The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

June 19, 2010 #3,888 Publisher-Barry Block, DPM, JD

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Patricia E. Kopenhaver, DPM, MA  

PM News is saddened to report the death of Dr. Patricia E. Kopenhaver. A graduate of the New York College of Podiatric Medicine, Dr. Kopenhaver earned a Bachelor's degree from George Washington University and a Master of Arts degree from Columbia University. 

Dr. Patricia E. Kopenhaver

From 1969 to 1978, Dr. Kopenhaver was President of the American Association of Women Podiatrists (AAWP). Her accomplishments and her dedication to podiatric medicine earned Dr. Kopenhaver many honors, including the Alumna of Distinction Award from NYCPM in 1997. From 1998 to 2005, she served as a member of the Boards of Trustees of NYCPM and its clinical affiliate, Foot Clinics of New York.

Ill-Fitting Shoes are Biggest Problem for Diabetics: PA Podiatrist

If you have diabetes, it’s critically important to pay attention to your feet. Shoes that rub or pinch can cause foot ulcers, a major diabetic complication. In fact, one study says that ill-fitting shoes are the most common precipitator of foot ulcers. And if not detected and treated early, foot ulcers can become infected and even lead to amputation.

Dr. Lee Sanders

"The biggest mistake that people with diabetes make with regard to their feet is that they are not fit properly for a pair of shoes. The shoe has got to fit." says Lee Sanders, DPM, Chief of Podiatry Services at the Veterans Affairs Medical Center in Lebanon, Pennsylvania, and co-author of A Practical Manual of Diabetic Foot Care (Wiley-Blackwell).

Source: Johns Hopkins Health Alerts via Bob Levoy

VA Podiatrist Joins Hospital Wound Care Team

Lewis-Gale Hospital has announced the addition of Dr. David L. Nielson to the wound care team. The team consists of vascular, general, plastic, and podiatric surgery. This team is running the wound care center, which has two hyperbaric tanks, TCPO₂ and an array of wound care equipment. 

Dr. David Nielson

Each physician had to go to a one-week intensive hyperbaric training certification program and a two-day wound care seminar. "It is a pleasure and honor to be working with a great team from many different specialties. My thanks to those who have gone on before to pave the way for podiatry to become integrated into the hospital settings," said Nielson.

CMS Will Process Claims on Friday June 18, with 21 Percent Cut

As the clock continues to tick toward the June 18 final deadline for implementation of the 21.3 percent cut in Medicare physician payments produced by the sustainable growth rate (SGR) formula, U.S. Senate debate continued June 17 over H.R. 4213, the American Jobs and Closing Tax Loopholes Act. In addition to providing another short-term reprieve from the impending Medicare cut, the legislation would increase federal Medicaid funding and extend various expiring programs, such as disaster relief and long-term unemployment insurance benefits.

If legislation is not signed into law before the weekend, the Centers for Medicare and Medicaid Services (CMS) will have no option but to instruct its contractors to begin processing Medicare claims for physician services provided in June at rates that reflect the 21.3 percent cut.

Source: AMA Alert [6/17/10}

Lighten up on Attachments

Once “snail mail” was the only option; then came overnight delivery. Fax technology opened new opportunities, and then e-mail revolutionized business communication. Suddenly, you could send digital files instantaneously. The only problem? As files became bigger and bigger, e-mail attachments began to clog your contacts’ inboxes.

Better: Send a link. Want to show a prospective patient what a podiatrist can treat? Post a video on YouTube and send the link to anyone you want. If the video is well done, it could “go viral” and become a YouTube sensation.

Source: Adapted from “The 25 Golden Rules of E-Mail,” Eric Griffith via Communication Briefings

Don't Mix Singular with Plural

Always match the appropriate pronoun with its noun. Keep in mind that a singular noun must be coupled with a singular pronoun, and a plural noun must be coupled with a plural pronoun. Examples:

Incorrect: When I asked the patient to pay for orthotics, they refused. 

Correct: When I asked the patient to pay for orthotics, he (she) refused.

Correct: When I asked my patients to pay for orthotics, they refused.

Those interested in finding out more about the American Podiatric Medical Writers Association can write to bblock@podiatrym.com

Query: Bunionectomy - Base Wedge Osteotomy

When a McBride-type bunionectomy and a closing base wedge osteotomy of the first metatarsal are performed in combination, how does one bill these procedures correctly? What are the most appropriate codes to use?

John Jurcisin, DPM ,New York, NY
 
Response: I suggest billing CPT 29292 in combination with CPT 28306. CPT 28296 defines a bunionectomy with distal osteotomy (all the parenthetical examples are distal osteotomies). Append a "-59" modifier on CPT 28306.

Tony Poggio, DPM, Alameda, CA

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

RE: Integrative Podiatric Medicine (Elliot Udell, DPM)
From: Robert Bijak, DPM, Marc Katz, DPM

Podiatry fought for the right to prescribe drugs. Now, Dr. Katz blames what he calls "Pharma" for not looking out for patients' and doctors' interests. So, are we not to write scripts because there have been deaths? Any wonder podiatrists are being "detailed" less than before? Dr. Katz claims he's the expert and implies a conspiracy against the patients and doctors. Podiatrists like Dr. Katz and Dr. Kornfeld keep pushing us further away from mainstream medicine. Dr. Katz also says he will not be held by government guidelines. I assume than he does not take Medicare or other insurances because they all have guidelines. 
 
As for Dr. Kornfeld's letter, it smacks more of a magical belief system that none but its practitioners can appreciate, as no large body of evidence substantiates homeopathy. Does Dr. Kornfeld's malpractice carrier cover his non-standard practice if something should go wrong? With all this talk of immune systems and neurotransmitters, I wonder if this falls under the scope of a limited licensed practitioner who has not had general medical training? On the positive side, I'll bet he makes money. And for some, that's what it's all about. 

Robert Bijak, DPM, Clarence Center, NY rbijak@aol.com

Editor’s Note: Dr. Katz’s extended-length letter can be read here.

RE: Problems With Eclypsis
From: Jeff Bean, DPM:

I am a Medinotes user for about 8 years, and my father had used it for years before that. A local podiatrist friend of mine bought Medinotes about a month or so before they announced that it would be discontinued. There was no disclosure by Eclypsis that they were going to discontinue the product. When he found out, Eclypsis refused to refund his money or offer any restitution at all. That sounds illegal to me.

Eclypsis automatically charged my credit card this year for my yearly fees without my consent. The only reason they had my credit card number was from my payment the previous year. I never authorized an automatic payment or any use of my credit card whatsoever. The only notification I received was an entry on my credit card statement from the bank. Then, about a month later, Eclypsis billed me for the full amount by mail even though they had already illegally gotten the money from my credit card.

From what I have experienced so far, I would discourage anyone from doing business with them. Even though I have a significant investment of time and money over the years with Medinotes, I have chosen to switch to another company's product.  

Jeff Bean, DPM, Carson City, NV, greenbean5@juno.com

RE: Dragon Questions (Burton Katzen, DPM)
From: Simon Young, DPM

I upgraded to Dragon v10 Medical, and ultimately 10.1 Medical. I find it worse than v9.5 Professional. It has been very difficult to use. I find there is a glitch in the program. I hope to see improvements in v11 Medical.  

Simon Young, DPM, NY, NY, simonyoung@juno.com

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

I want to comment and highlight some of what Dr. Gordon has said. Some of the key ingredients to successful mergers are “shared values” and starting with “entrepreneurial docs.” You have to make sure that everyone is on the same team. There is really no easy way to do this, but it can be done, if you are all committed. Trusted leadership and a competent management team  are going to be the keys to your success. You can’t have 20 chiefs running the show. One thing I have found is that committees in the beginning are good but can also slow down progress.

My biggest concern in the current marketplace is that you see lots of consultants charging fees regardless of whether the group mergers are successful. I also urge each and every one of you to view this process as creating a healthcare company with some type of vision for either a liquidity event or strategic partner who will infuse capital into your final model at a multiple far more than you would ever get as a practicing physician.

Unfortunately, as a practicing physician, you are only worth fifty cents of every dollar that you collect, but as a healthcare company with all the right ancillaries, your value goes up exponentially. My only added recommendation is to make sure that you do your homework and seek wise counsel, but don’t be penny wise and pound foolish. It’s going to cost you for top talent, and that is what is required for running a successful company.

David N. Helfman, DPM, Atlanta, GA, dhelfman@vpcenters.com

PRACTICE & BUILDING FOR SALE - MIDDLE TENNESSEE

Two locations each with 3 exam rooms, x-ray room, large waiting room, and ample parking. Excellent locations and growth potential. All equipment and furniture included. Website and marketing material included. Seller happy to assist with transition. Grossed 350K last year, priced to sell with financing available 200k. Call 931-446-5724.

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

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