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| PM News | |
The Voice of Podiatrists
Serving Over 18,609 Subscribers Daily
June 22, 2018 #6, 214  Publisher-Barry Block, DPM, JD
A partner of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2018- No part of PM News can be reproduced without the
written permission of Barry Block
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| PM NEWS QUICK POLL |
Quick Poll
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Do you prescribe uric acid lowering drug for the management of acute or chronic gout?
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| APMA STATE COMPONENT NEWS | |
Podiatists Improve Health Outcomes, Cost Savings in Obese Patients: NYSPMA Study
A research-based study by the New York State Podiatric Medical Association (NYSPMA) – the largest statewide component of the American Podiatric Medical Association (APMA) – showed that incorporating podiatric care may decrease healthcare costs among obese patients by $1.1 billion. The study also revealed a 19 percent reduction in the odds of a subsequent inpatient admission among obese individuals receiving services provided by a podiatrist.
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Dr. Paul Liswood |
“Our feet carry our entire body weight around and the more you weigh, the harder they work to support you,” said NYSPMA President, Dr. Paul Liswood. “Being overweight can also cause your posture and gait to change, which can affect the arches and tendons in the feet and ankles. Podiatry plays a key role in the prevention and management of chronic diseases, such as obesity, allowing patients to improve their quality of life and increase mobility.”
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| PODIATRISTS AND FOOTWEAR | |
TX Podiatrist Provides Summer Shoe-Buying Advice
Summer is here and if you’re ready to jump in feet first, be sure you’re wearing the right shoes. A podiatrist at Baylor College of Medicine offers tips on finding the right shoe for different types of summer vacations. “The type of vacation you go on will determine the type of shoe you need,” said Dr. Ronald Lepow, assistant professor in the Joseph Barnhart Department of Orthopedic Surgery at Baylor. In general, shoes depend on the type of activity rather than the weather.
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Dr. Ronald Lepow |
When you set out to find the right shoe, try going in the afternoon hours after you have been on your feet. Because your feet tend to be swollen at the end of the day, this will help you find an appropriate shoe that accommodates this swelling. Any shoe that you purchase should be broken in a couple of weeks ahead of the trip. To do this, Lepow suggests walking around the house in the shoes, massaging leather shoes, bending your shoes, and using shoe inserts to stretch the shoe.
Source: Dipali Pathek, bcm.com [6/19/18]
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| INTERNATIONAL PODIATRISTS IN THE NEWS | |
Feet Need Year-Round Attention: UK Podiatrist
We all know the importance of regular eye tests and dental check-ups, but what about those forgotten foot soldiers that pound the pavements every day? With summer finally here and the thought of getting our feet out on the beach very much on our minds, we spoke to podiatrist Dr. Bharti Rajput to find out what she'd like us to know.
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Dr. Bharti Rajput |
"When it's hotter in summer, people want to get their feet out and they come to us saying, 'I need to wear my sandals, can you just get rid of my fungal infection?' Of course, we can help, but summer feet are made in the winter. They need TLC all year round. We're taught how to brush our teeth and we go to the dentist once or twice a year, but people don't think about going to the podiatrist twice a year. That's something we should be changing."
Source: Alison Lynch, Net Doctor [6/20/18]
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| PRACTICE MANAGEMENT TIP OF THE DAY | |
Three Keys to Efficiently Collect from Patients - Part 3
3. Keep it Impersonal
When patients don’t pay, you have to decide how far to push for the payment. “If patients are not responsive to your request for payment, if they’re not returning your calls, you’ve probably already lost the patient,” says says Laurie Morgan, a San Francisco-based senior consultant and partner with medical consulting firm Capko & Morgan. “Stop wasting money trying to collect something you’ll never get.” Collecting from patients might take a bit more finesse than working with insurance companies and CMS, but with a few good strategies and some understanding, it can go well.
When you do collect, make sure you do it consistently. Alina Collins, office manager at First Coast Family Medicine in Jacksonville, FL runs a report every week; when a payment is three months past due, it automatically goes to a collections agency. If you’re very clear about this policy upfront, there should be no hard feelings from patients—and the collection agency can be the bad guy. "It's nice to not have to deal with that," says Collins. "And the telephone doesn't ring so much, either."
Source: Avery Hurt, Physicians Practice [6/7/18]
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| CODINGLINE CORNER | |
Query: Additional Work for Bunionectomy
I was performing an Austin bunionectomy and inadvertently severed the extensor tendon while making my osteotomy. After the completion of the bunion procedure, I repaired the severed tendon with a modified Krakow stitch. When billing for this surgery, is it appropriate to bill for the tendon repair along with the bunionectomy?
Archived Codingline Question
Response: I would not bill for the repair. It was iatrogenic even though inadvertent and it should be repaired. It's not fair to bill the insurance company or the patient for that. Even if the tendon needed to be lengthened or otherwise worked on, it is still part of the “bunion correction” and even in this scenario, I would not bill it.
Tony Poggio, DPM, Alameda, CA
For information on Codingline subscriptions, click here
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| RESPONSES/COMMENTS - (CLINICAL) | |
RE: Dermal Sarcoma
These photos show a dermal sarcoma that tripled in size over a 6-week period. The patient initially presented with a small lesion that a previous DPM tried to aspirate with no success. When I initially saw him, I told him we needed to excise the mass on an outpatient basis. Due to vacations, both his and mine, and failure to get authorization from his insurance company in a timely manner, we had to wait 6 weeks for the surgery.
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Sarcoma pre-op, the excised lesion, and regrowth |
The first photo shows what it looked like prior to that surgery. After the path report came back as dermal sarcoma, I spoke to his oncologist who said radiation would be necessary once healed, however within a 4-week period, the growth returned. The oncologist said to re-excise the mass, which we did this past Friday with extra wide margins. Once healed, he will have radiation. The path report once again said dermal sarcoma. It should be noted that after the first procedure, both a PET scan and CT scan where essentially negative, except for the obvious hot spot localized in the foot.
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| RESPONSES/COMMENTS (CLINICAL) - PART 1A | |
From: Paul Clint Jones, DPM, Thomas Graziano DPM, MD
The quick way to triangulate the intra-tendinous ossicle is to use a 25 gauge needle to probe the tendon intra-operatively to locate the mass, then dissect the mass free. If there is too much of the tendon missing following the ossicle removal, then doing a split tendon autograft works nicely. This is a technique developed by John Mozena, DPM. I made an animation that shows the technique nicely.
Paul Clint Jones, DPM, Portland, OR
I recommend you refer this patient out to someone who regularly performs this procedure. No magical mystery cures for this condition. The Achilles tendon needs to be detached, ostectomy performed with Achilles tenodesis. The newer fixation techniques for Achilles tenodesis are excellent and provide exceptional stability and repair.
Thomas Graziano DPM, MD, Clifton, NJ
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| RESPONSES/COMMENTS (CLINICAL) - PART 1B | |
From: James Nuzzo, DPM, Matthew Andrews, DPM
I have been successful on a number of occasions entering the area laterally and incising the tendo-Achilles longitudinally, removing the spur without detaching the tendon completely, maybe sometimes partially, It negated the potential for using an anchor to re-attach the tendon Achilles. It is of course important to make sure that the intrinsic presence of the spur is causing the pain.
James Nuzzo, DPM, Mount Prospect, IL
The radiograph demonstrates a calcific density which is likely enshrouded by the Achilles tendon. I have had good success with detachment of the tendon with tendon debridement, remodeling of the posterior heel, and re-attachment using the Stryker sonic anchor with immediate weight-bearing in a CAM boot. We use the sonic anchor with #2 braided suture (included in the kit) with excellent results. For significant tendon degeneration, we also augment with a Stravix graft.
Matthew Andrews, DPM, Sterling Heights, MI
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| RESPONSES/COMMENTS (NEWS STORIES) | |
From: JP McAleer, DPM
Colleagues, I invite you to read the requested sources found below. I agree it is a disquieting thought when we realize that there may be a better way to approach our surgical specialty. I have found that the Lapiplasty 3D Bunion Correction Procedure has been a ‘game changer’ for my patients, and I am proud to offer it to them. I respectfully invite you, the podiatric and foot/ankle ortho community, to read Dr. Paul Dayton’s book -Evidence-based Bunion Surgery as well as the current journal literature touting the benefits of triplane correction.
30% radiographic recurrence after Scarf at 10 years (Bock, et al., JBJS 2015)
65% radiographic recurrence after proximal open wedge at 2.4 years (Iyer, S et al., FAI 2015)
73% radiographic recurrence after distal chevron at 8 years (Pentikainen, et al., FAI 2014)
73% & 78% radiographic recurrence after Scarf and chevron respectively at 14 years (Jeuken, et al., FAI 2016)
Incomplete reduction of the sesamoids - 10x recurrence risk (Okuda, et al., JBJS 2009)
Incomplete reduction of metatarsal rotation - 12x recurrence risk (Okuda et al., JBJS 2007)
Also - please note that I was misquoted. I stated “Traditional bunion surgery has up to a 70% rate of recurrence based upon the literature.” I am working on having the printed article corrected.
JP McAleer, DPM, Jefferson City, MO
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| RESPONSES/COMMENTS (NEWS STORIES) - PART 2B | |
From: Joseph Borreggine, DPM
The “new” bunion procedure that is called the lapiplasty which was brought to fruition by Dr. Paul Dayton, et al. and his team certainly has “changed” the way we look at the biomechanics of a bunion deformity, let alone, how to correct it. But, the question I pose to the PM News readers and to my podiatric colleagues: is this bunion procedure the pinnacle of podiatric surgical success because of its continual outcome of “reproducible” results along with reduction in bunion deformity re-occurrence?
Or is this procedure driven like most of our profession’s innovations by the vendor dollars created by performing said procedure? Or is this procedure’s ability to stay in the limelight of surgical success fueled by the...
Editor's note: Dr. Borreggine's extended-length letter can be read here.
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| YOU CAN'T MAKE THESE THINGS UP | |
RE: Outrageous Shoes of the Day
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Inspired by rams! |
Source: Iskender Asanaliev via Virtual Shoe Museum
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MEETING NOTICES
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PM PODIATRY HALL OF FAME CEREMONY & RECEPTION
July 12, 2018 – Gaylord National Resort - Washington, DC
Honoring Brad Wenstrup, DPM and Dan Vickers
Sponsored by Bako Diagnostics (Bronze), PICA (Bronze), and Sammy Systems (Bronze)
PM News subscribers are invited to see Dr. Wenstrup and Mr. Vickers inducted in the PM Podiatry Hall of Fame, including roasts by special guests.
All ticket proceeds go to the APMA Educational Foundation Student Endowment Fund. Reserve your tickets now by sending $75 per ticket to: APMA Educational Foundation Student Scholarship Fund, 9312 Old Georgetown Road, Bethesda, MD 20814 or via the APMA Meeting registration form.
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| CLASSIFIED ADS - PART 1 - 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 plastic, 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 - ST. LOUIS AREA
Full time associate position immediately available in busy office. Multiple offices/locations. PSR-36 or 24 board qualified/certified foot and ankle surgeon. Competitive benefit package. Send CV to smadpm@charter.net.
ASSOCIATE POSITION - NASSAU COUNTY, NY
Exciting opportunity! Busy Nassau County, NY office seeks full time podiatrist. State-of-the-art facility. Complete EMR, digital radiograph and diagnostic ultrasound. Excellent salary and benefits. Must be board qualified. Please e-mail resume to: Medicalofficeinquiry@gmail.com, or call: 516-902-1073
ASSOCIATE POSITION WANTED - HUDSON VALLEY, NY
Full time associate position immediately availablein a busy office. Broad responsibilities including wound care, trauma call, hospital rounding, etc. Surgical based practice with privileges to local hospital and surgical center. Comparable pay. Position available Sept. 2018, will wait for right graduate. Office is located in the beautiful Hudson Valley. Close proximity to NYC as well as a multitude of outdoor activities. Please send CV in an email to hudsonvalleypodiatrist@gmail.com
ASSOCIATE NEEDED - WARREN/YOUNGSTOWN, OHIO
Ankle & Foot Care Centers operates 20 locations in Northeast Ohio. We are looking to add a full-time podiatric physician to help cover expanding office hours. Tremendous growth opportunity for a hardworking individual with an interest in reconstructive surgery and wound care. To learn more about us, visit our website at www.ankleandfootcare.com Please email your letter of interest and CV to Michael Vallas, Practice Administrator at mike@ankleandfootcare.com.
ASSOCIATE POSITION - HOBOKEN, NJ
ASSOCIATE POSITION - CENTRAL KENTUCKY
This town is home to outstanding college, an hour away from metropolitan market and has a friendly provider environment. Opportunity to build on strong patient base with surgery and in-office dispensing. Competitive salary and benefit package. Contact: MCrosby518@gmail.com
MULTI-LOCATION GROUP - CHICAGO/NEAR WEST SUBURBS
Seeking ABFAS Board Certified/Eligible associate. MINIMUM 2 year private practice experience required. Surgical/ortho patient load. Great staff. DME, Rx, Minimal Incision Sx, EMR, digital x-ray, laser, ultrasound, PRP, shockwave & MRI. PT to FT available- Top pay, associateship & practice equity available for experienced candidates. Send CV info@anklenfoot.com
ASSOCIATE POSTION - CENTRAL NJ
Associate needed for 30+ year busy private practices in Central NJ. Applicant should be personal, independent and motivated. Practice entails all aspects of podiatry. Surgery, orthopedics, wound care, primary care and sports medicine. Competitive compensation package. To apply please email letter of intent and CV to facenters1@gmail.com.
ASSOCIATE POSITION - UPSTATE NY
Rapidly growing practice seeks associate to join and become partner. Key attributes: Board Qualified/Certified, self-starter, willingness to build practice. Partnership starts beginning year 3 based on per-established criteria. Contact: docryanlee@gmail.com
MOBILE PODIATRIST NEEDED - NEW JERSEY
ASSOCIATE POSITION - LONG ISLAND/QUEENS
Advanced Podiatry Seeking Full Time DPM for upscale practices located at the Americana Manhasset, Huntington and Queens. Excellent work environment and company culture. Latest technology with digital x-ray, laser, EHR, Ultrasound, the latest Apple software and iPads. Must be surgically trained, motivated, with a great work ethic. Very competitive salary with significant upside. Visit www.LIFootCare.com and email eavieiradpm@gmail.com for more info.
ASSOCIATE POSITION - GREATER LOS ANGELES AREA
Join the fastest growing mobile podiatry group in California! Full time/part time, you pick your days, you pick your hours, cloud-based EHR, in house billing, dedicated support staff, excellent monthly compensation. email CV to: homefootcare@hotmail.com
ASSOCIATE POSITION - FLORIDA
KG Health Partners, the largest podiatric practice in Florida, is revolutionizing the continuum of care for seniors living in more than 200 long-term facilities in Central Florida. We currently have full-time and part-time openings in the state of Florida. If you are committed to helping seniors live healthy lives, this mobile-based position could be your perfect fit. Our physicians work Monday thru Friday and must maintain active Medicare and Florida licenses. We cover malpractice insurance, medical supplies, travel allowance, etc. Exceptional benefits include paid holidays, health insurance, and 401K retirement plan. Competitive Salary. Email CV kgadmin@kghealthpartners.com
ASSOCIATE POSITION – RENTON-KIRKLAND-EVERETT, WASHINGTON
This is an immediate opening for associate position. He/she must be highly motivated, hard-working podiatrist who is proficient in forefoot and rearfoot surgery. We have 3 office locations and multiple nursing home facilities. Prefer someone personable and a team player. Please email CV to seattlefootdoctor@yahoo.com
ASSOCIATE POSITION - MULTI-LOCATION GROUP - CHICAGO/NEAR WEST SUBURBS
Seeking ABFAS Board Certified/Eligible associate. MINIMUM 2 year private practice experience required. Surgical/ortho patient load. Great staff. DME, Rx, Minimal Incision Sx, EMR, digital x-ray, laser, ultrasound, PRP, shockwave & MRI. PT to FT available- Top pay, associateship & practice equity available for experienced candidates. Send CV info@anklenfoot.com
PM NEWS CLASSIFIED ADS REACH OVER 18,500 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 18,500 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 PART 2 - PRACTICES FOR SALE OR WANTED, EQUIPMENT FOR SALE |
PRACTICE FOR SALE IN SURROUNDING DENVER, COLORADO
Well rounded practice including general podiatry, outside wound care revenue and surgery. Existing doc will stay on for up to 1 year for transition period. Please email sqdpm@afaclinic.com for further details. Visit website: www.afaclinic.com.
OFFICE FOR SALE - NORTHERN, NJ
30 years. Modern Office. Large, off street, parking lot. Northern NJ, Passaic County. All commercial insurance . Fully equipped, 3 treatment rooms, digital x-ray. Priced To Sell. Email to Cj9996@gmail.com Please include cell phone number.
PODIATRY PRACTICE & CO-OP FOR SALE - SHEEPSHEAD BAY/BRIGHTON BEACH--BKLYN, NY
Luxury Co-op building with 24 hr. doorman. Four (4) treatment rooms; Consultation room; Large secretarial work area. Digital x-ray; EHR (Sammy) with networked computers (#5). All phases of podiatry--46 years in practice. Newly renovated. Russian speaking preferable. Contact: irat24@gmail.com
PRACTICE FOR SALE - WESTCHESTER COUNTY, NY
Are you looking to expand & add another location? This is the perfect opportunity to purchase a modern, fully equipped office with the latest technology. Favorable long lease in a medical building with on-site parking. Healthy new patient volume and hospital privileges easily attained. Willing to stay to provide a smooth transition if necessary. Let’s talk. Send letter of interest to DPM626@yahoo.com
PRACTICE FOR SALE – CENTRAL CALIFORNIA
Extremely successful, well-established solo practice (9 years old) grossing $900K for the past six years. After serving the community for 11 years, this turn-key practice is available for purchase. Doctor is relocating and ready to leave everything in place, including the fully functioning staff. Accepts all major insurances, Hospital and Surgical Center privileges, services 1 nursing home as well as volunteer work. Only serious inquiries and interested Doctors may contact toptenpodiatrist@gmail.com
PRACTICE FOR SALE - NEW YORK (BROOME COUNTY, NEAR BINGHAMTON)
RARE PRACTICE OPPORTUNITY: Well established, 38 year old practice. Patient pays for their services. I practice, “Fee-For-Service”/No Insurance. My average work week is 2.5 days. Last 3 years (2015-2017) average gross=$625K and average net=$250K. Practice emphasis is biomechanics, using Video (Dartfish) & F-Scan In-Shoe Pressure Mapping Analysis, as well as PinPointe™ Foot Laser for onychomycosis. Surgical pathology available. Quality and modern 2500 square foot office and equipment. I am ready to retire and have future plans in place and am willing to sell for less than market value. Make an offer! Reply to: uniquepractice@gmail.com
PRACTICE FOR SALE - LOS ANGELES
Practice has been around for 20 years. Robust payer mix including many IPAs and HMO plans. Has 3 exam rooms, and reasonable rent. Landlord willing to sign long-term lease. Doctor is relocating. Buyer must be able to provide proof financial ability to purchase. Please email for further info beorzeh@aol.com
PM NEWS CLASSIFIED ADS REACH OVER 18,500 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 18,500 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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