The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

July 27, 2011 #4,217 Publisher-Barry Block, DPM, JD

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OH Podiatrist Named New Chief Medical Officer

Dr. Dan Bailey has been named vice president of medical affairs and chief medical officer for Upper Valley Medical Center, according to a news release. The appointment was effective the week of July 11.

Dr. Dan Bailey

Bailey now oversees the hospital’s performance improvement and utilization management efforts, as well as all medical staff-related issues. Bailey has more than 28 years of medical and management experience with his Troy podiatry practice, and has served in various leadership roles at UVMC, including as past president of the medical staff and a board member.

Source: Dayton Daily News via Dr. David Armstrong [7/25/11]

NY Podiatrist is Medical Director of Hyperbaric Wound Care Institute

The Wound and Hyperbaric Institute at Good Samaritan Hospital has been awarded accreditation by the Undersea and Hyperbaric Medical Society (UHMS), the leading authority in hyperbaric medicine. This accreditation is recognition that few hospitals and facilities have earned, and identifies the Institute as providing patients with advanced care.

Dr. Jay Levine

Good Samaritan Hospital is the only hospital in the region to offer this treatment, which is designed to heal wounds stemming from infections, radiation, operations, post-operative complications, trauma, diabetes, and gangrene. The Institute is led by Hyperbaric Medical Director Bijo Chacko, M.D. and Medical Director of Wound Care, Jay Levine, DPM. Integrated clinical support is provided by System Director of Wound Services & Diabetes Education, Carla Errico, MPH, RD, and the entire Good Samaritan Hospital physician/clinician staff.

Source: News Blaze [7/25/11]

OH Podiatrist Returns to His Roots

Bellville native Michael Swiatek has returned to Richland County to practice in the podiatric office of Jeffrey Schwein, of Schwein Foot and Ankle Clinic at 377 Marion Avenue in Mansfield. A 1999 graduate of Clear Fork High School, Dr. Swiatek earned a bachelor’s degree in biology from John Carroll University in University Heights, Ohio and his doctor of podiatric medicine degree from the Ohio College of Podiatric Medicine in Cleveland in 2008.

Dr. Michael Swiatek

Swiatek completed his residency in June at The Ohio State University Medical Center Podiatric Surgery Program, where he was chief resident. He has been involved in various research projects and has presented lectures on foot and ankle disorders.

Source: WMFD TV News [7/24/11]

Editor's Note: PM News is proud to present excerpts from Meet the Masters.

Ribotsky: What is the significance of the recent California initiative?

Dr. Barry Block

Block: This is a great step in the evolution of podiatry as a medical specialty, and I applaud CPMA for their efforts. Being granted physician surgeon certificates in California will hopefully lead to true parity, which can only be obtained when future podiatric graduates are granted the MD and DO degrees. I am hopeful that APMA will allow its members to vote on a proposed referendum on this goal.

Dr. Stephen Merritt

Meet the Masters is broadcast each Tuesday Night at 9 PM (EST). This week's guest is podiatric residency director and coding expert Stephen Merritt, DPM. You can register for future events by clicking here

Tighter Medicaid Eligibility Considered

Bipartisan support for tightening Medicaid eligibility could allow such a measure's inclusion in a deficit-reduction deal, according to congressional sources. Bills by Republicans and a Democrat limiting Medicaid eligibility under the 2010 healthcare reform law would save a net $13 billion over the first 10 years, according to new Congressional Budget Office estimates.

Congressional staffers said the bipartisan support for the savings achieved by eligibility tightening indicates the measures are candidates for inclusion in any deal reached to lower future deficits, as part of an agreement to raise the federal debt limit.

Source: Rich Daly, Modern Healthcare [7/25/11]

FDA Wants More Rx Data

In a new report, the U.S. Food and Drug Administration outlines a need to improve access to post-market drug data and bolster the agency's risk-assessment capabilities to reinforce drug safety. The FDA's Center for Drug Evaluation and Research also opened a 60-day public comment period on its 28-page planning document, "Identifying CDER's Science and Research Needs Report."

Validating outcome-related information contained in patient records, the report notes, is a critical component in assessing drugs' safety. "The validity of exposure and outcome information, as identified in electronic healthcare data, needs to be evaluated for its use in regulatory assessments," the report's authors wrote. "Validated algorithms for ascertaining various safety outcomes could be used to better inform drug-safety studies conducted by the government, industry, and academia.

Source: Joseph Conn, Modern Healthcare [7/25/11

5 Important Conversations with Staff

Employees need ongoing feedback to thrive. So instead of having one long performance discussion each year, try holding a series of short, single-topic conversations that take place over a five-month period. Consultant Tim Baker recommends asking these questions during discussions:

•  Climate review. How would you rate your current job satisfaction? How would you rate morale? How would you rate communication?
•  Training and development. What are some skills you would like to learn? What courses would you like to take?
•  Innovation and continuous improvement for the practice. What’s one way that you could improve your own working efficiencies? What’s one way we can improve our practice?
•  Improved personal performance. In what ways can you improve your performance? How can I help you to do that?
•  Career. What part of your job do you enjoy? What would we need to do to help you develop?

Note: Baker suggests repeating the series of discussions during the second half of the year.

Source: Adapted from “The 5 Conversations,” Tim Baker, Training Journal via Communication Briefings

Query: Subsequent Surgery

My doctor performed a transmetatarsal amputation along with a pedicle flap in January. Now, a little over 5 months later, the patient needed an incision and drainage with resection of the non-viable portion of the flap, as well as a resection of the 4th and 5th metatarsal bases and distal cortex of the cuboid. How would these procedures be billed?

Jody Levy, Office Manager, Office of Andrew Levy, DPM, Jupiter, FL

Response: A lot depends on how much independent work was done.

The primary procedures appear to be resection of bone - 2 partial resections of metatarsal bone and 1 partial resection of tarsal bone. The I&D and soft tissue resection (i.e., flap) in the same site would probably be included in the related bone work. The possible coding would be

CPT 28122
CPT 28122-59
CPT 28122-59

The code above represents both partial excision of metatarsal and tarsal bone. Because you are out of the original global period, no "-78" modifier is necessary.

Tony Poggio, DPM, Alameda, CA

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RE: Hemostasis (Ivar E. Roth DPM,MPH)
From: Robert Kornfeld, DPM

I use Urgent QR for hemostasis on anti-coagulated patients. It is from Biolife - 1-800-722-7559
 
Robert Kornfeld, DPM, Manhasset, NY, Holfoot153@aol.com

RE: Chronic NSAID Use Doubles CV Deaths in Elderly
From: Robert Kornfeld, DPM

This is not the first, nor will it be the last article to reveal the potential dangers in NSAID prescribing. As we compile more and more statistics from research, it is quite obvious that these drugs should be for short term use only (7 to 10 days). It does not make sense to suppress inflammation long-term when inflammation serves to detoxify, repair, and protect our cells. We should not be creating higher levels of toxicity by using NSAIDs that suppress cellular detoxification and ultimately create a toxic liver that deepens the recruitment of chronic inflammation on a systemic basis.

What makes the most sense is to discover underlying physiologic mechanisms that have made the primary inflammatory pathway inefficient. Inefficient primary inflammation leads to chronic inflammation which ultimately leads to the expression of genes of degeneration. So we need to look for those factors that place a burden on the immune system. Once identified, we now have a health-promoting protocol rather than a potentially lethal one.
 
Robert Kornfeld, DPM, Manhasset, NY, holfoot153@aol.com

RE: Foot Defect Doesn't Stop Athlete from Running, Winning Medal at World Games  

In all their years of practice, neither Carine Haemels nor David Jenkins, podiatrists from Belgium and Arizona, had seen a case quite like that of Chanveha Sun, a 14-year old from Cambodia. Known clinically as a “subluxed and reversed hallux,” Chanveha’s big toe has been bent backwards on his foot since he was born.

Subluxed and Reversed Hallux

But the congenital defect has not stopped him from walking or running. In fact, Chanveha competed in the 50-metre sprint at World Summer Games in Athens.

Source: Special Olympics Resources

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