The Voice of Podiatrists

Serving Over 14,502 Podiatrists Daily

July 29, 2013 #4,834 Publisher-Barry Block, DPM, JD

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NY Podiatrist Angry at Medicare for Improper Refund Demand

Queens podiatrist Dr. Victor Chen is angry. Medicare is demanding that he repay thousands of dollars they paid him three years ago for treating Hector Toro, a diabetic who suffered severe diabetes and its complications."I had to amputate his right foot and make three trips to the O.R.," said Chen. Since Mr. Toro had a valid Medicare card, Dr. Chen's office billed Medicare and was paid in 2010.

Dr. Victor Chen

Sadly, Hector Toro, blind and disabled, died from diabetes two years ago. A few months ago, Medicare sent letters to Dr. Chen and the other doctors who treated Mr. Toro demanding that they return money because the patient was not in the country legally, a fact they say Dr. Chen should have known. But Mr. Toro was a legal citizen.

Editor's note: For the full story, click here.

Source: Arnold Diaz, Fox News [7/24/13]

OR Podiatrist Joins Surgical Specialty Clinic

West Valley Surgical Specialty Clinic announced that it recently added podiatrist Dr. R. Tyson Scott to its staff. Scott will see patients at the Dallas clinic and provide procedures and surgeries for feet, ankle, bunions, and plantar fasciitis at nearby West Valley Hospital.

Dr. R. Tyson Scott

Scott received his medical degree from the California School of Podiatric Medicine at Samuel Merritt in California and completed his residency with an emphasis in foot and ankle surgery at Fountain Valley Regional Hospital.

Source: Statesman Journal [7/27/13]

TX Podiatrist Moderates Meeting on Healthcare Reform

Dr. George Liu, Assistant Professor of Orthopaedic Surgery and President of the Faculty Senate, recently moderated a meeting on healthcare reform. Dr. Liu said he was pleased both with the turnout and with questions offered by faculty members. “For the Assembly, we chose to present topics of faculty interest,” Dr. Liu said, surveying the gathering of about 175 faculty members. “Though there are many pathways of communication at UT Southwestern, these meeting events are particularly important for faculty and leadership to convene and share information on a grass-roots level."

Dr. George Liu, the first podiatrist Faculty Senate President of the University of Texas Southwestern Medical School, moderates the annual medical school faculty assembly meeting.

"It is important to the faculty to appreciate that their concerns are being acknowledged and validated. The Senate will continue to function as the liaison between faculty and administration, helping to facilitate those lines of communication,” said Liu.

Source: Lin Lofley, Southwestern Medical Center News [June 2013]

WI Podiatrist Facing Possible Suspension After Billing Complaints

A Milwaukee doctor with a long history of complaints is now facing possible suspension, after a FOX6 hidden camera investigation exposed the doctor’s misleading practices. Dr. John Lanham is a Milwaukee-area podiatrist with a past record of fraudulent billing and an ongoing record of patient complaints. Five months after FOX6 caught him misleading patients on hidden camera, the state is finally moving to suspend his license. On Tuesday, July 30th, the Podiatry Board is scheduled to consider a summary suspension of Dr. Lanham’s license. That would prohibit him from practicing until a final decision on discipline can be determined.

Source: WITI My Fox Milwaukee [7/27/13]

RE: Chronic Pruritic Lesion (Arthur Gudeon, DPM)
From: Don Steinfeld, DPM

That looks like lichen simplex chronicus to me. Originally a pruritic lesion, the skin becomes indurated with exaggerated skin lines due to repetitive excoriation. This is an example of neuro-dermatitis. Try an Unna boot to physically prevent access to the site.

Don Steinfeld, DPM, Farmingdale, NJ, footdrdon@aol.com

RE: Chronic Pruritic Lesion (Arthur Gudeon, DPM)
From: Art Gudeon, DPM

Thanks for your responses; they’re much appreciated. As it turns out, Bryan Markinson, DPM, my “go-to podiatric dermatologist,” agreed with the consensus that the condition was NOT psoriasis, but lichen simplex chronicus. He advised treating this condition with clobetasol 0.05% bid (basically the same potency as the betamethasone dipropionate 0.05% ung., bid, that I’d already prescribed). I can alter the Rx later if necessary, and also add Benadryl prn (although she says the pruritis is minimal right now).

Just to clarify the biopsy situation - the reason she preferred not to have it on her first visit was due to a swimming competition “final” later that day, but said she’d want it if the response wasn’t proving satisfactory over a “reasonable” period of time. She was aware she’d have to D/C treatment 48-72 hours prior to the biopsy if so.

Art Gudeon, DPM, Rego Park, NY, afootdoc@hotmail.com

RE: Security Risk Analysis Cost (Mark Aldrich, DPM)
From: Michael L. Brody, DPM

Your security risk analysis involves much more than vulnerability and penetration testing. A proper security risk analysis looks at physical, administrative, and technical measures to protect your data. Penetration testing is only looking at one aspect of technical vulnerabilities.

Under the HIPAA regulations, you must do everything that is reasonable to protect your data. The question becomes "What is the risk of a hacker penetrating your network to obtain data?" If you look at the ONC 'wall of shame' that list large HIPAA breaches, you will see that most are due to human error or devices being physically stolen or lost. A very small percentage of breaches are due to an electronic break-in.

Therefore, the take away from this is that it is reasonable to determine that the probability of a cyber attack resulting in a breach is low, and you are better served spending that same money on physical and administrative measures. You can close a lot more gaps that are of higher risk in that manner and that is what a risk analysis is all about - determining what risks have a high likelihood of being exploited and closing those potential gaps in your security.

I do not recommend spending the money on this test until you have addressed the issues that have historically been shown to result in large breaches.  

Michael L. Brody, DPM, Commack, NY, mbrody@tldsystems.com

RE: Discontinuing Diabetic Shoe Program (Neil H Hecht, DPM)
From: Deborah Wehman, DPM
 
This is just another example of how a good program became a victim of fraud. We all know that the program has been abused since it was never meant to be a free pair of shoes for every diabetic every year. I'd be willing to bet that no more than about 10% of my diabetic patients truly need the shoes. I figured it was only a matter of time before it would have to be stopped because the government can't afford to buy a $350+ pair of shoes for every diabetic each year. 

Deborah Wehman, DPM, Richmond, IN, dswehman@comcast.net

RE: Missed Follow-ups a Potent Trigger of Lawsuits
From: Ellen Wenzel, DPM

We recognized early on the potential liability in missed appointments and even cancelled appointments in patients that require follow-up. It seems some of the highest risk patients are the worst recurrent offenders for missing appointments. Our office policy is 4 contact attempts with documentation. For all no-shows, the office staff calls the business day immediately following the missed appointment, then another two days later, and one week after that. If they are unable to reach the patient after the third attempt, a letter is mailed. Each attempt is documented with the outcome.

In addition, we document every cancelation with a reason and whether or not the patient re-appointed. When a patient does not immediately re-appoint and if he/she is one who requires follow-up (i.e., wounds and post-op), the same process is followed. We find many first time no-shows simply just get busy and forget (even with appointment reminders), and they appreciate the attention to their care.

Ellen Wenzel, DPM, Vancouver, WA, wenzeldpm@gmail.com

RE: Shotgun Surgery? (Burton J. Katzen, DPM)

I guess you could bill for removal of foreign body CPT 28190.

Salvatore J. Galluzzo, DPM, Clifton Park, NY, sal.j@aol.com

ASSOCIATE POSITION - SOUTHERN NEW JERSEY

Excellent opportunity for a full time podiatrist to join busy group practice! Surgery, wound care, sports medicine. Affiliated with residency program. Personable and great communication skills a must! Competitive salary, bonus, benefits package. Send CV to footdoc22@gmail.com

ASSOCIATE POSITION - CENTRAL FLORIDA

Associate wanted for well-established practice in central Florida. Experienced support staff, malpractice coverage and health insurance provided. Excellent opportunity for a promising future, this position will provide for the possibility of partnership in the future. To apply please go to www.yourcareerinpodiatry.com

ASSOCIATE POSITION - FLORIDA

Associate wanted for an established 25 year old practice. PSR24 or 36 would be preferred. Excellent opportunity. Please send CV or letter to bafamt@aol.com.

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

Very busy, two location group practice seeking a full-time, self motivated and hard working podiatry associate. Competitive salary and benefits are offered. Please email CV to: footcare4all@aol.com

ASSOCIATE POSITION - HUDSON VALLEY NY

Part time position in busy practice leading to f/t. Looking for well trained minimum PSR-12 with great technique and people skills for part time leading to f/t position in fast growing practice. Competitive salary with huge growth potential. Send cover letter, CV and work experience to: PodassociateNY@gmail.com

ASSOCIATE POSITION – PENNSYLVANIA

Associate Wanted for busy, multifaceted podiatry practice in Chester and Delaware counties, Pennsylvania. Seeking PSR-24/36 trained podiatrist for full/part time associate position. Two offices and hospital privileges. Send CV and letter to: 123bunion@gmail.com

POSITION AVAILABLE - MASSACHUSETTS

Boston Medical Center. Full-time career opportunity: surgery, diabetic foot care, wound care, general podiatry, resident training & research. Split position: (90%) on-site BMC and (10%) off-site health center clinics Boston University School of Medicine Academic appointment. Requirements: Completion of 24-36 month surgical residency. Please forward CV and letter of interest to: Erin.walker@bmc.org

ASSOCIATE POSITION- DAYTON, OHIO

Join an established group practice in Dayton, Ohio excellent reputation, large referral base.  Base Salary$120,000, benefits and bonus structure. EMR;diagnostic ultrasound; Padnet; CO2 and Cutera Laser for nails, all aspects of DME. We need well trained personable PSR24/36 surgeon. Future Buy-in available. Please send CV to Ohiomedical@aol.com

ASSOCIATE POSITION - SF BAY AREA

East SF Bay Area associate wanted for 3-office practice. CA License and PSR-24 minimum. All aspects of podiatry. Need to be highly motivated, a self-starter and be able to start Aug. 1, 2013. Salary BOE. Send CV to drscivally@sbcglobal.net
 
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.

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 - DEBARY, FLORIDA

Turn-key operation; 1,200 sq. ft. Suite, $56,000 for immediate sale due to illness in family; everything included; aggressive young podiatrist can triple gross income; www.DeBaryFamilyFootCare.com  ; Email  sweisman@cfl.rr.com for details.

EQUIPMENT FOR SALE - DIOWAVE 15 WATT, PORTABLE 980 LASER

This is a used multiple function laser, plantar fasciitis, Achilles tendonitis, joint pain. nerve pain, post surgical, warts, toenail  problems, two-year plus warranty, MSRP: $25,000. E mail Dr. Zuckerman at footcare@comcast.net. for questions and pricing.

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