The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

July 17, 2008 #3,300 Editor-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2008- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

UT Podiatrist Warns of Risks of Going Barefoot

Consider all of the risks before you go barefoot this summer. "Foot problems related to going barefoot are up in the summer, when kids are out of school and active outside," said Dr. Kelly Stagg, who practices in Ogden. "And by the time they come to see a podiatrist, they are hurtin' for certain." "I've seen a number of kids come in with their toenails ripped off," Stagg said. "They can catch it on a carpet or a stair. It's pretty painful."

Dr. Kelly Stagg

"I also see numerous fractures ," Stagg said. "People stub their toes and break them. After that, crush injuries are the most common. People open the fridge and a bottle falls out, or they are carrying groceries and something falls out of the bag, and the unprotected toes break." "People step on nails, glass or thorns a lot, and kids may cut themselves climbing a fence," Stagg said. "If they step on metal and aren't up on their tetanus shots, they'll need a shot. Any kind of laceration can lead to infections. I recommend people wash the heck out of their wounds with soap and water."

"Fungal infections are next, and I see a lot of athlete's foot, starting in kids in fourth or fifth grade," Stagg said. "They are at the swimming pool all day long, and the locker room is all covered with fungus. Fungus thrives in any warm, wet environment, and if you don't wash your feet, it will stick with you inside your shoe. Fungus loves that environment." Stagg recommended shoes of leather or nylon, to help air circulate and discourage fungi.

Source: Nancy Van Valkenburg, Standard Examiner [7/15/08]

NJ Podiatrist Speaks Three Indian Languages

Dr. Varun Gurjal, who specializes in podiatric medicine, began practicing at Affiliated Foot and Ankle in Edison, NJ in October 2007. Gurjal treats patients of all ages, and his practice offers on-site digital x-rays, ultrasounds and vascular testing to accurately and efficiently diagnose and treat a multitude of foot and ankle problems. And as many as 50 to 60 percent of Gurjal's patients leave the facility pain-free because of treatments, such as injections and off-loading.

Dr. Varun Gurjal

The importance of early diagnoses and timely, continual care is paramount to Gurjal, especially for diabetes patients. Gurjal says the number of lower-extremity amputations in diabetics could be cut in half with timely foot care. "I treat my patients in the same way I would treat my family," says Gurjal, who speaks three Indian languages — Punjab, Hindi and Gujariti — as well as English. "When I make a medical decision for a patient, it is the same decision I would make if the patient were my own child, wife or parent. Patient satisfaction is my number one goal because patients put their trust in me."

Source: Mycentraljersey.com [7/15/08]

Congress Overrides Bush Veto of Medicare Reform Bill

A Medicare reform bill that would stave off cuts to physician payments through 2009 effectively became law after the Senate voted 70-26 to override a presidential veto of the bill. The vote came shortly after the House voted 383-41 to override a veto on the same legislation. Both chambers of Congress acted quickly to overturn President Bush's rejection of the bill, which halts a 10.6% cut to physician payments for the next 18 months, includes a slight pay bump in 2009 and makes other adjustments.

The White House said the legislation is “fiscally irresponsible,” because it would take choices away from American seniors by cutting the Medicare Advantage program. “I support the primary objective of this legislation, to forestall reductions in physician payments. Yet taking choices away from seniors to pay physicians is wrong,” Bush said in a statement. The bill could decrease Medicare Advantage enrollment by about 2.3 million individuals in 2013 relative to the program’s current baseline, Bush said.

Source: Jennifer Lubell, Modern Healthcare [7/15/08]

Why You Should Ask Before You Tell

One successful persuasion technique: Ask what the patient needs, wants, objects to or has a problem with before you volunteer your treatment plan. That makes you a non-threatening collaborator instead of someone “selling” a particular approach and triggering reactions in the process. Simply grab your listener’s attention by asking a simple question: Here’s how:

Present a basic idea and then stop. Ask an open-ended question that is likely to start a conversation: “How does that sound to you?”

Source: Adapted from How to Talk so That People Listen: Connecting in Today’s Workplace by Sonya Hamlin

Query: Chronic Dryness and Cracking in Heels

I have a patient that has what appears to be the classic moccasin distribution tinea pedis. She has been to several doctors, has had three rounds of Lamisil, a biopsy that was negative for tinea pedis, and has used multiple moisturizing creams and topical anti-fungals.

Chronic dry skin with cracked heels

She is currently using Lotrisone which helps with the itching, but the dryness and cracking continue. She has no other areas of dryness and cracking on her body. Any thoughts of what this may be and what can be used to treat it would be greatly appreciated.

Rick Burnell, DPM, Camden, SC

Query: Billing Training Service

My last billing person of seven years quit. We hired another biller who quit after 4 weeks. I have now hired a replacement. I don't have a large pool of trained billing people of which to choose from. I am wondering if there is a "billing training service" of any kind? The previous billing employees are not available to train the new one.

Name Withheld

RE: APMA Wins Medicare Victory (Robert Scott Steinberg, DPM)
From: Ross Taubman, DPM

I agree that the larger problem is the Sustainable Growth Rate and the ridiculous formula that it employs to calculate physicians' fees. APMA has been part of a large coalition of physicians, including the AMA and American Osteopathic Association, which have been working to change this antiquated system permanently. At the same time, until physicians are successful in changing this formula, we must be vigilant to ensure that we don't lose all of the battles along the way that make it impossible to continue to see Medicare patients. Also, don't forget the other important aspect of the current legislation that resolves most of the onerous restrictions related to the prescribing and dispensing of durable medical equipment.

These issues achieved through a coalition with AMA, AOA and others would never have happened without the APMA bringing those issues to the forefront. Lastly, I would disagree regarding the impact that APMA and our PAC have had on Capitol Hill. APMA has been incredibly successful at making its voice heard in Washington, largely because of the support and involvement of its members. No other healthcare organization our size:

• has had a member serving on the DHS Practicing Physician Advisory Council almost continuously since its establishment.
• has a political action committee that contributes half a million dollars to Federal candidates in each two-year cycle - exceeded by only $3,000,000 by the AMA, and even the orthopedic surgeons.
• is as actively involved with organizations like the AMA and ADA in lobbying issues of mutual concern such as the fee cut reversal.

And as far as the cost of our recent federal legislative victories, less than 5% of each member’s dues is spent on lobbying at the federal level.

Ross E. Taubman, DPM, President, American Podiatric Medical Association, retaubman@apma.org

RE: MRI Harmony?

.

I ordered an MRI on a cantankerous 76 y.o. male and the following one-line conclusion was received:

"IMPRESSION: The stud is within normal limits."

What when on between him and the MRI tech will never be known, but this gives new meaning to "Open MRI" !

Nicholas R. Taweel, DPM, PT, Philadelphia, PA

ASSOCIATE POSITION – GEORGIA

Atlanta area need a full-time or part-time associate for a 25 years old well-established practice ,well rounded surgery and routine, please email your CV to superrang@bellsouth.net

CASE CONSULTING

Dennis Shavelson, DPM is now accepting referrals of difficult cases involving biomechanics, surgical complications, non-healing wounds diagnostic and treatment dilemma’s and subtalar stenting from DPM’S. Full reporting with second opinion only, rapid return after care and assumption of care options. Medicare and Out-of-Network Only. (212) 288-3668 or drsha@lifestylepodiatry.com

PODIATRISTS NEEDED - CHICAGO --NORTHWEST INDIANA

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists. We are located in Chicago and Northwest Indiana. Full and part time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com Visit our website

PRACTICES FOR SALE - BROOKLYN & QUEENS

Well-established practices grossing high $200's for sale with approximately 90% C & C and 10% SX. Great locations and visibility. Well-respected doctors and staff willing to stay. Ask about 90-125% financing options with little to nothing down. American Doctor Sales; 614-918-3000 or email us at sell_my_practice@yahoo.com. Please visit us our website

ASSOCIATE POSITION – CALIFORNIA

Central Valley/Southern CA. Salary excellent with all paid benefits/incentives including malpractice/401k and profit sharing. Surgery Center and hospital based with no HMOs/no rest homes. Bilingual in English and Spanish. Offering a permanent position/partnership in a multi-million dollar hi-tech practice. E-mail CV to: Tonya@wetreatyourfeet.com

ASSOCIATE POSITION - BOSTON, MA

Associate wanted, Full-time or part-time, for busy long time, well established, and well rounded practice. Good mix of general podiatry and surgery. Office will generate approximately 100+ surgical cases per year. Must have surgical background for this practice, ABPS Qualified minimum needed to obtain hospital privileges. Associate position is open for partnership or purchase. Contact robert.nunberg@comcast.net

ASSOCIATE POSITION - WEST CENTRAL MN

Associateship possibly leading to equity ownership. Compensation package of $100,000. Option for partnership or purchase as soon as associate feels ready. 260 402-7490.

PODIATRIST POSITION – SOUTHERN CA

Medical group in Southern CA seeking a residency trained DPM. Practice includes general podiatry, biomechanics, wound care, surgery, diabetic feet, trauma. Part-time position available may lead to full-time. Excellent salary/benefits. Position available in mid July 2008. Please reply to E-mail: slowed2@yahoo.com; 4476 Tweedy Blvd, South Gate, CA 90280.

ASSOCIATE POSITION - NEW JERSEY

Established practice in Ocean County seeks hardworking, ethical, energetic and well-trained (PSR 24/36) individual. Must be willing to do all aspects of podiatry! Base salary $100,000 to start plus benefits package. Hospital & surgical center privileges. E-mail CV to NJFeet@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.