July 10, 2006 #2, 626 Editor-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2006- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

NY Podiatrist Uses Restylane to Treat Painful Corns

Podiatrist Dr. Johanna Youner says the real problem with painful corns lies just below the surface. “There’s fat under the skin and the fat gets worn away so you’re basically left with skin and bone,” Youner says.

Now doctors are trying to repair the ailment with a product usually reserved for the face. Restylane is a filler used by cosmetic surgeons to plump up the skin and get rid of wrinkles. Youner uses it to pump up the skin on the toe. “It’s replacing the volume that has been lost over time, either by life, by abuse, by over-exercising, by high heels, by genetics ... so I just literally replace the volume lost,” Youner says. Youner also says there are no side-effects.

Health officials say Restylane is not a permanent fix. It lasts eight months to a year before another injection is needed.

Source: David Marks, CBS News Path [7/7/06]

FL Podiatrist Recalls His Role in Forming Runners Club and Jogging Trail

When Ocala podiatrist Dr. Lloyd Steinberg set out on a casual jog in his neighborhood, nearly three decades ago, he had no idea those initial steps would affect the running climate in Ocala for many years to come. Shortly after, Lloyd teamed up with other area physicians for group runs. In 1977, they formed the Ocala Runners Club and named Lloyd its first president.

Dr. Lloyd Steinberg

Lloyd designed a two-mile clay trail and suggested it be built at Jervey Gantt Park where the city already planned to install several exercise stations. But Lloyd faced a dilemma. While a grant would pay for the exercise stations, where would the funds come from for the trail? At the time, Lloyd served as sports medicine chairman for the Ocala/Marion County Chamber of Commerce. Chamber board members suggested that the runners club raise the money for the trail by holding a race before the Christmas Parade.

Now 71, Lloyd kept running over the years, competed in numerous races and finished the New York City Marathon in 1979.

Source: Marian Rizzo, Photography by Bruce Ackerman, Ocala Star-Banner (FL), 7/7/06]

Holt Elected to NYCPM Board of Trustees

Stephen Holt, M.D

Stephen Holt, M.D., has been unanimously elected to the Board of Trustees of the New York College of Podiatric Medicine (NYCPM). Dr. Holt is a distinguished academic who has held professorial appointments at several leading medical schools in the U.S. and the U.K. Currently, he is an adjunct professor at the New York College of Podiatric Medicine and an adjunct professor of Bioengineering at the New Jersey Institute of Technology. He is a best-selling author in the areas of health, wellness and natural medicine, and the founder of four health care corporations: Natures Benefit, Inc.; Holt M.D. Consulting, Inc.; Natural Clinician L.L.C., and Wellness Publishing, Inc.

Query: Off-Loading Healed 5th MPJ Ulcerations

Has anyone found a good way to off-load plantar 5th MPJ neurotrophic ulcerations once they've healed to prevent recurrence? Diabetic shoes,rocker soles, and off-loading horseshoe pads all consistently fail. Any pearls?

Thomasin Hammer, DPM, Spokane, WA, mailto:thomasink@pol.net

Query: Bundled Codes

The doctor performed CPT 28313-T9 (reconstruction, angular deformity of toe, soft tissue procedures only) with a diagnosis code of ICD-9 735.4 (hammertoe), and CPT 28234-51-RT (tenotomy, open, extensor, foot or toe, each tendon) with a diagnosis code of ICD-9 754.89 (other specified nonteratogenic anomalies; example: generalized flexion contractures of lower limb joints, congenital).

The insurance company denied the second procedure as bundled into CPT 28313 even though separate incisions were made. Can someone tell me if these codes are bundled, and, if not, what documentation I can submit to get it paid?

Denise Merrick, North Las Vegas, NV

Response: Performing procedure through separate incisions has no bearing on whether the procedures billed are to be independently reimbursed. The key is whether or not they are components of a more comprehensive code, or one procedure is bundled into one of the other codes billed.

The CPT 28313 procedure is pretty comprehensive when it comes to soft tissue correction of angular deformities of a toe. If a tight or contracted tendon results in the digital angular deformity, its release would be included (bundled) into CPT 28313.

Tony Poggio, DPM, Alameda, CA

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

RE: Supplies for Civil Air Patrol Encampment Sought
From: James Breedlove, DPM

The Civil Air Patrol, an all volunteer service, does over 90% of all the search and rescues of downed aircraft in the United States. It has a cadet program which emphasizes leadership training and aerospace education, helping to train young minds interested in futures in the technological and aerospace industry. Each state has a summer boot camp for the cadets where they are taught leadership skills, aerospace technologies, flying, as well as, physical training, obstacle courses and marching.

For the past six years I have volunteered as a medical officer for the California Encampment with over 200 cadets from ages 12 to 20. Most of the injuries are foot and ankle related, and include the usual sprains and strains associated with physical activities. There is also a lot of athlete’s foot, warts, hyperhydrosis, and other maladies. I have been able to treat many of the problems with samples from my office, but have run out of samples.

My reason for writing is to ask if the companies that have supported podiatry in the past could donate foot powders, topical antifungals, foot drying agents, callus creams, taping supplies, Coflex- type wraps, topical antibiotics, gauze, gauze wrap, cotton tipped swabs, arch supports, and even boot-type socks

This has been a very good, but subtle way to introduce podiatry to a young, yet very inspirational group of people. Many of the cadets and adults now know what a podiatrist is and what we do. It has also been a great way to introduce certain topical medications when home OTC medications failed. Any support would be appreciated.

James Breedlove, DPM, San Luis Obispo, CA

CAPFTDOC@AOL.COM

RE: The Rising Cost of Healthcare (Howard Fox, DPM)
From: Barry Mullen, DPM

Dr. Fox asks the rhetorical question where all of the healthcare insurance premium dollars are going. We know where they should be going, back into the healthcare system for continuous quality improvement (CQI). However, one need look no further than the pockets of the MCO's CEO's. When you see Aetna's CEO clearing 20 million dollars annually, then perhaps you begin to understand why the necessary radical changes in healthcare delivery, through the establishment of an efficient 1 payer system model, which would ultimately reduce healthcare costs and improve the quality of healthcare delivery, has little chance of being adopted. There's just way too much moolah at stake, being "earned" by too many people and being used to thwart these needed reforms. The same holds true for the malpractice tort reform issue.

PPAC's are great...but it's not even a David compared to the Goliath soft money raised by these CEO's and their special interest groups. One can't expect change until the American people wake up, demand it and adopt a political system that eliminates corruption. As far as what to tell your children with respect to their future employment...how about figure out what you love to do...what field stimulates you the most and then become the best you can be in that field. Too many people place way too much emphasis on money and unfortunately equate the amount of earned income to success. FYI- there are a lot of miserable people out there earning decent money. When you wake up in the AM excited to get to work, hate leaving, while providing a service that improves the quality of someone else's life...that's my definition of success.

Barry Mullen, DPM, Hackettstown, NJ, YAZY630@aol.com

Full time associate position for a PSR-24 podiatrist to join established dynamic medical and surgical practice in Central Texas. Looking for a personable, motivated, ethical, hardworking individual to join our board certified group. Please send resumes or CV to centexfootdoc1@aol.com

EQUIPMENT FOR SALE – SONOCUR ESWT

I have a Siemens Sonocur shockwave FDA-approved machine for sale $70,000. Call 416-545-1166 or email: dracula65@hotmail.com

ASSOCIATE POSITION- LAUREL, MARYLAND (SUBURBS WASHINGTON DC)

Great opportunity for a hard working, ethical podiatrist to join a vibrant, successful podiatric medical and surgical practice. ASC on-site . Practice has dedicated, supportive staff with marketing knowledge. Board eligible/certified referred. Surgical residency. Competitive salary with bonus. Fax CV to 240 465 0332

PRACTICE FOR SALE--BUFFALO, NY

Part time practice with full time possibilities. Mix of conservative, biomechanics and diabetic foot care. Good surgical potential. Gross 180K. Willing to stay through transition. Call 716-836-8123.

HOUSE CALL PRACTICE FOR SALE – SOUTHERN CALIFORNIA

House Call practice for sale which includes approx. 400 patients and continued referrals. erfect for solo practitioner. Extremely easy and profitable practice to run. Yearly gross of over $200K. Current DPM is retiring. Financials will also be provided. Please contact
ccipinc@ccipinc.net

ASSOCIATE POSITION- KANSAS CITY, MO

Excellent opportunity for a hard working, ethical podiatrist to join a vibrant, successful and growing podiatric medical and surgical practice. Dedicated, supportive staff with strong marketing and medical knowledge. Must be board eligible/certified. PSR/24. Partnership opportunity. Competitive salary, bonus structure, benefits. Wonderful place to raise a family. Fax CV to 816-455-8901

ASSOCIATE POSITION- NEW ENGLAND

Terrific Opportunity Now Available in growing New England practice. Well established and respected practice with new, large office space, latest technology, very helpful staff, loyal patients and solid referral base. Close proximity to hospitals with modern surgical suites. Opportunity for shared ownership. Prefer 24 month PSR with clinical practice experience or an experienced doctor looking to improve their situation. E-mail CV and particulars to NEAFC3@aol.com

PRACTICE FOR SALE - WALLA WALLA, WASHINGTON

32 year old established podiatry practice for sale immediately. 2 treatment rooms, 1 surgical suite, x-ray room, sterilization equipment, and private office area. Located at busy intersection, only 2 blocks from major hospital. $50,000 or Best Offer. Please call 509-525-2863 or email darcycharlesDPM@charter.net , if you are interested.

EQUIPMENT FOR SALE - ESWT - BEST OFFER CONSIDERED NOW!!!!

If you are using or thinking of using ESWT, I have a new machine that has only been used twice. There is no Orbasone in the country priced like this one. Will provide training and installation. Take a look at http://www.orbasone.com Call 1-856-229-2939.

WEEKLY SPECIAL - One week of ads (6x) for only $75

PM Classified Ads Reach over 8,000 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 8,000 DPM's. Write bblock@podiatrym.com for details. Note: For commercial or display ads contact David Kagan at (800) 284-5451 dekagan@aol.com

• 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.