The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

July 17, 2009 #3,598 Publisher-Barry Block, DPM, JD

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NC Podiatrist Provides Foot Care Advice

What the research shows: "Your feet may change size as you get older due to water retention or ligaments that relax," says Jane Andersen, a podiatrist and a spokesperson for the American Podiatric Medical Association. In extreme cases, badly fitting shoes can lead to problems such as bunions and hammertoes.

Dr. Jane Andersen

What you can do: Have your feet measured yearly (ideally at the end of the day), and vary your shoe types and heel heights. Bunions and hammertoes "come from repetitive motions," says Andersen, "and can often be prevented with supportive shoes that fit well, plus orthotics to neutralize foot position." Weight-bearing exercises will beef up bone density (the feet are a common site of osteoporosis). Andersen recommends moisturizing the feet nightly with a gentle exfoliator or an intense moisturizing lotion to keep them soft and supple.

Source: Sally Wadyka, Real Simple [7/15/09]

DC Podiatrist to Compete Again in Maccabiah Games

This week Alex Kor pursues his goal of a gold medal in men’s masters tennis at the Maccabiah Games in Israel, an Olympic-style competition that’s expected to attract 8,300 Jewish athletes from 60 nations, but winning the gold is pretty much all the Terre Haute North graduate has yet to accomplish.

Dr. Alex Kor

A nationally ranked player in the 45-49 age group, Kor is making his fourth Maccabiah appearance (the others coming in 1993, 1997 and 2005). He won a bronze medal in 1997, dedicating it to his parents — Holocaust survivors Mickey and Eva Kor — and placing it in his mother’s CANDLES Museum; that medal was lost when the museum burned in 2003, but he was able to replace it with a silver medal from the 2005 Games.

In addition to the quest for medals, Kor expects to get plenty of material for his regular column in the U.S. Tennis Association publication “Mid-Atlantic Match Point.” Kor is a podiatrist in Washington, D.C., and his writings address treatment and prevention of foot injuries.

Source: Andy Amey, The Tribune-Star [7/11/09]

ACFAOM 2009 Covers All Clinical Bases!

Doctors from 32 states, one Canadian province, and the Virgin Islands, gathered at Disney World last week for the Annual Clinical Conference of the American College of Foot & Ankle Orthopedics & Medicine (ACFAOM). John Steinberg, DPM, of Georgetown University, DC, kicked-off ACFAOM 2009 on Thursday, July 9, with a stimulating keynote address: “Diabetic Limb Salvage in 2009: Have We REALLY Made Any Progress?”

Dr. John Steinberg

The conference brought together 150 DPMs in clinical and practical tracks on diabetic foot ulcers (chaired by Dr. Lee Rogers, which included a live video connection via the Internet with Dr. David Armstrong), applied biomechanics (chaired by Dr. Marc Benard), and essential surgical skills (chaired by Dr. Jason Harrill.)  Twenty-minute plenary presentations and the “hands-on” afternoon workshops featured a faculty of 20 experts.  Other breakout sessions included a punch biopsy and plastic surgery workshop (Dr. Bradley Bakotic), two reimbursement workshops associated with the clinical content in the plenary sessions (Dr. Michael Warshaw), research papers presentations (Dr. Kathy Satterfield), diagnostic imaging (Dr. Daniel Evans), pediatrics (Dr. Benard), and electronic prescribing and medical records (Dr. Michael Brody).

A  scientific exhibition by 30 companies and several social events rounded out another very successful annual clinical conference.  Drs. Beth Jarrett (ACFAOM president) and James Stavosky (conference chair) announced that ACFAOM 2010 will be held at the same venue, the Buena Vista Palace Hotel, across from Downtown Disney, Florida, October 28-31.

Committee Leaders Optimistic on Merging Reform Bills

Leaders of two key Senate panels seemed optimistic they would be able to merge their respective healthcare reform bills and bring the legislation to a vote on the Senate floor in the next few weeks. The Senate Health, Education, Labor and Pensions Committee approved along party lines its comprehensive reform bill, the Affordable Health Choices Act, whose key provisions include a public plan option, an employer mandate and long-term-care insurance coverage.

In a statement, Senate Finance Committee Chairman Max Baucus (D-MT) reaffirmed his commitment to work with the HELP panel to bring legislation to the Senate floor “that ensures quality, affordable healthcare for every American and lowers costs over the long-term.” The Finance Committee is expected to officially release its reform bill before the end of this week. When asked if he considered moving the HELP bill to the floor on its own, Dodd responded, “that won't be necessary,” adding he was confident Baucus would “get his bill out so we can work on it together.”
 

Source: Jennifer Lubell, Modern Healthcare [7/15/09]

Part 10- Concluding Your Presention to The ALJ - By David Mullens, DPM, JD
 
When you finish with the patient care documents, let the judge know you will now refer to the articles and textbook sections submitted to  the QIC.  For example: “Your Honor, I would now like to direct the Court’s attention to the previously submitted article entitled…and written by …” 

Go through the articles and textbook sections one at a time and take great care to identify the page number and paragraph you are referring to as you make each point to the judge. When you finish with the articles and textbook sections, cite the contractor’s LCD that is controlling as to each issue. Walk the judge through the LCD sections that support what you did for that patient’s problem. Slowly and clearly state the section of the LCD you are referring to and explain to the judge how and why the LCD supports what you did for the patient.

Finish your presentation with something like this: “Your Honor, based on the patient care documents including the initial H&P, the letter to the referring primary care provider, and the progress note for date of service at issue – it is objectively clear the findings included…and treatment consisted of…  In addition, based on the articles and textbook sections submitted, the treatment for the patient’s problem meets the standard of care and was entirely appropriate and medically necessary. Finally, based on LCD L_____, the care received by this Medicare beneficiary is supported by published Medicare policy. As a result, the CPT code at issue (cite the CPT code) should be paid. Thank you, your Honor.”

Query: Flatfoot w/ LLD
 
I have a patient with a limb-length discrepancy (1cm.) and a foot that is more flat vs. the other. She also has a larger HAV deformity on the "flatter" side. In this case, the flatter foot is on the side with the shorter leg. I understand why a longer limb would/could present with a flatter foot and larger HAV, but why the short side? There is no appreciable equinus difference between the two legs, no back injury, no neurological component or systemic disease, no previous fractures or trauma, etc. I would like to hear from others what some of the possible etiologies or reasons might be.

Charles Morelli,  DPM, Mamaroneck, NY

Query: PhysicianRedFlagRule.com

Is anyone familiar with the advertised PhysicianRedFlagRule.com as seen in PM News advertising? Any thoughts would be appreciated.

Chuck Ross, DPM, Pittsfield, MA

RE: On-Line Back-up (Lynn LeBlanc, DPM)
From: Multiple Respondents

Tape back-up can be problematic; most users don’t know how to retrieve tape logs to see if there were any problems with the back-up and users don’t replace the tapes as often as required by the manufacturers.

The best back-up solution currently is web-based back-up. It is quick, easy-to-use, it is pro-active with its log reports and inexpensive. Just make sure the provider is truly HIPAA-compliant. You first question to a potential provider should be, “Will you sign my Business Associates Agreement?” If the answer is anything other than YES, move on.

Raymond F. Posa, MBA, Farmingdale, NJ, rposa@themantagroup.com>

I could only share my experience with Carbonite. For the cost of about $50 a year, I back up 1.5 terabytes of data. Their program does not work with server software, so I placed a few large hard drives on one computer in my office and also at my home, and run batch files to back up the server on this (XP professional operating software) computer and let it work 24/7. It took over a month for the 1st back-up to be completed. When my home had a fire, and all my stuff was destroyed - the computer data was safe and easily restored on line.

This might be the best money I have ever spent.

Bret M. Ribotsky, DPM, Boca Raton, FL, ribotsky@yahoo.com

I use a local vendor who has set up my two offices to back up automatically to external hard drives (for the digital x-rays), and all 8 workstations connect to a terminal server. It is the terminal server that connects via the Internet to an off-site location, and this is all done automatically. This process will provide multiple layers of protection should one or the other fail. Every day, we receive an automated e-mail informing us that the back-up was successful.
 
Excluding the initial cost of the hardware and software installation (no more than a few hundred dollars), the monthly service is $39.00. Storage space is cheap and a 1 terabyte external drive can be bought for ~$99.00. I Just had my 2 home computers, including my daughter's 3 laptops, added to the system, and the installation for that was $499.00. For this, you get 1 terabyte of storage space, Automated back ups of all computers, Complete sharing system for shared music and photos,Microsoft Windows Home Server OS, and a  Micro ITX case with Intel Atom motherboard/processor platform. This is who I use, and I have no financial interest or involvement with this company: Edmund R. Szamborski (Owner), edmund@aaccess.net

Charles Morelli, DPM, Mamaroneck, NY, podiodoc@gmail.com

RE: Insurance and Your Reputation (Greg Cohen, DPM)
From: Bob Kornfeld, DPM
 
It is truly unfortunate that some patients might interpret out-of-network doctors as money hungry. But I will bet you any amount of money that the patients who see out-of-network doctors will never complain about the quality of care they are receiving. Simply put, out-of-network doctors do not need to run a high volume practice. (I know, because I am one). And that can only bode well for patient care. However, the bigger picture is more staggering and alarming. Medicine is the only profession whose operating expenses are not considered in the payment equation. We are the only profession that cannot set its own fees. AND...we have cooperated with this situation, ultimately allowing insurance companies to make fortunes off of our backs.  Haven't you all had enough?
 
Bob Kornfeld, DPM, Manhasset, NY, Holfoot153@aol.com

RE: Sign of the Times (Peter Bregman, DPM)
From: Marc Garfield, DPM
 
Interesting perspective! Why are you expecting Washington to fix this problem? And what type of fix are you expecting? Why do you think…
 
Editor’s note: Dr. Garfield extended-length note can be read at: http://www.podiatrym.com/letters2.cfm?id=27478&start=1

RE: OIG's Targeting Podiatrists (David Mullens, DPM, Michael Rosenblatt, DPM)
From: Barry Mullen, DPM

From my perspective, if one practices within existing federally-mandated medical compliance guidelines, then no OIG issue exists! OIG doesn't target podiatrists; they target …

Editor’s note: Dr. Mullen’s extended-length note can be read at: http://www.podiatrym.com/letters2.cfm?id=27481&start=1
 

RE: After 15 Years, Albright to Retire from Scholl
From: Multiple Respondents

I have had the privilege of knowing and working with Dr. Albright during his early years at Region 1, later during our tenure as members of the APMA Board of Trustees, and most recently during his admirable role as President and Dean at Scholl. I have known him as a friend, a colleague, a mentor, and as my president. I saw him inaugurated as the APMA president, investitured as the president of Scholl and had the privilege of giving him the APMA DSC at the APMA HOD in 2005.
 
Someone once told me that there was only one person I could trust in my life as a podiatrist. That person was "Terry." Most people know him as Dr. Albright. I know him as a friend. I feel grateful that I have known him as "Terry." I feel indebted to him as Dr. Albright.
 
I am sure his wife, Jan, will welcome him back to Camden, Maine.  I hope his return to New England will give me more time to enjoy his company and that of Jan. I wish him and his family good health and the sense that his influence on the profession of podiatry is unparalleled. 
 
Lloyd S. Smith, DPM, Newton, MA, lloydpod@yahoo.com

I must say, with great sadness, that I will be sorry to see Dr. Terry Albright retire from Scholl College as their Dean. For as long as I have involved in podiatric medicine (even as far back as a student at Scholl), Dr. Albright has been a fixture of podiatry. His role not only as the Dean at Scholl, but also including his part as APMA President, APMA Trustee, and APMA delegate for the IPMA have certainly affected the continuing forward path that podiatric medicine has traveled during his on-going and prestigious career.

Dr. Albright is a man of great wisdom and knowledge. During my upcoming IPMA presidency, I will look forward to working closely with him.

Joseph Borreggine, DPM, Charleston, IL, footfixr@consolidated.net

I would also like to congratulate Dr. Albright in his retirement as Dean of the Scholl College of Podiatric Medicine. Our friendship goes back many years. I fondly remember serving together on the Project 2000 Committee of the APMA House of Delegates, where his vision of the incorporation of the colleges of podiatric medicine into the mainstream of medicine through affiliation with colleges of allopathic and osteopathic medicine was first presented.

He obviously was fortunate to see his dreams come true and through his excellent leadership brought the Scholl College back to the pinnacle of our profession. I wish him the best in his retirement and I know he will continue his passion for our profession, his vision for the future, and his determination to move our profession to new heights.

Gerald D. Peterson, DPM, West Linn, OR, drp@ifixft.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, ABPS Qualified minimum needed to obtain hospital privileges. Associate position is open for partnership or purchase. Contact robert.nunberg@comcast.net 

PRACTICE FOR SALE - ALABAMA, GULF COAST

Established 26 year old practice. Owner desires to sell and relocate. Operated 25 hours per week. Mixture of surgery and general podiatry. MD referrals. Surgery center and hospitals in close proximity. Highly profitable. Priced to sell. Will lease office to buyer. Call Mike Crosby at 888-776-2430 or email mcrosby@providerresources.com

PRACTICE FOR SALE – NEW YORK CITY

NY Manhattan, prime location. Upper East Side, 23. Y.O. practice, high visibility-traffic area next to post office, street level, All phases of Podiatry, NO surgery, retiring due to disability. call 516-759-4062 or Paulfxfeet@aol.com

ASSOCIATE POSITION - CHICAGO AREA

Join one of the most successful, long-established podiatry practices in the Chicago area, with excellent salary and benefits. We have an immediate opening for a full-time podiatrist in a multi practice location in Chicago. Must have two years of surgical residency. Please e-mail resume to .comf-massuda@footexperts

ASSOCIATE POSITIONS - CALIFORNIA

Podiatrist needed for busy North Hollywood office. Part-time Monday-Friday 8am-2:30pm. No weekends and no call. Pay negotiable. New podiatrists are encouraged to apply. Please email resume and salary request to Coasttocoastpodiatry@yahoo.com

PRACTICE FOR SALE - FLORIDA—CENTRAL/SOUTH

Turn-key operation grossing $570,000 annually based on one full-time doctor. Great opportunity for growing the top-line. Surgery is only 14% of the professional man-hours; it can significantly increase income. Medicare makes up 64% of revenues. Seller will assist with transition. Call 863-688-1725, ask for Chas.

ASSOCIATE POSITION – MARYLAND

Maryland Eastern Shore Practice has opening for associate with ownership interest. MCR approved ASC, EMR, Ultrasound, Flouro, with Hospital Privileges available. E-mail CV to: patimmons@comcast.net 

PRACTICE FOR SALE – WESTCHESTER COUNTY, NY

Established 30+ year old practice. Well respected podiatrist in beautiful Westchester County Owner ill and needs a quick sale. Mixture of surgery and general podiatry. Hospitals in close proximity. Will lease office to buyer. Call Mali McGrinder at 914-434-1663.

PRACTICE FOR SALE-VIRGINIA (SOUTHEAST)

Very busy office near Williamsburg. Currently, a satellite office 2 days a week. Great opportunity to make office full-time. Grosses approx. 150,000/year. The office has everything needed to start practicing. All included. Must sell. If interested, e-mail
totalfootcareva@hotmail.com

NEEDED CHICAGO -- NW IND & BALTIMORE/WASHINGTON, DC PODIATRISTS 

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists in Chicago, Northwest Indiana, and Baltimore, MD. 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

PM News Classified Ads Reach over 11,500 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 11,500 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 Ext 110.

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