The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

June 26, 2010 #3,894 Publisher-Barry Block, DPM, JD

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We've just posted an article from the June issue of Podiatry Management titled "Retail Custom Orthotics: The Big One That Got Away from Podiatry?" by Jason Kraus. 

Jason Kraus

This article can be accessed by clicking here.

Summer Activities Require Additional Protection for Feet: APMA President

Summer is a great time to stay - or get - active, but you still need to take precautions to ensure your exercise routine is also healthy for your feet.

Dr. Kathleen Stone

"Let's face it - we all have a lot riding on our feet, and we demand a great deal from them, especially when we're engaging in strenuous exercise," says Dr. Kathleen Stone, president of the American Podiatric Medical Association (APMA). "Foot health is a key component of overall health and well-being. Fortunately, it's not difficult to take the right steps toward protecting your feet when you run, jog, power walk, or engage in other exercise."

Source: Creston News Advertiser [6/24/10]

Stress Fractures Becoming More Common in Runners: FL Podiatrist

Stress fractures of the foot are becoming more common in runners, especially first-time marathoners, according to the American College of Foot and Ankle Surgeons. “Runners who increase their mileage too quickly or change to a more intense phase of training may be more susceptible to a stress fracture due to the increased force placed on the bones,” says Alan MacGill, DPM, AACFAS, a foot and ankle surgeon from Boynton Beach, FL. “A general rule of thumb for runners is to increase the mileage by no more than 10 percent each week. Runners who are training also need to have adequate rest time in between runs to help decrease the risk of injury.”

Dr. Alan MacGill

“Stress fractures can occur anywhere in the foot and can eventually lead to a complete break of the bone if left untreated,” Dr. MacGill explained. “Early diagnosis and treatment are important to ensure proper healing.”

Congress Passes Six-Month Medicare-Payment Fix

On Thursday, Congress approved  a bill that averts for six months a planned reduction in fees paid to doctors who treat Medicare patients. The House voted 417-1 to pass the measure, a week after the Senate confirmed it unanimously.

It means that a pending 21% cut in payments to physicians that see Medicare patients will be delayed through the rest of the year. House Speaker Nancy Pelosi (D. CA) said earlier Thursday that in light of the Senate's failure to approve more comprehensive legislation including funds to avoid the payment reductions, the House would move to ensure that doctors don't see the reduction in their payment rates.

Source: Corey Boles, Wall Street Journal {6/24/10]

APMA Scientific Meeting to Feature Timely Topics

The APMA educational program in Seattle will include plenary lectures on these timely and captivating topics:

• The Team Approach to Disaster Relief: Response to Haiti Earthquake
• Kaposi’s Sarcoma: An Update
• Chronic Lower Extremity Pain: New Options for a Difficult Problem

For registration and more information click here. Note that the early bird registration is valid until July 1, 2010.

Query: Mystery Shoppers

Has anyone used "mystery shoppers" or other feedback methods to evaluate staff? What experiences have you had?

Chad Schwarz, Affiliated Foot & Ankle Center, Howell, NJ

Query: Payment for Surgical Trays

Is there ever a situation where the surgical tray, CPT 99070 or A4550, can be billed with a procedure? Is there a code that can be used to get a surgical tray paid when billing it with a surgical procedure in an office setting (e.g., CPT 17004 - destruction, premalignant lesions, 15 or more lesions - or CPT 20680 removal of buried hardware, deep)?

Why would there be a separate code if it is always included in the surgical procedure?

Stephanie S., Office of Joseph Hall, DPM, Mill Creek, WA

Response: Welcome to the conundrum of the coding and billing world. Just because there's a code, it doesn't mean payers will actually reimburse it.

Medicare stopped paying for the A4550 code years ago. Other payers have their own rules for paying these codes. You will need to research each insurance company benefit language to see if they will pay for a surgical tray when the procedure is performed in the surgeon's office.

Paul Kinberg, DPM, Dallas, TX

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

RE: Distal Toe Problem (G. Stephen Gill, DPM)
From: Jay Helman, DPM, Jon Purdy, DPM

You can confirm with a shave biopsy. Using a high potency cortisone cream should resolve the condition.

Jay Helman, DPM, Pearl River, NY, footdr80@hotmail.com

A biopsy would be indicated in this case.

Jon Purdy, DPM, New Iberia, LA, Podiatrist@mindspring.com

RE: Integrative Podiatric Medicine
From: Daniel Grapel, DPM

I am shocked to read several postings in this forum regarding integrative medicine. The pure fact is that conventional medications approved by the FDA have saved the lives of tens of thousands of patients. Those medications originated from pharmaceuticals companies which spent billions of dollars on research and development. Show me ONE cancer patient whose life was saved by alternative medication! As far as greed is concerned, the same podiatrist who criticized the profit-driven pharmaceutical companies has the audacity to boast that he is charging $800 dollars for custom orthotics! Talk about hypocrisy.

Daniel Grapel, DPM, Forest Hills, NY,danipod@aol.com

RE: Integrative Podiatric Medicine (Dennis Shavelson, DPM)
From: Robert Bijak, DPM

Dr. Kornfeld states, "Science behind RCT's falls by the wayside the minute a patient is placed on more than one drug at a time or adds an OTC medication." I suggest that a reading of the PDR shows scads of data that we as practitioners rely on daily regarding the influence of a drug in vivo when a patient is on another medicine or has a particular co-morbidity. There is even a PDR on OTC interactions with medications.  It seems he's incorporating the "non-locality" theory of quantum physics that states just observing a phenomenon changes its reality. So, I guess, experimentation based on the "scientific method" is lost. Perhaps that would benefit the case of homeopathy.

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

RE: Integrative Podiatric Medicine (Dennis Shavelson, DPM)
From: Arnold B. Wolf, DPM

Once again, I am compelled to respond to Dr. Shavelson’s comments. He refers to RTC’s but I am assuming his reference is to randomized clinical trials (RCT’s). Whether we like it or not, the harsh reality is that money is the lubricant for the “research engine”. Without it, the “engine” stops running. Following that line of thought, without those “evil” profit-driven corporations, the development of new technologies and therapies would, at the very least, be hampered or at worst, grind to a halt (I wonder if the vitamin supplement manufacturers are profit-motivated or are they...

Editor's Note: Dr. Wolf's extended-length letter can be read here.

RE: Dragon Questions (Carl Solomon, DPM)
From: Gary A. Lieber, DPM

I use Dragon Speak 10.1 extensively for dictation. I find that when I try to use it in a word processor like MS Word that the memory requirements of running both programs slow down the speed and reliability of dictation.

To solve this problem, I dictate letters or other long dictations to the Dragon Speak word processor Dragon Pad.  When I am finished, I simply copy the letter to the clipboard and paste it into whatever word processor I wish to finish and store it in.

This may eliminate the need to deal with a floating cursor, which by the way, is a problem I have never seen. If someone has a problem, I find the Dragon Speak tech support people very helpful.

Gary A. Lieber, DPM, Delray Beach, FL, richd3668@gmail.com

ASSOCIATE POSITION - BRITISH COLUMBIA

Beautiful Victoria British Columbia, on the ocean, fast growing area. Associate for multi-office full scope practice. Interviews at APMA meeting in Seattle July 15-18 Reply to dr.cole@shaw.ca or phone 250-516-7440.

ASSOCIATE POSITION - FREDERICK, MARYLAND

Fredericks premier group practice is located only 45 minutes from both DC and Baltimore. Immediate opening for a minimum PSR 36 Podiatrist for full time position. We have it all: EMR, digital x-ray, ultrasound, ASC, etc. Excellent salary with bonus structure and benefits. Please email resume to docsbnb@aol.com

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

PRACTICE FOR SALE – MAINE

25 year full scope in medical building, podiatrist friendly hospitals, appreciative and cooperative patients, excellent expansion potential, physician referrals. Wonderful place to raise a family. Retiring seller will stay for transition. mainefootdoc@yahoo.com

1-YEAR PODIATRIC SPORTS MEDICINE FELLOWSHIP - MONROVIA, CALIFORNIA

Applicants must have completed a podiatric residency program and must have or be eligible for a California license. Annual stipend: $48,000 and $60,000. If interested, please e-mail your resume with cover letter to the Program's management company at victoriamanagers@gmail.com

TN PRACTICE FOR SALE (SOUTH OF NASHVILLE)

Active, established practice with new equipment (digital x-ray, ultrasound, computer network, etc.). Great referral network with an excellent scope of practice. Turn-key operation with seamless transition. Grossed over $350K last year. Call 931-446-5724 or e-mail mchad500@gmail.com ASSOCIATE POSITION – COLORADO

Excellent opportunity to grow and expand a practice in the northern front range, Great compensation package with buy in potential. Desire individuals with motivation to succeed and grow professionally, Please fax CV and letter of interest to; 970-351-0940.

ASSOCIATE POSITION – LOS ANGELES AREA

Busy podiatry practice in South Bay, Los Angeles area looking for associate podiatric physician. Part-time initially. Good opportunity for young or established physician looking for additional work, income. Well established practice, large patient base, competent staff. Please send CV, respond to berstein.david@gmail.com

MANHATTAN MEDICAL SPACE AVAILABLE

Multispecialty Medical Building with 24/7 doorman. Prime Luxury Building and Location, Gramercy, Stuyvesant, Peter Cooper Area. 305 Second Avenue (17th-18th). Prior tenants past 23 years; podiatrist, dentist (plumbing/electric intact), internist. Ideal for podiatry, co-share with dentist, MD, etc. (flexible lease terms). E-Mail; jbdrun@aol.com Phone; 480-951-2480.

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 POSITION – LONG ISLAND 
 
Busy Bellmore, NY office. Motivated, board certified, hard-working, experienced in all phases of podiatry. P/T hours available. excellent salary, call 516 242-7540 or Fax Resume 516 826-9036 or email jobke@aol.com

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

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.

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