The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

June 19, 2009 #3,575 Publisher-Barry Block, DPM, JD

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Don't Ignore Foot Pain: OR Podiatrist

Your feet are more than road warriors or prettily painted nails in high heeled peep-toe shoes, they're one of the hardest working and most important parts of your body. "We each take about 10,000 steps a day and that's a lot of pounding," says Oregon podiatrist, Dr. Lynn William Rawcliffe. Here are five things to keep in mind, so that your feet stay happy and healthy.

Dr. Lynn William Rawcliffe

Don't Ignore Pain. Pain is the body's signal that something is wrong, and Dr. Rawcliffe, with Medford and Ashland Foot Clinic, says to pay attention when your feet are yelling for attention.

"Pain can indicate a structural deformity or a soft tissue abnormality like tendonitis, inflammation or arthritis," Dr. Rawcliffe explains. Your foot pain can also be telling you that you need better fitting shoes, shoes that give you the support you need to stand and walk.

Source: Maureen Battistella, Joy Magazine, [6/17/09

CA Podiatrist Hopes to Gain From "Barack" Image

President Barack Obama’s name has become shorthand for a black man with integrity, character and spirituality, one who loves and values his wife and makes his family a priority If women of any race are expecting to find a Barack, they’re bound to be disappointed, said Audrey B. Chapman, a black marriage therapist in Washington, D.C. She thinks many black women are too picky.

Dr. Chris Otiko

Some single black men are hoping Michelle Obama changes that. When the first lady met her husband, he was broke, funny looking and a bit nerdy, said Chris Otiko, 40, a divorced podiatrist in Riverside, Calif., who said when he was a broke medical student, black women wouldn’t go out with him.

He said he hasn’t seen any changes in the dating scene yet but is hopeful that Michelle Obama “will enlighten our African-American women to give guys like me a chance.”

Source: Chicago Sun-Times [617/09]

MO Podiatrist Sentenced for Altering Patient Records

A local podiatrist was sentenced to five months in prison and five months of home confinement for obstructing a federal audit into her fraudulent Medicare claims. 59-year-old Dr. Bic Chau Stafford will also pay $425,000 to the federal government and a $25,000 fine.

Dr. Stafford billed Medicare for numerous complex foot surgery procedures to 39 patients when she was really providing these patients with only routine foot care, such as toe nail clipping. When she was audited by the Medicare program in 2007, Medicare denied her claims for reimbursement regarding these 39 beneficiaries and requested that she re-pay $6,840 to the Medicare program for these non-covered services.

Stafford challenged this. As part of her efforts to avoid paying the overpayment back to the Medicare program, Dr. Stafford created new treatment records for these 39 patients in May 2007, back-dating the records with dates from December 2004 using false and fraudulent treatment information, claiming that she had provided these patients with podiatric surgical procedures instead of routine foot care.

Source: KSDK [6/17/09]

Physicians Worry Health Reform Will Increase Costs

While physicians and other health care professionals believe in the importance of health system reform, many are concerned about the financial impact some changes could have on their practices, according to a recent survey.

IVANS, an insurance and health care services vendor based in Stamford, Conn., found that 72% of surveyed health care entities believe a pay-for-performance model could lead to improved patient outcomes. Seventy-nine percent, however, said it would increase their costs of doing business, most likely due to increased reporting and record-keeping requirements. When it comes to implementing a national health insurance plan, 60% said the move would increase costs or have no affect at all.

Source: AMNews [6/15/09]

Query: New Patient Nursing Home E/M Code

When our podiatrists see a new patient at a nursing home, what is the proper new patient CPT code?

Marc Maikon, DPM, Cedar Rapids, IA

Response: The proper E/M CPT code for non-consultations by specialists (e.g., podiatrists, orthopedists, etc.) is CPT 99307-99310. The codes, CPT 99304 - CPT 99306, are for the admitting physician who perfromes a complete examination as well as setting up physical/occupational/ speech therapy, etc.

Tony Poggio, DPM, Alameda, CA

Codingline subscription information can be found at:
http://www.codingline.com/subscribe.htm

RE: Chronic Pain, Edema, and Neuropathy (Ron Worley, DPM)
From: Barry Mullen, DPM

In deference to Dr. Worley's comments, unilateral edema in an otherwise healthy female is a DVT until proven otherwise. Its potential sequella are much more debilitating than lymphedema. Re-check the history for DVT risk factors (obesity, smoking, BCP's, DM) and whether she recalls, upon 2nd questioning, a blunt trauma to her affected leg. Check for an elevated hematocrit, seen in polycythemia, another risk factor. I'd order a stats venous duplex scan.

The neuropathy symptoms Dr. Wolfington’s patient  experiences are likely a secondary manifestation of the increased hydrostatic pressure on the peripheral nerves from the lymphedema associated with a DVT. These should resolve once treated.

Barry Mullen, DPM, Hackettstown, NJ, yazy630@aol.com

RE: Diabetic Shoes for Odd-Sized Feet (Jennifer Ryder, DPM)
From: Paul Kesselman, DPM, Susan L. Boren

Odd shoes (or split sizes) are available from most large distributors or manufacturers at a surcharge which is less than purchasing two pairs of shoes. For most patients, a split size is not required unless the foot size differential is more than a full size or more. A full size difference or less may usually be accommodated by adding extra inserts, padding, heel counter or tongue pads.

Unfortunately, Medicare and most other third-party payers will not reimburse for this extra charge and this fee should be passed onto the patient. Most patients will be more than willing to pay this extra charge as they may be used to purchasing two pairs of shoes for every one they actually wore.

Paul Kesselman, DPM, Woodside, NY, pkesselman@pol.net

Adding a filler to a custom orthotic is a viable alternative to ordering odd-sized shoes. We commonly do this for patients with one 'short' foot, and/or amputees.  The patient is very satisfied, as they would prefer to wear a matched pair of shoes for appearance, expense, and convenience.
 
Susan L. Boren, President, Earthwalk Orthotics, Inc., eworthotics@neo.rr.com

RE: Francine Schilardi-Deck, DPM
From: M. Joel Morse, DPM, Lester J. Jones, DPM, MS

The American Society of Podiatric Dermatology, its Officers and Board of Directors mourn the passing of Dr. Francine Schiraldi-Deck, who served as our president and executive director for several years. She dedicated herself to the goals and activities of our organization, the understanding of foot health, and the strength of our podiatric profession.

Our thoughts and prayers go out to her husband, children, and community.

M. Joel Morse, DPM, President, American Society of Podiatric Dermatology

It is with great sadness that I add my condolences to the family of Dr. Francine Schiraldi-Deck. I had the pleasure of meeting Francine very early in her professional career, when she was a 4th year student from the New York College of Podiatric Medicine .

Through the years that followed, I was also fortunate enough during the past 25-30 years to serve with her on numerous national committees of the APMA and affiliated organizations; especially with the activities involving the unification of the American Board of Podiatric Orthopaedics with the new Primary Podiatric Medicine Board in the early 1990's. Her many contributions clearly speak for themselves.

She was a delightful, kind and spirited individual with a great love for her family. It was always a pleasure to share experiences involving our families, especially the children. I will certainly miss the pleasure of her company. My best regards and heart-felt sympathy go to her family.
 
Lester J. Jones, DPM, MS, Pomona, CA

ASSOCIATE POSITION WITH POTENTIAL FOR PARTNERSHIP - NJ

Associate needed for multiple location practice in Bergen County N.J. Full or Part-time hours available. Reply by E mail to dr_toefu@hotmail.com

EQUIPMENT FOR SALE -- OFFICE CLOSING

All equipment is 3 years old and in excellent physical and working condition. 1 MTI chair model #524 blue ridge color with matching stool; 2 Midmark M7 Speedclaves; and 1 All-Pro 2010 x-ray processor (2 lightboxes and an older X-cel mid base model will be included). e-mail nefootandankle@optonline.net for further info and pricing.

NEEDED CHICAGO -- NW IND & BALTIMORE/WASHINGTON, DC PODIATRISTS 

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists in Chicago, Northwest Indiana, and Baltimore, MD. Full and part-time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com Visit our website

ASSOCIATE POSITION AVAILABLE-MIDTOWN MANHATTAN 
 
Looking for Full-time associate to work in well established practices in midtown Manhattan and Forest Hills. Immediate opening for PSR 24-36 surgically trained Podiatrist. Great opportunity with competitive salary along with malpractice benefits. Position includes Saturday office hours. Please send CV to slurie@papapc.net

PRACTICE FOR SALE – NEW YORK CITY

NY Manhattan, prime location. Upper East Side, 23. Y.O. practice, high visibility-traffic area next to post office, street level, All phases of Podiatry, NO surgery, retiring due to disability. call 516-759-4062 or Paulfxfeet@aol.com

PRACTICE FOR SALE - FLORIDA—CENTRAL/SOUTH

Turn-key operation grossing $570,000 annually based on one full-time doctor. Great opportunity for growing the top-line. Surgery is only 14% of the professional man-hours; it can significantly increase income. Medicare makes up 64% of revenues. Seller will assist with transition. Call 863-688-1725, ask for Chas.

1-YEAR PODIATRIC SPORTS MEDICINE FELLOWSHIP

Monrovia, California. Applicant must be a licensed podiatrist and have completed a podiatric residency program. Monthly Stipend $4,000 to $5,000. Please email your curriculum vitae to victoriamanagers@gmail.com Thank you for your interest in our Program.

EQUIPMENT FOR SALE

 Amfit Orthotic Making System. Includes new computer, recently updated digitizer, and orthotic mill, and $2,500.00 in supplies (which would generate about $20,000.00 in orthotics). skip the middleman. Cost $35,000.00. Asking $23,000.00 OBO AMERICAN FOOT CLINIC 405-733-2783 OR 405-820-6887 americanfoot@email.com

ASSOCIATE POSITION - CHICAGO AREA

Join one of the most successful, long-established podiatry practices in the Chicago area, with excellent salary and benefits. We have an immediate opening for a full-time podiatrist in a multi practice location in Chicago. Must have two years of surgical residency. Please e-mail resume to f-massuda@footexperts.com

ASSOCIATE POSITION - 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

PRACTICE OPPORTUNITY - DALLAS TEXAS AREA

New practice started in Irving Texas by two 15 year established podiatrists from Austin. We've decided to stay in Austin and travel only for research. Opportunity for new practitioner podiatrist to start practice immediately with no money out-of-pocket. Write to MRobsonDPM@aol.com

ASSOCIATE POSITION/WASHINGTON, DC/SILVER SPRING, MD 
 
Excellent opportunity to join a multi-doctor practice with its own Certified Surgical Center. Practice is full-scope with an emphasis on sports medicine. Competitive salary plus bonus structure. PSR 24+ only. Send CV to hgodpm@verizon.net

OFFICE SPACE/ MRI RENTAL – NYC, LI   
 
Turn-key space available, daily, monthly; East 60th off Park Ave, East 22nd St. off 3rd Ave, Hicksville and/or Plainview Long Island. JACHO-certified operating rooms available, as well as all surgical equipment and anesthesia. Extremity MRI Rental. Stark compliant. All exams read by board certified radiologist. Call for details. 516 476-1815

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