The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

June 23, 2009 #3,578 Publisher-Barry Block, DPM, JD

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Wearing Flip-Flops Requires Sensible Use: MO Podiatrist

Podiatrists say they see more complaints of plantar fasciitis (heel pain and inflammation) during the summer months, particularly after people get back from vacation. "I definitely see issues with people when summer comes and all they're in is little flimsy flip-flops," said Dr. Seth Anderson of Missouri Foot and Ankle in Creve Coeur. Flip-flops were originally intended for short distances, namely to protect feet from the hot sandy beach. Now they're worn to work, weddings and even the White House.

Dr. Seth Anderson

Flip-flops launched a footwear fiasco in 2005 when several members of the Northwestern women's national champion lacrosse team wore them to a visit at the White House. Etiquette gurus cringed at the exposed toes shown in photos of the offending soles. But aside from any dress code or etiquette violations, flip-flops aren't so bad for anyone with perfect feet. "Usually if you don't have underlying issues and you're somewhat sensible about it, you can get away with wearing sandals more often," Anderson said.

Source:  Blythe Bernhard, St. Louis Post-Dispatch, [06/18/2009]

Alumni Assn Pledges Gift for NYCPM’s Centennial Celebration

While the economy is clearly mired in a deep recession, “The financial condition of the New York College of Podiatric Medicine’s Alumni Association has never been better,” says Terry Spilken, DPM, the retiring association president. At a meeting this weekend, the board voted to approve a donation of $10,000 each year for the next three years in honor of the college’s upcoming 100th anniversary celebration. These funds will likely be used to renovate the college’s library.

Dr. Terry Spilken, Shane Baker, Dr. Alan Bass, Bobbi, Alicia & Shari Frankel, Dr. Steven Plotka

At the meeting, the association presented the second annual Bruce Frankel Award and scholarship to Shane Baker of the Class of 2010. Baker is well-known and respected by his classmates and was chosen for dedication to his fellow students through his extensive tutoring. Shane is also involved in research at the college and volunteers for Special Olympics. He embodies many of the characteristics of Dr. Frankel, who dedicated most of his life to serving the college. “He’s the first to arrive at school, and the last to leave,” said Joseph Santi, one of his classmates.

More Practices Refusing to Accept Credit Cards

Even as patients increasingly are paying for care out of their own pockets, more practices are stopping them from doing so with one of the most-used items in their wallets: credit cards.

A third of physician practices did not accept credit cards as of April, up 5 points from 28% last year, according to SK&A Information Services. The company, which aggregates data on physician practices for pharmaceutical and device manufacturing companies, did a telephone survey of 202,650 physician offices nationwide at the behest of an undisclosed credit-card company client.

Still, practice management consultants say the option of credit cards is well worth the cost of transaction fees, compared with issuing paper statements and dealing with the hassles and costs of bounced checks, which practices are reporting seeing with greater frequency.

Source: Bob Cook, AMNews [6/22/09]

Practice What You Preach.

Do you advise all of your post-op and injury patients to rest, ice, and elevate? If so, how do they do that while waiting for you in your reception area? A great solution is to purchase small foot stools on wheels. These are easily stored under end tables and moved around the room. It is a great gesture and shows your concern when the staff knows to provide these for your patients' use.

Jon Purdy, DPM, New Iberia, LA    For information on the American Academy of Podiatric Practice Administration click here.

RE: Wound Care and Nursing Home
 
Several weeks ago, I was presented with an opportunity to see patients in a local nursing home. Shortly after I started seeing patients, the administrator of the nursing home  told me in a face-to-face meeting that my obligations included only cutting patients' nails, and  asked me to defer all wound care to a "wound care specialist", i.e., a nurse practitioner/wound care nurse who attends to the same residents. I made it very clear to the administration that this scope of my "obligations" presented a problem for me.

A week later, a memo was circulated among all nursing units which stated that I MAY treat the wound on a patient's foot if there is a consult from a primary care physician specifically stating that the podiatry consult is for the wound. If it is not documented that the consult is for the wound, I am to assume that the consult is just for the nails. I suppose if I happen to see a wound upon examining a patient, I should just pretend it is not there. I am looking for suggestions on how to handle this situation.    
 
Ashley A. Keren, DPM,Buffalo Grove, IL

Query: Dorsiflexory Night Splint Denial

I dispensed a dorsiflexory night splint (L4396) to a Medicare recipient who has plantar fasciitis (ICD-9 728.71). I was denied by my DMERC carrier with an explanation of CO-50: "These are non-covered services because this is not deemed a 'medical necessity' by the payer." Any thoughts?

David Sands, DPM, Great Neck, NY

Response: There was an issue with non-payment for night splints for plantar fasciitis several years ago when the policy was revised. I, however, have not seen this issue come up since.

Other reasons for rejection could include:

1) Lack of the LT/RT modifier; or
2) Lack of the KX modifier.

If these modifiers were not used, then your claim would similarly be denied.

Paul Kesselman, DPM, Woodside, NY

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

RE: Liquid Nitrogen for Verruca (Elliot Udell, DPM)
From: Greg Aposperis, DPM , John Hahn, DPM

I bought the Cryoprobe several years ago for several hundred dollars.  I was also impressed by the design and laser-like application. However, the freezing agent cost $20/canister and was only good for a few days once you began to use it.  Additionally, I found the unit leaked nitrogen and I could only treat 2-3 patients, over a few days, before the unit ran out.

I was told that the reason was that I was tightening the unit too much and rupturing a gasket.  I purchased extra gaskets and ran into the same problem.  I finally returned the probe and paid a $250 restocking fee.

Greg Aposperis, DPM, Santa Barbara, CA, santabarbarafootclinic@yahoo.com

Editor’s note: An extended-length letter by Dr. Hahn appears at: http://www.podiatrym.com/letters2.cfm?id=26980&start=1

Book Airfare Early or Wait?

When is the best time to book the cheapest flight?  There are websites that try to predict the fares (farecast.com).  Various travel writers have come up with various lead times for the best deal, frequently either several months or just a month out.

There is another way to get peace of mind, use the tracking service Yapta (yapta.com). Yapta takes your flight details (either entered manually or by giving it your record locator number) and watches your flight every few hours.  If the price goes down, you get an e-mail alert.

It turns out that for most airlines, even if you have a heavily restricted ticket with $150 change fees, you can still get a travel voucher used for future flights if you call and ask. Not every ticket will trigger an alert: in fact, most airfares go up and up.  But I’ve had about 4 or 5 go down, resulting in a couple of hundred dollars in vouchers.  And it only takes a couple of minutes to enter the information, less if you install Yapta’s web browser add-on.

Source: Gregg Marshall, CPMR, CSP, is a speaker, author and consultant. He can be reached by e-mail at gmarshall@repconnection.com

CASE CONSULTING

Dennis Shavelson, DPM is accepting referrals of difficult cases involving biomechanics, surgical complications, non-healing wounds, pigmented & derm lesions, PRP and diagnostic dilemma’s from DPM’S. Full reporting with second opinion only and rapid return after care options. Medicare and Out-of-Network Only. (212) 288-3668 or drsha@lifestylepodiatry.com

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.

SALES REPRESENTATIVES WANTED

SureFit has immediate openings for three sales representatives – one for Midwest, Mid-Atlantic and Southeast territories. Responsibilities include but are not limited to obtaining new business, executing sales strategy, initiating contact with customers, identifying their needs and selling appropriate products to meet those needs. Ideal candidate will be enthusiastic, highly motivated individual with a positive attitude who prefers a team environment. Minimum requirements include Bachelor’s degree, 3+ yrs sales experience, preferably in Podiatry and/or O&P Industries. Position requires up to 70% travel with residency in each territory. Please e-mail resume and references to: James R. Grady, Director of Sales SureFit jgrady@surefitlab.com

PRACTICE FOR SALE - WASHINGTON STATE: BELLINGHAM 

With Medicare-Approved ASC, located by hospital and in medical community. Seller will consider financing. This is an exceptional value. Bellingham is rated in national magazines as one of the most desirable places to live or retire. 386 597-5766 or 260 402-7490. 

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

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

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/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

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

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