The Voice of Podiatrists

Serving Over 9,500 Podiatrists Daily

July 03, 2007 #2,977 Editor-Barry Block, DPM, JD

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AL Podiatrist Starts Running Camp

Cullman podiatrist Eric Fillinger ran cross country in high school and was an All-American runner in college at Cedarville (Ohio) University. A foot injury during his senior year led him to get into podiatry to try to help the next generation of runners when they had to deal with injuries such as his.

Dr. Eric Fillinger

Now that his practice is in Cullman, Fillinger is doing his part to help keep the runners in the Cullman area in shape and injury-free. One of the ways he is doing that is the running camp he held this week in Cullman with a number of the top varsity cross country runners in Cullman County.

“This is something that I’ve wanted to do for a few years, but the planning and logistics were just never right,” Fillinger said. “Then a few parents and pediatricians asked me if I would be interested in doing it sometime this summer. “Running is a good sport where participants can learn the lessons about teamwork, sacrifice, perseverance and life in general that can also be learned in other sports,” Fillinger said. “I think these runners are the type that will pass those lessons on to those who are coming up behind them.”

Source: Brandon Shields, Cullman Times [6/29/07]

Regional Payment Adjustment Leaves Many Underpaid

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Many doctors argue that Medicare's geographic payment adjustment formula does not accurately reflect practice costs in some regions. Here is a sample of what are believed to be some of the counties where physicians are most underpaid relative to their costs.

Competitive Bidding Program Deadlines Extended

The Centers for Medicare & Medicaid Services (CMS) is extending the registration and bid submission deadlines for the first round of the Medicare durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) Competitive Bidding Program.

Please note: All bids are now due by 9:00 p.m. prevailing Eastern Time on July 20, 2007, and the registration deadline is July 7, 2007.

• On May 15, 2007, CMS issued a request for bids for the first round of the Medicare DMEPOS competitive bidding program. The original due date was 9:00 p.m. prevailing Eastern Time on July 13, 2007. All bids are now due by 9:00 p.m. prevailing Eastern Time on July 20, 2007.

• Suppliers interested in bidding must first register and receive a User ID and Password before they can access the Internet-based bid submission system. Suppliers should register immediately to avoid a delay in being able to submit bids. Registration opened on April 9, 2007. The original registration deadline was June 30, 2007. The registration deadline is now July 7, 2007.

• Suppliers must be accredited or be pending accreditation to submit a bid and will need to be accredited to be awarded a contract. The accreditation deadline for the first round of competitive bidding is August 31, 2007. Suppliers should apply for accreditation immediately to allow adequate time to process their applications.

For a list of the CMS-approved Deemed Accreditation Organizations,
visit: http://www.cms.hhs.gov/CompetitiveAcqforDMEPOS/

For more information on the program, please visit http://www.dmecompetitivebid.com

Source: CMS via Paul Kesselman, DPM

Query: Value of Deceased Podiatrist’s Charts

I was contacted by the office of a podiatrist who practiced in the same town. The podiatrist passed away recently. The office wants to sell the patients list to me. In the meanwhile, my office has seen the influx since the other office closed. I would appreciate any comments from this talented group on similar experiences and information regarding a fair price for the patient list.

Catherine Wu, DPM, Revere, MA

RE: Using a Higher Concentration of Alcohol For Neuromas (Amy Schunemeyer-Purdy, DPM)
From: Marc Katz, DPM

There are many Drs. using higher concentrations. I personally know a well-known, well- published Pain management specialist in my area and she uses between 50 & 100% alcohol. This Dr. has a chapter in most pain management textbooks. She is an authority on this topic.

I believe that these are the therapeutic levels that are necessary to destroy the nerve. I also believe that there must be some direct localization of the nerve to avoid surrounding tissue injury. Ultrasound is one way of finding the nerve and the second is using a nerve stimulator to precisely find the nerve.

The general medical community consensus is that a 4% or 6% solution is not therapeutic. I'm not saying that there is no relief with these solutions. But we need to keep in mind that this is for neurolysis not pain relief. You need the strong solution and localization for neurolysis, otherwise you are giving a nerve block.

This is already an issue with insurance companies. That should be no surprise to anyone that is in touch with podiatry. I've received a note from an insurance company recently stating that alcohol injections at such dilute levels is experimental and not reimbursable.

So I believe that it is a good time for podiatrists to use the strong solutions just like our colleagues in other specialties. I also think that we should continue neuroablation with cryosurgery and radiofrequency. These outcomes will likely help us avoid neurectomy and its associated complications.

Marc Katz, DPM, Tampa, FL, dr_mkatz@yahoo.com

RE: AAOS and Podiatry
From: Bryan C. Markinson, DPM

I was informed this past Wednesday that the American Academy of Orthopedic Surgeons voted to de-list from their directory of any Foot and Ankle Surgery Fellowship that was directed by a DPM. In truth, the vote was actually for requiring that any program listed in their directory have an MD as the named director. Apparently there is a program on the west coast where a DPM is the named director.

The AAOS has begun to openly wage war. They have mounted a multi-state presence against advancing podiatric scope bills. Now they say they can't learn anything from a DPM surgeon. It is about time we announced to the public that they should be protected from an orthopedic surgeon who does minimal foot and ankle training as a resident (15 months in five years) and then after six months in a Fellowship calls him or herself a foot and ankle surgeon. Although we certainly have issues regarding standardization of training, it is time we brought out the glaring deficiencies of orthopedic surgeons who claim a heightened level of competence that is undeserved. We certainly appreciate that both orthopods and DPMs have more experience than the other in different areas.

The few individual relationships existing that are positive and fraternal all over the country are not enough. Divided loyalty is the rule. What the AAOS thinks and does is much more important to most orthopedic surgeons than any great relationship they may have with a DPM. The overwhelming majority of orthopedic surgeons, including those that have trained side-by-side with podiatrists, will never do anything open in public where they may be perceived by colleagues to be advancing the cause of podiatry. The exception to this are orthopedic surgeons who have reached an extraordinary high level of repute and AGE, that they couldn't care less about the immature notions of their national organizations. In a more positive light, much of this means that what is really happening is that we are making great impact and the right noise.

Working in a group of academic orthopedic surgeons daily for the past nine years, the past eight weeks (lots of mud-slinging over the podiatry enhanced scope bill in New York and elsewhere) have been very stressful, as I realized that for me and anyone in a similar position, it is really just "we love you, but not your family."

Bryan C. Markinson, DPM, NY, NY, bryan.markinson@mountsinai.org

PRACTICE FOR SALE -FORT LEE, NEW JERSEY AND MANHATTAN

Nice mix of commercial insurance, Medicare, cash, routine care, surgery. Experience the NY metro life with shopping, dining, professional sports, culture at your doorstep. AMERICAN DOCTOR SALES 614-918-3000 or email us at sell_my_practice@yahoo.com

EQUIPMENT FOR SALE - WASH. DC

Name your reasonable price and pay shipping- Body chairs, X-Cell X-rays, Konica developer, SmartDop20, viewboxes, lakesidecart, Endoscopic unit with all attachments, topical hyperbaric O2 units, castle autoclave, xerox copier, fax machines, etc. call 202-841-5545 or email to JHALLUX@yahoo.com

ASSOCIATE POSITION - MIAMI BEACH, FL

Seeking well trained PMS 36 / PSR 24+ for Full-Time associate position. Leading to partnership for the person. practice is 50% hospital based. Must have strong Sx skills, including Limb Salvage & Trauma. Competitive Salary & benefits Package. Fax 305-652-6672 or Call 305-785-2559 Email: doctorsole@aol.com

PRACTICE FOR SALE - RIVERSIDE, CA

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Practice grossing over 250K/yr three days/wk. room to expand, large physician referral, good mix of sx., wound care, DME's, routine care. no rest homes. Medicare cert. surgery center on site. Will consider associate-to-purchase. may carry paper. Consider all offers. Office and sx. center also for sale. e-mail tentoes001@hotmail.com or call 951 7804782.

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ASSOCIATE POSITION FLORIDA - NORTHEAST REGION

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Busy, well established, full scope podiatry practice seeking highly motivated, hard-working, reliable, responsible and especially likeable to the average human, Associate. Surgical training a plus. Prefer PSR 24+. This is an Associate position with lots of potential. Team players only. Email CV to: healthparkmgr@bellsouth.net or fax CV to: 904-826-1586, Attn: Amy

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POSITION AVAILABLE - SOUTHEAST TENNESSEE/ NORTH GEORGIA

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Immediate position available or will wait for the right individual. Unique practice opportunity in growing multi-physician/multi-office practice. Well established/cutting edge within the medical community. Close proximity to hospitals as well as opportunity to become involved with a free standing podiatric surgical center. Must be BQ/BC. Minimum PSR/24. Competitive salary, bonus structure and benefits. E-mail CV to afcjen@hotmail.com

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