The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

July 28, 2012 #4,526 Publisher-Barry Block, DPM, JD

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Obesity + Flip-Flops Equals Foot, Knee, Hip, and Back Pain: FL Podiatrist

According to the National Foot Health Assessment 2012, 78 percent of adults over the age of 21 experience a foot problem. Foot doctor David Simonson in Rockledge said there are two big reasons why -- the number of obese people in America and the type of shoe you wear.

Dr. David Simonson

Dr. Simonson said flip-flops can cause pain in your knee, back, hip, as well as muscle aches in the legs and feet. "They're flat and there's nothing to control the arch and support the arch of your feet," explained Dr. David Simonson. He recommends people only wear flip-flops occasionally, like when you're going to the beach. Otherwise, it should be walking shoes, or sandals on your feet.

Source: Jerry Hume, cfnews13.com [7/24/12]

444 Mile Bike-a-Thon Supports Barry’s Yucatan Project

After several weeks of training and a hearty breakfast at the historic Loveless Café in Nashville, TN, seven intrepid riders climbed aboard their bikes, and one trike for good measure, ready to conquer the 444 mile scenic Natchez Trace Parkway.

(L- R) Dan Nolen, Noah Glaser, Julie Hippie, Mike Conley, Dr. Edward Glaser, Keith Copley with Dr. Charles “Chip” Southerland.

Six employees, including CEO Dr. Ed Glaser, from Sole Supports, Inc., the Lyle Tennessee based orthotics laboratory, as well as Dr. Chip Southerland, Professor at Barry University  School of Podiatric Medicine in Miami Shores, Florida and Director of the Yucatan Crippled Children’s Project (YCCP) braved the heat and the road in order to draw attention to and raise funds for the YCCP.

Feds Announce New Anti-fraud Initiative

HHS and the U.S. Justice Department have partnered with about a half-dozen health insurers to help prevent fraud and abuse in healthcare billing. The initiative is designed to share information on specific schemes, billing codes, and even geographical hotspots that have been used in fraudulent activity. The government hopes, for example, to be able to immediately detect when payments are billed for the same patient in two different cities on the same day.

The initiative will use advanced technology and data analytics to identify when and where healthcare fraud is occurring, according to an HHS news release. Trade group America's Health Insurance Plans is participating in the partnership with the Blue Cross and Blue Shield Association as well as health plans including Humana, UnitedHealth Group, and WellPoint. A total of 21 groups, representing federal, state, and private payers have signed on so far. The healthcare law sets stricter penalties - such as longer sentences - for cases with damages over $1 million—and allows for enhanced screenings of and suspended payments to providers or suppliers who are suspected of fraudulent activity.

Source: Beth Kutscher, Modern Healthcare [7/26/12]

Demand For Podiatrists Expected to Rise From Healthcare Reform

As with many healthcare-related industries, demand for podiatrists will likely benefit from healthcare reform. Subsidies will help those with low incomes gain coverage, increasing the number of insured patients and bolstering demand for podiatric services. However, the profession will continue to face competition from general practitioners, threatening growth.

Source: Companies and Markets [7/26/12]

Query: Tablets for EMR, Training a Scribe

I recently purchased Tracknet EMR and am hiring a scribe. I would like recommendations on the different tablets/laptops to carry from one exam room to the next. How does training a scribe differ from that of the traditional podiatry assistant?

Olga Luepschen, DPM, Sebring, FL

Query: Bunionectomy with Packing of Bone Cyst

I am looking for advice on the proper code to bill for "packing of bone cyst." The doctor performed an Austin-type bunionectomy. The 1st metatarsal head was cystic. The bone was taken off the medial eminence (bunion) and was grouped into bone chips. The cystic area was curetted and packed with bone chips.

Would it be appropriate to bill the bunionectomy code, CPT 28296 (correction, hallux valgus [bunion], with metatarsal osteotomy) with CPT 28106 (excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus; with iliac or other autograft [includes obtaining graft]) or CPT 20900 (bone graft, any donor area; minor or small)?

Laurie Bodo, Lake Orion, MI

Response: Using the discarded bone portion of the bunionectomy (medial eminence of the first metatarsal head) for packing bone does not add significantly to the work included in the bunionectomy procedure. Remodeling portions of the medial eminence is no different than remodeling allograft bone. It doesn't involve obtaining autogenous bone (CPT 20900). As far as the presence of cystic bone at the 'bunionectomy with osteotomy' site, this is not an unusual finding. If a cyst is present, the curetting, remodeling, packing are included in the global surgical package for the bunionectomy. It is considered a component procedure performed in the same surgical site (per the AAOS "Complete Global Service Data for Orthopaedic Surgery" and the APMA "Global Surgical Service Report").

The coding should be CPT 28296 (correction, hallux valgus [bunion], with metatarsal osteotomy). If the cyst was unusually large and presented a real surgical challenge, a "-22" (increased surgical services) modifier can be appended. A detailed operative report of the unusual work and a letter of explanation would be sent to the payer.

Tony Poggio, DPM, Alameda, CA

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RE: Affordable Care Act (Obamacare) Perk (Richard Rettig, DPM)
From: Ken Hatch, DPM,

I recently retired. My  Medicare supplemental premium is $151 monthly. My wife, younger than me, pays $1,056 monthly (BC/BS CAREFIRST of Maryland). This is a $100 monthly premium increase. We both use the same insurer. She got nothing back because her carrier "Met or exceeded the federal payout standard." I got $ 40.35 back for mu last year's  premium on my Medicare supplemental policy, same carrier. I'll wave my  forty buck rebate and hope that Congress dumps OBAMACARE! 

Ken Hatch, DPM, Annapolis, MD, KLHDOC@aol.com

I have a difficult time believing what I am reading. If a company is forced to spend millions of dollars on themselves or give it away and they just “can’t make that happen”, we would be reading about the firing of a major CEO.
 
Presupposing it is the case, that insurance companies are now restrained by a government mandate to limit profits, it is amazing to me that anyone would be in favor of this. The easy out is to dismiss the possible...

Editor's Note: Dr. Purdy's extended-length letter can be read here.

RE: Fotona Laser for Onychomycosis (Dennis Shavelson, DPM)
From: Joseph F Campbell, DPM, Robert G. Parker, DPM

I'm in total disagreement with Dr. Shavelson. We purchased a Fotona Laser from that same person over 2 years ago. We could not be happier with the laser as well as the support that we get from them! Of all the equipment over the years I have purchased, never has anyone been as responsive as they have been! They will call us or e-mail us to this day with any suggestions that may produce a better result. Even with marketing, they give suggestions. This is 2 years after they have been paid! How much better can you get? I would never hesitate to buy again from them.

Joseph F Campbell, DPM, N Ft Myers, FL, baron767pc@earthlink.net

I had the first laser in Houston for the treatment of onychomycosis and have now advanced to my third and best laser, the Fotona. I  strongly disagree with Dr. Shavelson's report on Fotona and am very puzzled as to how he can be critical of one of the most professional and knowledgeable presentation and training one could receive in this area. I have had my Fotona now for over two years and found Robin Sult, RN, an international speaker and instructor in Fotona technology, always responsive to my phone calls and e-mails and available for help when we needed it.

It is disheartening to hear a colleague speak disparagingly of Robin and Fotona. I have several colleagues who feel as I do, that this instrument, produced by a company in the laser business for I believe now over forty-five years, has moved us years ahead with their patented variable square pulsed laser delivering equal 5mm homogenous wavelength, where the others, though effective, are Gausian hot center-cool pheriphery delivered.

Robert G. Parker, DPM, Houston, TX, drparker1@me.com

RE: Best Laser for Onychomycosis (Greg Teles, DPM)
From: J. Michael Lunsford, DPM

I have utilized lasers in my practice since 1982. Onychomycosis treatment options have traditionally been limited to oral meds, topicals, or surgical procedures. I am extremely pleased to note that my experience with the HyperBlue 1530 laser system I purchased a little over a year ago has exceeded my expectations. I researched a total of 5 systems over a 2 year period and consistently found the HyperBlue superior to all others in both success and support. Before you purchase a system, give them a long hard look, and I think you will find they are the correct choice.

J. Michael Lunsford, DPM, Houston, TX, jmldpm1@aol.com

ASSOCIATE POSITION - BIRMINGHAM, ALABAMA

Immediate opening. Strong established group practice. 30-40 office patients per day to start. Surgery available, but not required. Base salary, production bonus, benefit package, relocation assistance. Aggressive work ethic a must. Email resume and cover letter to: dwh101@bellsouth.com

ASSOCIATE POSITION - OHIO

Ohio practice with excellent reputation and patient base seeks to hire a Podiatric Surgeon. The offices are state of the art including Digital X-Ray, EMR, Diagnostic ultrasound, Padnet Vascular Testing, CO- 2 Lasers all aspects of DME. The base salary is $120,000 with a bonus structure and benefits also would like to have this individual buy into the practice eventually. Please send CV to: Ohiopodiatrist@aol.com

ASSOCIATE POSITIONS – MARYLAND

Are you motivated, personable and enjoy working with the elderly? We are offering part-time positions in Maryland. Our group, Podiatry Management Services, provides care in Nursing Homes, Assisted Living, Senior Homes, Adult Daycare and other similar facilities. Please e-mail your CV to: drhprosen@verizon.net or fax to 410-486-2049 or call Dr. Herbert Rosen at 410-580-0255.

ASSOCIATE POSITION - YONKERS, NEW YORK

Immediate part time associate position now available. Appx: 3 1/2 days per week with room to grow. Practice is a good balance of all aspects of podiatric foot care, including surgery. Perfect opportunity for new graduate, or experienced podiatrist. Looking for the right person to transition into vacancy that will be left by current associate leaving the area and you will have an immediate, full schedule of patients. Over 25 year well-established practice with large referral base, and both hospital and surgery center privileges available. Interested persons please forward CV and brief summary of surgical log to: Podiodoc@gmail.com  914.584.1434

ASSOCIATE POSITION - BAKERSFIELD, CA

IMMEDIATE OPENING: Office and hospital-based podiatry group in Bakersfield, CA seeks highly trained surgical associate to join us. Prefer surgeon with trauma and Charcot reconstructive experience. Staff privileges with 5 local hospitals. Offering health insurance, CME allowance and competitive salary. Must be PSR 24/36 trained, ethical and thoughtful when treating patients. Please forward CV and letter of intent to modpm@aol.com.

ASSOCIATE POSITION - SEATTLE, WA AREA

Established podiatric clinic looking for an associate to join our team, 5 offices located around the greater Seattle, WA area. Great base salary, benefits and friendly work environment. Please send resume to: seattlefootdoctor@yahoo.com

ASSOCIATE POSITION - MANHATTAN

Well-established successful Park Avenue podiatry practice is recruiting skilled and well trained DPM with a minimum of 3 years of experience. Must be experienced in rear and forefoot reconstruction. Must be self- motivated, and great with patients. State-of-the-art practice facilities and technologies which include: in-office physical therapy, digital x-ray, diagnostic ultrasound, and electronic medical records. MRI, and private operating room. All interested candidate email CV to elautin@gmail.com

ASSOCIATE POSITION - NORTHWEST IOWA

A well-established, midwest multi-physician practice with strong hospital affiliations seeking FT podiatrist. Applicant should be well trained surgical physician, completed a 12/24 month residency, & board eligible. Practice offers high surgical volume, advanced wound care and good mix of general podiatry. Competitive salary, excellent benefits. Fax resume: 712-258-9977

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, and other Medicaid plans. Contact me at: Podocare123@gmail.com

ASSOCIATE POSITION - NASSAU COUNTY, NEW YORK

Exciting Opportunity! Associate position. Must be Board Qualified. Joining all Board Certified Doctors in foot surgery and reconstructive rear-foot and ankle surgery. Respond to:  Podiatryoffice@doctor.com

ASSOCIATE POSITION TUCSON - SOUTHERN ARIZONA

Accepting applications for an associate position. Applicant must have completed surgical residency and be Board Qualified/Certified. Our practice involves multiple office locations and looking to expand. We offer all aspects of foot and ankle medical and surgical care. Hospital and Surgery Centers privileges. Competitive salary and benefits. Partnership opportunities available. email resume to: drdafac@gmail.com

ASSOCIATE POSITION - LOUISVILLE, KY

Immediate position for established practice in excellent location with option to buy. All phases of podiatry with good mix of patients. Two local residency programs with foot and ankle and trauma privileges. Office has EMR qualifying for meaningful use in the first year. PADnet vascular testing. Send resume to: samuel10530@yahoo.com.

EQUIPMENT FOR SALE - USED PODIATRIC LASERS

Great price, great outcome. Stop wasting money on expense lasers. Personally owned and used few hours in my office,. 10 and 30 watts lasers. Two handpieces in one. First one for plantar fasciitis, Achilles tendonitis, arthritis, pain, inflammation. 2nd handpiece for surgical ablation and fungus toenail conditions. Portable fast and very cost-effective.   footcare@comcast.net

EQUIPMENT FOR SALE

Retiring from practice. Equipment For sale. Mini x-ray. One year old Ultrasound with MS arterial/venous X-ray plates. Great condition Ritter chairs. Drills, surgical tools. So much. Just ask, I probably have it: 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 516 476-1815  PODO2345@AOL.COM

PRACTICE FOR SALE - SOUTHWEST FL

multilocation multidoctor practice in beautiful Southwest Florida . Practice has grossed over seven figures consistently and currently shows 10-15% growth in revenues with increase in new patients and patient visits. EHR is already implemented with meaningful use criteria met. Practice has been professionally evaluated by Provider Resources. Only serious inquiries to this email address. This is a great practice in Paradise and a good opportunity for the right doctor or doctors. Email to practiceforsaleswfla@gmail.com.

PRACTICE FOR SALE - BALTIMORE, MARYLAND

Established 40+ year old well-rounded practice of both surgical and non-surgical care with special emphasis on sports medicine. Medicare and BS/private insurance base, no Medical assistance. Needs to transition to a confident well trained individual. Purchase can include building. Contact: podiatrypracticesale@gmail.com

PM News Classified Ads Reach over 13,500 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 13,500 DPM's. Write to:bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $115 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.

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