The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

June 24, 2009 #3,579 Publisher-Barry Block, DPM, JD

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NC Podiatrist Discusses Home Pedicures

Be careful with water temperature, says podiatrist Roxanne Burgess of Queen City Foot and Ankle Specialists. Soaking can soften callused areas, but if the water is too hot, it can suck the moisture out of your feet.

Dr. Roxanne Burgess

Cleanliness and sterilization are always important, Burgess says, but the risk of toe fungus is decreased in a home setting, where pedicure implements are less likely to be shared. To be safe, give your instruments a quick wipe with rubbing alcohol to clean before you start. Dry your foot before trimming nails straight across with nail clippers Burgess says, to lessen the chance of painful ingrown toenails.

Toenails should be kept short, she says. If not, they'll rub against shoes, and the pressure will turn the nail bed black. Contrary to some advice, Burgess says, do not push back or trim cuticles. "(Cuticles) attach the skin to the nail plate and keep fungus from getting under the nail," she says.

Source: Rachel Sutherland, The News and Observer [6/22/09]

OCPM’s Glass Slipper Fete Raises $45,000 for Student Scholarship Fund

The 5th Annual Ohio College of Podiatric Medicine (OCPM) Glass Slipper Fete was recently held in Independence, Ohio.  The black-tie (optional) event featured a silent and live auction, hors d’oeuvres, a formal sit down dinner, and music and dancing to the band “The Avenue.” 285 event guests helped the college raise $45,000 for the OCPM Student Scholarship Fund, which supports financial assistance to OCPM students. 

Dr. Jeffrey Robbins gives his acceptance speech for the OCPM Hall of Fame

The highlight of the evening was the induction of three prominent OCPM alumni into the OCPM Hall of Fame Society. The OCPM Hall of Fame Society is the highest honor given to an OCPM alumnus and is designed to recognize alumni who have demonstrated major accomplishments to the profession.  The 2009 Hall of Fame class included Dr. James Conforti, class of 1944, Dr. H. Darrel Darby, class of 1956, and Dr. Jeffrey Robbins, class of 1976.

AZ Podiatrist to Complete 3-Year Residency in MI

Trevor Whiting, DPM, of Eagar, AZ has completed the doctor of podiatric medicine degree at the Arizona Podiatric Medicine Program of Midwestern University. An official graduation ceremony and conferring of degrees took place on the MWU Campus in Glendale on June 5.     

Dr. Trevor Whiting

Whiting said his wife, Jennifer Whiting, was his source of inspiration  by supporting him in all of his efforts during the entire podiatric medical school experience. Following graduation, Whiting plans to complete a three-year podiatric surgery and medicine residency program at Henry Ford Wyandotte Hospital in Wyandotte, MI.
     
Source: WMICentral.com [6/23/09]

Democratic Leaders Stay Cold on Single-Payer

Advocates of a single-payer health system finally got their hearing in Congress, but they remain on the outside looking in as Democratic committee leaders seek to reform -- but not eliminate -- private health insurance.

Supporters of single-payer health care, in which the federal government would be the sole third-party payer, are frustrated. They cite national polls indicating that a majority of Americans support their proposal. They also say such a system would slow the growth of health spending by vastly improving preventive care and eliminating the administrative costs incurred by the roughly 1,300 health plans in the U.S.

Democratic leaders favor creating a public health insurance plan to serve as competition to private health plans, rather than radically transforming the health system. Republicans staunchly oppose a single-payer system, and they say a public plan option eventually would lead that way by unfairly competing against private plans and luring away consumers.

Source: Doug Trapp, AMNews [6/22/09]

A Quick Fix for Your Slow Computer

Ask yourself this question whenever you notice that your computer seems to be running more slowly than usual: “How many files are cluttering my computer desktop?” To speed your computer functions, clean your desktop.

Problem: Every time Windows launches, the program must devote operating memory to all files on the desktop. Shortcut files take little memory, but other types of files— especially photos—require much memory and that forces the system to compensate using a process called memory paging.

Solution: Place your files into the My Documents folder. Create separate subfolders, if you have a lot of files. The simple act of cleaning your desktop will free operating memory and allow your computer to run faster.

Source— Adapted from “Speed Up Windows: Clean Your Windows Desktop,” Mark Baggensen via Communication Briefing

Query: Neuropathy From Chemotherapy

I have a 59 year old female patient who had chemo for breast cancer starting in October 2008. Her last dose of chemo was in February 2009.  She has profound neuropathy to the plantar aspect of both feet with her left foot being worse in her opinion. She cannot feel the Semmes-Weinstein monofilament wire to the bottoms of either foot. She is on Neurontin and Zoloft by her PCP. I will try Metanx BID for now, but wonder if adding Lyrica or Cymbalta may also be beneficial. Any favorable results with any of these drugs for chemo-induced neuropathy?

Jim Benedict, DPM, Kent, OH
 

RE: Liquid Nitrogen for Verruca (Elliot Udell, DPM)
From: Jasen Langley, DPM

We have been using the Cryoprobe for the past two years and getting very good result on warts, porokeratosis, etc. It is easier and less cumbersome than liquid nitrogen, and it is certainly more effective than products we have used with liquid nitrogen.
  
Jasen Langley, DPM, Howell, NJ, jas4footsurg@aol.com 
 

RE: Wound Care and Nursing Home (Ashley A. Keren, DPM)
From: Multiple Respondents

The nursing home has the right to determine who can do what and under what circumstances, but if you see some other serious foot pathology while treating a patients nails, it is imperative that you document it in the chart and note that you apprised the authorities of the nursing home that urgent care is necessary. That way, if the order falls through the cracks, and the ulcer gets worse and has not been properly treated, at least you have proof that you did everything in your limited capacity to help that patient. I would also recommend that you make a copy of those orders and take them home with you. 
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

I have a formal relationship with the nursing homes that I attend. I have a written agreement, signed by the administrator of the home that I will provide podiatry services to the home according to my scope of licensure. I rely upon referrals from the residents primary doctor for treating and managing a wound.  until i receive the referral I do not start treatment. On the other hand, if during my podiatry service, I discover a wound, I call the nurse to the room and identify the wound to her. I then have the nurse call the PCP and brief them on the wound and ask if they want the podiatrist to treat. Most PCPs welcome podiatric input and treatment on wound of the feet. This relieves them of extra work. I make sure that a progress note is written in the record reflecting that I was consulted for the care. I even make sure that the nurse's consult to me is written and specific and I get a copy for my records. 
 
Dan Klein, DPM, Ft. Smith, AR, toefixer@aol.com

Perhaps you have discovered why you were presented this opportunity.  If you can be satisfied being a twenty-plus year educated toenail clipper, that is your option. Personally, I would thank the nursing home for extending you this opportunity, but respectfully decline the offer to provide them services. Your concern should always be the liability you might incur by acquiescing to a subordinate (the director of nursing or the administrator) while neglecting your professional responsibilities (ask your healthcare attorney to review any contract).

On another note, you will find yourself having to find Medicare-eligible reasons to trim toenails, or spend an inordinate amount of time trying to collect money from family members who will demand you bill it to Medicare or simply refuse to pay.

Richard A. Simmons, DPM, Viera, FL, rasdpm32822@aol.com
 

RE: Dorsiflexory Night Splint Denial (Paul Kesselman, DPM)
From: Jason Cohen, DPM

I too have received several denials for previously covered L4396 items. It would seem that the LCD covering these services was changed on 6/1/2009, but after careful review of the LCD, I am unclear why the claims are being denied. I never used a KX modifier when billing for these items. Is this required now as of 6/1/2009, and what would the KX modifier represent?
 
Jason Cohen, DPM, Bronx, NY, phootdr@optonline.net
 

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

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.

Whether you have used equipment to sell or our offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 11,500 DPM's. Write to  bblock@podiatrym.com or call (718) 897-9700 for details. THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451 Ext 110.

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