: Chad Schwartz)

Dr. Ornstein is actively involved in community service and non-profit organizations both locally and nationwide. He and his team at Affiliated Foot and Ankle Center, LLP are ongoing supporters for the Howell Food Pantry, and he is founder of the De-Feet Childhood Hunger (DFCH) movement which is a national coalition of podiatric medical offices and podiatry students who are dedicated to ending childhood hunger across America.

Source: Gina Columbus, Asbury Park Press [5/30/13]

This is the last day to vote!

Quick Poll
What do you do after discovering that staff delays patient appointments?
Click HERE for Results

ADA President Delivers Keynote Address at NYCPM Graduation

John E. Anderson, MD, President, Medicine and Science, of the American Diabetes Association, delivered the keynote address to the graduating class of the New York College of Podiatric Medicine (NYCPM) and received the honorary degree of Doctor of Humane Letters-Honoris Causa, during the College’s 2013 Commencement Ceremony at Lincoln Center’s Alice Tully Hall in New York City on Wednesday, May 29th.  

NYCPM President & CEO Louis L. Levine awards the College’s medallion to Dr. John E. Anderson, MD as Michael J. Trepal, DPM, NYCPM VP for Academic Affairs & Dean, looks on.

The college also presented a Doctorate in Sciences to Abraham “Abe” Lavi, MBA, PhD, founder of Vilex, Inc., a manufacturer of medical devices for the upper and lower extremities. In 2006, the New York College of Podiatric Medicine awarded him an Honorary Doctorate of Humane Letters.

IL  Podiatrist Makes His Own Orthotics

Dr. Frank Bongiovanni started making orthopedic shoes when he was just six years old. His father, Tony, who had worked at the Dr. Scholl shoe factory, had his own custom orthopedic shoe business, and set out to teach his son everything he knew. “I liked the art of hand crafting a device specifically for a patient,” said Bongiovanni, who far surpassed his dad’s expectations when he became a Doctor of Podiatric Medicine, a Certified Pedorthist, and the maker of his own custom orthotics. “I liked how my dad changed people’s lives and put them in shoes that allowed them to live better, quality lives.”

Dr. Frank Bongiovanni (Photo: Jackie Pilossoph)

“Most doctors will mail out orthotics to an outside manufacturer who has never seen your feet,” said Bongiovanni, who graduated from the Ohio College of Podiatric Medicine, and who holds a second degree from the Scholl College of Podiatric Medicine. He is also a professor at the Scholl College of Podiatric Medicine.

Source: Jackie Pilossoph, Chicago Sun-Times [5/28/13]

GPMA Holds Master Wound Care Course

On May 4th, 2013 Drs. Bob Coleman, Wes Daniel, Paul Kanter, and John Land successfully completed level-one of the Georgia Podiatric Medical Association’s Master Wound Care Course, while Drs. Eileen Bernard,  Reginald Richardson, John Wright, Mr. Garrett Hendrix, and Mr. James Hill completed level-two. This five-level wound care course is provided in two-day segments per level. The course is directed by the renowned wound care specialist, Wm. Barry Turner, BSN, DPM, CWS, FAPCWA.

Attendees at GPMA Master Wound Course

These attendees have taken it as a personal challenge to improve wound healing and decrease amputations - by extension- improving the quality of life for their patients. The course presented evidence-based research and accurate information from wound care specialists who use it in their practices. The course has both lectures and hands-on labs. The GPMA Masters Wound Care Course is offered in January, May, and August of each year.

Query: Diabetic with Hemorrhagic Keratosis

I have a 41 year old active athletic male diabetic patient with hemorrhagic keratosis under the IP joints of both halluces. These were neuropathic ulcerations that took over a year to heal. They require debridement every two weeks to prevent re-ulceration. There are no visible IP sesamoids present. Surprisingly, the range of motion at both MPJs is excellent/unrestricted.

Hemorrhagic Keratosis

I am considering resections of the heads of the proximal phalanges. I am looking for comments from those who have experience with this, concerning whether patients' lesions resolved and the stability of the toes.

Query: Fasciotomy and Surgical Tenotomy?

I have a coding question regarding the Tenex ultrasonic tendon and fascial debridement device. The company rep states that the ultrasonic-guided debridement instrument removes only ''diseased'' tissue and said you would bill either CPT 28008 (fasciotomy, foot and/or toe) or CPT 27605 (tenotomy, percutaneous, Achilles tendon [separate procedure]; local anesthesia), whichever is appropriate. I would like to know if these are the correct codes. Should I be adding a "-22" modifier?

David Mader DPM, Naugatuck, CT
 
Response:  You have been misled about the coding. Use of the Tenex instrumentation may very well debride a tendon, and encourage revascularization, but to use codes that suggest or imply that this represents fasciotomy (CPT 28008) or tenotomy (CPT 27605), in my opinion, is grossly misleading. I recommend that you bill the procedure using an unlisted code.

NOTE: I am NOT disputing the effectiveness of the procedure or technology; merely the applicable CPT coding.

Rick Horsman, DPM, Olympia, WA

Codingline subscription information can be found here

APMA Members: Click here for your free Codingline Silver subscription

RE: Medicare Calling Patients

I have had two patients come into my office for follow-up visits and tell me that they had been called by someone from Medicare inquiring why these people see me and how they feel about my "work." One patient was asked why he continues to see me. Both patients described the questions insinuated that Medicare was searching for something and not supportive of me being their physician. The patients did not state Medicare spoke badly about me - it was just the tone of the questions were almost insinuating of something not quite right in regard to my practice/abilities.
 
I suppose the old accepted respect that was once provided to physician-patient relationships is a thing of the past. I am anxious to know how many of my peers are having similar conversations with their patients and how the rest of my peers feel about this intrusion into the physician-patient relationship.

Name Withheld (GA)

RE: Billing Service Fees
From: Cynthia Ferrelli, DPM, Joe DeTrano, CPC

I do not think a medical billing company should be taking a percentage of your gross. If they are not billing for items sold from your office, why would they get a percentage of that money? I have a billing company who charges me 6.5%, but that is only on what they bill/collect. In order to keep more of the money that I earn, my office staff does the billing for the high ticket items like orthotics and surgeries. If your billing company insists on collecting the way they have been from you, I would find another one.

Cynthia Ferrelli, DPM, Buffalo, NY, sm330ile@yahoo.com

There really is no "industry standard" in regard to what a billing service charges a doctor for their work; a firm can charge any percentage or fee they want, and can bill co-pays. It does not mean the doctor has to pay it.

My firm does billing for about 150 DPMs nationally and DOES NOT charge for any upfront payment(co-pays). We can keep track of everything collected including co-pays, but only charge for work we did regarding billing insurance. We then just take our fee out of what we collect via insurance for the practice.

Joe DeTrano, CPC, Medical/Medical Data Resource Providers, joe@medical-billing.com

RE: How Do Doctors Get Paid (Bret Ribotsky, DPM)
From: Robert Gjertson, DPM

The author could have gone a little further in his analogy. The second party at the table, because the same dinner was ordered, only paid 75% of the allowable amount. His guests, the third and fourth diners at the table, only paid 50%. So, the owner ends up losing money each time he serves a meal.

Robert Gjertson, DPM, Saint Paul, MN, drbobdpm@hotmail.com

RE: Staff Performing Routine Foot Care (Name Withheld)
From: Jeffrey Kass, DPM

I find it terribly disappointing to read a question as the one asked by "name withheld" asking if a "trained staff member" can perform the doctor's duties while the doctor gets paid for it. Did your trained staff member go to podiatry school for four years and pay 100 grand to get a podiatry license? If not, then why should they get to practice podiatry?

I don't want to hear how easy nail debridements are - heck, a skin biopsy above the ankle is probably easier, and I am not allowed to do one of those, so keep your trained staff members away from the feet. If you are that busy, hire an associate.

Jeffrey Kass, DPM, Forest Hills, NY jeffckass@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. Also availability E 22nd between 2nd and 3rd and E 70th off 3rd. Turn-key operation - no investment needed PODO2345@AOL.COM 516-476-1815.

PRACTICE FOR SALE IN CENTRAL FLORIDA

33 year old practice grossing $550k seeing an average of 40 patients per day. Possible owner financing for both practice and large office building. Five year average profit margin of 35%. New Listing. For more information call Chas Smith at 863-688-1725 or email Chas@cpalliance.com

PRACTICE FOR SALE - WEST PALM BEACH FLORIDA
 
Well established successful West Palm Beach practice grossing $475K with excellent reputation and good referral base. Consistent new patient growth, great opportunity with increased gross revenue and surgical growth potential. EHR implemented with meaningful use criteria met. Great area to live and work. Serious inquires E- mail wpbfootdrs@gmail.com

PRACTICE FOR SALE - SOUTHWEST FL

Multilocation multidoctor practice in beautiful Southwest Florida . Practice has grossed over seven figures consistently and currently shows 10-15% growth in revenues with increase in new patients and patient visits. EHR is already implemented with meaningful use criteria met. Practice has been professionally evaluated by Provider Resources. Only serious inquiries to this email address. This is a great practice in Paradise and a good opportunity for the right doctor or doctors. Email to: practiceforsaleswfla@gmail.com

PRACTICE FOR SALE - BROOKLYN, NY

28 year old practice in a desirable part of Brooklyn. EHR certified with stage 1 criteria successfully met. Practice has room to grow. Good mix of Medicare hazardous foot care; surgery and wounds. Low overhead. Priced to sell. Email Inquires to: brooklynpracticeforsale@gmail.com

PRACTICE FOR SALE - CALIFORNIA

Unique opportunity to purchase a very busy 50 year old practice in Coronado Ca. Large and stable patient and referral base with consistent new patient growth. Low overhead. Priced to sell. Great staff. Hospital privileges available. Willing to stay on for transition. Inquiries please email foothold@msn.com

IMMEDIATE OPENING OR PURCHASE IN DALLAS TX  

Turnkey in Dallas’ beautiful and prestigious Uptown neighborhood:   modern, fully furnished office in 24/7 security high rise and large patient base. There is tremendous growth potential in this affluent and diverse area. Perfect for new practitioner, to share, or second office.  afc1dfw@gmail.com

ASSOCIATE POSITION - PENNSYLVANIA

Associate Wanted for busy, multifaceted podiatry practice in Chester and Delaware counties, Pennsylvania. Seeking PSR-24/36 trained podiatrist for full/part time associate position. Two offices and hospital privileges. Send CV and letter to 123bunion@gmail.com.

ASSOCIATE POSITION - BAKERSFIELD, CA

Office and hospital-based podiatry group seeking a highly trained surgical associate to compliment our 3-doctor group. Minimum PSR-36 trained with rear-foot reconstructive experience required. Must have CA license and x-ray and fluoroscopy license. Previous practice experience is preferred. Competitive salary and benefits package. Please forward cover letter and CV to modpm@aol.com.

ASSOCIATE POSITION - CENTRAL FLORIDA

Associate wanted for well-established practice in central Florida. Experienced support staff, malpractice coverage and health insurance provided. Excellent opportunity for a promising future, this position will provide for the possibility of partnership in the future. To apply please go to www.yourcareerinpodiatry.com

ASSOCIATE POSITION - WASHINGTON, DC/ MD SUBURBS

Prominent, established two office practice seeking well rounded, personable, ethical individual with sharp medical and surgical skills. Must be 24/36 month trained, ABPS qualified or certified. Partnership opportunity with ownership potential. Competitive salary with benefits package. Please send CV to ponyrunner66@gmail.com

ASSOCIATE POSITION - NASHVILLE TENNESSEE

Want to live and practice in the "It City" Nashville, TN? ISO  well-trained (PSR-36) individual. Located in suburb of Nashville. Hospital and Surgery Center privileges. Rearfoot and Ankle allowed. Base pay, bonus incentives, and benefits. Send resume to Mendozadpm@comcast.net. $1,000 finder's fee paid to referring individual with hiring.

ASSOCIATE WANTED - CENTRAL/SHORE AREA - TOMS RIVER, NJ

FT/PT Looking for a HIGHLY motivated, organized, ethical associate. EMR/digital 20/20 x-ray/NCV/vascular testing all on premises. Trauma, DM, wound care & large routine & children mix. Must have NJ license. Should be Board Qualified/Certified Potential for future BUY-IN Send CV to toesec@aol.com

ASSOCIATE POSITION – VIRGINIA
 
Established private practice, foot and ankle reconstruction and trauma management, strong referral base, ED trauma call. Hospital and surgery center privileges. Two locations with modern offices. ABPS qualified or certified. Competitive compensation package. Potential for position to lead to partnership. To apply, please email a letter of intent and CV to: vaposition@yahoo.com 

PODIATRIST FOR NURSING HOME CARE - MASSACHUSETTS

Excellent Opportunity. Seeking independent physician for growing nursing home podiatry care Work independently, make your own hours. Must do own billing. YOU KEEP 100% OF PROFITS. Must be personable and have good patient skills. Acquisition fee based position. Please e-mail CV and short bio to: americanmobile@verizon.net

ASSOCIATE POSITION- DAYTON, OHIO

Join an established group practice in Dayton, Ohio excellent reputation, large referral base. Base Salary$120,000, benefits and bonus structure. EMR; diagnostic ultrasound; Padnet; CO2 and Cutera Laser for nails, all aspects of DME. We need well trained personable PSR24/36 surgeon. Future Buy-in available. Please send CV to Ohiomedical@aol.com

ASSOCIATE POSITION - MASSACHUSSETS

Located near Boston. Busy multi-office podiatry practice looking to expand. Need extremely energetic dedicated individual. Must be PSR 12-24 trained, EMR, laser, vascular testing the works. Must have sense of humor. MA License, NH License A+! Surgery, sports medicine, pediatrics, shoe store. Please send resumes to resumesent11@comcast.net.  

PM News Classified Ads Reach over 14,000 DPMs 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 14,000 DPMs. 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.

• To Post a message, send it to:    bblock@podiatrym.com
• Notes should be original and may not be submitted to other publications or listservs without our express written permission.
• Notes must be in the following form:
  RE: (Topic)
  From: (your name, DPM)
  Body of letter. Be concise. Limit to 250 words or less). Use Spellchecker
  Your name, DPM City/State
• Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.