The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

July 30, 2011 #4,220 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.

Mimimalist Shoes are Risky for Most People: NY Podiatrist

Those Funky Shoes That Look Like Gloves for Feet are designed for barefoot running, a new movement that tries to replicate the unshod experience using barely-there shoes. This practice, which borrows from indigenous peoples who don’t have the luxury of the latest Nikes, supposedly strengthens the foot muscles and allows the feet to move more naturally. But is it safe?

Dr. John Brummer

“If you didn’t grow up running on bare feet, it’s extremely risky, resulting in everything from stress fractures to arthritis,” warns John Brummer, DPM, a spokesperson for the American Podiatric Medical Association, in New York City. Feet not only need protection from hard, uneven surfaces but also require customized support for their unique structure.

Source: Real Simple Home & Lifestyle Network

Bakotic and Herman Inducted into the PM Podiatry Hall of Fame

The 2011 APMA Scientific Meeting started off in grand fashion as a sold-out capacity crowd of 300 podiatrists, corporate sponsors,  family, and friends welcomed the newest inductees  into the PM Podiatry Hall of Fame. This event, which has become an institution at the APMA national, also serves as a major fundraiser for the APMA Educational Fund, which provides schoraships to hundreds of podiatric students each year.  This year's event, sponsored  by  Pinpointe Laser and Formula 3 raised over $27,000.

Betsy Herman Receives PM Lifetime Achievement Award

It was thus fitting that Betsy Herman, the first Executive Director of the American Podiatric Medical Students Association received the Lifetime Achievement Award after first being gently "roasted" by her husband, Past APMA President Dr. Ross Taubman, and soon to be President of the PICA Insurance Group. Herman will be leaving her position as Director of Career Development at APMA to join her husband in Nashville, TN. 

(L-R) Dr. Barry Block Presents PM Lifetime Achievement Award to Dr. Bradley Bakotic

Bradley Bakotic, DPM, DO, CEO of Bako Labs joined an illustrious list of podiatrists in the PM Podiatric Hall of Fame, but not until he was thoroughly "roasted" in hilarious fashion by Dr. Bryan Markinson and Hall of Famer Dr. Allen Jacobs. As usual, Jacobs pulled no punches, taking pot shots at Emcee Dr. Barry Block, as well as other Hall of Famers seated at the Dais. Dr. Bakotic and Bako Labs have been generous benefactors to a wide variety of podiatric institutions and causes.

AAPPM Honors PM Editor with  Honorary Lifetime Trustee Designation

Dr. Hal Ornstein, Chairiman of the American Academy of Podiatric Practice Manangement (AAPPM) surprised Podiatry Management Magazine's editor, Barry H. Block, DPM, JD at the PM Hall of Fame Luncheon by presenting him with a crystal trophy designating him as an Honorary Lifetime Trustee of AAPPM.  This is the first time in the illustrious fifty year history of AAPPM that such an honor has been bestowed.

Dr. Hal Ornstein Presents Honorary Lifetime Achievement Trophy to Dr. Barry Block

Ornstein told the audience in the packed ballroom  that "since Block was ineligible for induction in the PM Podiatry Hall of Fame, AAPPM thought it was fitting that Block be recognized for his lifetime of tireless efforts to advance the podiatric profession. Block is a previous recipient of AAPPM's B.C. Egerter Award.

Query: Mandrel for Dremel Drill

Can anyone tell me where to buy a mandrel with a 3/32" stem to fit my Dremel drill? 

Joe Borden, DPM, Reseda, CA

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 - two partial resections of metatarsal bone and one 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

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

RE: Bone Stimulators and Hammertoe Deformities
From: Joel Lang, DPM, Peter Gregory, DPM

It is doubtful that her foot was "normal and beautiful" before the injury since a similar, but lesser, deformity is present contra-laterally. Since this a suit-conscious patient, she already has a lawyer. I would proceed very carefully.
 
It is more likely that either the original ankle trauma caused some neurological damage or some damage was done as a result of a tight cast during the course of treatment. I think the bone stimulator is a 'red herring'.
 
I would take a very careful history and obtain records from the treating physician to see exactly when the deformities first presented. The timing is not definitive but will contribute to the body of knowledge about this case. A thorough neurological exam is indicated. Attempted surgical correction in the presence of permanent neuropathology is destined to be less than satisfactory,  so expectations need to be modified from the beginning.
 
Joel Lang, DPM - retired, Cheverly, MD, langfinancial@verizon.net
 
Doesn’t the orthopedist have radiographs, taken at the time of the ankle fracture, that show the forefoot?
 
Peter Gregory, DPM, Livonia, MI, pfgregory@biztwmi.rr.com

RE: Accessing Patients' Medication History (John Chisholm, DPM)
From: Jeffrey Kass, DPM

I am at the early stages of converting to EMR. I currently use the Sammy system and with certain patients, you can do this. I am not sure why that with some you can and some you can't. It may have to do with their particular drug plans. One suggestion would be when confirming or giving out appointments, tell the patients in advance to bring a list of all medications and dosages, or the actual bottles in a bag. While, certainly it is a pain in the butt obtaining the information at times, knowing your patients' medications is a vital aspect of proper care of the patient and can help avoid a disaster; i.e, drug-drug interactions, etc.

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

RE: Credit Card Chargeback (Follow-up)
From: Tyler B. Brahm, DPM

A few weeks ago, I requested help in a letter to the credit card company because my patient requested a full refund for her functional biomechanical orthotics. Even though I did not have a signed form stating that they were not guaranteed, the credit card company repaid me, as was only right. The orthotics functioned very well in her walking shoes, but did not work in her stylish shoes. She decided not to have a second adjustment. I always verbally inform my patients that orthotics are not guaranteed.                          

Tyler B. Brahm, DPM, Clearwater , FL, Buckeyes72@aol.com

RE: About the D.O. Program for D.P.M. Graduates (Barry Block, DPM, JD)
From: Ricardo Lundi, DPM

To clarify on the remarks of Dr. Block, here's the details of the DPM, DO program taken directly from the Nova Southeastern University website.

"Nova Southeastern University (NSU) has established a program leading to the Doctor of Osteopathic Medicine (D.O.) degree for doctors of podiatric medicine (D.P.M.) who are graduates of U.S. accredited colleges of podiatric medicine.  Interested D.P.M. graduates must provide evidence of being accepted by or enrolled in the Council on Podiatric Medical Education.  The D.P.M. /D.O. program provides the opportunity for a limited number of D.P.M.s each year to complete the requirements of the D.O. degree in a three- year period.  NSU’s College of Osteopathic Medicine will determine on a yearly basis the number of D.P.M.s that may be accepted and enrolled.

After completing the requirements for the D.O. degree and a one-year osteopathic medical internship, the educational requirements will have been met for eligibility to obtain a license to practice osteopathic medicine in states requiring one year of graduate medical education.  The program is designed for doctors of podiatric medicine who wish to obtain full medical licenses (i.e., osteopathic medicine) to provide added value to podiatric practice."

Ricardo Lundi, DPM, Englewood, NJ, captaindargo@gmail.com

• 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.