The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

July 14, 2010 #3,909 Publisher-Barry Block, DPM, JD

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1) Time is running out to purchase tickets to the PM Podiatry Hall of Fame Luncheon honoring Allen Jacobs, DPM and Lynn Homisak, PRT in Seattle on Friday, July 16. We strongly recommend that you buy your tickets now by calling APMA at (800) ASK-APMA or e-mailing sfarez@apma.org. Only a limited number of tickets will be available in Seattle. 

2) PM News will NOT be publishing from July 18-25th while we attend the sold out AAPPM/PM News Alaska Practice Management Cruise.

MO Podiatrist Sees Many Injuries in Barefoot Runners

Dr. Amy Balettie with Foot Healers says she sees many injuries in barefoot runners. “The Masai of Africa run barefoot, but these people also are not obese, have a shorter lifespan, and don’t sit behind a desk all day,” she points out. “They are out working in their fields, using all their muscles.” In runners who have been running on the sides of roads on uneven surfaces and through trash, she sees cuts, fractures, strains, and tendonitis from lack of foot support. She reports that with most exercising patients, it’s not the shoe causing the problem, it’s the foot structure and not having it supported enough.

Dr. Amy Balettie

Balettie says that there are some times when it is appropriate to go barefoot. Being barefoot is important in doing yoga, for instance, because you want to stretch all the toes and tendons without the restriction of shoes - but that’s in a controlled environment. It’s also generally okay to walk barefoot around the house, she says, except for diabetics or anyone who gets pain from going barefoot. Diabetics should always wear a supportive slipper or sandals in the house, something to cushion and protect the feet. And they should check their feet frequently. “Older diabetics who can’t see the bottoms of their feet often injure them and don’t know it. They shouldn’t be walking barefoot anywhere,” Balettie says.

Source: Mary Jo Blackwood, RN, MPH, Ladue News

NY Podiatrist Receives Excellence in Action Award

Dr. Howard Baskin, a podiatrist in Spring Valley, received the Excellence in Action Award from the New York State Podiatric Medical Association. Baskin was nominated for "exemplary performance and outstanding contribution to the profession of podiatric medicine."

Dr. Howard Baskin

For 13 years, he has been a team leader in the Avon Walk for Breast Cancer. He and 20 other podiatrists treat walkers during the two-day event.

Source: NY Journal News [7/11/10]

AL Podiatrist Builts Home for Ospreys

Pell City's Joseph Barra knows his birds. When the retired podiatrist spotted an osprey flying over Lake Logan Martin last year, he immediately knew what it was. While osprey are fairly common along Alabama's Gulf Coast and the rivers in south Alabama, Barra was somewhat surprised and tickled to see an osprey visiting the Coosa River. Barra was so happy, he decided to invite the bird to stay awhile.

Dr. Joseph Barra with a wildlife friend

Barra knew that along Alabama's Gulf Coast, river folk often erect poles with platforms on top in their lakefront yards to attract osprey. Osprey typically nest in the tops of old dead trees, but will gladly accept a man-made platform on which to build their nests. Barra cut down a pine tree in his yard. He removed the limbs and attached a plywood platform on top. He relocated the pole to a spot closer to the lake in view of his front porch and cemented the pole in the ground. It wasn't long before an osprey was building a nest.

Source: Michael C. Bolton, Birmingham News, [7/11/10]

U.S. Dependent on International Graduates to Provide General Surgeons: Report

The U.S. has “remained inherently dependent” on international medical school graduates to sustain its ranks of general surgeons, but the number of graduates from foreign programs practicing here is declining and this could create “a crisis of urgency” and exacerbate a projected general surgeon shortage, concluded a report in the Journal of The American College of Surgeons.

The report noted that the percentage of foreign medical school graduates in general surgery has decreased from 17.4% of general surgeons in 2005, to only 14.8% now; and that the overall number of general surgeons working in small, rural practices has fallen almost 39% since 2005. Until domestic production of general surgeons increases, the nation is dependent on graduates of foreign medical schools, the report concluded, but those graduates are now facing resistance to their applications, potential political and bureaucratic barriers, and uncertainty in their ability to travel.

Source: Andis Robeznieks, Modern Healthcare [7/11/10]

5 Things to Simplify Today

Becoming organized is a sure path to a low-stress life. The only problem is that becoming organized can seem to be a daunting task. Key: Do not attempt to do it all at once. Start with these tips:

• 1. Make a short list. Grab an index card and list four or five things that are most important to your work. Simplifying starts with understanding priorities.
• 2. Drop one thing from the list. Identify the one thing that provides the least return, something you do routinely but that does not contribute much to your success. Decide if you can safely drop that item or delegate it to someone else.
• 3. Clear something. Pick something small and contained, such as a drawer, a shelf or a corner of your office—not an entire room. Empty everything from that area into a pile. Pick out only important items that you use and love, and place them back in the area. Trash or donate the rest of the items.
• 4. Set limits for time wasters. What is your worst time-wasting habit or vice? Top contenders are e-mail, casual hallway chats, social media sites and daydreaming. Decide how long you can afford to spend on those time wasters each day. Set limits to protect your productivity and then stick within those limits.
• 5. Cut your to-do list. If you have listed 10 or more “priority” items, simplify your list. Start by paring your list down to size: Identify items that you can eliminate, delegate, outsource or ignore. Pay special attention to “carryover” items that linger from week to week.

Source: Adapted from “Simple Living Simplified: 10 Things You Can Do Today to Simplify Your Life,” Leo Babauta via Communication Briefings

Query: Will DME Fees Also Increase?

Do we know if Medicare DME fees are going to increase by the 2.2%?

A call to CIGNA DME jurisdiction C said they did not know if the fees would increase.

Paula Miller, Office of Terry Nayfa, DPM, Oklahoma City, OK

Response: CMS treats physician reimbursement as a wholly separate issue from DME reimbursement.  DME reimbursement is frozen at last year's rates.

In addition, there are quarterly updates for many HCPCS codes (drugs and biologics) as well as for some orthotic and prosthetic products.

Paul Kesselman, DPM, Woodside, NY

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

RE: Digital Scanners for Orthotics (Kenneth Meisler, DPM)
From: Dennis Shavelson, DPM

The recent evidence reveals STJ neutral custom orthotics vs STJ neutral OTC orthotics to be equally effective:

Whitman D, Esterman A: A randomized controlled trial of two types of in-shoe orthoses in children with flexible excess pronation of the feet; Foot Ankle Int, June 2007;28(6):715-23.

Pfeffer G, Baccetti P: Comparison of Custom and Prefabricated Orthoses in the Initial Treatment of Proximal Plantar Fasciitis. Foot Ankle Int. Aug 1999; 20:214-221.

Landorf KB, Keenan AM, Herbert RD: Effectiveness of foot orthoses to treat plantar fasciitis: a randomized trial,  Arch Intern Med, June 2006;166(12):1305-12.

The ease of performing a STJ neutral cast allows...

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

RE: Internet-Based Software Systems (Elliot Udell, DPM)
From: Martin R. Taubman, DPM, Michael Brody, DPM

I agree with Dr. Udell that the government is planning for all of our medical records to be connected through the Internet. He makes excellent points. He states… “Because the EMR business is extremely volatile and no one knows for sure what demands the government will make on us to get the stimulus money, the wisest approach might be to go with a system that is either free or close to it.”

While I don’t disagree with his logic, I recommend that besides price, one should also consider a system that is tried and true, has the sophistication to incorporate all the essentials of the “meaningful use” rules: allows patients to register on the Internet, has an appointment manager, interoffice communication, allows electronic prescriptions, lab registrations and test results, uploading of documents, and the flexibility and commitment to meet all the requirements as they become further defined.

So, don't just look for a "cheap," potentially disposable system - look for one that fits the requirements of meaningful use and that will be a keeper.

Martin R. Taubman, DPM, MBA, San Diego, CA, mtaubman@san.rr.com

Dr. Udell made the following statement: "The government wants all physicians to have Internet-based electronic medical records systems."  The government is technology-neutral. None of the laws or incentive packages indicate the type of EHR that you must use.

You have the option of using Windows-based programs, Mac-based programs, or Linux-Based programs. The program can be run locally out of your office on your computers, or it can be...

Editor’s Note: Dr. Brody’s extended-length letter can be read here.

RE: Podiatry’s Limited License (Thomas Brosky, DPM)
From: Michael Forman, DPM

I understand Dr. Tom Brosky's frustration when he reads articles by podiatrists about flip-flops, etc. I believe Dr. Block puts this information in PM News to show us how to reach the public. It may be simple and obviously below our level of care, but it is what patients are interested in. If an article appears in a magazine or newspaper and credits a podiatrist as the author, the goal has been accomplished. I don't believe it demeans us.
 
Tom, I think podiatry is doing just great. I thought a three-year residency WAS mandatory. No?
 
I am very proud of our profession and proud of docs like Tom Brosky.  When I was doing my training many years ago, I remember one of my teachers made the statement that we "went from the nail groove to the sinus tarsi." We have now gone from the sinus tarsi to the tibio-talar joint. We are doing great things.
 
Michael Forman, DPM, Cleveland, OH, IM4MAN@aol.com

RE: Cerner/Wisdom
From: Paul Somers, DPM

Cerner/Wisdom has been in business for many years and were originally DRSoftware, which was a podiatry company and had great service.  As they have grown/merged, they have had serious issues with service.  Also, their main focus now is large group practices, primarily anesthesiology ones - this is a very different billing "animal' than the podiatrist's office. Their contracts are very long and difficult to manage.

I would hesitate to get involved in a five-year contract period with them - we are clients of theirs, but would change if we could find someone else who could transfer our data and get us up and running reasonably, but the transfer issues are very costly.

Paul Somers, DPM , Nashville, TN, optim37209@hotmail.com

RE: FL Podiatrist Survives First Cut on Big Brother
From: Barry Blass, DPM

I have enjoyed reading PM News almost since its inception. I rarely post an e-mail. However, I must make an exception. I understand that "Big Brother" is a game and the true idea is to win, regardless of tactics. But I must point out the obvious fact brought about by one of our practitioners, Andrew, and his game plan. Although I understand that he wishes to avoid the notion that as a doctor, he does not need the money; that's his plan and he is entitled to it.

For years, podiatry has spent thousands of hours and hundreds of thousands of dollars to promote knowledge of our profession and our skills. Here sits Andrew in a hot dog costume, with a media capability that exceeds anything we could beg, borrow, or buy. More people watch the show and more time is available than any other media outlet. This was an opportunity to educate millions of viewers on multiple nights across the country. Instead, we must watch as a "shoe salesman" ignores his profession. He is rightly proud of his religion, too bad he is not equally vocal about his profession. I hope it is a Kosher hot dog costume.

With the way he is behaving, I seriously doubt he has a chance of not being evicted early. The other housemates already believe he is the saboteur. Our "shoe salesman" is missing a multi-million dollar opportunity to educate the nation.

Barry C. Blass, DPM, Tampa, FL  footdoc@verizon.net

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

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

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

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

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

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

PM News Classified Ads Reach over 12,000 DPM's and Students

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