June 13, 2006 #2,604 Editor-Barry Block, DPM, JD

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MI DPM’s Aid Baja Project as a Labor of Love

Perhaps it was when a 7-year-old girl on the Baja Peninsula in Mexico took her first steps that became the turning point for Dr. Jeffrey Yung. “She took her first steps and she just cried," said Yung, a podiatrist who has been on numerous medical missions to help children with club feet and other foot and ankle deformities in Mexico, El Salvador and Honduras. "She had never walked in her life."He went on medical missions to Mexico every weekend for three years and traveled to El Salvador once or twice a year and to Honduras "eight or nine times" to treat children. Club feet are prevalent in poor nations, said Yung, where prenatal care is lacking. The condition is also genetic.

Most recently, Yung traveled to Honduras, along with two podiatry residents from Botsford General Hospital in Farmington Hills, Jarrod Shapiro and Larry Ward. They joined surgeons from around the United States on a five-day surgical mission, supported by the Baja Project. The team performed 55 surgeries on patients ranging in age from 4 months old to mid-40s, said Yung. The doctors often spend their own money to go on the missions. Yung said the Baja Project for Crippled Children is always seeking donations. "We plan to keep it going as long as we can -- until either we drop dead or run out of money," Yung said.

Yung, who has a podiatry practice in Farmington Hills, MI said he's proud to be part of the project. "It's really a very rewarding feeling," Yung said. "It turned out to be a labor of love."

Source: Stacy Jenkins, Hometime Life [6/11/06]

Many Insurers Still Not Ready For Upcoming NPI’s

With just a year left before the compliance deadline, health plans still are finalizing strategies and lining up vendors to help them process the National Provider Identifier (NPI) created by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), according to a consultant.The 10-digit numeric NPI is intended to replace the many different identification codes providers are assigned by health insurers and other entities. Providers could start applying for an NPI in May 2005.

The May 23, 2007, compliance deadline applies to all healthcare clearinghouses, healthcare providers and large health plans that use electronic transactions for which HHS has established HIPAA standards. Small health plans have until May 2008 to meet the NPI
requirements.

Source: Managed Care Week [6/7/06]

SOUTHWEST FOOT & ANKLE CONFERENCE

September 15-17, 2005, Westin Park Central Hotel, Dallas, Texas. Mark calendars now - PICA Risk Management course, FAIV workshop series, Coding Track , Assistants Tracks , Terrific Vendor Hall with giveaways. http:// www.txpma.org or 1-800-TEX-FOOT

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For a list of all meetings go to: www.podiatrym.com/meetings.pdf

Query: HIPAA and Custody Battle

I had an unusual situation arise this past week. A mother called to schedule an appointment for her minor child. The patient was referred by her primary care physician and has Title 19 - Medicaid coverage. Shortly after the appointment was made, another call came and the person identified himself as the patient’s father. He said he would be calling after his daughter’s appointment to get information on her visit. I said that we would not be able to give that information because of HIPAA. He said that he was the patient’s father and she had his last name and by law I had to furnish him with that information. I told him that since we have not even seen the pt yet we have no information on who makes decisions for the minor child or who has custody. He said he has joint custody and has every right to get her records. Any words of advice? Would he just need to supply me with the legal paperwork to show that he has joint custody along with identification.

Sherri Hayes, Black Hills Podiatry, Rapid City, SD

Editor’s comments: PM News does not provide legal advice. The key to HIPAA privacy cases is to take "reasonable" steps to protect the privacy of the records. Requesting a copy of the court order granting him custody of the child is in my podiatric opinion, a reasonable step to take. Keep the copy of the order in your records.

HIPAA sets only minimal standards. If South Dakota law is stricter, you must abide by those rules. I recommend contacting your state podiatric association; it a benefit of being an APMA member.

RE: Inexpensive Nail Nippers
From: Barry Finkelstein, DPM

I am no financial expert, but I wanted to share this one with the team. I work across the street from a Rite-Aid pharmacy. The pharmacy sells nail nippers for about $13 each (Sometimes they are two for the price of one). They work great and are durable. I autoclave them with no problem. At that price, I am able to stock enough instruments to use freshly autoclaved instruments on each patient. If only the pharmacy made x-ray machines and examining
chairs.

Barry Finkelstein, DPM, Bronx, NY, NYNJfootandankle@aol.com

RE: Going Bare (Name Withheld)
From: John Scheland, DPM, Barry Mullen, DPM

It strikes me that every time malpractice subject matters come up that little is ever said about the injured patient and how the lawyer seem to walk away with everything (defense costs, judgments). For example, a patient of mine lost her husband in a wrongful death. After 5 years and a hard fought/defended cases she won a judgment of 8 million dollars. After her lawyer got done with fees and contingencies, she received a check for a measly $500,000 dollars. One can only imagine what the defense attorneys received, a healthy sum, I am sure. This poor lady lost twice.

This ruined a doctors practice, and subjected the surviving victim through five years of anguish only to have the attorneys walk away with pretty much everything. The talk is always over rising healthcare costs, rising operational costs to doctors, how to protect assets. Little attention is paid to the victims who once came to us for help and suffered the consequences of doctors being human too.

The courts and lawyers have preyed on the unfortunate long enough, leaving the doctors and everyone who sees a doctor or buys insurance to foot the bill. Enough is enough. We need tort reform not only to improve to delivery of health care but to see that true victims of malpractice get some form of justice too. Doctors are not the only victims of the present tort system.

John Scheland, DPM, Scranton , PA, limblengthener@yahoo.com

It is ridiculous since most, if not all of the prior legal loopholes that would have effectively protected one's personal assets from a lost malpractice lawsuit have been closed. Fix the problem! Energy needs to be expended on four key malpractice tort reform
components.

First and foremost...Americans must be awakened from their political comas to demand the elimination of "soft money" politicians are paid under the table by various special interest groups. With respect to malpractice tort reform, it is the American Bar Association. To accomplish this, people need to be educated that this does occur and how this negatively impacts quality of care delivery and healthcare costs.(i.e.-technically excellent healthcare providers forced to quit private practice because they just can't make ends meet and how this translates into increased negative medical outcomes within a given specialty from reduced quality care ancillary healthcare providers render relative to those specialists.

If this can be accomplished, then create a loser pay malpractice system, as adopted in every other civilized country. Create a mechanism whereby nuisance cases can be proactively reviewed by an objective panel to determine the lawsuit's merit before it is allowed to proceed. Create a similar "expert witness" panel that allows that privilege only to those qualified while ensuring that rules and regulations are adopted that levies meaningful penalties against those "experts" who either falsify testimony or misrepresent the facts pertaining to a given malpractice case. This, boys and girls...is malpractice tort reform 101! It's just not so easy to implement because of the money involved.

Barry Mullen, DPM, Hackettstown, NJ, mailto:YAZY630@aol.com

RE: Barefoot and Magnetism (Bret M. Ribotsky, DPM)
From: Elliot Udell, DPM

To say that in shoe magnets do not work is a generalization without total merit. It is true that there are fakers out there that try to sell patients magnets for every conceivable condition and in most cases they don't work. There has been ongoing research testing the efficacy of certain stationary as well as electromagnets for the treatment of painful diabetic neuropathy. The few papers published thus far have shown that magnetic therapy has been effective in managing some of the symptoms associated with peripheral neuropathy caused by diabetes.

I have recommended and used magnetic therapy for this condition in my office and found it quite effective I have also found it to be worthless for many other conditions. Because magnets cannot be patented there is no incentive for major pharmaceutical firms to invest millions of dollars testing these modalities. I am aware of other low-budgeted ongoing studies and I suspect that their findings will be similar to studies conducted elsewhere.

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

PM&S-36 POSITION – SAN ANTONIO, TEXAS

The University of Texas Health Science Center at San Antonio. Contact Program Director, Javier La Fontaine, DPM at (210) 567-5174 or e-mail casteele@uthscsa.edu

ASSOCIATE POSITION - PHILADELPHIA, PA

Full time associate to join large 6-doctor group. PSR-24 trained with excellent people skills. Competitive salary/benefits package. Fax CV and introduction (215) 742-3902.

RESIDENCY POSITION – NORTHERN VIRGINIA

One Year Foot and Ankle/Rearfoot Surgical Fellowship with excellent salary/benefits available July 1, 2006. If you are finishing a PSR24 and don't have a job yet, this is an excellent way to learn additional surgical and business skills. Please fax resume to 703-491-9994.

RESIDENCY POSITION - HOUSTON, TX

RPR, PSR-24, Houston Podiatric Foundation, Starting ASAP. Must have successfully completed PARTS 1 & 2 of National Boards. Contact: Dr. Randal M. Lepow, Director (281-348-3338) (713-725-8988)

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