The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

July 06, 2010 #3,902 Publisher-Barry Block, DPM, JD

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KS Podiatrist Uses Law Degree to Better Understand Health Legislation

Over the past 30 years, Phyllis Ragley has handled thousands of feet. She says she has never seen an ugly one. “You need to be nice to your feet and treat them well,” she says. No, Ragley doesn’t have a foot fetish. She’s a board-certified podiatrist, foot specialist, and lawyer. Ragley graduated with a juris doctorate in 1989 and passed the Kansas Bar examinations in 1990. “While I’m licensed to practice law, I’ve chosen not to,” she says. “I use my knowledge to help me better understand health legislation and related issues.”

Dr. Phyllis Ragley (Photo: Nick Krug)

Among her many achievements, Ragley is a fellow of the American College of Foot and Ankle Surgeons, the American Society of Podiatric Surgeons, American Academy of Podiatric Sports Medicine and the American Professional Wound Care Association. She’s on the active medical staff at Lawrence Memorial Hospital, the Wound Healing Center and Lawrence Surgery Center, and she still finds time to provide medical services for Health Care Access, and lecture to local and national physician organizations.

Source: Eileen Roddy, LJWorld.com [7/5/10]

Use Sunscreen on Feet to Prevent Deadly Skin Cancer: TUSPM Professor  

Skin cancer on the legs and feet actually has a high mortality rate due to people forgetting to do skin checks on that area. It’s often caught too late,” says Tracey Vlahovic, DPM, associate professor of podiatric medicine and orthopedics at Temple University’s School of Podiatric Medicine “This is due in large part to the fact that many people simply forget to apply or reapply sunscreen to the lower extremities.” Vlahovic adds that African- and Asian-American women can also be susceptible to skin cancer of the lower extremity, mainly because they feel they are immune to it due to their darker skin tones.

Dr. Tracey Vlahovic

“No matter race or ethnicity, the legs and feet are not immune to the sun’s effects, and women have an even greater chance of developing skin cancer than men, because they often have more of their leg exposed,” says Vlahovic. A sunburn on your feet can cause swelling, blisters, pain and limit your ability to walk in closed shoes. The result could mean wounds that take a long time to heal or even greater diabetes complications. To protect your feet, Vlahovic suggests applying sunscreen every few hours or more often if you are going to be in the water.

Source: Diabetes Life [7/5/10]

AZ Podiatrist is Amputation-Prevention Ambassador in Japan

David G. Armstrong, Professor of Surgery and Director of the Southern Arizona Limb Salvage Alliance (SALSA) at the University of Arizona, was the featured guest at two gatherings in Tokyo and Kobe Japan highlighting the "team approach" to amputation prevention. The audience, consisting of physicians, surgeons, and nurses from throughout Japan, filled two standing-room-only auditoria in the two cities. "This is such an extraordinarily exciting time", noted Dr.
Armstrong, "To see Japan embracing wound healing in general, and amputation specifically, augurs a new era for care in the Pacific Rim and beyond."

Dr. David Armstrong (center) in Japan

Professor Ted Uemura, Chief of Plastic Surgery at Saga University was equally enthusiastic, "Podiatric medicine has existed in the USA since 1912. We have very little exposure to this level of
medical education to the lower extremity in Japan. This must change if we are to embrace the 'SALSA' approach nationwide."

A 4^th of July Spectacular for ACPME

It was a perfect combination of beautiful Catskill weather and engaging speakers at the Academy of Continuing Podiatric Medical Education Seminar held this weekened at Kutsher's Country Club in Monticello, NY.

(L-R) Drs. Robert Marcus, Barry Block, and Elliot Udell

Speakers for this conference included: Drs. Barry Block, Howard Friedman, Emanuel Haber, and Elliot Udell. Kudos to ACPME's Chair, Dr. Robert Marcus for a well-run meeting.   

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

Bret Ribotsky: What do you think podiatry should be doing to prepare for the future healthcare environment?

Dr. Lawrence Oloff

Lawrence Oloff: One of the problems that we face is declining reimbursement. We are in tough economic times, and this is where I think podiatric groups are stable and stronger. Groups can get other revenue sources through ancillary income from surgery centers, and they can purchase MRIs. Some group practices also provide physical therapy. All these avenues can make up for losses. These alternatives are very difficult for a solo practitioner to do. Of course, solo practitioners can become partners in a surgery center and so forth, but they cannot avail themselves of the same opportunity. So, I think banding together is a good idea.

Dr. Marc Benard

Meet the Masters is broadcast each Tuesday Night at 9 PM (EST). This week's show features Dr. Marc Benard, Executive Director of American Board of Podiatric Orthopedics and Primary Podiatric Medicine.  You can register for this event by clicking here

RE: Determining Accounts Receivable

How do you determine the cash receivables to the seller? Is there a formula? The buyer is an associate.

David Zuckerman, DPM, Woodbury, NJ

Editor's Comment: PM News does not provide legal advice. Generally, the accounts receivable can be determined by the historic collection rate of a particular practice. Since all practices are different, there is no set formula to use. A better idea is to simply estimate the anticipitated A/R, and then adjust this amount based on the actual monies collected from the A/R within the year following the transfer of the practice. 

RE: Physician Status in Title XIX (John Chisholm, DPM)
From: Randy Brower, DPM
 
Dr. Chisholm, did you proof-read your response? You talk out of both sides of your mouth which actually highlights frustration felt by many of us. I have been a paying member of the APMA for the past 5 years of my post-residency career. I have made contributions to PPAC over the years, although admittedly small due to my giant student loan burden.

I am choosing this year to remove myself from the APMA. I don't feel the dues match the changes and benefits I had hoped for. I am not saying our efforts have been timid, but have honestly fallen flat on the national stage. Dr. Chisholm is frustrated over lack of progress nationally over the years with title XIX but encourages us to continue to invest?  Is money really the answer?  Texas can't get ankle scope of practice fixed.  As Kathleen Stone from Arizona knows well, Arizona can't change its scope so that we can amputate a toe. If states can't fix their issues, it explains why nationally, not much gets changed. Hence the thought by many of us....the definition of insanity is doing the same thing over and over while expecting a different result. Until a real world long-term plan to accomplish title XIX is presented and implemented with incremental results achieved, don't berate those of us who withhold our money in skepticism.

My advice, instead of focusing on title XIX, go state by state,, standardize scope of practice in each state, and the APMA will see a large increase in membership and future ability to tackle national issues. Let's form an equal and empowered United States of APMA that can tackle national issues on equal footing.

Randy Brower, DPM, Prescott Valley, AZ, footdoctor33@yahoo.com

RE: Physician Status in Title XIX (John Chisholm, DPM)
From: Richard A. Simmons, DPM

With all due respect to Dr. Chisholm's frustration concerning Title XIX legislation, for the most part it is doubtful that the majority knows the significance of this piece of legislation. Many would wonder why podiatrists are spending so much time and money on it.  I can hardly remember a time in my professional career that podiatry was not involved in passing podiatric physician status in Title XIX. In the same time frame, I have observed colleagues become millionaires in the practice of podiatric medicine and integrated into large orthopedic surgical groups, etc.

I believe the lackluster response from the majority is due in large part to the fact that many are doing phenomenally well with Title XIX as it is, and many see this as some academic exercise that our delegates have chosen to take on. For instance, specifically, how will the day-to-day practice of the average podiatrist change once Title XIX is passed? Somehow, what seems to be "much ado about nothing" needs to be presented as the huge necessity that it is.

Richard A. Simmons, DPM, Rockledge, FL  RASDPM32822@aol.com

RE: Discharging a Neo-Nazi (Name Withheld)
From: Multiple Respondents

I had a somewhat similar situation. I was doing a fifth toe arthroplasty on a patient in my office under just local anesthesia.  We were talking throughout the whole procedure and having a very nice conservation. The  subject changed and something about money came up and her reply was it was due to those damn Jews. She continued her diatribe and added a few more words that I can't print here.  Finally, I looked up from the surgery and told her I am Jewish.  She became very pale, stopped talking and could not get out of my office fast enough when I was through. She never returned for any post-op visits, but I remained professional and did send a certified letter reminding her of her missed appointments.

This does prove that it really is a good idea to keep your thoughts to yourself because you never really know who you are talking to, even though I have an obvious Jewish last name.
 
Steven Moskowitz, DPM, Houston, TX, SSSSmosk@aol.com

While I'm not sure you can enlighten someone who leads such a radical life, if anyone can, Dr. Name Withheld may have done so. By treating the Neo-Nazi patient with kindness, skill and care and ultimately revealing to her that he is Jewish, he will have proven to her that she should not judge people by our religions. She may not get it now, but some day, when she changes the people she hangs around with and matures, if that happens, she will reflect upon that day when he had the conversation with her. Boy, I wish I could be a fly on that wall!
 
Kathy Satterfield, DPM, Boerne, TX, vksatterfielddpm@aol.com

I am very surprised that Dr. Block has allowed inclusion of political and ethnical critical issues that have nothing to do with what this forum should be about. Let me get this straight, "name withheld" treated this patient for over a year, with no issues, until he got to see her tattoos. Instead of being proactive and "teach" her how well and efficiently she was treated by the doctor no matter his or her religious or ethnical origins are, he chooses to revert to the past and the ignorant continuation of hatred separatism.

I do not care where you are from or what your religious or political views are, we are all human, and the comment from the colleague from Israel was most inappropriate. I hope these issues do not surface in this forum again since they will only bring unwanted animosities among all that claim to be on the side of "righteousness."

Narmo L. Ortiz, Jr., DPM, Cape Coral, FL, nlortizdpm@embarqmail.com

RE: Medicare Fee Reversal (Marc Bendeth, DPM)
From: Wm. Barry Turner, BSN, DPM

I agree with what Dr. Bendeth is saying and I am awake. Now, what does he recommend? Marc, I do not think that many practicing physicians - regardless of specialty, are asleep. We are simply powerless. Physicians are no longer respected or treated as we have worked so hard to deserve. No, now the politicians and the media have taken the few bad apples in medicine and put all the rest of us in the same basket. Patients come into my office distrustful of what I...

Editor's Note: Dr. Turner's extended-length letter can be read here.

MANHATTAN MEDICAL SPACE AVAILABLE

Multispecialty Medical Building with 24/7 doorman. Prime Luxury Building and Location, Gramercy, Stuyvesant, Peter Cooper Area. 305 Second Avenue (17th-18th). Prior tenants past 23 years; podiatrist, dentist (plumbing/electric intact), internist. Ideal for podiatry, co-share with dentist, MD, etc. (flexible lease terms). E-Mail; jbdrun@aol.com Phone; 480-951-2480.

ASSOCIATE POSITION - SOUTHEAST GEORGIA

Beautiful weather year round & near the Coast. Opportunity for Early Buy-in. Seeking associate or new residency graduate to join practice. Must be PSR-24/36 trained. Multiple locations. Full range of services with new facilities. E-mail cover letter & CV to melissafoot@pol.net

PRACTICE FOR SALE - MINNESOTA

Practice Grossing over $500K yearly. Good mix of surgery, orthotics, DME, diabetic care, general podiatry. Commute < 5 miles to work. Friendly Midwest lakes area with arts, good schools, affordable living, restaurants, shopping. Option to purchase building. Will consider associate to buy-in/ buy-out. Midwestpractice@gmail.com

CANADIAN PODIATRISTS COME BACK HOME!

An Edmonton, Alberta group of DPM’s requires an additional Podiatrist. Interest in biomechanics essential. Given Canadian visa restrictions, this position is open only to Canadian Citizens or permanent residents. Very attractive compensation package. Fax C.V. or letter of interest to: (780) 483-5796.

ASSOCIATE POSITION - FREDERICK, MARYLAND

Fredericks premier group practice is located only 45 minutes from both DC and Baltimore. Immediate opening for a minimum PSR 36 Podiatrist for full time position. We have it all: EMR, digital x-ray, ultrasound, ASC, etc. Excellent salary with bonus structure and benefits. Please email resume to docsbnb@aol.com

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

Full-time 3-DPM group in South Bay of LA County. Minutes from best living in LA County. Practice is an excellent mix of surgery, general podiatry, diabetic care, and DME. Beautiful office with EMR, Digital X-ray and Orthoses, etc. Please e-mail cover letter, and resume to footcareone@verizon.net

PRACTICE FOR SALE – MAINE

25 year full scope in medical building, podiatrist friendly hospitals, appreciative and cooperative patients, excellent expansion potential, physician referrals. Wonderful place to raise a family. Retiring seller will stay for transition. mainefootdoc@yahoo.com

TN PRACTICE FOR SALE (SOUTH OF NASHVILLE)

Active, established practice with new equipment (digital x-ray, ultrasound, computer network, etc.). Great referral network with an excellent scope of practice. Turn-key operation with seamless transition. Grossed over $350K last year. Call 931-446-5724 or e-mail mchad500@gmail.com

1-YEAR PODIATRIC SPORTS MEDICINE FELLOWSHIP - MONROVIA, CALIFORNIA

Applicants must have completed a podiatric residency program and must have or be eligible for a California license. Annual stipend: $48,000 and $60,000. If interested, please e-mail your resume with cover letter to the Program's management company at victoriamanagers@gmail.com

PM News Classified Ads Reach over 12,000 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 12,000 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

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