The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

July 04, 2012 #4,505 Publisher-Barry Block, DPM, JD

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Podiatry Management is proud to announce the launching of its new Facebook page www.facebook.com/PodiatryManagement We encourage you to visit it. 

Dr. Patricia Casey Kirk

The winner of this week's contest is Dr. Patricia Casey Kirk of Lexington, TN. There has been an overwhelming response to our new Facebook page, so we are giving away another prize this week. Simply "like us" and be eligible to win a free registration for the Greenbrier Coding and Practice Management Workshop (Value $395). Enter now. The contest ends July 7th, 2012. No Purchase necessary.

SC Podiatrist Discusses Summer Protection of Feet

Summer is here and, for many, that means it's time to break out the sandals. Dr. Joseph Menn of Coastal Podiatry Associates advises everyone to protect their feet. He suggests you apply sunscreen everytime you are out in the sun. "People often forget to apply sunscreen to the feet or they go into the ocean, which washes off the sunnscreen, and they forget to re-apply it to their feet," says Menn. 

He also says you should apply moisturizer to your feet to prevent them from becoming dry and cracked. "Normally, closed shoes provide a moist environment by trapping moisture in the shoe and socks. In summer, people wear open shoes, which allow the skin to be exposed to the air," says Menn.

Source: Anne-Marie Bost, WBTW 12 [6/2/12]

OH Podiatrist Discusses Treatment of Small Blisters

The rising mercury brings a telltale sign of summer: Band-Aids slapped over foot blisters. Even seemingly comfortable summer shoes can cause them. Dr. Bryan Caldwell, assistant dean of clinical education at Ohio's Kent State University College of Podiatric Medicine, discusses  treatment of small blisters. 

Dr. Bryan Caldwell

The recommendation for small blisters is to leave them alone. But that is not always practical. And who's to say that it won't burst on its own? So, typically, as long as the patient isn't a diabetic, we say that if you have a painful blister, get a needle and heat up the end to sterilize it, cleanse the area with rubbing alcohol, and put a small hole in the upper skin, the roof, of the blister. Once it is dry, put some Neosporin and a Band-Aid on it.

Source: Heidi Mitchell, Wall Street Journal [7/2/12]

AR Podiatrist Protests Neighborhood Targeted for Demolition

Dr. Anika Whitfield, a podiatrist who has been among the most outspoken in the central Little Rock neighborhood targeted for demolition to build the taxpayer-financed Little Rock Regional Chamber of Commerce technology park office building, has more to say today, inspired by the demolition of Ray Winder Field for a UAMS parking lot. She asks, why not look there for Technology Park acreage?

Dr. Anika Whitfield

She also talks about the meaning of blight, inspired by a recent lecturer at the Clinton School, Dr. Mindy Fullilove, a writer and teacher at Columbia University. To those cheering the destruction of residential neighborhoods for an office building, the project is "blight removal." (And we'll worry later where the human element of that blight will rest once they are made home clearance refugees), comments Whitfield.

Source: Little Rock Arkansas Times [7/2/12]

26% of Small Practices May Close, Survey Says

One third of physicians in small group practices who responded to a recent survey expect their 2012 income to fall below what they earned last year. Financial pressures could have a devastating effect on physicians in practices of 10 or fewer participants: 26% surveyed said they might have to close their practice within the next 12 months.

"The survey was emailed in April to a random selection of 15,000 of the 200,000 physicians who are registered members of MDLinx, a medical news website, and 673 responded," a spokesman told Medscape Medical News. A total of 49% of small practice physicians reported cutting staff and services to reduce operating expenses. Despite such measures, 23% said they have used personal savings, and 20% have had to borrow money to cover expenses.

Source: Susan Jaffe, Medscape News [7/2/12]

Query: Dispensing DME at a Second Office Location

We have opened a second office location and would like to begin dispensing DME products to our Medicare patients. I have downloaded the appropriate CMS 855S form, but have a couple of questions that my local carrier is not giving me much help on.

Do we need to get a new NPI for the second location for the DME?; or can we just apply to get a new PTAN number?; or can we just bill from our "main office" without regard to where (i.e., out of which office location) we are dispensing the DME items?

Danny Albertson, APRN, Office of Paul Krestik, DPM, London, KY
 
Response: 1) You may use the same NPI. NPI is linked to your Federal Tax ID number, and you may have as many offices linked to NPI as you wish.

2) Each office must have its own unique PTAN.

Paul Kesselman, DPM, Woodside, NY

Editor's note: Dr. Kesselman is a featured speaker (and available for your questions) at the Codingline-PM News Coding & Practice Management Workshop, August 20-22 (following the APMA Annual Meeting) at the Greenbrier -www.podiatrym.com/greenbrier.cfm

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RE: Newton Running Shoes and Forefoot Pain (Pete Smith, DPM)
From: Robert Scott Steinberg, DPM

I would ask the developer of the shoe if she thinks it contributed to your patient's problem. From where I sit, it may be that for every action in an unstable shoe, there is a multiplied increased impact and resulting failure of the shoe to protect reaction.

Robert Scott Steinberg, DPM, Schaumberg, IL, Doc@FootSportsDoc.com

RE: EHR Exemption for Small Practices?
From: Eric Trattner, DPM

There is no governmental requirement to implement EHR systems. There is an incentive for adopting EHR and meeting meaningful use. If you don't adopt:
1 - you will not get the meaningful use incentive.
2 - in 2016, you will start getting penalties.
3 - you will not be able to receive electronic referral requests; you will get fewer referrals for new patients; you will not be able to electronically communicate with other doctors and patients.

If you do not adopt, you are doing your practice and your patients a great disservice.

Michael L. Brody, DPM, Commack, NY, mbrody@tldsystems.com

RE: Unrestricted Medical Licenses (Elliot Udell, DPM)
From: Larry Kansky DPM, JD
 
Here we go again. Another podiatrist, Dr. Elliot Udell, bashes PAs and nurse practitioners based on some unfortunate anecdoctal evidence. It is interesting to note how some podiatrists continue to irrationally demean other health professions. Haplessly, these same podiatrists then get upset when the same behavior is exhibited towards them. Maybe the real elephant in the room is podiatric medical ethics; and not some unsubstantiated claim of a future injury crisis caused by other health professionals.
 
Larry Kansky DPM, JD, Wilkes-Barre, PA, larry.kansky@gmail.com

RE: Reimbursement Parity from Insurance Companies (Harold Glickman, DPM)
From: Ira Baum, DPM
 
Accomplishing reimbursement parity from insurance companies through EBM is a dream. In fairness to Dr. Glickman, I did not read or hear the broadcast of Meet the Masters. But I do know that insurance companies, at this time, are profit-driven with limited government regulations. Things may change under Obamacare, but that remains to be seen. 

Therefore, there are limited options podiatry has to obtain reimbursement parity. 1. Effectively modify the “supply and demand” equation. 2. Change the medical degree so that insurance companies cannot financially discriminate against a medical specialty. 3.  Compel the insurance companies to pay “equal pay for equal service”, through the courts (I think it was successful in Maryland and unsuccessful in Connecticut).

Methodology:  1. Reduce the number of podiatric students and graduates, or educate them on the importance of demographics impact on reimbursement.  2. Force insurance companies to discriminate on an anatomical area, not by degree. Let’s see how MDs and DOs would react. 
 
Ira Baum, DPM, Miami, FL, ibaumdpm@bellsouth.net

RE: CA Podiatrist Comments on Supreme Court Decision on Affordable Care Act (Elliot Udell, DPM)
From: Jeffrey Kass, DPM

Dr. Udell discussed rising healthcare premiums, deductibles, and co-payments. I have encountered this problem first-hand as a patient. My question is, as the doctor, when am I going to see a piece of this pie?
 
Jeffrey Kass, DPM, Forest Hills, NY jeffckass@aol.com

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