The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

August 01, 2009 #3,611 Publisher-Barry Block, DPM, JD

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APMA Holds First Ever Scientific Meeting In Canada

Dr. Ronald Jensen

Over 3,700 attendees, including 1,200+ podiatrists and over 120 exhibitors were treated to the warm hospitality of cosmopolitan Toronto. Opening festivities took place Thursday afternoon with welcoming remarks by APMA President Ronald Jensen.

Gov. Mike Huckabee (Photo Stephen Pribut)

This year’s keynote speaker was Fox TV News celebrity and former Arkansas governor Mike Huckabee. Huckabee, a recent presidential candidate, was greeted with numerous standing ovations by a packed room of over 1,000 attendees. He related his strong bond to podiatry formed when running several marathons with Jeffrey Ross, DPM. Huckabee related the storyt of how he got healthy after being diagnosed with diabetes. Then, he outlined his plan for a healthy America, recommending that insurance premiums be determined by having people rewarded for healthy habits such as the cessation of smoking, losing weight, and getting more exercise.  

Ornstein, Carson Inducted into PM Podiatry Hall of Fame

"Fun is part of the word 'fundraiser', said Podiatry Management editor Barry Block, DPM, JD who served as emcee of this year's sold-out Hall of Fame Luncheon. And that's exactly what the 275 attendees were treated to as two more podiatric legends were inducted into PM Podiatry Hall of Fame. Over the past five years, this event has raised over $100,000 for the APMA Educational Foundation.   

John Carson (L) and Dr. Barry Block

Hall of Fame member Irv Kanat, DPM started the festivities by roasting John Carson, former APMA Director of Govermental Affairs. After relating some anecdotes about Carson's interaction with,politicians and podiatrists, Kanat reminded everyone of the instrumental role Carson played in securing podiatry's place in critical legislation which paved the way to today's quest for physician parity.

Dr. Hal Ornstein

John Guiliana, DPM and Ben Weaver, DPM representing the American Academy of Podiatric Practice Management (AAPPM) then took turns poking fun at Hal Ornstein, DPM, Chair of AAPPM. Ornstein, in accepting the PM Lifetime Achievement Award challenged the students and young members of APMA "to give back to podiatry and to others." He related how his service to others brought him fulfillment, and how he appreciated the blessings and sacrifices of his family.

House Committee Adds Title XIX to Reform Bill

The House Energy and Commerce Committee unanimously adopted an amendment offered by Congresswoman Diana DeGette (D-CO) to include APMA's Title XIX initiative (HR 1625/S 654) in the House tri-committee health reform bill (HR 3200). The amendment mirrors the language in HR 1625, and will recognize doctors of podiatric medicine as physicians in Medicaid. Ultimately, that means the services of DPMs will be considered "physician services," which are mandated in every state under the Social Security Act's Title XIX statute.
  
Credit for the success of this amendment is in large part due directly to the constituent grassroots action of APMA members who contacted their US Representatives and urged them to help get our initiative included in the health reform bill. This is particularly true of California, which mounted a massive, successful statewide effort to press Chairman Henry Waxman to amend the reform bill.

Source: APMA EDaily News [7/30/09]

RE: Candela V-Beam Laser

I own a Candela V-beam laser that is 5 years old. I have had it for two years. Twice in the past 6 months, the fiber has required repair. I am looking for additional names/resources for repair and maintenance.  Since I did not buy directly from Candela, they will not sell me parts for it. I am specifically looking for a place to purchase a used fiber/hand piece to have available if it should go down in the future.

Jeff  Szczepanski, DPM, Traverse City, MI

Query: Removal of Foreign Body (Glass)

I used CPT 28192 (removal of foreign body, foot; deep) for the removal, in my office, of a piece of glass from a patient's foot (the patient had be referred by the hospital emergency department).

This code was denied by Medicare. The EOB says that the claim "lacks information" (code 16); and that the procedure code billed is not correct (code N56). We called NGS Medicare. and were told that they have no record of this code in their system.

What is the correct code for the surgical procedure requiring anesthesia, incision, removal and primary closure of a deeply embedded piece of glass, performed in an office setting?

Charles Morelli, DPM, Mamaroneck, NY

Response: That is the correct code.

I am assuming you used a diagnosis code that supported the procedure, such as ICD-9 729.6 (residual foreign body in soft tissue). Not knowing why your Medicare carrier would not have this code in their system is baffling. Other than making sure this is a code that can be performed in an office setting, an appeal is surely in order for this one.

Denise Paige, CPC, COSC, Long Beach, CA

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RE: Swimmer with Cramps in Arches (Alan Mauser, DPM)
From: Howard J. Bonenberger, DPM

With Morton's neuroma, there may be spasms or cramps of the intrinsics resulting in the involved toes going into a spastic dorsiflexed position. Sometimes, the pain of the spasm is felt back along the length of the intrinsic (what the patient is calling an arch cramp?). Ask some more specific questions and consider neuroma as a possibility. Bear in mind that the cold water can cause spasms and when the toes are pointed as in swimming, the intrinsics may fatigue and cramp, especially if the person does not swim often or is swimming a greater length than is typical for them.

Howard J. Bonenberger, DPM, Nashua, NH, howardbon@aol.com

RE: New or Used Autoclaves (Laura R Lefkowitz, DPM)
From: Marc Garfield, DPM

I bought a used Midmark M9 from a company that sells Tuttenauer, but takes trade-ins and refurbishes them. He indicated that the Midmark is the most trouble-free automated autoclave. Don't write off bells and whistles. There is a lot to be said for an autoclave that does not require you or your staff to vent, with the potential for steam burns, setting timers to check the thing, etc.

In addition, the automated claves generally have faster cycles to keep your instruments and patients moving efficiently. They also said that the steel tanks are usually good for life but the guts outside the tank go after about 5 years, so try to buy one that has these quasi consumables replaced when buying used/refurbished. There is also a small automated "bucket" (Prestige Medical Classic) autoclave for around $1,000 new, sold all over the Internet, but check dimensions and make sure it will fit all of your instruments. 
 
Marc Garfield, DPM, Williamsburg, VA, mgarfield1@cox.net

RE: Online Scheduling for Multiple Offices (Mark Wolpa, DPM)
From: Brian Kiel, DPM

It is unlikely that you can see multiple offices on one screen at the same time as the screen would not be large enough or the print would be too small to read. We use McKesson's Practice Partner successfully for multiple Drs. and offices for years. Their website is PracticePartner.com.
 
Brian Kiel, DPM,  Memphis, TN, Footdok4@gmail.com

RE: Dragon Naturally Problem (Bruce Krell, DPM)
From: Burton J. Katzen, DPM

I purchased Dragon Naturally V.10 (non-medical) with accompanying digital recorder for $250.00. After hearing bad reviews on previous versions, I  heard that V.10 was much better. The first day was an endless source of entertainment. I couldn't figure out why all patients with low arches (pronators) were member of the Green Party (pro-Nader) or why all patients with "metatarsal" pain had to "meet a car pool." That being said, I made a list of the words that were dictated improperly and after only about two days and maybe 30 words I had to train, it became about 95% accurate, with most of the mistakes due to my mumbling (um = him).

If you don't have a digital recorder and pay the extra 50 bucks for the included one, the downloaded file has to be converted to a .WAV file. If you get a cheap microphone from Best Buy and attach it to your computer, it magically transcribes to MS Word. I would give it a grade of A- after only 1 week and strongly discourage you from paying $1,500.00 for the medical version. The regular version works fine.

PS: If your wife works in the office, makes sure she knows that everyone you prescribe Metanx to you didn't (meet and neck).

Burton J. Katzen, DPM, Temple Hills, MDDrburtonK@aol.com

ASSOCIATE POSITION - FLORIDA

Busy practice in East Central Florida in search of full-time podiatrist to perform routine foot care in office and nursing home. Competitive salary and full benefits available. Reply to jrdpm@bellsouth.net

LOCUM TENENS – TEXAS

Looking for locum tenens to work about 3 weeks for me while I am out for an operation. Need Texas license and obviously need malpractice.  Tentative dates are: Last week in August 09 - first two weeks of September. Need to be able to see variety of post-op patients, and otherwise, general podiatric practice and common office procedure (nail, etc.) skills. Salary/terms negotiable. If interested, please call, 409-466-7401 and mention this ad.

ASSOCIATE POSITION - FLORIDA

Busy practice in East Central Florida in search of full-time podiatrist to perform routine foot care in office and nursing home. Competitive salary and full benefits available. Reply to jrdpm@bellsouth.net

PRACTICE OPPORTUNITY - CINCINNATI, OH
 
Well-established practice located in medical/professional building minutes from hospital. Many referrals, three satellite clinics and two assisted living facilities to keep you busy. Associate leaving due to family emergency-need to either find an associate or sell ASAP. Contact bjadpm@hotmail.com for more details.

NEEDED CHICAGO -- NW IND & BALTIMORE/WASHINGTON, DC PODIATRISTS 

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists in Chicago, Northwest Indiana, and Baltimore, MD. Full and part-time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com Visit our website

ASSOCIATE POSITION – ILLINOIS 
 
Quality Podiatry Group provides quality services to residents at long term care facilities. We are currently offering full-time or part-time positions for motivated ethical podiatrists. Immediate openings available. If interested, fax curriculum vitae to 312 225-9366 or e-mail feetwork@aol.com

ASSOCIATE POSITION – PACIFIC NORTHWEST

Russian-speaking podiatrist needed. Looking for well-rounded, recently out of residency, podiatrist. Would you like to raise your family in our beautiful Pacific Northwest? We are well-established and fast growing multi-office practice with all aspects of podiatry. Attractive compensation, malpractice and medical insurance provided. Call 206-661-9644.

ASSOCIATE POSITION - WASHINGTON — WEST PUGET SOUND

Well-established, two-doctor practice in all phases of treatment looking to replace associate who is leaving the area. Looking for energetic, affable, surgically-trained DPM to take over associate position leading to partnership. Satellite office and adjacent multi-disciplinary ASC available for use and possible partnership. Silverdale rated 92nd in best 100 locations in Money/CNN 2009 poll. See link . Contact and résumé at pwa@kitsappodiatry.com

PRACTICE FOR SALE - ALABAMA, GULF COAST 
 
Established 26 year old practice. Owner desires to sell and relocate. Operated 25 hours per week. Mixture of surgery and general podiatry. MD referrals. Surgery center and hospitals in close proximity. Highly profitable. Priced to sell. Will lease office to buyer. Call Mike Crosby at 888-776-2430 or email mcrosby@providerresources.com

ASSOCIATE POSITION - BOSTON, MA 
 
Associate wanted, Full-time or part-time, for busy long time, well established, and well-rounded practice. Good mix of general podiatry and surgery. Office will generate approximately 100+ surgical cases per year. Must have surgical background, ABPS Qualified minimum needed to obtain hospital privileges. Associate position is open for partnership or purchase. Contact robert.nunberg@comcast.net 

PRACTICE FOR SALE – WESTCHESTER COUNTY, NY

Established 30+ year old practice. Well respected podiatrist in beautiful Westchester County Owner ill and needs a quick sale. Mixture of surgery and general podiatry. Hospitals in close proximity. Will lease office to buyer. Call Mali McGrinder at 914-434-1663.

ASSOCIATE POSITION - CHICAGO AREA

Join one of the most successful, long-established podiatry practices in the Chicago area, with excellent salary and benefits. We have an immediate opening for a full-time podiatrist in a multi practice location in Chicago. Must have two years of surgical residency. Please e-mail resume to fmassuda@footexperts.com

ASSOCIATE POSITIONS - CALIFORNIA

Podiatrist needed for busy North Hollywood office. Part-time Monday-Friday 8am-2:30pm. No weekends and no call. Pay negotiable. New podiatrists are encouraged to apply. Please email resume and salary request to Coasttocoastpodiatry@yahoo.com

PRACTICE FOR SALE - FLORIDA—CENTRAL/SOUTH

Turn-key operation grossing $570,000 annually based on one full-time doctor. Great opportunity for growing the top-line. Surgery is only 14% of the professional man-hours; it can significantly increase income. Medicare makes up 64% of revenues. Seller will assist with transition. Call 863-688-1725, ask for Chas.

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