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PM News

The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily


July 01, 2009 #3,585 Publisher-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2009- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

Aetrex Adds Style to Ambulator’s

Aetrex is proud to introduce the newest styles of Ambulator Biomechanical footwear for both men and women. Ambulators provide extraordinary cushioning and support and are now offered in fashion forward designs.

The new women’s styles include clogs, Mary Janes, lace ups and Velcro closures. The new men’s styles include stitched and moc toe oxfords, a boat shoe, and plain toes in lace up, single and double strap closures and a slip on.

All Ambulator shoes have ½ inch removable depth, rocker soles and soft leather linings and are available in medium, wide and extra wide widths.

These shoes can be viewed  here or call Aetrex at 800 526 2739 for a catalog or to schedule a presentation with you Aetrex representative.


PODIATRISTS IN THE NEWS

OK Podiatrist Issues Warnings to Flip-Flop Wearers

Dr. Brad Beasley has nothing against folks who wear flip-flops. He does, however, have a few warnings for those of us who are wearing them this summer.

Dr. Brad Beasley

Flip-flops are easy to wear and clean, said Beasley, a podiatrist with Restoration Foot and Ankle in Owasso and the president of the Oklahoma Podiatric Medical Association. They are also inexpensive and very flexible. Consequently, they're not supportive enough for your feet, he said. Wearing flip-flops could possibly lead to stress fractures, and inflamed tendons and ligaments.

Source: Jason Ashley Wright, Tulsa World [6/29/09]

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APMA IN THE NEWS

Proper Children's Shoes Avoid Future Foot Problems: APMA President

As parents and children begin their annual routine of back-to-school shopping, one item is a must-purchase for every list-shoes that fit properly. That's the advice from podiatrists who say that many adult foot ailments have their origins in childhood and are present at birth.

Dr. Ronald Jensen

"Neglecting foot health invites a host of problems and can leave children eligible to injury," said Dr. Ronald Jensen, president of the American Podiatric Medical Association (APMA). "It is highly important that parents purchase children's footwear that offers the proper support and fit necessary to keep a child's feet safe both at school and at home."

Source: North American Press Syndicate [6/29/09]

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E-HEALTH NEWS

First Draft of EHR "Meaningful Use" Definition Unveiled

President Obama's point man on healthcare information technology has asked a key working group to revise its recommendations on what constitutes "meaningful use" of electronic health records, a pivotal term that will decide which physicians can obtain billions in federal EHR money.

In a general sense, meaningful users have been defined as physicians who demonstrate to the government that they are using electronic prescribing, that their technology is connected in a manner that provides for electronic exchange of health data to improve quality of care, and that they submit information to the government on clinical quality measures.

But for the past month, the meaningful user working group has been trying to detail exactly what objectives physicians would need to meet to earn the Medicare incentives. For example, the initial draft proposed that to be considered a meaningful user, practices should be able to maintain electronic medication and allergy lists, record vital signs, and incorporate lab results into their EHRs by 2011. The proposed list of mandates grows in 2013 and 2015.

Source: Chris Silva, AMNews [6/2909]

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QUERIES (CLINICAL)

Query: Chronic Ulcer with Plantar Fibromatosis Lesion

I have 46 years old African-American male with a chronic ulcer on plantar aspect of right mid-foot which he has had for a year. The patient had 2nd digit amputation with the incision extending to mid right foot. Everywhere healed very well except a small 2.0 x 2.0 cm area at mid-foot. He has a history of abscess right 2nd toe, MRSA, and insulin-dependent diabetes. When I saw this patient about 6 weeks ago, I found that under the ulcer is a firm soft tissue mass, size about 3.5 x 3.5 x 1.0 cm with hyperkeratosis and hyperpigment rim, which  is tender with palpation. There is no swelling, No redness, no sign of acute infection.

Chronic Ulcer with Plantar Fibromatosis Lesion

I continued wound care and ordered an MRI which shows a 2.0 x 2.0 x 2.0 cm fibrosing lesion beneath the plantar fascia layer with ulcer or abscess. The wound appears to improving over time with wound care and off-loading of the ulcer area. Last week, I saw some content of a fibrotic lesion come out from the ulcer site. A biopsy of plastic-like tissue content shows 1. soft tissue necrosis with acute and chronic inflammation. 2. few epithelioid cells showing inflammatory atypia are present. What is a good approach for surgical recession of a plantar fibromatosis lesion? What about a skin flap? 
 
Dang H. Do, DPM, Saint Louis, MO

Red Flag Rule Compliance Deadline: August 1, 2009

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QUERIES - (NON-CLINICAL)

Query: Converting Billing Database

My office is in the process of changing billing software providers (Company A to Company B). The previous billing software company (Company A) has agreed to allow us to keep the discs. The billing records database can be copied/archived indefinitely for the life of the practice; however, Company A will no longer provide support once the contract is terminated. I need to be able to access these records indefinitely. At some point in time, the software will have to be installed and the database of past billing records made accessible. I cannot be sure simply inserting the CD of Company A will bring up the billing records. This frequently requires technical assistance, which they will no longer provide. This then creates a problem, as the new company (Company B) will not assist with configuring software from Company A. How have others handled this? This is not a matter of simply converting the billing records from Company A to Company B, as this is not an option.

Steven Block, DPM, Owensboro, KY

SafeStep Is Exclusive Podiatric Distributor of the Arizona AFO

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RESPONSES / COMMENTS (CLINICAL) - PART 1

RE: Non-Painful Limp 1 Year Post-op (B.T. Sullivan, DPM)
From: Michael B. DeBrule, DPM

What do you mean by a limp? Is the non-surgical side with equinus striking the ground forefoot first causing the ankle moment to be plantarflexor rather than dorsiflexor? Or does that side strike with the knee flexed and foot flat? Does the surgical side strike with knee flexed to compensate for increased height from early heel off or is limb-length difference possibly a factor? Is stride length and arm swing symmetrical when walking? The answers to these questions can help you decide your treatment. Consider video gait analysis for assistance with diagnosing problems like this first rocker dysfunction. Video can also help you monitor improvement to see if the heels are lifting normally and symmetrically. I use Pedi-Gait, but there are other excellent video systems available.

For treatment, I would consider ankle manipulation, possibly correcting limb-length, heel lifts, and heel dampening pads. A dampening pad of 1/8 inch PPT (Poron) might work well with or without a heel lift. You could also do this by trial and error with instant video feedback if you wish. An in-shoe pressure analysis system (F-Scan, Pedar) could give you similar information if you don’t have video analysis at your office. The Achilles lengthening procedure could be considered when conservative measures fail.  

Michael B. DeBrule, DPM, Marshall, MN, Dr.DeBrule@InnovativeFootCare.com

FREE SAMPLE--Powerstep Protech CustomPost Customizable Orthotic*

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ProTech CustomPost’s unique snap-on heel options allow medical professionals to truly customize a prefabricated orthotic to meet patient needs.  A professional can select from neutral, two degree and four degree heel posts, and combine it with CustomPost’s firmer shell and extra heel cushioning to help relieve heel and arch pain as well as knee and lower back pain. ProTech CustomPost is being sold only to members of the medical profession.

*This offer is for medical professionals only. Call us today for your free sample at 888-237-3668 Stable Step, Inc. www.powersteps.com


RESPONSES / COMMENTS (CLINICAL) - PART 2

RE: Peeling on Heels (Patrick J. Nunan, DPM)
From: Charles Morelli, DPM

If the condition "did not respond to antifungals", and there are no other contributing clinical reasons to suspect a fungal infection, then maybe.........just maybe......this isn’t a fungus?

This past month on PM News, there were multiple discussions regarding whether or not to do a biopsy. Do we do too many? Do we not do enough? I am sure this debate will continue. My suggestion is to do a biopsy and get a diagnosis. Then, treatment becomes easier, and not a guessing game.

Charles Morelli, DPM, Mamaroneck, NY, podiodoc@gmail.com

Register NOW for ACFAOM’s Clinical Conference
JULY 9-12 – DISNEY WORLD

Get what you need to:  treat diabetic foot ulcers and manage wounds; prescribe orthotics for specific conditions, improve your basic surgical skills25 CMEs.

Billing & Coding workshops, an exhibition, and social events.  Plus special “hand-on” workshops on Punch Biopsy & Plastic Surgery, Electronic Medical Records, Imaging Studies, Pediatrics.  ACFAOM 2009 has it all!

Faculty: David Armstrong, Nicholas Bevilacqua, Michael DellaCorte, Robert Frykberg, Lee Rogers, James Stavosky, John Steinberg, Marc Benard, Laurence Huppin, Robert Marcus, Douglas Richie, Jeffrey Root; Paul Scherer, Michael Warshaw, Jason Harrill, Bhavesh Shah, Brad Bakotic, Michael Brody, Daniel Evans, Kathleen Satterfield

For full information and to register go to Click here or call 1-800-265-8263 x 6525


RESPONSES / COMMENTS (NON-CLINICAL) - PART 3

RE: Heel Pain in Runner (Jeffrey Kass, DPM)
From: Philip McKinney, DPM

I agree with both points that Dr. Kass brings up. I would also consider a vascular insufficiency to the area as another possibility. I have had two very similar presentations where under the stress of running, the skin would break down along the margin of the weight-bearing surface of the heel.
 
Philip McKinney, DPM, Eugene, OR, oregonpodiatry.net

CODINGLINE CORNER

CURRENT TOPICS BEING DISCUSSED ON CODINGLINE'S LISTSERV INCLUDE:

o Related Services in a Global Period
o Cheilectomy with Bone Plug Coding
o Requirements for Coding CPT 99204
o DME Requirements
o Patients Referred Without X-Rays 

Codingline subscription information can be found here


RESPONSES / COMMENTS (NON-CLINICAL)

RE: Answering Service (Anas Khoury, DPM)
From: Pete Harvey, DPM

We use Telemed. It’s about $120/month. There is a brief text first, then a transfer to voice. Telemed then texts a brief description of the problem to my cellphone, calls my back line, and calls my office. On my cellphone, the text is a blue highlighted number of the party I am to call back. I tap it and the call goes straight to the patient or hospital (without me having to write anything down). Telemed will also fax a record if asked. (telemedinc.com)

Pete Harvey, DPM, Wichita Falls, TX, pmh@wffeet.com

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CLASSIFIED ADS

ASSOCIATE POSITION – SOUTHERN CALIFORNIA 
 
Flexible, Part-Time or Full-Time opportunity with growing podiatric medical group in busy offices in Southern California. CURRENT DME supplier number a plus. NO nursing homes. Most days are available with flexible hours available. If interested, e-mail scpods@yahoo.com

ASSOCIATE POSITION – MARYLAND

Maryland Eastern Shore Practice has opening for associate with ownership interest. MCR approved ASC, EMR, Ultrasound, Flouro, with Hospital Privileges available. E-mail CV to: patimmons@comcast.net 

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

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

INTERESTED IN JOINING A DYNAMIC GROUP PRACTICE?

That treats all patients ethically · That offers an academic environment with an exceptional residency program· That will improve your clinical and surgical skills· That offers a strong case load to get you Board Certified fast· That provides a guarantee for growth and advancement. Does this sound unusual and refreshing? IT IS! Do NOT miss this incredible and exciting opportunity- apply now to: Hudson Valley Foot Associates, PO Box 3300, Kingston, NY 12402-3300; or email CV and cover letter to: jobs@hvfa.com

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

Who wants to continue making good money in a down economy, and who would like to live in Florida on the coast? I have been working for over 45 years and have had enough. My business grosses over $940,000 dollars a year and my net is over $250,000. I see approximately 40 patients a day in a coastal Florida town and am sitting on a little gem. Office is 2000 sq. ft. Hospital very close with surgical center. Large scope of practice in Florida. Contact me if you are ready to step up. $585,000 dollars. Contact me at: hagen5644@yahoo.com

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

PRACTICE FOR SALE - ALABAMA, GULF COAST

Established 26 year old practice. Owner desires to sell and relocate. Operated 25 hours per week. Mixture of surgery and general podiatry. MD referrals. Surgery center and hospitals in close proximity. Highly profitable. Priced to sell.  Will lease office to buyer. Call Mike Crosby at 888-776-2430 or email mcrosby@providerresources.com

 

 

PM News Classified Ads Reach over 11,500 DPM's and Students

 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.

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.
Guidelines
  • To Post a message, send it to:    bblock@podiatrym.com
  • Notes should be original and may not be submitted to other publications or listservs without our express written permission.
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    RE: (Topic)
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  • Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.

Barry H. Block, DPM, JD
 
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