The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

August 05, 2008 #3,315 Editor-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2008- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

Hand-Me-Down Shoes Bad for Kids’ Feet: NY Podiatrist

While you’re looking for ways to trim your budget, don’t let your kids wear hand-me-down shoes. That’s the advice of podiatrist Dr. Michael Pliskin of Manhasset, NY. “We never recommend wearing someone else’s shoes,” Pliskin says. “You’re asking for possible problems.”

Dr. Michael Pliskin

Pliskin was seconded by Dr. Douglas Livingston, a podiatrist in North Bellmore, NY. “A shoe should be fit for the person who is going to be wearing the shoe,” Livingston says. That means length, width and height of the toe box. As new shoes are worn, they mold to the wearer’s foot. Then, they can be harmful to another child. “The wear pattern may affect the other person’s gait,” Livingston says.

Dr. Douglas Livingston

Wearing shoes that have adjusted to another child’s foot can also cause irritation and long-term foot problems for your child, Pliskin says.

Source: Newsday [8/3/08]

FL Podiatrists Unite to Form Subgroup

The podiatrists of Lake County recently formed a subgroup of the Florida Podiatric Medical Association. Its purpose: to strive for scientific, ethical and material advancement of the podiatry profession and the improvement of podiatric medical service and foot health in their communities.

Dr. Nicholas Przystawski

The following podiatrists were elected to lead the group, which serves Lake and Sumter counties: Nicholas Przystawski of Leesburg, president; Janet Black of Mount Dora, vice president; Michelle McGowan of Clermont, secretary; and Victor Torres of Eustis, treasurer.

Source: Orlando Sentinel [8/3/08]

P4P Found To Have Little Impact on Care Quality

The idea of paying physicians more for providing guideline-based care has taken the American health system by storm in the last decade. Today, more than 150 pay-for-performance programs are centered on the notion that rewarding evidence-based care is key to improving health care quality.

But research shows there is a fundamental problem with the P4P programs: They have had little to no impact on quality. That is the conclusion of many studies, including a new analysis of quality incentives, published in the July/August Health Affairs. It compared 81 Massachusetts physician groups eligible for quality incentives with 73 that were not.

Unlike earlier studies, researchers had access to data from a cross section of doctors and payers -- five health plans that contract with more than 90% of the state's practicing primary care doctors. The study found that overall performance from 2001 to 2003 improved on 73% of preventive care measures such as diabetes hemoglobin A1c testing, breast cancer screening and well-child visits.

But the performance of the 5,350 physicians analyzed was statistically indistinguishable. Everyone's quality improved, regardless of whether the physician group stood to earn a bonus, which ranged from $200 to $2,500 per quality measure for an individual physician, depending on the health plan.

Source: Kevin B. O'Reilly, AMNews, [8/4/08]

Add Power to Your External Marketing With Internal Support

A common error made by many practices is their failure to include appropriate internal support for their external marketing programs. It’s not uncommon for excellent campaigns to fall flat due to a lack of clear focus from your staff.

The best way to avoid this problem is to set up an effective internal structure for staff to follow. This may include:

• Protocols for answering the telephone such as a written script to be followed so that each call is responded to in a personal, friendly, informative manner. Remember your telephone is the first impression patients (new or otherwise) get of your office. Why not make it a good one.

• Monitor the “quality” of information given to each caller, revise it as needed over time, so that prospective patients become actual patients.

Source: Rudy Svezia, DocGrwo Newsletter, [7/30/08]

Query: Linear Toenail Hyperpigmentation Streaks (Mario Rizzo, DPM)

Below is a clinical photo of the condition described in my previous post.

Melanocytoma?

I think it's familial melanonychia brought on by trauma.

Mario Rizzo, DPM, San Francisco, CA

Editor's note: We recommend that readers submitting clinical queries attach relevant photos or x-rays.

Query: Hepatitis B and Liability

I have questions in a hypothetical situation concerning hepatitis B and liability:

If a surgicenter partner (non-DPM) has hepatitis B, what are the legal and/or ethical roads to travel?

1. Should the HepB Dr. tell all his surgical patients? 2. Should the HepB Dr. tell the scrub techs?
3. Should the HepB Dr. tell the administration/owners/malpractice Ins? 4. Should the non-HepB Dr/partner in the surgicenter do or say anything?

Name Withheld

Editor’s comment: PM News does not provide legal advice. In many cases, the answer to these questions depends on state laws or facility policies. For an interesting article which discusses this topic in detail, click here.

RE: Prescription Shoes (Bob Kornfeld, DPM)
From: Paul Kesselman, DPM Woodside NY

C.Ped's (like pharmacists) cannot substitute one product for another unless the prescribing doctor rewrites the Rx (generic vs. brand name is a different situation). With all the various lasts and modifications out there, a good C.Ped could fit a specific patient with a stock shoe instead of a more expensive custom-molded shoe. If this was attempted, the CPed should have discussed this with the podiatrist from the outset and obtained a modified or new prescription. This is no different than a pharmacist taking it on his own (if you will) and filling a "DAW" prescription with a generic without first consulting the physician, or changing the prescription entirely, (e.g. Augmentin for Erythromycin).

Additionally, if an auditor reviewed this CPed's chart, the C.Ped would likely be required to refund the money for the stock shoe to Medicare, as the payment he received for the stock shoe was inconsistent with the prescription (which denotes a custom-molded shoe).

Paul Kesselman, DPM, Woodside, NY, PKesselman@pol.net

RE: Take Everything Off But Your Socks

One of my routine foot care patients came to my clinic yesterday, and related that he had been having pain in his left foot for about two months. He had a fracture there three years ago which was treated by a local orthopedist. Thinking it was somehow related to his prior fracture, he returned to his orthopedist rather than discussing the problem with me. His orthopedist took x-rays. They were negative. So he sent him for a bone scan. It was negative. He gave him oral steroids. No effect.

Finally, the patient asked me to look at it in the course of our exam. I began palpating his foot in the area that he indicated was formerly fractured. No pain. Then, I slid my hand a few centimeters away and pressed on a very deep keratoma. “Oh, that’s it!” he cried. “You found it!” I was so shocked that I had to ask, “Did your orthopedist LOOK at your foot?” Can you guess the reply? “No, he didn’t even take my shoes off.” Needless to say, he was quite happy after his debridement. I’m still shaking my head in disbelief.

Juliet Burk, DPM, Muskogee, OK

PRACTICE FOR SALE - BEVERLY HILLS, CA

After 48 years in practice, it's time to retire. My current practice is 1 1/2 to 2 days per week and generates a six-figure gross. An excellent choice as a srart-up or for semi-retirement in beautiful Beverly Hills. MUST HAVE BACKGROUND IN BIOMECHANICS AND SURGERY. Will stay to train and introduce. Price negotiable. Call Bill Orien at 310-271-1944.

ASSOCIATE POSITION WITH OPPORTUNITY FOR PARTNERSHIP

Group practice located on NY-PA border with excellent growth in the area’s industrial, retail, and college campuses. Surgical privileges in medical centers in NY and PA. This position will involve rotating through multiple office locations, and wound care centers. Local insurance reimbursement involves mostly private pay PPO models. We are looking for an ABPS Board Qualified podiatrist to join our team. Candidates would need to obtain licenses in NY and PA, and become ABPS certified to maintain hospital privileges. Base salary starting at $85,000 plus bonus plan incentive, vacation, and health/mp insurances. Forward CV to prefprovider@hotmail.com

ASSOCIATE POSITION – GEORGIA

Atlanta area need a full-time or part-time associate for a 25 years old well-established practice, well-rounded surgery and routine, please email your CV to superrang@bellsouth.net

CASE CONSULTING

Dennis Shavelson, DPM is now accepting referrals of difficult cases involving biomechanics, surgical complications, non-healing wounds diagnostic and treatment dilemma’s and subtalar stenting from DPM’S. Full reporting with second opinion only, rapid return after care and assumption of care options. Medicare and Out-of-Network Only. (212) 288-3668 or drsha@lifestylepodiatry.com

ASSOCIATE POSITION OPPORTUNITY IN MULTI SPECIALITY GROUP PRACTICE - ILLINOIS

Christie Clinic is a large Multi-Specialty Group practice located in Champaign, Illinois. We are seeking a PSR-36 ABPS Board Certified or Board Eligible podiatrist to join a well established Podiatry department. Must be competent in all phases of podiatric care, Surgical and Conservative. This position will involve rotating through multiple office locations with surgical privileges available at two medical centers and two outpatient surgery centers. Very competitive salary, bonus plan, vacation, and health/mp insurances. Forward CV to wpierce@chrisiteclinic.com

PRACTICE FOR SALE WA STATE: BELLINGHAM - WITH ASC

Located by hospital and medical community. Owner will carry part of financing. Potential for increased revenue abounds. This is a value that should not to be overlooked. Bellingham is rated in national magazines as one of the most desirable places to live or retire. 386 597-5766.

ASSOCIATE POSITION - BOSTON, MA

PODIATRISTS NEEDED - CHICAGO --NORTHWEST INDIANA

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists. We are located in Chicago and Northwest Indiana. 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

UNIQUE OPPORTUNITY FOR THE RIGHT PERSON! - NEW YORK

We’re in search of a motivated, well-trained DPM who is great with patients. Our well-established multi-doctor, multi-office practice is located in the Hudson Valley region of New York State. All DPM´s in our group are board-certified and there is a residency program affiliated with our practice. Please reply to HVFA, PO Box 3300, Kingston, NY 12402-3300; or via email to bud@hvfa.com

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

Multi-office group seeks associate in Southern California for general podiatry in office setting. NO nursing homes! Spanish speaking a plus. Full or part-time. Excellent compensation with potential for partnership. E-mail scpodgroup@yahoo.com for more details.

ASSOCIATE POSITION – CALIFORNIA

Coast to Coast Mobile Podiatry Group Seeks Podiatrist with Nursing Home contracts! Join our group and let us handle the back-breaking task of billing and managing your patients. This will equal great compensation for you. Please email us back at coasttocoastpodiatry@yahoo.com

WEEKLY SPECIAL - One week of ads (5x) for $89 One month of ads (20x) for $340 .

PM Classified Ads Reach over 11,000 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 10,900 DPM's. Write bblock@podiatrym.com or call (718) 897-9700 for details. THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451 Ext 110.

• 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.