The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

June 18, 2010 #3,887 Publisher-Barry Block, DPM, JD

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Time to register and available staterooms for the AAPPM/PM News Alaska Practice Management are running out. We have received several requests from single podiatrists who would like to be paired up. If you are in that situation, please contact Greg DeClemente of Courtyard Travel at (800) 437-9685.   

IL Podiatrist: Gardeners Have Similar Foot Health Concerns as Athletes  

Many gardeners will experience foot pain this season as a result of overlooking the necessary care of their feet. But a few minutes of preparation and common sense can keep gardeners comfortable all season. "Gardening is an exertive, weight-bearing activity and should be considered a sport more than a passive hobby," said Dr. Paul R. Kasdan, a board-certified podiatrist and medical director for OurHealthNetwork.com. "As with any sport, one should make sure to wear appropriate footwear, and to properly stretch before engaging in the activity."

Dr. Paul Kasdan

During weight-bearing activities or sports, the feet play an important role in supporting and balancing stance to reduce falls. They also act as shock absorbers. Foot problems commonly associated with weight-bearing activities like gardening are usually due to wearing inappropriate footgear, or the lack of proper warm-up exercises. "

Source: Beta Health [6/16/10]

TX Podiatrist Sponsors Foot-Based Artwork Scholarships

Four students from Lone Star College-Montgomery recently put their best foot forward, and because of their artistic talent, were selected as winners in a campus-wide art scholarship contest generously hosted by Dr. Robert E. Neville of Foot Health Care Center in The Woodlands. For the contest, Dr. Neville asked students to submit original artwork based on “feet.” The winners were granted varying scholarship amounts, and their framed artwork will be on display in Dr. Neville’s office for the next year.

Dr. Robert Neville With Award-Winning Students

“Dr. Neville has been providing this scholarship for several years,” said Michelle Rogers with Foot Health Care Center in The Woodlands. “It’s a great opportunity to promote the students’ talent and provide scholarship money for their future.”

Source: The Paper [6/16/10]

FL Podiatrist and Son Search for Lost City of Gold

Doctor John Mina of Lee County is a podiatrist by profession, but he's an explorer and adventurer at heart. Starting this Friday, Dr. Mina, his 17-yr. old son Tony, and eight other veteran explorers, will head into the jungles of the Dominican Republic, looking for a 'Lost City of Gold'. "When you have a passion to discover, only an adventure will quell it," Dr. Mina told WINK News. "It is a rush, very exciting, to un-earth something that no human hands have held for maybe 2,000 years!" he added.

Dr. John Mina

The Minas will fly to the Dominican Republic, and will become the first foreigners officially invited by the government there, to try to find the lost city of Bartholomew Columbus. He was the brother of Christopher, and travelled to  what we know as Hispaniola in the late 1400's, on Columbus' second voyage to the new world. Bartholomew found gold in the jungles of what is now the Dominican Republic, and he founded a city near the site of the gold. Later though, he abandoned the area, and nobody has found the city since then. "We will have metal detectors and old maps. We hope to find some artifacts that will tell us, this was the settlement," said Dr. Mina.

Source: WINK News [6/16/10]

Senate Crafts Six-Month Doc-Pay Fix

Physicians would see a 2.2% increase in Medicare payment—but only through November—under a long-stalled package of tax provisions and safety-net health spending that the Senate strained to pare back in order to gain enough votes for passage.

The revised package could come up for a vote as early as Thursday. “We heard what the senators were saying, and we adjusted accordingly,” Senate Finance Committee Chairman Max Baucus (D-MT), who shaped the House-passed package, said.

Source: Matthew DoBias, Modern Healthcare [6/16/10]

FDA Creates Adverse-Event Website

The Food and Drug Administration has launched a webpage where it will post newly identified adverse-event information for recently approved drugs and biologics. The webpage will be accessible to the public and will feature safety information that emerges during a product's post-approval life cycle. Summary postings will be culled from items submitted to the FDA's Adverse Event Reporting System and the Vaccine Adverse Event Reporting System, as well as other sources.

The summary reports will include information about previously unidentified risks and adverse events that occur more frequently than they did during clinical-trial studies. Reports also will describe the actions the FDA is taking to address the safety concerns.

Source: Shawn Rhea, Health IT Strategist [6/16/10]

Query: American Physician Insurance Company

I am thinking of switching to American Physician Insurance Company for my malpractice coverage. Does anyone have any feedback on this company?

Marc Sock, DPM Houston, TX

RE: Another Shark Bite
From: Narmo L. Ortiz, Jr., DPM

Here  are some shark bite pictures of a case I did in 2005 with the assistance of Dr. Brian Burg. This was a 19 yo Austrian male tourist who was bitten by a bull shark in Boca Grande, FL. on July 1, 2005.

Shark Bite

All tendons where severed at the ankle joint level, and we were able to reconstruct them and primarily close all wounds.

Narmo L. Ortiz, Jr., DPM, Cape Coral, FL, nlortizdpm@embarqmail.com

Integrative Podiatric Medicine (Marc Katz, DPM, Bret Ribotsky)
From: Elliot Udell, DPM
 
"Alternative healthcare therapies run the gamut from helpful therapies which may not yet be part of classical medicine  to therapies that are completely bogus and may even be life-threatening. Some  "alternative" healers toggle between both. My chiropractor has done wonders for me when he treated me for back pain. I resent when he tells people not to vaccinate their children. This past winter, there was a public health crisis involving an epidemic of mumps in both Monsey, NY and parts of Brooklyn because members of the Chassidic communities bought into the propaganda that they should not vaccinate their children.  As for "alternative" cancer treatments, I know of two young women who, independent of each other, were diagnosed with early stages of breast cancer. Both had good prognoses had they followed their oncologists, surgeons, and radiologists advice. One, however, opted to see a homeopath. The other opted to use herbs. Both are dead.
 
I co-organized a medical ethics seminar with one of the leading oncologists at Beth Israel Hospital in NY. He gave numerous examples of patients with treatable forms of cancer who opted for "alternative" regimens who died from their conditions when their lives could have been saved or prolonged.
 
Doctors are legally obligated to dispense proper medical advice to patients, and the law will hold us accountable if a patient has an untoward result if we deviate from recognized standards of care.
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: Traumeel as an Analgesic (Elliot Udell, DPM)
From: Marc Katz, DPM , Bob Kornfeld, DPM

With regard to the comments by Dr. Udell and Turlik, you're missing the point. Integrative and alternative medicine is a whole new paradigm. Many studies are done and have been done, but much of the medicine does not rely on the same methodologies that you believe are the only truth. You can crunch your numbers and review your studies and p values and there is certainly some value. However, when all is said and done, this new medicine will move us to the next level without studies fudged by Pharma and special interests. While we do see good treatments approved by the FDA, we also see many medications that are not safe and kill people each day. The FDA and Pharma are no longer looking out for our best interests. 

So I believe that it is in the best interest of everyone to read and understand the future of the new direction of medicine. I personally will not rely on the government to oversee my treatments to make sure that their guidelines are used for my treatment. Medicine is advancing rapidly beyond this, and I'm the expert, not the academics doing studies and the government. This is an erroneous method, only used to lower our reimbursements and further knock us down. I link all of these, studies, Pharma, and government because this is the triad that places us in a box, hinders progress, and dictates how we practice and make money.

"Was the government to prescribe to us our medicine and diet, our bodies would be in such keeping as our souls are now." - Thomas Jefferson

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

Editor’s note: Dr. Kornfeld’s extended-length letter can be read here.

RE: Compliance Program (Noah A. Blumofe, DPM)
From: Michael Hriljac, DPM, JD, LLM

The best source for a podiatry Medicare compliance manual is the APMA. The APMA and PICA insurance joined forces to develop a compliance manual specific to podiatry. The document is available on the APMA website. Download the document and review each section for relevance to your practice. Keep the appropriate sections, develop your reference library (as defined in the document), and implement the use of the plan.

Having a functional plan in place reduces the risk of a Medicare audit. If audited, having a plan in place reduces the risk of penalties.  Compliance can help the bottom line in practices that have been under-coding due to fear of  adequate documentation.

Michael Hriljac, DPM, JD, LLM, Darien, IL, mhriljac@rsplaw.com

RE: Dragon Questions (Burton Katzen, DPM)
From: Larry Kosova, DPM

I have called Nuance and talked to my contacts in the digital speech world who either work with the product or resell the product, and there is no Version 11 coming out in July. They are targeting an end-of-the-year release, since Nuance is working on a new Macspeech version that they acquired, and some other products.

Usually, you see the standard version come out, then...

Editor's Note: Dr. Kosova's extended-length letter can be read here.

RE: The Super Group Practice Model - How Do I begin? (David Helfman, DPM)
From: Sloan Gordon, DPM

I think that was a great response from Dr. Helfman, however, there is an easier way. You don't need to reinvent the wheel. We started with a "steering committee" of entrepreneurial docs and sought out companies who facilitate this process. We vetted each company and found the one we felt worked best and was most viable. Just as was done in Dallas with the formation of a SuperGroup, we hope to image their structure in Houston. There are fewer headaches, enormously less fees, and it can be done without looking for a lawyer, an office manager, an MBA, etc. The right company will have all of those ready to go. 

The membership is the key. They have to recognize the importance of belonging to a group; to realize the group runs the "facilitator"; the group makes the decisions. Start with a core, get the practices going, get a good software platform. When things are smooth and you have negotiated better insurance contracts and benefits, move on the ancillaries, where there are significant financial rewards:  PT, MRI, lab, ASC, mobile laser, home health, home infusion, and so on.
 
Sloan Gordon, DPM, Houston, TX, sgordondoc@sbcglobal.net

RE: "Inflammed" Ingrown Nail

Have any of our colleagues ever heard of this (bizarre) treatment? A 17 yr. old male presented with a blackened distal hallux after having his toe lit on fire after "special Chinese medicine" was applied! The original diagnosis was apparently an infected ingrown nail and the medication and flame was a "common Chinese treatment" used to clear it up according to the patient's father. What were these practitioners thinking? The toe had a big black eschar with inflamed tissue beneath it. Of course, the nail itself was still ingrown.

Lloyd Nesbitt DPM, Toronto, Canada

ASSOCIATE POSITION - SOUTHEAST GEORGIA

Beautiful weather year round & near the Coast. Opportunity for Early Buy-in. Seeking associate or new residency graduate to join practice. Must be PSR-24/36 trained. Multiple locations. Full range of services with new facilities. E-mail cover letter & CV to melissafoot@pol.net

LIMB PRESERVATION RESEARCH AND SURGICAL FELLOWSHIP

Boston University Medical Center offers a unique fellowship position. Be part of this unique opportunity at a major internationally-known teaching medical center. During this time, he/she will become a knowledge expert who will contribute significantly to research, surgical procedures, teaching, and innovations in limb preservation and tissue repair. Requirements: Completion of a two or three year surgical residency; Annual Salary: Year 1 $61,000, Year 2 $66,000 plus excellent benefits. Submit a CV and letter of interest to: Erin Springhetti @ erin.springhetti@bmc.org and Dr Vickie Driver @ vickie.driver@bmc.org

ASSOCIATE POSITIONS – TEXAS

Full-time podiatrist(s) needed in Austin or San Antonio. Current Texas license required. Unique mobile podiatry practice. Better pay, fine working conditions with excellent support staff. Check out our website www.footmobile.com. Reply to footcenter1@sbcglobal.net

EQUIPMENT FOR SALE – PODIATRY CHAIRS

2 podiatry chairs - used Midmark 117 and a Ritter 317. Great condition. $950 each Greenwich, NY Call:518-466-3287. Pick up only.

PRACTICE FOR SALE - MINNESOTA

Practice Grossing over $500K yearly. Good mix of surgery, orthotics, DME, diabetic care, general podiatry. Commute < 5 miles to work. Friendly Midwest lakes area with arts, good schools, affordable living, restaurants, shopping. Option to purchase building. Will consider associate to buy-in/ buy-out. Midwestpractice@gmail.com

CANADIAN PODIATRISTS COME BACK HOME!

An Edmonton, Alberta group of DPM’s requires an additional Podiatrist. Interest in biomechanics essential. Given Canadian visa restrictions, this position is open only to Canadian Citizens or permanent residents. Very attractive compensation package. Fax C.V. or letter of interest to: (780) 483-5796.

ASSOCIATE POSITION NORTH CAROLINA - ASHEVILLE/MOUNTAINS

Well established, multi-doctor, multi-office diverse practice has immediate need for associate doctor leading to partnership. Associate doctor will be very busy from day one. Attractive compensation and benefits. Buy-in potential after one year. Contact at smfc2@charterinternet.com or 828-734-1535

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

Full-time 3-DPM group in South Bay of LA County. Minutes from best living in LA County. Practice is an excellent mix of surgery, general podiatry, diabetic care, and DME. Beautiful office with EMR, Digital X-ray and Orthoses, etc. Please e-mail cover letter, and resume to footcareone@verizon.net

PODIATRISTS NEEDED NATIONWIDE

Seeking a part-time or full-time podiatrists to provide podiatry house call and diabetic shoe fitting services to patients nationwide. We are a podiatry management company and have contracts with clients that have 1,000’s of established patients and all we need are hard-working good doctors to service them. We offer an excellent compensation package with benefits and the opportunity to build a fairly large practice very quickly. coasttocoastpodiatry@yahoo.com

EQUIPMENT WANTED – CR SCANNER

Reina 812 Manual CR Scanner in good condition. Contact: pmh@wffeet.com

ASSOCIATE POSITION – HOUSTON, TEXAS

Full-time, surgically-trained podiatrist needed for multi-office practice in Houston, TX. Ideal candidate must be motivated, dedicated and personable. Practice is a good mix of general podiatry and surgery, no nursing facilities. Must also be willing to do significant networking and marketing to help build the practice. Please e-mail cover letter, and resume to faajobs@gmail.com

PRACTICE FOR SALE – EASTERN OREGON

Recent poor health requires sale of busy 30+ year old practice in Eastern Oregon. Good mix of surgery and general podiatry. Pleasant community with year round outdoor recreation. Major metropolitan center 50 miles away. Current staff and doctor will stay on as needed. sparris@fmtc.com

PRACTICE FOR SALE – MAINE

25 year full scope in medical building, podiatrist friendly hospitals, appreciative and cooperative patients, excellent expansion potential, physician referrals. Wonderful place to raise a family. Retiring seller will stay for transition. mainefootdoc@yahoo.com

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