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July 24, 2007 #2,997 Editor-Barry Block, DPM, JD

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Weisman Appointed to FL Board of Podiatric Medicine

Gov. Charlie Crist appointed Sherwood Weisman of Altamonte Springs to the Board of Podiatric Medicine. Weisman is a self-employed podiatrist. His term runs through October 2010, pending Florida Senate confirmation.

Dr. Sherwood Weisman

Before arriving in Florida in 1972, Dr. Weisman was a Clinical Instructor at The Foot Clinics of New York, affiliated with the New York College of Podiatric Medicine. He was also a clinician at the foot clinic at Beth Israel Medical Center in New York City. He has served as President of the Central Florida Podiatric Medical Society, and was also President of the DeBary-Deltona Rotary Club (1980 - 1981), a service organization affiliated with Rotary International.

In his spare time, Dr. Weisman is a volunteer at the Hebrew Day School of Central Florida and is the trustee for Amateur Radio Station K4HDS, where he started a Ham Radio Club.

Source: Orlando Business Journal [7/23/07]

Better Healing through iPods?

Clinician-Scientists, such as David G. Armstrong, DPM, PhD, Professor of Surgery and Associate Dean at Scholl's Center for Lower Extremity Ambulatory Research (CLEAR) at Rosalind Franklin University of Medicine and Science in Chicago, have long been accustomed to cutting-edge therapies to treat complex maladies. But now, some are using consumer electronics to assist in education and care. He identified that many of his students and residents did not have the ability to listen and differentiate very subtle peripheral heart sounds (called Doppler signals) to make important life and limb-sparing decisions in persons at high-risk for amputation.

"Now, we just posted those Doppler sounds to our Podcast on iTunes, so students and resident/trainee physicians and surgeons can listen over and over again." The podcast, called "CLEARcast" is freely available on iTunes and http://diabetic-foot.net . After all, notes Dr. Armstrong (who totes a new iPhone), "Who better than a PODiatrist to use an iPod?"

CA Podiatrist Presents at American Orthopaedic Society for Sports Medicine

Amol Saxena, DPM from Palo Alto, CA presented his abstract "Articular Talar Injuries in Athletes: Results of Microfracture and Autogenous Bone Ggraft" at the the American Orthopaedic Society for Sports Medicine’s (AOSSM) annual meeting in Calgary, Canada. This meeting was attended by over 1,000 orthopedists specializing in sports medicine.

Drs. Amol Saxena and Hans Gollwitzer

Saxena’s article will be published in The American Journal of Sports Medicine later this year. Hans Gollwitzer, MD from Munich, Germany (shown on right) presented the results of an ESWT feasibility study for plantar fasciitis.

Query: Removing Monsel's Solution Stains

Has anyone had any luck removing stains caused by Monsel's Solution?

Arden Smith, DPM, Great Neck, NY

RE: Casting Code & Description (Vicki Hicks)
From: Robert Scott Steinberg, DPM

United Healthcare of Illinois does not recognize CPT 29799 by itself. It needs to be billed CPT 29799-RT-59 & 29799-LT-59.If you do it this way and include the specific description your claim should not be delayed. But as Codeline stated, UHC of IL will consider the casting, materials, and even the E/M as part of the global L3000 RT & L3000 LT

Other companies accept CPT 29799-50-59. Some pay and some don't. I do keep a "cheat sheet" to remind how to bill different companies.

Robert Scott Steinberg, DPM, Schaumburg, IL, doc@footsportsdoc.com

RE: Definition of “On The Job Injury” (Robert Scott Steinberg, DPM)
From: Multiple Respondents

Mail carriers for United States Postal Service are covered by the United States Department of Labor http://www.dol.gov/ for their worker's compensation benefits. In general, for a mail carrier doing a walking route, foot injuries, such as plantar fasciitis, are common occurrences and are many times considered to be work-related injuries. The determination of whether or not a specific injury is work-related is made by the treating physician and is not determined by a union representative, an attorney, or by non-medical personnel of the US Postal Service. However, just because a podiatrist states that the mail carrier's plantar foot pain is work related, this does not also mean that the patient's worker's compensation claim will necessarily be accepted by the Department of Labor. The podiatrist must provide the Department of Labor with a detailed written medical explanation as to why he or she feels that it is medically justified to consider the worker's foot injury to be work-related.

In my 20+ years of treating work-related cases in California, I have noted that the decision of whether a worker has a work-related injuryor not is very much dependent on which physician is making that determination. This is especially true if the injury is caused by
repetitive microtrauma to a specific anatomical structure of the foot and/or lower extremity, such as would be true in most cases of plantar foot pain. In general, if you truly feel that the patient's long hours of walking and standing and carrying a bag full of mail for many years has contributed to their plantar foot pain, and that this plantar foot pain would not have occurred if they weren't involved in these types of job activities, then this should certainly be considered to be a work-related injury.

Kevin A. Kirby, DPM, Sacramento, CA, kevinakirby@comcast.net

As with each patient we treat, each possible Workers Compensation claim should be evaluated individually. You cannot decide a patient does not have a work related injury based on, when they filed, the diagnosis or where it occurred. You must look at each patient and their individual history. Three unique claims come to mind.

Diagnosis: Paronychia, how could this be a work related injury? One patient presented with a paronychia caused by having to wear shoes that did not fit her foot from a very limited choice of sizes. The patient was a professional actor at a Broadway show and because of the unique costumes required there were very limited sizes in the show wardrobe and the tight shoes caused the paronychia.

Where the injury occurred: A patient had a Jones fracture from playing basketball. The surgery was covered under Workers Compensation because he was playing on a basketball team representing the company he worked for in a league the company had entered. Another patient was covered because although he was not in his office he was within a certain number of feet of the building either coming or leaving work, or going outside for lunch, each state may have different rules regarding this.

When the patient filed: A patient was a guard in a building and did quite a bit of walking. He developed pain in his foot and kept working. He was still working when he finally came in to see me. An -xray showed a stress fracture that was already developing callus formation. Based on his history the fracture developed at work approximately 3-4 weeks earlier and although he hadn't filed a claim it had occurred at work. He was basically a "couch potato" on the weekends and it obviously had not occurred then.

If it was a work related injury your patient's days out of work are not deducted from his/her sick days and the patient also does not have to pay multiple co-pays for each visit. In addition, services like orthotics are frequently covered. In New York State you are not allowed to treat a patient for a work-related injury unless you are a licensed Workers Compensation doctor, except for an emergency visit. Some doctors do not want to find out the "truth" because of the additional paperwork required with workers compensation and also the usual delayed time it takes to get paid. It is our job to determine whether we think the injury was work related based on our expertise as podiatric physicians.

Kenneth Meisler, DPM, New York, NY, Kenmeisler@aol.com

With respect to Dr. Steinberg's comments with regards to my "on the job injury" question. I do not doubt for a second my patient is a "malingerer" at all. She presented with pain under her second MPJ which she denied any acute injury but did recall feeling an episode of pain or discomfort to that area of the foot during her route. She did not pay it any mind and thought the pain would go away. After the weekend - she noticed it did not get any better and was concerned and came in for a visit. Clinical suspicion was for a plantar plate rupture which was conformed via MRI. Due to the insidious onset the injury was not reported immediately.

I don't subscribe to the theory everyone is a bad guy.

Jeffrey Kass, DPM, Forest Hills, NY, Jeffckass@aol.com

ASSOCIATE POSITION-SOUTHERN CALIFORNIA

Full scope of podiatry. Requires usual skills in surgery, medicine and biomechanics. Must be self-starter and highly motivated. Two full days per week. May soon increase to three days per week. All billing and administrative aspects handled by staff. Can practice autonomously. footguy1@pacbell.net

ASSOCIATE WANTED - IMMEDIATE OPENING- NEW YORK

Associate Position with immediate opening in the Hudson Valley (NY) for multi-office well rounded podiatric practice including general podiatry, high volume orthotics, and reconstructive surgery. Looking for well trained (PSR- 24/36. Outstanding opportunity to work into partnership. Competitive starting salary, bonus incentives, benefits, and pension. PER DIEM also available for immediate placement. Please submit: CV, letter of intent and references to: footassociate@yahoo.com

ASSOCIATE POSITION – BOSTON, MA

20 year old, well established, modern practice with 2 locations just out of Boston, looking for associate, P/T or F/T, motivated 24/36 trained or ABPS-Certified or eligible to start immediately. Strong surgically-based practice. Looking for motivated individual, able to practice all facets of podiatry practiced. Electronic scanning for orthotics and voice activated EMR already in office. Fax CV to (617) 567-0822

ASSOCIATE POSITION SANTA FE, NEW MEXICO

Immediate opening for PSR 24/36 individual in three office practice. We are looking for an ethical, hard working, well trained Podiatrist. Partnership available. Please Fax CV to sfpodiatry@aol.com

ASSOCIATE POSITION – MISSOURI

One of our long term associates needs to relocate due to family reasons. Step into full schedule. Five locations in growing population area without HMO's. Partnership available. Missouridpm@yahoo.com

ASSOCIATE WANTED – NEW YORK IMMEDIATE OPENING

Busy multi-dimensional practice; 70 miles north of New York City. Currently five (5)-doctor practice. looking to expand – all phases of podiatric medicine. contact: (845) 454-8308 EXT: 106

ASSOCIATE POSITION – YONKERS, NEW YORK

15 year old, well-established, modern practice located in Westchester County, looking for associate, P/T or F/T, motivated 24/36 trained or ABPS-Certified or eligible to start immediately. Looking for motivated individual, able to practice all facets of podiatry practiced. Fax CV to (845-225-4097)

POSITION AVAILABLE - SOUTHEAST TENNESSEE/ NORTH GEORGIA

Immediate position available or will wait for the right individual. Unique practice opportunity in growing multi-physician/multi-office practice. Well established/cutting edge within the medical community. Close proximity to hospitals as well as opportunity to become involved with a free standing podiatric surgical center. Must be BQ/BC. Minimum PSR/24. Competitive salary, bonus structure and benefits. E-mail CV to afcjen@hotmail.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-773-292-4800. Fax 773-486-3548 ---------------------E-Mail sschneider@homephysicians.com -- www.homephysicians.com

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