The Voice of Podiatrists

Serving Over 14,000 Podiatrists Daily

June 06, 2013 #4,789 Publisher-Barry Block, DPM, JD

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CA Podiatrist Uses Minimal Incision with Fixation for Bunion Repair

Previously, bunion surgery required a long incision, which resulted in large amounts of pain, swelling, and loss of range of motion. A new procedure has been perfected by  Alireza Khosroabadi, DPM, which requires only a 5 mm incision. Dr. Khosroabadi has been performing this procedure for the past year. The entire procedure is visualized real-time on a TV monitor, so the doctor can see exactly what he is cutting and fixating.

Dr. Alireza Khosroabadi

"I cut the bone with an osteotome, slide the bone over and insert a pin to hold the bone together until it heals (in about 4-6 weeks). This reduces the amount of swelling and loss of range of motion. Patients can walk in about 2 or 3 days," says Dr. Khosroabadi.

Source: The Drs [5/24/13]

High Heels Hurt, And Damage is Long-Term: UK Podiatry Study

High heels may cause permanent injury, with most women suffering pain in just over an hour of wearing height-enhancing footwear, a new study has found. Wearing the ill-fitted shoes can cause long-term damage including arthritis, stress fractures, and trapped nerves, which may even require surgery or steroid injections, consultant podiatrist Mike O'Neill warned.

Podiatrist Mike O'Neill

Researchers at The College of Podiatry, UK, found that almost half of women have suffered foot problems after wearing an uncomfortable pair of shoes, but 43 per cent will suffer in the name of fashion. One third of women also admitted that they had worn heels they knew did not fit, simply because they "looked nice" - and could not find a pair in their size, The Telegraph reported. On average, high heels start to hurt after 1 hour, 6 minutes and 48 seconds, but 20% of women started to feel the pinch within just 10 minutes.

Source: Business Standard [6/4/13]

NY Podiatrists Named to Head Residency Program

St. John’s Episcopal Hospital has recently announced that Arnold Hertz, DPM, has been named Chief of Podiatry and Director of their Podiatry Residency Program, and that David J. Gordon, DPM, has been named Associate Director of the Podiatry Residency Program. Dr. Hertz has assumed administrative and clinical responsibilities for both areas.

(L-R) Drs. Arnold Hertz and David Gordon

Dr. Hertz has an extensive background in podiatric medicine, wound care, and diabetic care. He is board certified in foot surgery by the American Board of Podiatric Surgery and in podiatric orthopedics by the American Board of Podiatric Orthopedics and Primary Podiatric Medicine.  Dr. Gordon was previously affiliated with The Brooklyn Hospital Center, and before that was Director of Westchester Square Medical Center Hyperbaric Department.

Source: The Wave [5/31/13]

FL Podiatrist Publishes 2nd Edition of e-Book

Richard Santo Mallia, DPM, MPH has recently published the second edition of his e-book titled How to Walk Without Pain. This e-book is designed for the lay public. 

Dr. Richard Santo Mallia

Dr. Mallia received his DPM at Barry University (2000) and received his Masters in Public Health Specializing in Health Policy and Management from Florida International University (2007). He completed his residency at Cedars Medical Center (now named the University of Miami Hospital).

Query: Fraudulent Billing 

A 50 year old male complains only of thick fungus nails. The podiatrist does nothing at the visit, but makes an appointment for the patient to come back later for treatment, and gives the patient an order for foot x-rays to be done at the clinic next to the office. During the initial visit, the podiatrist introduces the patient to Doctor MD at the clinic. The doctor briefly pops his head in and says hi, and after a short discussion, recommends that the patient take vitamins. The patient pays the co-pay for the podiatrist visit.

Four weeks later, the EOB comes through for the podiatry office visit, x-rays, orthotics, and removal of a lesion. The patient calls up and complains. No explanation is ever given for the charges. Four weeks later, the patient receives a bill for the co-pay for the MD’s visit and gets an EOB for an office visit with the MD. The patient files a complaint with the state board. The state board says that they got a copy of the patient's x-rays from the office, which is impossible, as none were ever taken. The case now is under investigation. What do you think should happen to this podiatrist and the MD? How does submitting false x-rays to the board complicate matters?
 
Name Withheld (CA)

Editor's note: PM News does not provide legal advice. Submitting false x-rays is fraud, which can easily be determined by comparing the submitted x-rays to actual x-rays of the patient's feet. Fraud (including illegal billing) is considered professional misconduct and subjects the doctors to professional discipline.

RE: Compounding Pharmacies
From: Marc Katz, DPM

I'm sure you have all noticed that compounding pharmacies are multiplying like rabbits! I've been using compounds with some success for many years, but I have a dilemma. Are these pharmacies potentially using unethical practices? My patients complain that they had a 200 dollar co-pay and the insurance paid 1,800 DOLLARS!  Other patients get the compound for $35 dollars cash. The pharmacies use multiple unproven drugs together to increase the price, they recommend large tube sizes to increase the price, they recommend at least 3 refills. When I ask them about their practices, they say, "we don't set the prices, the insurance companies are paying for it"! So does that make it right? Does this sound familiar to anyone?

So, maybe these compounds help to some degree, but they are solely adding ingredients and heavily marketing for revenue only. This is happening, and insurance companies are handing out thousands of dollars while our fees are getting cut. Is compounding cream worth 3-4 times more than a foot surgery performed by a doctor? I believe that this hurts medicine in general, running up the cost of healthcare. Does this industry need to be shut down?

I would like to hear the opinion of others and what you think needs to be done. 

Marc Katz, DPM, Tampa, FL, dr_mkatz@yahoo.com

RE: Podiatric Residency Crisis - Where Are We? (Robert Kornfeld, DPM)
From: Dennis Shavelson, DPM

I have always been willing to do my part. I will immediately open my NYC practice for one year to one of the unplaced DPMs. Grow, learn, and practice - we commit to preparing you for a residency next year.
 
In addition, I am available to work with any DPM nationwide willing to do the same. Let’s show these young men and women that we are on their side.

Dennis Shavelson, DPM, NY, NY, drsha@foothelpers.com

RE: Podiatric Residency Crisis - Where Are We? (Robert Kornfeld, DPM)
From: Ivar E. Roth DPM, MPH

Concerning Dr. Kornfeld’s observations, here is what happened recently with some highly qualified 2013 graduates who did not match, and the preceptorship program that I offer. These graduates initially said they wanted my program, so I accepted them. Shortly afterwards, they said they needed some more time to make one last effort to get a residency program and asked if they could put my program on hold. I said yes. After their drop dead acceptance date passed, they again asked for more time. Again, they were not matched.

They were scheduled to start on June first. They then notified me that they wanted to take a month-long vacation, so I said okay. Just before going on vacation, they said that they could not now promise to take the program unless I agreed that they would have the full ability to apply to programs as they came up during the year, and that if they were accepted, they would leave my program. I said "no" at that point.

I was prepared to pay them very well for a year and give them excellent training. It seems like they want to have their cake and eat it too. I bent over backwards to help them out, and they seem so unappreciative of the opportunity made available to them. So now, they will probably do nothing in podiatric medicine for the next year. What a shame.
 
Ivar E. Roth DPM, MPH, Newport Beach, CA, ifabs@earthlink.net

RE: Staff Performing Routine Foot Care
From: Norman Wallis, PhD

Without addressing the arcane issues related to billing, which other correspondents have addressed, all readers of PM News should know that ACFAOM has just launched an online Clinical Podiatric Medical Assistant course, in collaboration with Medinail Learning Center, to provide a convenient and well-structured educational program for all podiatric medical assistants to help them assume more clinical responsibilities, including routine foot care, under the direct supervision of their DPM. 

In addition to the 10 online modules and 2 online tests, a 40-hr structured internship with a DPM is required before certification is awarded. This program was created after a survey of ACFAOM members showed overwhelming interest in, and support for, such a program.  More details of this course can be found at acfaom,org or by contacting me at 301-718-6539 or nwallis@acfaom.org.
 
Norman Wallis, PhD, ACFAOM Executive Director, Bethesda, MD

RE: The Passing of Ellen Schwartz

I'm so sorry to hear of Ellen Schwartz's passing.  Her dad, Gus Rapp (shortened from Rappaport) and his partner Bernie of Mayflower Podiatry Supply Co., set up my entire 1st office in 1960. They were always very fair in their dealings throughout my early years in practice. Gus and her mom, Marion Rappaport, died several years ago, but even though I didn't purchase through Gill, Ellen was always smiling, extremely friendly, and we used to reminisce often at the podiatry conferences.  She'll be very much missed.

Art Gudeon, DPM, Rego Park, NY

WANTED: ASSOCIATE PODIATRIST IL

4 Days per Week Chicago Practice - will perform all phases of podiatric medicine Accredited JCAHO Surgical Suite. Benefits will cover Malpractice and Health Insurance. Six Figure Base Salary. Inquiries Contact:  Dr. J. B. Jenkins - 773-374-5300

ASSOCIATE POSITION - KENTUCKY

Immediate opening in beautiful Southern Kentucky with 8-provider group with excellent reputation, full-time physical therapy, MRI, CPED/CO on staff along with a full schedule awaiting.  Wonderful place to raise a family, excellent schools and phenomenal quality and cost of living. Excellent compensation package, full benefits, and buy-in opportunity after 2 years. Email a letter of interest and CV: jonkim12000@yahoo.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 - SOUTH CAROLINA

South Carolina's largest provider of foot care is a multi-doctor, multi-location practice currently seeking a highly skilled, personable, and hardworking physician to join our TEAM. South Carolina License is necessary. Above average salary and benefits. Please send Letter of Interest and CV to scdpmjobs@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 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

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. 

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 - 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

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 - 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 - 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

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

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