The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

July 10, 2010 #3,906 Publisher-Barry Block, DPM, JD

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Obesity Takes a Toll on the Feet: OH Podiatrist

Too much weight is bad for your heart, your lungs, your knees and even your brain. But you'll have to gaze downward to find the place where you literally may feel extra pounds first -- your feet.

Dr. Darryl Haycock

The problems are most pronounced for the most obese. "The foot was made to carry the average body of, maybe, up to 200 pounds," says Darryl Haycock, a surgeon in Lima, Ohio, and a spokesman for the American College of Foot and Ankle Surgeons. "When you add 100 or 200 pounds, it overloads the tendons, the ligaments, and the bones."

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

Annual NYCPM Faculty Retreat Features Pi Delta Pinning Ceremony

On a recent Friday, the faculty of the New York College of Podiatric Medicine gathered in one of the College’s large lecture halls for its annual, all-day Faculty Retreat. Traditionally, the Faculty Retreat has been more than just a time for reviewing the state of the College, hearing updates from the various departments, and taking care of academic and administrative housekeeping items. A substantial block of time during the day is given over to one or two guest speakers who address issues at the heart of what is most important to fulfilling the College’s mission.  
 

NYCPM Pi Delta student inductees taking the oath, alongside faculty members of Pi Delta, during the recent NYCPM Faculty Retreat.

In addition, Khurram Khan, DPM, Assistant Professor of Podiatric Medicine, and faculty advisor to NYCPM’s Pi Delta National Podiatry Honor Society, Gamma Chapter, conducted the Chapter’s pinning ceremony, at which eight students from the Class of 2011 were initiated into the Chapter.

Georgia Trend Magazine Recognizes GA Podiatry Supergroup for Remarkable Growth

Georgia’s fastest growing companies are celebrated this month by Georgia Trend Magazine in their July edition. The business publication annually recognizes the state’s top performers with a print feature and at the Gala Dinner and Awards Presentation, held at the Ritz-Carlton Buckhead. Village Podiatry Centers placed thirteenth in the 2010 top 20 small, middle-market category for its outstanding growth.  

Receiving the award for Village Podiatry Centers , Al Wiggins , COO with Dawn Patrick, CBH and Dom Mazzone, Mazzone Associates.

“Our doctors and staff are working diligently to provide the highest quality of care and meet the increasing demand for podiatric medical service,” said Al Wiggins, COO of Village Podiatry Centers. “It is exciting to see our efforts recognized by such a highly regarded publication as Georgia Trend.” Village Podiatry Centers began as a solo practice in 1992 and has grown to encompass 24 Georgia locations, with 27 podiatric surgeons and more than 150 support staff.

HHS Proposes Changes to HIPAA Privacy Rule

HHS has proposed a new federal healthcare information privacy rule to amend the Health Insurance Portability and Accountability Act of 1996. Reflecting changes Congress sought last year in the stimulus law, the proposed rule would give patients the right to restrict certain disclosures and ban the sale of patient data without patient consent, according to HHS. According to an HHS announcement made jointly by David Blumenthal, head of the Office of the National Coordinator for Health Information Technology, and Georgina Verdugo, director of the Office for Civil Rights, the proposed rule would:

• expand individuals' rights to access their information
• restrict certain disclosures of protected health information to health plans
• extend the applicability of certain of the HIPAA privacy and security rule requirements to the business associates of covered entities
• establish new limitations on the use and disclosure of protected health information for marketing and fundraising purposes, and strengthen and expand OCR's ability to enforce HIPAA's privacy and security provisions.

A 60-day public comment period on the proposed rule opens July 14.

Source: Joseph Conn, Health IT Strategist [7/8/10]

Focus on Patients' Needs

When patients’ own words indicate that they have identified something lacking in their current situation, lock in on that unmet need. Listen for trigger words and phrases like these:

•  Trying to. • Dealing with.
•  Problems. • Concerns.
•  Hopeful. • Unclear.
•  Stressful. • Seeking.
•  Needs. • Frustrated.
•  Struggling. • Improvement.

Response: After hearing those words from customers, incorporate them into a question. Here are some examples:

•  “You say you are trying a new approach. What has worked so far and what has not worked?”
•  “Can you give me some specifics of what you mean when you say concerns? ”
•  “When you say it has been challenging, what exactly do you mean?”

Source: Adapted from Questions That Sell, Paul Cherry, AMACOM via Communication Briefings

Query: Endochondroma

I have a 7 y/o girl with a distal lesion 2nd digit present for three months. No trauma is reported. My diagnosis is endochondroma.

Enchondroma in 7 Year Old

I know that recurrence can be a problem with these lesions. What surgical approach do my colleagues recommend?

James W. Clark, DPM, Salinas CA

Query: Internet-Based Software Systems

For several years, our office has used Wisdom software, which is provided by Cerner. We have our own server which has had some upgrading difficulties in the past. Cerner has suggested that our office switch over to their Wisdom ASP system which, as I understand it, is an Internet-based system where their server does all the work, and there would be no need for our own server. Their contract seems to be very complicated but I am told it is "the standard." The cost is only about $40 per month more than I am currently paying. They require a 5-year contract. What experiences have PM News readers had with this or any other Internet-based system? 

Tip Sullivan, DPM, Jackson, MS

Query: Locum Tenens

I am covering an office for an ill colleague. Do I bill Medicare and Blue Cross Blue Shield with my provider numbers or his?

Gary Trent, DPM, Chicago, IL 

Response: I would recommend you go to his office - see the patients, and have HIS OFFICE bill your services with modifier "-Q6" (locum tenens) to all plans, and under the "ill" provider's name and provider number. Keep in mind many of his patients may be in post-operative periods, and there may be non-billable services.

Not all plans recognize modifier "-Q6", but it shows a good faith effort to report accurately. If you see the patients in YOUR OFFICE, the claims are submitted under your name and provider number, but this places a huge administrative burden on staff - because the patient demographic information has to be retrieved and entered into your practice management system.

You aren't responsible for keeping your colleagues' practices afloat while they are ill; they should have revenue insurance for that. However, seeing patients during the post-operative period is a good step to help a colleague in need. Seeing patients who need urgent care is always a good step, but those patients might be considered 'new' if seen in your office.

Karen Hurley, CMM, CPC-I, Waldor, MD

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

RE: Digital Scanners for Orthotics (Jeff Root)
From: Kenneth Meisler, DPM

I appreciate Dr. Root's comments about scanners. He questioned how I was able to tell if the contour of the casts/orthotics were correct.  I was basing the contour on how well the orthotic fit the foot. I have dispensed more than 20,000 pairs of orthotics over 35 years in a practice that has a large athletic population. With all labs, there are some orthotics where the arch is too high, too low, is too high in the wrong place, too tight in the heel, too wide in the heel. I am very good at knowing whether an orthotic will cause a problem due to the fit of the device when I dispense it. I have seen many devices dispensed by other practitioners where they don't fit well, patients were told to wear them for a while, and the patients were so unhappy with the devices that they didn't go back to the doctors who made them.
 
My experience with this particular scanner is that it has at least the same percentage of very high "excellent fitting" orthotics as a well done cast. I think that a "foam box", poorly done cast will not give the same consistency.  Doctors should try scanners before purchasing them, and see if they are happy with the results. I am.
 
Ken Meisler, DPM, NY, NY, kenmeisler@aol.com

RE: Arrested Podiatrists
From: Russell F. Trahan, DPM, Bryan C. Markinson, DPM

I am frankly growing weary of my colleagues calling a podiatric medical license “limited.” I was once told by an older practitioner that podiatrists have full treatment scope of the foot and perhaps lower leg (depending on the state where licensed). The license is therefore not "limited", and describing it as such certainly can feed into an inferiority complex.

Russell F. Trahan, DPM, NY, NY, dr.trahan@att.net

There is lamenting over the fact that a large number of podiatrists net under $75,000 per year. It has been stated that nurse practitioners, and PAs, and nurse anesthetists make more than this out of school, but their training is less "extensive" than ours. This perpetuates a myth that is disturbing. Comparing training is ridiculous and in the end, for most areas of medicine, on comparison alone, we come up short, not them. Do surgical intensive care units need a DPM monitoring intake/outake, multiple drips, vitals, chest tubes, etc, or someone trained otherwise, like a specialty nurse?

There are 150,000 nursing vacancies in the U.S. You can make $100,000 dollars or more per year with overtime, working three days and being off two days. The new DPN degree, ever more gaining popularity, will equip the nurse for more intense care skills and management opportunities than ever. This is why it is folly to compare training when discussing income. If we can't think clearly of what we bring to the table as DPMs, and then make a good living at it, there is something with the individual, his or her management abilities, etc. that is the reason.

Shouting that we are trained better than other professionals whose duties do not even compare to ours has never worked, and never will, and never should. We need more dialogue about how great we are, with humility, and not ever explain away colleagues who set out to hammer the system with fraud and abuse by whining about how hard it is to make a living.

Bryan C. Markinson, DPM, NY, NY, Bryan.Markinson@mountsinai.org

RE: Markinson Named to New Position at NWPF
From: Howard R. Fox, DPM

Kudos to Bryan Markinson! I have had the pleasure and privilege of working with Dr. Markinson at NYCPM from a point soon after he finished his post-graduate training and received his faculty appointment in the Department of Medicine. He rose to high position the old-fashioned way: he earned it through education and experience above and beyond any typical call. It’s truly a pleasure to see him become the leader of the profession he is and set an example for others.

Howard R. Fox, DPM, Staten Island, NY, foxhr@yahoo.com

RE: Runners Need To Take it Easy After Blisters: DC Podiatrist
From: Steve Pribut, DPM

Media 101:

1) Always clearly state your facts. Explain carefully so that anyone can understand what you are trying to say.

2) Be very careful in making any jokes. Even if you make it clear that you are relating an impossibility, you may find that the off-hand remark is your quote (without context, qualifiers, disclaimer, or explanation).

3) Do your best to state things so that even out of context your words will still make sense, and cannot be misconstrued.

4) You represent not only yourself but your profession. Make sure you represent it well.

5) Stuff happens. And someday you could find yourself on one side of an embarrassing, if not entirely accurate or complete quote.

And yes, we all know gangrene will not happen from a friction blister. We do know that diabetics with insensitive feet can develop severe problems from blisters including ulcers, infections, and even osteomyelitis. I've added a comment to that effect on the Washington Post's website.

Steve Pribut, DPM, Washington, DC, dr.pribut@gmail.com

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

POSITION AVAILABLE - SOUTHERN CALIFORNIA 
 
Very well established, multiple location group practice has immediate opening for associate doctor. Attractive compensation and benefit package offered. E-mail resume to mrsmcmackin@aol.com

PODIATRISTS NEEDED NATIONWIDE

Podiatry referral company has thousands of diabetic patients nationwide in need of immediate service. We are looking for podiatry practices interested in joining our network to receive referrals. Email coasttocoastpodiatry@yahoo.com

ASSOCIATE POSITION - VIRGINIA IS FOR LOVERS

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

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.

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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