The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

July 06, 2011 #4,199 Publisher-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2011- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

Joseph M. Giannini, DPM

Dr. Joseph M. Giannini, past president of the Illinois Podiatric Medical Association (1980-81), passed away due to natural causes early Saturday, June 18, 2011. Besides running his own successful practice, Dr. Giannini was a committed representative of the podiatric profession. 

Dr. Joseph M. Giannini

In addition to his involvement with the IPMA, he was past chairman of the Podiatry Assurance Company of America, past chair of the Illinois Medical Licensing Board, and a member of the Illinois College of Podiatric Medicine Alumni Association.

WA Podiatrist Receives Dr. G. Dock Dockery Special Achievement Award 

The Board of Directors of the International Foot & Ankle Foundation created a new award this year called the Dr. G. Dock Dockery Special Achievement Award. The first recipient of this award was presented to Dr. Byron L. Hutchinson by Board Member, Dr. Cherie Johnson, at the Forty-First Annual Graduation of the Northwest Podiatric Surgical Residency Consortium, in Seattle, Washington. 

Dr. Byron Hutchinson

The Award is engraved: "For a foot & ankle physician and surgeon who exemplifies Dr. Dockery’s life passion and commitment to professional activities and endeavors, such as supporting educational events, lecturing, publication of lower extremity surgical books or articles in peer reviewed journals, lower extremity research, foot & ankle residency or fellowship training and participation in various organizations within the podiatric medical profession."

RI Podiatrist Assists Foreign-Trained MD Seeking U.S. Licensure

Through the Rhode Island Welcome Back program at Dorcas Place Adult and Family Learning Center, Dr. Ericka Olivera from Columbia is applying her breadth of experience, as well as her language skills and cultural background, as she works toward medical licensure in the United States.

Dr. Thomas Mancini

On one recent evening, Olivera assisted podiatrist Dr. Thomas Mancini with a diabetic patient whose lower leg was swollen, its fragile skin a mottled blue and brown, and itching. This is “venous stasis,” or slow blood flow in the veins; a condition that increases vulnerability to blood clots.

Source: Karen Lee Ziner, Providence Journal [7/4/11

OR Podiatrist, Winner of Wildflower Triathlon Prepares for World Championships

Dr. Michael Rushton, a podiatrist, really uses his feet. The Baker City resident, who sees patients in John Day and La Grande as part of his practice, will soon step into the World Championship level in the sport of triathlon. In three separate events this spring, Rushton clocked times that moved him into the upper level. He is busy preparing for two separate World-level triathlons this fall. 

Dr. Michael Rushton kisses daughter Aliza after winning the Wildflower triathlon

“I used to run and cycle a lot,” said Rushton, 41, who first entered a triathlon 17 years ago. The years went by, and a friend invited him two summers ago to enter one in La Grande. He won it. In late April, he jumped into the Wildflower Triathlon in San Luis Obispo, Calif., and won his age group, men 40-44. He was first among 273 competitors in that class.

Source: Sandra Gubel, Blue Mountain Eagle [6/29/11]

Query: Coding for Re-do Surgery

A patient presented for a second opinion for a painful big toe joint s/p hemi-implant insertion in the hallux proximal phalanx for hallux rigidus. The x-rays showed that the implant had been inserted at the wrong angle, which is why the patient has zero motion at the joint, and it's very painful. I plan on removing the hemi-implant and doing a revisional Keller arthroplasty with possible EHL lengthening and pin fixation.

Question #1: what is the correct code for removal of the implant?
Question #2: What is the code for EHL lengthening???

Tim Kirk DPM, Boyertown, PA

Response: I think you've answered your own question when you described just what you plan to do. The revisional Keller procedure is the primary operation. As with any other Keller operation, EHL lengthening and pin fixation is part of that operation and should not be billed separately.

With regard to removing the implant, there may be others with different opinions, but since this is not being done independent of the Keller operation, I also feel that this is part of the revisional Keller procedure and should not be billed.

You may want to consider adding a -22 modifier indicating a higher level of complexity than a typical Keller operation and request consideration for additional payment.

Howard Zlotoff DPM, Camp Hill, PA

Codingline subscription information can be found here
APMA Members: Click here for your free Codingline Silver subscription

RE:  DVT Prophylaxis Protocol (Yelana Barsky, DPM)
From: Randall Brower, DPM

I struggle with the question about DVT prophylaxis. If a surgeon doesn't understand the etiology, risk factors and prevention, s(he) shouldn't be doing surgery. And the podiatry school who trained her or the residency she graduated from ought to be ashamed. This is not intended as an offense, but highlights the true problem with grandfathering and pushing residencies to become three years when those basics like DVT prophylaxis are being missed.

Please reconsider doing any surgery until you have mastered surgical pre-operative and peri-operative management didactic protocols.  I know that sounds harsh, but in this litigious world, and for the sake of patients, avoid surgery if you don't have the educational background. Otherwise, all you are doing is potentially adding a 4th garage onto a malpractice attorney's summer home and ruining our standing in the medical community.

Randall Brower, DPM, Avondale, AZ, footdoctor33@yahoo.com

RE: Failed Keller (Judd Davis, DPM)
From: Vincent Gramuglia, DPM

In the presence of an intact FHL in a patient of this age, why not consider EHL lengthening combined with arthrodesis of the IPJ. This will give the flexor a mechanical advantage to plantarflex the MPJ and avoid the pitfalls associated with MPJ arthrodesis after a failed Keller (poor bone stock, etc.,) Use bone graft with prolonged immobilization.

Vincent Gramuglia, DPM, Bronx, NY, a2onpar3@optonline.net

RE: Brad Wenstrup, DPM for U.S. House of Representatives
From: Hal Ornstein, DPM

I would like to encourage my fellow podiatrists to join me in contributing to the campaign for Brad Wenstrup for U.S. House of Representatives. If we truly want to get Title XIX and other legislation passed in Congress, there is no better way than having a podiatrist on Capitol Hill.

This is likely to be a close race and your contribution can make a real difference. You can donate to his campaign at www.usabrad.com

Hal Ornstein, DPM, Howell, NJ, toetoe@optonline.net

RE: The Passing of Muriel E. Osborne Young, DPM

It is with great sadness that I inform you of the passing of Dr. Muriel E. Osborne Young. Dr. Osborne Young graduated from The Long Island University Podiatry School in 1944 and was the only female student in her class. She practiced podiatry in Washington, DC for over 40 years. During her extensive career, she was involved in private practice as well as working at  what was known as Freedmen’s Hospital, but now is Howard University Hospital. She was a mentor and educator to so many podiatrists in the Washington, DC area. 

Dr. Muriel E. Osborne Young

Additionally, she served on many civic and professional boards during her extensive career. Upon retirement, she moved to Spring Hill, Florida to enjoy traveling, boating, and reading. She leaves behind a daughter, Linda O. Wellmon and a host of family and friends. She was an inspiration to our profession.

Kirk Geter, DPM, Chief of Podiatry, Howard University Hospital

RE: Where is Organized Medicine?
From: Doug Milch, DPM

Where is orgainized medicine? The term "Organized Medicine" is an oxymoron like "Jumbo Shrimp." The problem started with (mis) managed care. Insurance companies got together and signed up patients to enroll in this supposedly less expensive model. Then they went to physicians and said, "if you want to see the patients in our program, you can sign up, but these are the discounted fees we will pay you for each service. Take it or leave it. Oh, and you are no longer physicians; you are 'providers,' and these are no longer patients; they are 'covered lives.'"

Doctors, fearful that they wouldn't see enough patients, signed up for these programs and discounted fees. But we found that our overhead kept going up, so we...

Editor's note: Dr. Milch's extended-length letter can be read here.

RE: How Would Your Life be Different if You Had an MD Degree?
From: Art Korbel, DPM, MD

I have an MD degree, and the difference is that I am accepted as an equal with the other MDs. We talk as friends, and they learn from me as I from them about all types of medical-related topics.

As far as treatment goes, they take my advice too regarding alternatives, and I am the expert when it comes to the foot and ankle. Orthopods also take my advice, unless they are members of AOF&AS.
 
Art Korbel, DPM, MD, Pompano Beach, FL, Classicboats4425@aol.com

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

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.

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

PM News Classified Ads Reach over 12,500 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 12,500 DPM's. Write to bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $109 for a 50-word ad THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451.

• To Post a message, send it to:    bblock@podiatrym.com
• Notes should be original and may not be submitted to other publications or listservs without our express written permission.
• Notes must be in the following form:
  RE: (Topic)
  From: (your name, DPM)
  Body of letter. Be concise. Limit to 250 words or less). Use Spellchecker
  Your name, DPM City/State
• Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.