The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

July 20, 2011 # 4,211 Publisher-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2011- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

Toning Shoes are More Gimmick Than Science; TX Podiatrist

Toning shoes are huge sellers, more than $1 billion sold last year. But as sales grow, so do the numbers of injuries doctors are seeing. "The most common injury I've seen with toners, or rocker-bottom shoes are ankle sprains," said Dr. Walter Strash , a podiatrist. He said the shoe is, by design, unstable. And, that instability is a problem for many people.

Dr. Walter Strash

The Consumer Product Safety Commission has received more than three dozen complaints of injuries, from aching hips to broken bones, since spring. Toning shoes are the fastest growing segment of athletic shoes. But, many doctors like Strash say the toning trend is more sales gimmick than science. "I would advise patients to stick with what has worked for centuries and stick with a more traditional shoe," said Strash.

Marilyn Moritz, KSAT 12 [7/17/11]

Scholl Student SALSAL Chapter to Host Benefit Concert

The Save a Leg Save a Life (SALSAL) chapter at Rosalind Franklin University will be hosting their first annual benefit concert on August 20, 2011 beginning at 7 pm in downtown Chicago at the Centro. The bands that will be playing are Train Company and Facing Forward. 

Scholl College of Podiatric Medicine

The intent of this event is to bring awareness to students, faculty, staff and community members about the importance of limb salvage and to raise money for the national organization of SALSAL.

Barefoot Cuts Should be Treated Within 24 Hours: Ontario Podiatrist

With summer in full swing and the barometer climbing, Sudburians are understandably tempted to lose the shoes and go barefoot. John Lanthier, a doctor of podiatric medicine, said that parents and families can prevent cuts, puncture wounds and other follies of the foot by taking simple steps. Lanthier said shoes are the best way to protect your feet from injury in the warm summer months, but acknowledged that there are those whose feet can't take the heat.

Dr. John Lanthier

For a safer barefoot summer, Lanthier said barefooters who cut their feet should see a doctor or podiatrist within 24 hours. "These injuries can embed un-sterile foreign objects deep inside the foot. The wound must be cleaned properly and monitored as it heals," he said.  

Source: Tony Muma, The Sudbury Star {7/18/11]

Doc Hours Vary Widely by Specialty: Report

Doctors work an average of just more than 50 hours per week, but their time on the job varies widely based on their medical specialty, according to a University of California at Davis study on physician work hours. The study, published in the July 11 issue of the Archives of Internal Medicine, looked at family-practice doctors as a basis for work-hours comparisons. Vascular surgeons, at the top of the weekly average work-hours list, spent nearly 18 hours a week more on the job than did family-practice physicians. Pediatric emergency medicine specialists worked nearly nine fewer hours a week than did their family-practice peers.

Other top time-consuming specialties included critical-care intensive medicine, neonatal and perinatal medicine, and thoracic surgery. Occupational medicine, dermatology, and physical medicine and rehabilitation landed with pediatric emergency medicine at the bottom of the list. In addition, female physicians worked about 12% fewer hours than their male counterparts, and doctors employed by medical schools worked about 6% more hours than did physicians employed elsewhere. Work hours included direct patient care as well as administrative tasks and professional duties.

Source: Christine LaFave Grace, Modern Physician [7/18/11]

Personalize Presentations

Capture custom photos for your presentations. Carry a digital camera with you, and snap shots of patients' feet or anything else that tells an interesting story. Point and-shoot cameras with resolutions of 5 megapixels and higher will take photos that look good on a big screen.

Example: Take a photo of a standing patient's legs and feet, with and without orthotics, to show the structural correction achieved.

Source: Adapted from “Presentation Tools,” John Edward Love, Rough Notes via Communication Briefings

Query: VOIP

Has anyone used the AccessLine Voice Services offered by Costco (VOIP system) or another VOIP system that might also offer a deal on the phone equipment? The Costco setup includes multi-function phones. Does VOIP support electronic claim submission via a dial-up modem.  

David Kahan, DPM, Sacramento, CA

Query: Coding for Post-Op Complication

What would be the correct procedure code/modifier one would use for a complication of surgery resulting in treatment of a post-op infection in a diabetic patient? The treatment consists/will consist of bi-weekly open wound debridement with application of Steri-Strips and redressing. This is not routine post-op care.

Donald Triolo, DPM, San Diego, CA

Response: If this is a Medicare patient, all post-op follow-up - both routine and complications - is included in the original surgical reimbursement allowance. Medicare only reimburses related procedures if they are performed in an operating room (i.e., "unplanned return to the operating room" - modifier "-78").

If along with the surgery, there are planned post-op staged procedures, those procedures can be performed in the office, operating room, etc. A "-58" modifier would be included for planned staged procedures related to the original surgery. NOTE: complications and their treatment are not 'planned' (i.e., predicted), and cannot be staged.

Non-Medicare payers may vary their guidelines and reimbursements for treatment of complications. For instance, the "-78" CPT modifier definition includes not only operating rooms, but procedure rooms (opposed to the stricter "operating room" only Medicare definition). Check with the specific non-Medicare payer for their guidelines.

Harry Goldsmith, DPM, Cerritos, CA

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

RE: Pain in Peroneus Brevis Tendon (Mark Ray, DPM)
From: David Stoller, DPM

The pain that your patient is experiencing at the base of the 5th metatarsal may be due to a subluxated cuboid. I have noticed that it is common for the cuboid and/or subtalar joint to become subluxated with inversion injuries. Compare lateral views of the right and left foot for any differences in position of the cuboid and subtalar joints. Perform manual distraction reductions followed by post-reduction lateral x-ray to confirm better position. This is a billable procedure that pays very well.

David Stoller, DPM, Mission Viejo, CA, david@missionviejofootcare.com

RE: Tenosynovitis, Posterior Tibial Tendon (Hartley Miltchin, DPM)
From: Robert S. Schwartz, C. Ped

Try high top shoes with medial flare and heel elevation.

Robert S. Schwartz, C. Ped, NY, NY, rss@eneslow.com

RE: Medicare Number and Moving (Mike Piccarelli, DPM)
From: Cristal Grant-Spence, DPM
 
Having just gone through this process when I moved and opened my new office, my suggestion is to submit an 855I application just to change the address. If your legal structure has not changed (i.e. sole proprietor to group/corp), you really do not need a new Medicare number, and then you can set the effective date for when you start in the new location and when you will stop in the old one. You only need to fill out the required sections of 855I (1, 2a, 3, 4 -just what is changing- 13 and 15) of the form and send it in . This is the simplest way to transition.
 
Cristal Grant-Spence, DPM, Tamarac, FL, drcsgrant@gmail.com

RE: Voice Dictation System Compatible with Practice Fusion (Larry Dorman, DPM)
From: Steven J. Kaniadakis, DPM

The company called, "Nuance" (makers of "Dragon") makes a voice dictation program with medical terms. Virtually all programs require training to "teach" the computer to recognize your library of words and terms. I have a voice-to-text dictation feature as part of my "House DR" ("House DNA Robot") software program, by Ametex-Medical. Although, not the main function, it performs this task. You will need to differentiate between speech-to-text and voice recognition programs.  

The key will be the "library" that is already populated with the data base. I have studied these programs and others extensively as related to podiatry, billing, codes and coding. A voice program should have the "extraction" enabled, to pull out the text for the billing and coding system selected. Mine is able to do this task very well.  After all, it's an important function key to dictations and translations, correct?  

Steven J. Kaniadakis, DPM, St. Petersburg, FL stevenkdpm@yahoo.com

RESIDENCY OPPORTUNITY - MASSACHUSETTS

Mount Auburn Hospital, a teaching hospital of Harvard Medical School (HMS), Cambridge, MA is immediately seeking candidates for a new CPME approved three-year residency in Podiatric Medicine and Surgery Residency (PMSR) with additional Reconstructive Rearfoot and Ankle (RRA) credentialing. The emphasis of this PMSR-RRA well-rounded high volume program includes surgery (particularly complex reconstructive forefoot, rearfoot, and ankle surgery, sports medicine, and trauma), academics, and research. Interested applicants should immediately contact Emily A. Cook, DPM, MPH, CPH at MAH.Residency@gmail.com. Candidates must: start October 1, 2011, have completed a podiatric doctorate, passed parts 1 & 2 of the NBPME.

PRACTICE FOR SALE - NANAIMO, BRITISH COLUMBIA, CANADA

Have you ever dreamed of owning a practice where... you can see 0-50 patients daily .. .average 100 new patients monthly have zero accounts receivable ... gross $480 M per year .... live in a beautiful community with skiing, hiking, fishing and boating on your doorstep. This could be yours! If interested contact pistone@telus.net or 250-754-4192.

ASSOCIATE POSITIONS - NW INDIANA

2 Full-Time positions open - One for Northwest Indiana. Must have 2-year surgical residency. Must be motivated and a self-starter. State License required. If interested email: f-massuda@footexperts.com

ASSOCIATE POSITION – NEW YORK

Busy, well-established for 35 years, multi-site practice in upstate New York looking for licensed podiatrist who is ready for a thriving practice. Must be highly motivated, personable and great with patients. Competitive salary and benefit package. Send CV or letter of interest to associateinfoot@yahoo.com

ASSOCIATE POSITION - NYC, NY

Part/time, full/time associate for busy, well established multi-doctor, multi-office NYC group. Seeking motivated, ethical, NYC licensed DPM with excellent office management and clinical skills in all phases of Podiatry. Board Qualified/Certified preferred. Salary plus incentives, pension/medical/dental. Partnership potential. E-Mail CV to jermaire@aol.com

ASSOCIATE POSITION - NEW YORK CITY & QUEENS

High Income Potential. One of the fastest growing podiatry practices in New York City and Queens seeks a hard-working podiatrist who participates with HealthFirst, Fidelis, Metroplus, and other Medicaid plans. Preferably a Spanish-speaking podiatrist. Contact me at Podocare@aol.com

ASSOCIATE POSITION - NORTHWEST FLORIDA BEACHES

Excellent opportunity for an energetic, compassionate, hardworking individual with superior surgical and medical proficiency. Recent graduate or experienced practitioner. Excellent salary, benefits and partner-buy in offered, full admit privileges and surgical scope. Fax CV to Ecpodiatry@aol.com

EQUIPMENT FOR SALE - CLASS FOUR LASER

I have a class four pain laser for sale. Used for plantar fasciitis, Achilles tendonitis, neuroma, arthritic conditions and even fungus toe nails This laser is portable, re-chargable and can be move from room to room or office to office. This isn't the cold laser that you see. It is a 10 watt laser. We have used this laser on NFL sports players. For those that understand a good laser. E-mail David Zuckerman, DPM for Details and pricing. footcare@comcast.net

SPACE AVAILABLE- NYC & LI

Office to sublet and share - East 60th Manhattan, and Plainview Long Island. access to an MRI, Joint Commission certified operating rooms, digital x-ray, diagnostic ultrasound, and access to a multi-specialty ambulatory surgical center. Also availability E 22nd between 2nd and 3rd and E 70th off 3rd. Turn-key operation - no investment needed 516 476-1815PODO2345@AOL.COM

TURN-KEY PODIATRIC OFFICE - CALIFORNIA

Fully equipped modern suite with built-ins at Mission Regional Medical Center, Mission Viejo CA. Four treatment rooms, New Midmark chairs, x-ray/processor, phone system & much more. $45,000/assume lease. Call Jackie, 949-493-8020.

 PM News Classified Ads Reach over 12,500 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 12,500 DPM's. Write to bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $109 for a 50-word ad THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451.

• 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.