The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

July 07, 2010 #3,903 Publisher-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2010- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

Even Small Increases in Weight Can Take Toll on Feet: NJ Podiatrist

Even small amounts of excess weight -- common in a country where two-thirds of adults and one-third of kids are overweight or obese -- can take a toll on feet. "Overweight people are going to get increased swelling especially with the heat, arthritic changes because of the joints. Obesity causes a lot of ailments," says Dr. Scott Warren of the Academy Podiatry Associates in Mount Ephraim, NJ.

Dr. Scott Warren

The bottom line, according to Warrren, ". . . If people went out and walked for 30 minutes a few times a week and ate better, they would be better off. Obesity leads to other things. It puts stress on the body. From a biomechanical standpoint, it's our metabolism. People who are sedentary can't lose weight because their metabolism doesn't stay up."

Source: Kim Painter, Courier-Post [7/5/10]

AAPPM Introduces Practice Management Curriculum For Residency Program

Dr. Hal Ornstein, Chairman of the American Academy of Podiatric Practice Management visited Wyckoff Heights Medical Center on Tuesday June 29th to give an orientation for the comprehensive practice management curriculum he established along with the help of Dr. Ron Guberman, Director of the Podiatric Residency at Wyckoff. The Wyckoff Heights Medical Center residency program trains twenty-eight residents and four fellows. 

Drs. Hal Ornstein and Ron Guberman Present Practice Management Program to Wycoff Residents

This revolutionary adjunct to the training schedule is actually a spinoff of the four-year practice management curriculum created for the Ohio College of Podiatric Medicine by Ornstein and the American Academy of Podiatric Practice Management. At Wyckoff, it will be a required curriculum for all of the post-graduate podiatry residents. Teaching will be delivered through on-site presentations, Webinars, and a variety of other technologies. Required books and articles will be supplemented by regimented practice management rotations through top podiatric practices throughout New York and New Jersey.

OH Podiatrist is New Pastor at Church

On Sunday, Richard Rasper, 47, will become the new pastor at Church in the Valley, the church founded by Whitehawk-Day's father, the late Rev. John Fisk. The congregation of the Bible-based, independent non-denominational church had been searching for a pastor since Fisk died in 2007.

Rev. Dr. Rick Rasper (Photo: Phil Masturzo)

The Chesterland native first came to Church in the Valley as a guest minister, filling the pulpit on several occasions. He had no expectation of becoming the permanent pastor because he was comfortable where he was. The podiatrist was working part-time at the wound center at St. Thomas Hospital and serving in ministry full-time at Riverwood Community Chapel in Kent. Rasper is working on his master's of divinity degree and has plans to pursue a doctorate of ministries. 

Source: Colette M. Jenkins, Akron Beacon Journal [7/2/10]

OPEIU Holds its 25th Triennial Meeting in Washington, DC  

Guild 45, (The First National Guild of Healthcare Providers of the Lower Extremity)  was represented by Drs. John Mattiacci, Michael Wodka, Ed Smith, and Robert Herpin at the recent OPIUE Triennial Meeting. Resolution 8, " Descrimination against Doctors of Podiatric Medicine / Title XIX," was presented and passed unanimously.

Dr. John Mattiacci

Dr. Mattiacci was unanimously re-elected as a VP of Region 2. In his remarks,  Mattiacci spoke of the formation of Guild 45, and the major benefit of this relationship to our legislative efforts. He introduced the other professional medical professions who have been organized under the OPEIU, including the Hawaii Nurses Association, clinical social workers, radiologic technicians, and chiropractors.

Physicians Should Not Fall Under "Red Flags" Rule: FTC Chair

Physicians should not be required to follow the so-called red flags rule that requires anyone offering credit to develop and implement written identity theft prevention and detection programs. That's the word from the head of the Federal Trade Commission -- the organization that first declared physicians must submit to the rule. "We feel your pain on red flags, and we want to fix it," Federal Trade Commission Chair Jon Leibowitz said at the American Medical Association Annual Meeting. "We agree with you that the red flags rule reaches too far."

Leibowitz said the rule will not be enforced on members of the AMA, the American Osteopathic Assn., state medical societies, and the Medical Society of the District of Columbia while one of at least two lawsuits on the red flags rule works its way through the court system.

Source: Victoria Stagg Elliott, AMNews [6/28/10}

Query:  Jones Fracture Complications

A 14 y/o boy suffered an avulsion fracture at the base of the 5th. met. He wore a CAM walker for 8 weeks. Periodic x-rays did NOT reveal normal healing, however, since there was no pain, edema, inflammation, etc., he was permitted to return to activities (the belief was that we treat patients, NOT x-rays) There was no joint involvement. He returned to all activities, including basketball with no pain/edema/problems. Then, two months later, while playing in his backyard, he re-injured this same bone. Again, 8 weeks of using a CAM walker did not produce healing of any significance. The avulsion fracture was through all cortices, but did not involve more than 20% of the joint surface. There was no pain, edema, etc.

I would not want him to continue another 4-8 weeks of using a CAM walker if the result will be the same. Would there be a long-term consequence to excise the bone fragment? His younger siblings and cousins all had fractures (shoulder, wrist, ankle) in the past year that did not heal as expected. He has significant flexible pes planus (and flexible FF varus). I want him to eventually get orthotics. Question: Should he have an NSTJ functional orthotic or one made in slight pronation to avoid the effects of the peroneus brevis on the compromised area?
 
B. Zaccardelli, DPM, Cleveland, OH

Query: Repair of Spring Ligament

I'm having trouble finding a code of repair of spring ligament. My podiatrist did a repair of the posterior tibial tendon (CPT 28200), talonavicular joint fusion, (CPT 28740), and repair of the spring ligament. The only code I can come up with for repair of spring ligament is the unlisted code. Any help would be appreciated.

Elaine Barnett, CPC, Jefferson City, MO
 
Response: I agree with your research; there is no code that exists for repair of a spring ligament of the foot. Using CPT 28899 (unlisted procedure, foot) would be your only viable option presuming the repair was a separate procedure independent of any other procedures performed at the same site.

I would not be surprised, however, if the insurer would deny payment of the spring ligament repair since a fusion was performed. I have seen this considered as a component of the arthrodesis at the talonavicular joint, which has also been performed in this case.

Howard Zlotoff, DPM, Camp Hill, PA

Codingline subscription information can be found at:
http://www.codingline.com/subscribe.htm

RE: Discharging a Neo-Nazi (Narmo L. Ortiz, Jr., DPM)
From: Joseph J. Weisenfeld, DPM, Ivan Cooper, DPM

I must disagree with Dr. Ortiz. This is the correct forum to discuss professionalism. We are doctors, not automatons. We are emotionally affected by our environment. We have an obligation to treat patients in a courteous and professional manner to the best of our ability. However, if something in the patient's behavior and/or demeanor leads you to question that it may affect your ability to care for the patient impartially, you actually have a duty to inform the patient of your concern. 
 
Joseph J. Weisenfeld, DPM, Staten Island, NY, JAtoe2@aol.com

Dr. Ortiz does not get a lot of things.  PM News is not being used for a political publication. "Dr. Name Withheld" had a dilemma in his office. He needed advice. More than ever, podiatrists are faced with situations like this. It is a REAL problem in Dr. Name Withheld's medical practice and obviously in others. Look at the responses.  Obviously, it needs addressing. There is a real concern. It seems that Dr. Ortiz wants to turn his back on a serious problem called doctor-patient relationship.

Ivan Cooper, DPM, Knoxville, TN, ccooper3668@aol.com

RE: Discharging a Neo-Nazi (Name Withheld)
From: Gary S Smith, DPM

I had a neo-Nazi patient once and found it quite interesting. I have learned new things from my patients everyday and he was no exception. Listening to him rant gave me an education on how they twist religion and politics to indoctrinate young minds. They are like any other cult. It also gave me an opportunity to correct HIS misconceptions. When it comes right down to it, it is just another way for these people to control others, enrich themselves, and make themselves feel more important, not unlike with Charles Manson.

I found it educational and interesting, like treating disorganized schizophrenia patients, etc. Treating a prisoner that has murdered or raped is part of my job as well, and even though they make my skin crawl, treating them puts me above them, not with them.
 
Gary S Smith, DPM, Bradford, PA, penndoc@verizon.net

RE: Snake Oil, Anyone?

While looking through some papers, my wife found a yellowed front page of the Philadelphia Daily News dated April 27, 1911. A featured article on page one was entitled, "New Way of Curing Corns." 

"Every owner of a corn, callus, wart, or bunion is going to get the surprise of a lifetime. No longer do you have to gouge out these things with a digger or knife; no more slicing with razors and drawing blood; no more blood-poison; no more sticking plasters. GETS-IT, the new preparation, is as harmless to the skin as water, but, blazes, how it works! Nothing to stick or hurt, lo and behold your corn comes out. You don't have to drag it out. GETS-IT is sold at all druggists at 25 cents a bottle."

This obviously was an advertisement, but was not labeled as such.

Bob Sherman, DPM, Stratford, CT

PODIATRIST NEEDED - BROOKLYN, NY

Position available for 2-3 days busy office in large medical group. HIP credentialed. email resume to hallux62@aol.com

PART-TIME PODIATRIST NEEDED - LOS ANGELES, CALIFORNIA

Busy Podiatrist looking for assistance with patients located in facilities, home, office etc. Flexible hours, independence, and great compensation. If interested email CV to homefootcare@hotmail.com or call Terri at 323-353-8103.

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

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

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

• 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.