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PMNews
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| PM News | |
The Voice of Podiatrists
Serving Over 18,446 Subscribers Daily
June 10, 2019 #6,436  Publisher-Barry Block, DPM, JD
A partner of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2019- No part of PM News can be reproduced without the
written permission of Barry Block
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| PM NEWS QUICK POLL RESULTS |
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Results of last week's poll |
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| PM NEWS QUICK POLL |
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Have you implemented EMR in you practice?
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| AT THE COLLEGES | |
Midwestern University Celebrates AZ Graduates
Midwestern University celebrated the graduations of master’s and doctoral degree recipients who are beginning their professional careers in healthcare. More than 1,600 graduates crossed the stage to receive their graduate hoods in ceremonies held on university campuses, including Glendale, AZ, representing 11 healthcare specialty degrees across 10 Midwestern colleges.
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Midwestern University Celebrates Glendale Graduates |
28 students were granted Doctor of Podiatric Medicine (DPM) degrees by the Arizona School of Podiatric Medicine.
Source: Your Valley [6/5/19]
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| PODIATRISTS IN THE NEWS | |
FL Podiatrist Discusses Ingrown Toenails
According to Cary Zinkin, DPM, a podiatrist and spokesperson for the American Podiatric Medical Association, there are four main causes of ingrown toenails: footwear that’s too tight, trauma to the toe (like badly stubbing it), improper trimming, and heredity. The first three can be prevented, but there are some people who are just prone to ingrowns “because of the shape of the nail root and the way the skin goes around it,” Zinkin says. In those cases, he recommends seeing a podiatrist for a simple procedure in which part of the nail is removed to prevent further ingrowns.
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Dr. Cary Zinkin |
Zinkin recommends soaking your foot in Epsom salt and warm water at the first sign of a minor ingrown toenail, in order to soften the skin so that you can “reach that little area [of the nail] that’s pressing in and trim it out.” He also advises anyone with diabetes or poor circulation to see a podiatrist if they have an ingrown toenail, because it could quickly progress to a dangerous infection.
Source: Karen Iorio Adelson, The Strategist [6/6/19]
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| OIG NEWS | |
OIG Adds Podiatry Services to 2020 Work Plan
The OIG recently added podiatry and related ancillary services to their Work Plan. While routine podiatry services like nail trimming and callus/corn removal are generally not covered by Medicare Part B, some medically necessary services may be covered if they meet one of the following exceptions:
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Performed as a necessary and integral part of otherwise covered services, such as diagnosis and treatment of ulcers, wounds or infections
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Mycotic nails (toenail infections)
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Treatment of foot warts
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Performed in the presence of another systemic condition(s) such as diabetes
In addition, evaluation and management services (E/M) are generally not covered the same day as other podiatry services UNLESS the E/M service is a significant, separately identifiable service above and beyond the routine evaluation that is included in the podiatry service being performed. The OIG is also looking at ancillary services ordered by podiatrists (labs, x-rays, prescription drugs and therapy) which are permitted as long as the service is deemed medically necessary.
Source: OIG via Dr. Joseph Borreggine
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| RESPONSES/COMMENTS (CLINICAL) - PART 1A | |
From: Allen Jacobs, DPM, Daniel Chaskin, DPM
The question is why do you require the information and what do you intend to do about it? If you intend to treat with an expensive topical agent or with systemic therapy, then speciation is appropriate (e.g.: culture, genetic testing). If you merely need to answer the question as to whether it is or is not a fungus (e.g.: qualify for palliative or accommodative care, or for laser therapy), but speciation is not required, as it will not alter the specific therapy, KOH, PAS, or dermoscopy is adequate.
Allen Jacobs, DPM, St. Louis, MO
Clinically, a mycotic toenail might be thick, brittle, discolored, with subungual debris present; however, there are further ways to test for onychomycosis. To test for onychomycosis, one should consider finding a laboratory that performs Alcian blue stains. Furthermore, the feet could be checked with a dermatoscope to see if there is a wispy pigmentation present with Tinea nigra. My personal favorite dermatoscope is the Dermlite 4. With its wide field and ice cap, it is especially useful for contact dermoscopy used in toenails.
Contact dermoscopy, with Purell as a medium to limit surface glare, might show spikes on the onycholytic area. Lastly, there might be a micro-Hutchinson's sign present seen on dermoscopy. One should explain the risks, benefits, and alternatives of a matrix biopsy.
Daniel Chaskin, DPM, Ridgewood, NY
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| RESPONSES/COMMENTS (CLINICAL) - PART 1B | |
From: William P. Scherer, DPM, MS
I have been treating, studying, publishing, and lecturing about onychomycosis for the past 30 years, serve as the senior podiatric medical advisor for Bako Diagnostics, and have experience with every diagnostic test used for fungal nails. I believe that obtaining one adequate specimen from the most involved nail (usually the hallux) is sufficient to obtain an accurate diagnosis, rather than sampling every fungal nail. However, if there are significant differences in the appearance of two different nails, especially on different feet, then a second specimen for additional testing may be warranted.
There is no question that laboratory testing for fungal nails is far superior to in-office testing (i.e. KOH Prep or DTM). The most sensitive laboratory tests include Periodic Acid–Schiff (PAS) and Gomori methenamine silver (GMS), while the most specific test includes DNA molecular testing (PCR assay). Using a comprehensive nail analysis approach, by combining PAS, GMS, and DNA testing will provide maximum diagnostic data for patients presenting with onychodystrophy. If the cost of testing is a patient’s primary concern, PAS alone is minimally acceptable, but including GMS will provide improved sensitivity, especially for geriatric patients.
The addition of Fontana-Mason stain can also be beneficial for identifying and confirming pigmented saprophytes, as well as highlighting any melanin deposition in the nail unit which may be indicative of a melanocytic process. Physicians that desire genus and species identification, especially before prescribing topical or oral antifungal medications, should utilize DNA testing (PCR assay) as this provides the best granular diagnostic information rapidly and is far superior to fungal cultures.
William P. Scherer, DPM, MS, Boca Raton, FL
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| RESPONSES/COMMENTS (CODINGLINE CORNER) | |
From Elliot Udell, DPM
There are two facets to having an EMR system. One is the MACRA and other legally related issues. The other greater reason to have an EMR system is that it makes your office far more efficient. Once your practice starts rolling, you will be getting requests from insurance companies, attorneys on both sides of a slip and fall injury trial, referring doctors, etc. With an efficient EMR system, you can generate these reports with the click of a button. If you have hand-written notes, you will spending all night and every weekend writing up these reports. Isn't your time worth something?
Elliot Udell, DPM, Hicksville, NY
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| RESPONSES/COMMENTS (OBITUARIES) | |
I am very saddened to learn of the loss to our profession from Dr. Alan Whitney. A number of my colleagues have already expressed very good thoughts regarding Alan. He was a pioneer, independent thinker, and ahead of his time, and more importantly, he was just a very nice guy. He enjoyed teaching, enjoyed the students, and after their graduation enjoyed becoming their friends. His wife Loretta is remembered as a first class representative on the switchboard as one entered the lobby of the college. I'm always pleased to see his son, Ken, at the college, carrying on the same dedication to education --- A great legacy.
Steven Kravitz, DPM
As an educator, Dr. Whitney was one of the most unique professors I ever encountered. His style of teaching involved an impeccable knowledge of biomechanics interspersed with humor and the recurrent attempt to affirm as to whether we were with him in understanding those concepts. At times, it would necessitate a more serious academic approach when he would wear his 'green Dartmouth blazer' in a return to his Ivy league roots. But it was another side of him that was most intriguing. He was always approachable and willing to share his academic knowledge, wisdom, humor, and also fatherly advice.
One of my fondest memories was following the last final exam as a third year student at PCPM in 1981. Several members of my clinic group and classmates along with AKW went on an all night offshore charter boat trip out of Barnegat inlet for Jersey bluefish. I can't remember how many (if any) fish we caught, but it was sharing the time, stories, and laughs together that made it memorable. I will keep him, his lovely wife Loretta, my friend and colleague Ken, and the entire Whitney Family in my thoughts and prayers. Please accept my sincere condolences.
Erwin J. Juda, RPh, DPM, Wilmington, DE
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| RESPONSES/COMMENTS (NEWS STORIES) - PART 1A | |
From: Ira Baum, DPM, Donald R Blum, DPM, JD
Dr. Levy’s recommendations to reduce the risk of seniors falling and risking severe injury is a responsibility that all podiatrists should honor. I add the importance of gait aides to mitigate falls, when necessary, for the aged and not so aged, with neurological impairment to the lower extremities. Our concern for the whole person is what makes us physicians.
Ira Baum, DPM, Naples, FL
Thank you, Dr. Levy, for comments about "Falls" related to "Seniors". One more item that needs to be considered, for all ages, is injuries resulting from walking the dog. People are out walking the dog or walking for exercise and paying more attention to a telephone conversation, a text, or a social media post than the squirrel or rabbit that your dog wants to run after; or they are just not paying attention to the curb or the debris on the sidewalk.
Donald R Blum, DPM, JD, Dallas, TX
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| RESPONSES/COMMENTS (NEWS STORIES) - PART 2 | |
From: Paul Liswood, DPM
Falls in the elderly is a significant public health issue. The New York State Podiatric Medical Association (NYSPMA) recently had high level meetings with the New York State Department of Health section on aging (DOH) to discuss podiatry’s role in fall prevention. Through our Public and Population Health Task Force, NYSPMA developed an evidence-based fall prevention program, and we are working on a payment model in connection with this issue. The clinical protocol was reviewed with DOH.
In working with DOH, NYSPMA has developed a webinar course for CME credit on fall prevention prepared by Allen Jacobs, DPM. This members’- only benefit will educate our members on fall risk assessments, interventions, and coordination of care among other providers as part of the team approach to care. We will provide our members' names that completed the course to DOH and managed care organizations, and we are looking to expand podiatry’s role in fall prevention within the NYS prevention agenda.
NYSPMA has also began working with hospital systems on demonstration projects around podiatry-led fall prevention teams, and we are engaging CMS in discussions on fair payment models for podiatry-led fall prevention collaborative care models. We believe these approaches will not only improve public health, but strengthen and raise the profile of our profession. For those at risk for falls, help is on the way as podiatry is stepping up in NY!
Paul Liswood, DPM, Brooklyn, NY, Past President, NYSPMA
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| YOU CAN'T MAKE THESE THINGS UP | |
RE: Outrageous Shoe of the Day
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Easiest way to tote an extra pair of shoes? |
Source: Deborah Kiwi via Virtual Shoe Museum
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MEETING NOTICES
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MEETING NOTICES
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NEED CME CREDITS FAST?
PODIATRY MANAGEMENT'S AFFORDABLE ONLINE CME
You can Earn up to 50 Continuing Education Contact Hours (CECH) Online
Earn 15 CECH only $229 (less than $16 per CECH)
(Only $15 per credit) http://www.podiatrym.com/cme.cfm
All required credits can be taken online for AL, AK, AR, CA, CO, DE, HI, IN, KS, LA, MA, ME, MI, MI, MS, NV, NJ, NM, ND, OH, OR, RI, SC, SD, UT, VA, VT, WV, and WI
Partial required credits can be taken online for AZ, FL, GA, ID, KY, IL, ID, IA, MD, MN, MO, MT, NE, NH, NY, NC, OK, PA, PR, TN, TX, WA, and DC
Choose any or ALL from 25+ CECH Category-1 articles posted
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| CLASSIFIED ADS - ASSOCIATE POSITIONS AND FELLOWSHIPS |
WOUND CARE FELLOWSHIP - NEW YORK
CPME-APPROVED 12 month fellowship beginning July 1st, 2018. Hospital and clinic environment, with onsite hyperbaric medicine. Working with infectious disease, dermatology, as well as general, vascular, and podiatric surgeons. Must have completed a PMSR residency. Please contact drarnoldhertz@aol.com or jtfootcare@gmail.com. EOE (equal opportunity employer)
ASSOCIATE POSITION - KENTUCKY
Associate positions open for well-trained, compassionate physician for busy central office in the beautiful Somerset/Lake Cumberland KY and in our Bowling Green location. Wide range of services to be offered with several ancillary services onsite. Generous base salary with incentive/full benefits and partnership opportunity. Email CV to: kypodjob@gmail.com
ASSOCIATE POSITION – LOS ANGELES, CA
Established multispecialty private practice group seeking well trained and ambitious specialist to treat podiatry and wound care patients. Expertise in complex and chronic wounds is needed but residency or wound care certification not required. Full-time and well compensated based on a private practice productivity model with salary and benefits guaranteed. Our experienced team provides beautiful, fully equipped offices with on-site ASCs. We provide trained office staff, marketing and expert revenue cycle management, ensuring doctors can focus on patient care. Excellent opportunity to build a great wound care and podiatry practice as part of a reputable and established company. TWCCJobs@gmail.com
FULL OR PART-TIME POSITIONS AVAILABLE - GREATER LOS ANGELES AREA
Home Foot Care, Inc. Mobile Podiatrists needed to see homebound patients in San Bernardino/Riverside, Lancaster/Palmdale, Ventura/Oxnard, Los Angeles/San Fernando Valley. Choose your own days/hours, excellent monthly compensation, cloud-based EHR, dedicated support staff. If interested, email CV to: homefootcare@hotmail.com our website: www.footdocs2u.com
ASSOCIATE POSITION – HAMPTON ROADS, VIRGINIA
Searching for a FT DPM for a growing 2 office location practice. Must be compassionate and able to provide general podiatry care, wound care and surgery. VA license and BQ/BC preferred. Base + Bonus, health and IRA. Please email sara.bouraee@gmail.com with subject HRFAS POD OPP
PODIATRIST POSITION – SOUTH CAROLINA
Work and live in one of the greatest states for outdoor fun and recreation. Centrally located 2 hours from the mountains and the ocean, well established practice of 21 years seeking an associate for its rapidly growing and expanding office. Must be board qualified/certified by ABFAS. Looking for someone with great people skills who is dedicated to putting in the effort to grow the practice. No traveling, no nursing homes. You must have SC podiatry license and next test date is June 1. Please send cover letter and CV to docdan@earthlink.net
ASSOCIATE POSITION AVAILABLE – NORTH CAROLINA
New associate position that can lead to partnership. We are a very busy practice providing care in both office and hospital settings. We are fully integrated in a large tertiary teaching hospital. We are located in the beautiful mountains of western North Carolina. Research opportunities are available. Applicant should be ethical, personable, hardworking, and committed to quality patient care. We are offering a competitive salary with bonus opportunities and a wide range of benefits. North Carolina license to practice is required for this position. All interested candidates should send a CV with 2 letters of reference to JCMOOREDPM@aol.com
MOBILE PODIATRIST NEEDED - NEW JERSEY
Well-established and fast growing House-call podiatry practice (www.homefootcareservices.com) is looking for Full-Time/Part time podiatrist to do home visits to home-bound patients in NJ. Email resume - Lana.Raginsky@homefootcareservices.com
PM NEWS CLASSIFIED ADS REACH OVER 18,000 DPMs AND STUDENTS
Whether you have used equipment to sell or are offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 18,000 subscribers. For details, click here or write to: bblock@prodigy.net or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at davidekagan@gmail.com or call (215) 808-0770
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| CLASSIFIED ADS - PRACTICES FOR SALE OR WANTED, EQUIPMENT FOR SALE |
PRACTICE FOR SALE – VISALIA CALIFORNIA
Extremely successful, well-established solo practice grossing $850K for the past six years. Doctor is relocating and ready to leave everything in place, including the fully functioning staff. Accepts all major insurances, Hospital and Surgical Center privileges. Serious inquiries only toptenpodiatrist@gmail.com
PRACTICE FOR SALE - JACKSON HEIGHTS, NY
Well established 27 year old practice. Turn-key operation. Great opportunity for established or new graduate. Excellent income potential on/off the insurance plans. Busy walk in traffic. 1100 square foot office in multi-specialty building. Email: gping1@yahoo.com
PRACTICES WANTED TO BUY - SOUTHERN CALIFORNIA
Building out a network of podiatry practices throughout southern California. We are looking to buy podiatry practices large, small, rural or urban. Podiatrists who are looking to retire soon or in the near future, or wanting to join a larger group to handle business operations can contact us at podiatrymanagementinc@gmail.com. Competitive compensation and benefits package for those who would like to sell and work within the larger company.
PM NEWS CLASSIFIED ADS REACH OVER 18,000 DPMs AND STUDENTS
Whether you have used equipment to sell or are offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 18,000 subscribers. For details, click here or write to: bblock@prodigy.net or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at davidekagan@gmail.com or call (215) 808-0770.
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| Disclaimers |
Acceptance and publication by this newsletter of an advertisement, news story, or letter does not imply endorsement or approval by Barry Block or Kane Communications of the company, product, content or ideas expressed in this newsletter. Podiatric Medical News does not represent the views, and is a separate entity from Podiatry Management® Magazine and Podiatry Management® Online. Any information pertaining to legal matters should not be considered to be legal advice, which can only be obtained via individual consultation with an attorney. Information about Medicare billing should be confirmed with your State CAC.
THIS MESSAGE IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR
ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS
PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE.
If the reader of this message is not the intended recipient or an
employee or agent responsible for delivering the message to the
intended recipient, you are hereby notified that any dissemination,
distribution, or copying of this communication is strictly
prohibited. If you have received this communication in error, please
immediately notify me and you are hereby instructed to delete all
electronic copies and destroy all printed copies.
DISCLAIMER: Internet communications cannot be guaranteed to be
either timely or free of viruses.
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