The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

July 05, 2011 #4,198 Publisher-Barry Block, DPM, JD

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Thomas Patrick Bresnahan, DPM

Dr. Thomas Patrick Bresnahan, 84, of Springfield, passed away on Friday at Mercy Medical Center, Springfield. He received a bachelor of arts degree in 1951 from Marquette University in Milwaukee. After his graduation, he attended seminary for two years. In 1958, he graduated from Temple University in Philadelphia with a doctorate in podiatric medicine. He served the Greater Springfield areas with his practice of podiatric medicine for more than 40 years.

Dr. Thomas Patrick Bresnahan

Bresnahan served his country during World War II with the United States Navy on the NTS Sampson and received the American area medal and the Asiatic-Pacific area medal.He served as president of the Massachusetts Podiatry Association from 1972 to 1973 and the Pioneer Valley Diabetic Association from 1984 to 1985.

Source: MassLive.com [07/04/11]

WI Podiatrist's Fees Shock Patients

Rachel Quintero saw an ad for the podiatrist and noticed that one of his offices was on her way to work. He wasn't in her health plan's network - but after all, how much could it cost to have part of a toenail removed? The answer, if John S. Lanham is the podiatrist: More than $2,300. Lanham, whose fees were the subject of a story in the Journal Sentinel in 2007, has built a podiatry practice with a history of billing unsuspecting patients ,fees that can be multiples of what other podiatrists charge for similar services.

Steven Frydman, executive director of the Wisconsin Society of Podiatric Medicine, estimated that he receives one to two calls every six weeks, on average, about Lanham's fees. "His charges are outlandish," Frydman said. He got two letters from former patients of Lanham the day that Quintero called him. And he suspects that just a fraction of the patients affected by Lanham's billing practices contact him. "We are a very small profession, and it looks bad for all of us," Frydman said. Yet the society and state regulators are virtually powerless to stop Lanham. The society can only send information to patients on how to challenge the bill in small claims court.

Source: Guy Boulton, Journal Sentinel [7/3/11]

Editor's Note: PM News is proud to present excerpts from Meet the Masters.

Bret Ribotsky: How would your life to be different if you had an MD degree?

Dr. John Mozena

John Mozena: I think that, first of all, my interactions with insurance companies would be easier. I think the referral basis would be easier.  I think that we’d see less discrimination with proper referrals from the ER. It would pass all the way through from the patient, to the insurance company, to the hospitals, to the referral basis from the family physicians.

 

Dr. Anthony Poggio

Meet the Masters is broadcast each Tuesday Night at 9 PM (EST). The next segment will feature podiatric billing and coding expert Dr. Anthony Poggio. You can register for this event by clicking here

Set Specific Deadlines

Eliminate confusion. Be specific when you set a deadline. If you say “I want the project tomorrow,” you might expect it in the morning, while staff members might think they have until midnight to email it to you.

Source: Adapted from Leading in Turbulent Times, Kevin Kelly and Gary Hayes, Berrett- Koehler via Communication Briefings

RE: Donating to Brad Wenstrup for Congress

Please let me know where I can send my contribution for Dr. Wenstrup's campaign. 

Neil A Burrell, DPM, Beaumont, TX

Editor's comment: We are very proud of Dr. Wenstrup. Podiatry would be helped immeasurably by having someone in Congress who knows our issues and concerns first-hand. Donations can be sent to: www.usabrad.com

Query: Hall Micro E 5040 System Repairs

Does anyone know someone who repairs and deals with parts on the Zimmer Hall 5040 electric power system? Any help would be greatly appreciated.
 
Mark Lambert, DPM, Pensacola, FL

RE: DVT Prophylaxis Protocol (Yelana Barsky, DPM)
From: Larry Kollenberg, DPM, Pharm D

There are multiple 'guidelines' that exist for thrombophlebitis prophylaxis. See NIH, or orthopedic guidelines. In general, most institutions have specific criteria. Ask the nurse educator at your hospital. The guidelines are all essentially aimed at prevention. The risk for PE and DVT of the leg is relatively high with increasing co-morbidities. The individual patient should be evaluated based upon the given criteria and then graded or scored. If appropriate, minimal treatment should be compression stockings and local extremity exercises, such as NWB leg lifting and bending of knee for podiatric procedures (even with a BK cast). If the patient is at moderate or high risk, then you should consider unfractionated Heparin or LMWH.

Consider the need to bridge to warfarin. Consider and prescribe prophylactic treatment for ANY patient who it is indicated in ,especially if you have NWB home-bound patients.You are well within your scope to be prescribing these medications for short term use (i.e., 2-3 weeks). SQ Heparin bid is cheap, even if no insurance. If you have renal patients (CrCl <30ml/min) or are going to need long-term use, then you should include the PCP for monitoring, etc., as the patient should be closely watched, or bridged when appropriate to oral anticoagulants.

Larry Kollenberg, DPM, Pharm D, Baltimore, MD, lkollenberg@hotmail.com

RE: Failed Keller (Judd Davis, DPM)
From: Michael Forman, DPM

Thirty or forty years ago, Dr. Jim Ganley wrote a classic article about modifications of the Keller procedure.  This is great reading for anyone doing this procedure. He discussed a number of options, including some ideas about capsular closure. One of the suggestions he made to avoid an elevated hallux was to reattach the flexor hallucis brevis to the base of the remaining portion of the proximal phalanx. 

Dr. Ed Floyd recommended attaching the entire flexor complex, i.e. flexor longus and brevis. You can choose to use a non-absorbable suture through a drill hole to fixate this. I fully agree that most cases require an extensor hallucis longus lengthening.
 
Michael Forman, DPM, Cleveland, OH, IM4MAN@aol.com

RE: Where Is Organized Medicine? (Elliot Udell, DPM)
From: Richard Rettig, DPM

Dr. Udell mentioned that the co-payment for a $55 office visit was $50.00. He has discovered a 'secret' regarding the insurance industry.  Back in the old days, they sold 'indemnity plans' that did not cover office visits. Then HMOs came along, so everyone wanted and demanded covered office visits. So they added office visit coverage (and kept raising the rates to cover this). Then they started creeping up the co-payments. Now they are essentially NOT covering office visits anymore, but no one gets it.

Richard Rettig, DPM, Philadelphia, PA, rettigdpm@gmail.com

RE: The Passing of Howard Marshall, DPM
From: Doug Richie, DPM

When I entered my fourth year of podiatric medical training in 1979 at Los Angeles County-USC Medical Center, I had already studied under the legends of podiatric biomechanics: Drs. Root, Weed, and Orien.  But none were able to teach me the practical application of the science as well as Howard Marshall did that year. He was truly the best mentor I ever had during my entire education and post-graduate endeavors.

Howard Marshall combined superb intellectual gifts with a charismatic personality, and he became an iconic educator and inspiration to an entire generation of podiatric physicians. Howard Marshall's greatest attribute, however, was his steadfast commitment to honesty and integrity. He exemplified and demanded that we adhere to the highest level of ethical standards in professional practice. This will be the enduring legacy of Howard Marshall, which all podiatric educators should strive to emulate.
 
Doug Richie, DPM, Seal Beach, CA

RE: One in 10 Electronic Prescriptions Contains an Error: Study
From: Elliot Udell, DPM
 
The fact that there is a significant number of errors due to electronic prescription writing comes as no surprise. When a physician handwrites a  prescription, he or she has time to think about what is being written and look at the form before it is given to the patient. The patient also gets to read it. With E-Scripts, a physician clicks on several icons in different windows, and it is all too easy for a busy doctor to click on an icon for the wrong medication and an icon for it to be sent to the pharmacy. 

What compounds this problem is that e-prescribing, which is now mandated by the government with the threat of being "fined" via lower Medicare re-embursement, is a much more time-consuming process than writing out the prescription by hand. Many doctors might be relegating this to staff , and even if the doctors are sending off their own prescriptions, there is incentive to rush because of the extra time it takes to go through the process.
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

PRACTICE FOR SALE - NANAIMO, BRITISH COLUMBIA, CANADA

Have you ever dreamed of owning a practice where... you can see 0-50 patients daily .. .average 100 new patients monthly have zero accounts receivable ... gross $480 M per year .... live in a beautiful community with skiing, hiking, fishing and boating on your doorstep. This could be yours! If interested contact pistone@telus.net or 250-754-4192.

PRACTICE FOR SALE - MISSOURI

Well established, but still growing. Grossed over $300,000 last year. Located in a thriving medical community. Good payer mix. All aspects of podiatry needed in the area. Do not let this opportunity to own your own practice pass you by. Contact footdoc2002@yahoo.com for more information.

PRACTICE FOR SALE - MISSION VIEJO, CA

Relocating to Tulsa. Great opportunity. Located at Mission Regional Hospital. Sale price $205,000 including supplies. Gross income 2010 was $340,000. Gross income 2011 estimate $420,000. Approximately 1200 sq ft with 3 treatment rooms, digital x-ray and fully computerized. A/R available at 50% discount. 949-702-1052. David Stoller, DPM (Family Footcare)david@missionviejofootcare.com

PRACTICE FOR SALE - NORTHERN NJ

Well established, part-time practice is for sale in Northern NJ. Digital X-rays, EMR, located in a medical condo building. Surgery 35%, Routine 30%, Average Gross is $130K on 2 half days per week. Practice is expandable to full time with increasing hours and marketing. Real estate available for purchase. Financing available. Please call 800-983-4194, or emailcontactus@podiatrypracticeconsultants.com

PRACTICE FOR SALE - BROOKLYN, NY

A large, busy practice is for sale in Brooklyn, NY. This practice has been in the same location for over 50 years. Average 150 pts/week, average gross $760K, most surgery is currently being referred out. Financing available. Please call 800-983-4194, or email contactus@podiatrypracticeconsultants.com

ASSOCIATE POSITION – IOWA CITY AREA

Modern practice seeking a well-trained (PSR 24/36) associate. Excellent opportunity for an energetic, hardworking individual with strong surgical and medical skills. Solid referral network and 13 years of growth. Come live in the Iowa City area and enjoy the quality of life and stability of a Big Ten University community. Competitive salary and benefit package available. If interested, fax CV to 319-354-1014 or e-mail to dave@341foot.com

ASSOCIATE POSITION - CENTRAL NEW JERSEY

Seeking associate for busy, growing practice located in Toms River, Ocean County. Looking for PSR 24/36, board eligible doctor. Basic podiatry a must. Practice has a up-to-date EMR and practice management program. Digital x-rays, ultrasound, laser, vascular studies. Excellent opportunity for highly motivated and ethical DPM. Send CV to toesec@aol.com

ASSOCIATE POSITION - NORTHWEST FLORIDA BEACHES

Excellent opportunity for an energetic, compassionate, hardworking individual with superior surgical and medical proficiency. Recent graduate or experienced practitioner. Excellent salary, benefits and partner-buy in offered, full admit privileges and surgical scope. Fax CV to Ecpodiatry@aol.com

ASSOCIATE POSITION - SAN DIEGO

Well-established practice is seeking an associate with the opportunity for a future partnership position. Great location and medical environment. Must have a California license and an interest in the full range of podiatric services. Please email resume and cover letter to ethuen@hotmail.com

ASSOCIATE POSITIONS: NW INDIANA & CHICAGO AREA

2 Full-Time positions open - One for Northwest Indiana and one for the Chicagoland area. Must have 2-year surgical residency. Must be motivated and a self-starter. State License required. If interested email: f-massuda@footexperts.com

TURN-KEY PODIATRIC OFFICE - CALIFORNIA

Fully equipped modern suite with built-ins at Mission Regional Medical Center, Mission Viejo CA. Four treatment rooms, New Midmark chairs, x-ray/processor, phone system & much more. $45,000/assume lease. Call Jackie, 949-493-8020.

SPACE AVAILABLE- NYC & LI

Office to sublet and share - East 60th Manhattan, and Plainview Long Island. access to an MRI, Joint Commission certified operating rooms, digital x-ray, diagnostic ultrasound, and access to a multi-specialty ambulatory surgical center. Also availability E 22nd between 2nd and 3rd and E 70th off 3rd. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM

PM News Classified Ads Reach over 12,500 DPM's and Students

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