June 03, 2006 #2,621 Editor-Barry Block, DPM, JD

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A. Isadore Gordon, DPM

A. Isadore Gordon, 89, of Media, died June 27, 2006, after an illness of several months. He was a longtime resident of Lancaster, PA.

A. Isadore Gordon, DPM

Dr. Gordon graduated from Temple University in 1940 with a degree in chiropody. He was drafted into the Army in 1942, serving as a surgical technician in the European Theater of Operations. Through the years, Dr. Gordon built a thriving practice of devoted patients. The fifth patient to enter his office was still coming to him when he retired in 1986. He was known for sending people home feeling much better and laughing.

Dr. Gordon was a Fellow of the Academy of Ambulatory Foot Surgeons and held every office including the presidency in the Lancaster Podiatry Society. He served on the board of governors of the Pennsylvania Medical Podiatry Association and was a member of the American Podiatry Medical Association. He also served as an advisor to the Lancaster County Practical Nurses Association.

PM News policy is to recommend that memorial donations be made to the APMA Educational Foundation, 9312 Old Georgetown Rd,, Bethesda, MD 20814.

Source: Lancaster Sunday News (PA) [6/29/06]

Flip Flops Also a Flop in Florida

No, they won’t kill you. But flip-flop overuse can give you tendonitis, arch pain and even sprained ankles, podiatrists say. “Many people, especially in Florida, wear flip-flops in the summer as replacement for their normal footgear,” said Cary Zinkin, a Deerfield Beach podiatrist who is a spokesman for the American Podiatric Medical Association. “That’s where we find the problems.”

“We’re probably seeing 10 people a week with flip-flop issues,” said Sarasota podiatrist Robert Frimmel, past president of the Florida Podiatric Medical Association. People wear them for too long, and flip-flops have no support. They don’t absorb shock. They’re unstable, making it easier to turn an ankle.

“Yes, it is Florida, but you can’t go walking Disney World in flip-flops and expect your feet to feel good at the end of the day,” Frimmel said. Frimmel sees shin splints and arch pain, heel pain and blisters.

Source: Lisa Greene, St. Petersburg Times [6/30/06]

Charities Tied to Doctors Get Drug Industry Gifts

Around the country, doctors in private practice have set up tax-exempt charities into which drug companies and medical-device makers are, with little fanfare, pouring donations -- money that adds up to millions of dollars a year. And some medical experts see that as a big problem. The charities are typically set up to engage in medical research or education, and the doctors involved defend those efforts as legitimate charitable activities that benefit the public. But because they operate mainly under the radar, the tax-exempt organizations represent what some other doctors, as well as regulators and industry consultants, say is a growing conduit for industry money. The payments, they say, can bias the treatment decisions of physicians, may lead to suspect research findings and at times may even risk running afoul of anti-kickback laws.

Source: NY Times [6/28/06]

Make more money while increasing staff, patient, and physician satisfaction by attending a power packed one-day practice management meeting being held by the American Academy of Podiatric Practice Medicine http://www.aappm.org on Saturday, July 22, 2006 (optional and complimentary comprehensive coding and billing session Sunday morning) at the Pittsburgh Airport Marriott. What makes this THE ultimate meeting of the year? A wide array of practical topics presented by podiatric experts, inexpensive room rate for premier Marriott Hotel, low-cost registration, peer exchange and roundtable discussions, workshop specifically to address maximizing billing and coding, no weekday away from the office, and special reduced rates for residents and new practitioners. See program brouchure at www.aappm.org

For a list of all meetings go to: www.podiatrym.com/meetings.pdf

Query: Cold toes in 11 Y/O FL Patient

I have an 11 year old girl, with cold 2nd - 5th toes of both feet. This occurs whenever she goes to the movies or sits in rooms. She can't wear sandals due to cold toes. Otherwise she plays tennis 4 - 5 hours daily. Does anyone have any suggestion for cause of this condition?

Richard Berkun, DPM, Bradenton, FL, RBerkun@aol.com

Query: Treating Mosaic Verruca

How do you code surgical excision by electrodesiccation of warts? A total of 19 warts were removed.

John Decicco, DPM, Plainview, NY

Response: If you have treated via destruction more than 15 verrucae, bill CPT 17004 (destruction, all benign or pre-malignant lesions other than skin tags or cutaneous vascular proliferative lesions, 15 or more lesions). Do not bill CPT 17004 in addition to any CPT 17000 or CPT 17003 coding.

Your documentation should clearly evidence the presence of 15 or more lesions. This is where a digital camera comes in handy.

Tony Poggio, DPM, Alameda, CA

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

RE: CRPS (Peter Riznyk, DPM)
From: Elliot Udell, DPM

I treat many CRPS patients at all stages. Early intervention is important and the condition can be reversed very quickly at this point in time. Physical medicine is extremely important. Interferential therapy combined with H wave is the way to go, and see this patient every day. If you don't have this modality in the office, refer him to a center that does.

Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: MD/DO Degree
From: Multiple Respondents

In view of the new increase in discussion about the MD or DO degree and license for podiatric physicians, attached is an information sheet we use for perspective applicants to the DO Program for DPMs conducted at Nova Southeastern University College of Osteopathic Medicine in Fort Lauderdale, Florida . This may be of interest to those who have participated in the debate. Our program was approved by the college, university and in December 2004, by the American Osteopathic Association. The accelerated program enrolled its first students in July 2005

http://www.podiatrym.com/letters2.cfm?id=10016&start=1

Leonard A. Levy, DPM, MPH
Nova Southeastern University College of Osteopathic Medicine
Fort Lauderdale, FL, levyleon@nova.edu

I have been reading the comments concerning the long overdue notion that a DPM/MD degree designation is the next natural progression for our profession. I am in total agreement with the comments brought forth by some of our esteemed colleagues on this site.

The fact is we have been talking about this for the last 25 years and while most podiatrists think it’s a great idea, and it is, nothing happens. Really, it’s like a soap opera. You can avoid the show for 20 years, one day turn it on and your right back to the last viewed episode. Think about it. The positive changes in our profession like in most others has been made by the individual accomplishments of its members. The recognition we have gained over the past 20 to 30 years was due to the service we provide to our patients. Nobody does it better and the public realizes it. All of our positive strides come from this core fact. Let's face it.

While I am in favor and a supporter of the APMA because I believe we need a cohesive presence, we really don't take advantage of the old adage "there is strength in numbers." The bottom line: If you want to attain the MD degree change, and I think its obvious, most of us do, there are ways to accomplish it. There are international programs specifically designed allowing us to complete the requirements and attain the degree. Do it because you want to change your specialty or simply because you want to be a better doctor. If you wait for it to happen through our political process, the sand in the top of your hour glass will surely be empty.

Thomas A. Graziano, DPM, Clifton, NJ, TGrazi6236@aol.com

We will always be podiatrists, whether known by DPM, MD-P, DPM/DO, MD/DPM or whatever initials are after our names.

Until I had experienced the blank look on faces of recruiters and human resource personnel at biotech and government agencies when looking at the DPM degree, I did not believe that the need for a degree change was present. My personal experience has illustrated to me that the quality of our education, experience and expertise is still known to only a small handful of people. Whether it be MD or DO, we do need to add/change the degree designation after our names if we intend to survive as a profession in the future.

One very significant and unexpected consequence of not being legally MD/DO is the loss of residency programs. So far the State of Maryland is the only state that has gotten a waiver from CMS to be able to disperse its hospital funds as the State sees fit. The wording for CMS funding for residencies is for “MEDICAL" programs. This has allowed the State of Maryland to stop specifically funding podiatric residencies, meaning that hospitals would have to take these funds out of their general operating funds [money from their bottom line] if they want to fund our residents. As a consequence all of the residencies in Maryland other than the VA [funded by the VA not CMS] have closed.

As other states gain this same exception the residency programs will slowly but surely close and eventually the profession will no longer be able to train new practitioners. The profession will shrink, shrivel, and die just as the need for our expertise in treating the effects of aging and diabetes will be in ever growing demand. Our profession has always been an allopathic one; why not just make that clear up front?

H. David Gottlieb, DPM, Baltimore, MD
hdavidgottliebdpm@gmail.com

I love being a DPM, but the reality of private practice has become DPM = "Doesn't Pay Much" MD = More Dollars

Many of you might remember that the LCPMEP was in charge of Project 2000. The LCPMEP (Liaison Committee on Podiatric Medical Education and Practice - which is made up of representatives of ACFAOM, ACFAS, ABPOPPM, ABPS, JCRSB, COTH, APMA, and CPME). I was fortunate to be a representative to this "Podiatric Think Tank" for many years and even was the chairman for a brief period, so I know that they have the talents to outline a plan.

It's time to stop talking and develop an plan. I would like to be the first to ask the LCPMEP to take on this task.

Bret M. Ribotsky, DPM, Boca Raton, FL

Ribotsky@doctorbret.com

Practice for Sale - Walla Walla, Washington

32 year old established podiatry practice for sale immediately. 2 treatment rooms, 1 surgical suite, x-ray room, sterilization equipment, and private office area. Located at busy intersection, only 2 blocks from major hospital. $50,000 or Best Offer. Please call 509-525-2863 or email darcycharlesDPM@charter.net , if you are interested.

EQUIPMENT FOR SALE - ESWT - BEST OFFER CONSIDERED NOW!!!!

If you are using or thinking of using ESWT, I have a new machine that has only been used twice. There is no Orbasone in the country priced like this one. Will provide training and installation. Take a look at http://www.orbasone.com Call 1-856-229-2939.

RESIDENCY POSITION – VIRGINIA

One Year Foot and Ankle/Rearfoot Surgical Fellowship with excellent salary/benefits available July 1, 2006. If you are finishing a PSR-24 and don't have a job yet, this is an excellent way to learn additional surgical and business skills. Please fax resume to 703-491-9994.

PRACTICE FOR SALE - NEW JERSEY

Well established practice with modern equipment for sale. Two main offices and two satellite offices included. One podiatrist has been able to make very comfortable living, but also great for two docs looking to start up. Willing to transition over 1 year. This is a great opportunity! contact DOCCAPO@YAHOO.COM

ASSOCIATE POSITION - PITTSBURGH, PA AREA

Excellent opportunity for a hard working, surgically trained podiatrist to join a well-established, high volume, multi/location practice in the suburbs of Pittsburgh. Must be willing to perform all aspects of podiatry. Incentive-based salary, compensation package, with potential for partnership. Must presently have Pennsylvania license. Would like to fill position asap. Fax resume to 412-831-2115.

ASSOCIATE POSITION- KANSAS CITY, MO

Excellent opportunity for a hard working, ethical podiatrist to join a vibrant, successful and growing podiatric medical and surgical practice. Dedicated, supportive staff with strong marketing and medical knowledge. Must be board eligible/certified. PSR/24. Partnership opportunity. Competitive salary, bonus structure, benefits. Wonderful place to raise a family. Fax CV to 816-455-8901.

PRACTICE FOR SALE - CENTRAL FLORIDA

Well established surgical podiatry practice for sale. Located in a state-of-the art out patient surgical center.Grossed $1,038,000 in 2005. Low down payment. Price negotiable. Contact Camille Todd/Transworld 321 217-3625 or camille@tworld.com

ASSOCIATE POSITION- NEW ENGLAND

Terrific Opportunity Now Available in growing New England practice. Well established and respected practice with new, large office space, latest technology, very helpful staff, loyal patients and solid referral base. Close proximity to hospitals with modern surgical suites. Opportunity for shared ownership. Prefer 24 month PSR with clinical practice experience or an experienced doctor looking to improve their situation. E-mail CV and particulars to NEAFC3@aol.com

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