The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

August 06, 2009 #3,615 Publisher-Barry Block, DPM, JD

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We've just mailed the August 2009 Podiatry Management. This 228-page issue contains 14 major wound care articles, and is filled with a variety of interesting, informative, and useful articles. You'll also find our usual assortment of features, including our columns, and a CPME-approved CME.

August 2009 Podiatry Management

MI Podiatrist Receives FIP International Humanitarian Award 

The International Federation of Podiatrists (FIP) held this year's Annual General Meeting in Toronto, Canada on July 28, 2009. The FIP consists of 28 international podiatry organizations on 6 of the 7 continents, representing over 80,000 podiatrists who perform over 200,000,000 episodes of foot and ankle care each year.  

(L-R) Drs. James Hill, President of Ontario Podiatric Medical Association, Vicki Anton-Athens, and Robert Chelin, President International Federation of Podiatrists.

Each year, the FIP awards one individual with its International Humanitarian Award. This award goes to someone who goes above and beyond the daily routine to make a difference to improve the quality of life for those individuals or populations who are disadvantaged. This year's award went to Dr. Vicki Anton-Athens of Flat Rock, MI.

The FIP presented Dr. Anton-Athens with this award in recognition of her outstanding dedication and generosity over many years in bringing foot care to impoverished children in Guatemala.

Health Plans Employ New Technologies to Detect and Thwart Fraud

Health insurers are stepping up efforts to detect fraud in light of expectations that a struggling economy could fuel more illegal schemes. Health plans say their efforts are increasingly successful, aided by new technology and outreach efforts.

Case in point: The Blue Cross and Blue Shield Association’s national anti-fraud department said June 30 that Blues companies’ anti-fraud investigations resulted in overall savings and recoveries of nearly $350 million in 2008, up 43% from the previous year. It also cited a significant increase in fraud cases opened and closed.

The National Health Care Anti-Fraud Association (NHCAA) and others are urging Congress to include the fight against health fraud. NHCAA released a “white paper” in June citing FBI estimates that as much as 10% of U.S. healthcare costs, or $224 billion, was stolen from the American public through fraud in 2007. Fraudulent schemes are becoming increasingly complex, the association warns, and the situation will only worsen unless more is done to stop it. NHCAA urges taking immediate steps, such as putting language in reform legislation to ensure more proactive information sharing between government and private health insurers to combat fraud.

Source: Judy Packer-Tursman, Health Plan Week [8/4/09]

Lift Spirits

Make one simple change today that has the power to boost morale throughout your practice: Start telling your employees that you appreciate them. Employees who receive positive comments at work have higher morale and job satisfaction. Simply tell them: “You made a difference,” “Great job” or “I really appreciated your help with …”

Suggestion: On your way home from work each day, think about the people you came in contact with. Did you show each—or any—of them the appreciation and positive support you should have? If not, plan to do so tomorrow.

Source: Adapted from “Pep Up Your Staff With Morale-Boosting Tips,” Joel Zeff, Joel Zeff Creative via Communication Briefings

Query: Patient with Recurring Infections in Interspaces
From: Elliot Udell, DPM
 
For the past five months, I have been treating a patient with recurring bacterial infections and superficial cellulitis proximal and dorsal to the left and right fourth toe interspaces. My initial clinical impression was that we were dealing with a tinea and a secondary bacterial infection. Incision and drainage of each lesion revealed Proteus mirabilis. We placed the patient on the appropriate antibiotics and in each instance, the infection abated .I also placed her on topical antifungals,  and topical antibiotic creams in addition to the orals.

The problem is that when she discontinues the oral antibiotics, within two to three weeks, a new superficial abscess forms, along with cellulitis, and again the same microorganism is cultured out. I have since sent her for an ID evaluation, a general surgeon/wound care specialist in my area, her own internist, and an immunologist who worked her up for immune deficiencies, which were negative. Blood cultures were negative. Three weeks ago, she was sent to a dermatologist who did deep and superficial biopsies, bilaterally along with PAS stains ordered. The only findings with all of the biopsies were the presence of granulation tissue. The PAS stains and fungal cultures were all negative for hypae or fungal growth. The immunologist was concerned about eosinophils in the biopsy, which would point to allergy .This too was negative. A deep culture done at the time of biopsy once again revealed the presence of Proteus mirabilis. Any input would be helpful.  
 
Elliot Udell, DPM, Hicksville, NY

Query: HMO Cancellations Tied to Hospitals

There are some HMO's that only allow participation if you are affiliated with hospitals they have contracts with. I have noticed that if the HMO cancels the contract with that hospital, they then will drop you as well. Is this fair? This practice can be disruptive when you have been caring for these patients. Is there a way this can be stopped - other than hunting for another hospital they do have a contract with?  
 
Jeffrey Kass, DPM, Forest Hills, NY

RE: Meet the Masters is a Success
From: Ronnie Lepow, DPM

I hope everyone was witness to Dr. Bret Ribotsky’s “Meet the Masters” telephone call-in program on Tuesday night at 9 PM (EST). This series is a major achievement for intraprofessional communication and learning. It allows you be able to sit comfortably in your living room,  listen and participate in a stimulating conversation with a legend of our profession, like Lowell Weil as well as  hear questions from colleagues in a unique venue.

I look forward to hearing Dr. Barry Block next week. Spread the word on this. This is a good deal for our people and a real opportunity to engage in grass roots fraternalism.

Ronnie Lepow, DPM, Houston, TX, doclepow@gmail.com

RE:  John Carson Inducted in Hall of Fame
From: William, L. Reider, DPM

Add my name to those testimonials for PM's Hall of Fame inductee John Carson. 
 
Many years ago, when I was in the New York State Podiatric Medical Association headquarters, I answered a phone call from John. After identifying myself, John said....."Bill you may be just the person I want to talk to. We have a problem with Texas Pacificare a tri-state federal PPO of postal workers (Texas, Oklahoma and Arkansas). "Their healthcare booklet has failed to recognize podiatric benefits with the exception of routine foot care. New York Congressman Gary Ackerman is the head of a postal subcommittee that can correct this. If I fax you pertinent materials could you speak to him and see if he could correct the error?" I met with Rep. Ackerman and the problem was immediately corrected. John displayed keen insight as well as know-how in excising a problem that could have proliferated throughout federal health plans across the nation.
 
Congratulations to a true icon for receiving this most prestigious award.
 
William, L. Reider, DPM, retired, Boca Raton, FL, Wlrdpm@aol.com

RE:  American People Don’t Want Rationed Healthcare: DE Podiatrist
From:  J. Boylan, DPM, Jon Purdy, DPM

Dr. Mullen's comments are well taken. But patient and physician advocacy via legal recourse against an insurance company is a good thing. When the government "rations" healthcare, who shall we (patients, physicians, other providers) sue? The federal and state governments are better suited to regulate health insurance companies rather than become "the" health insurance company.         

J. Boylan, DPM , Ridgefield, NJ,  Drb0327@aol.com

I think a pertinent point here is that in the free market, private companies are open for litigation and failure. In the case of the government, the public is at the mercy of the politicians and have strongly worded letters and high dollar lobbyists as their primary tools of coercion. In the free market, one has the opportunity to know what terms they are signing on to and can pick another company if they are dissatisfied. With the federal government, the terms are vague and can change at the whim of the political tide; there is no other government from which to pick. 

Jon Purdy, DPM, New Iberia, LA, jpurdy@mindspring.com

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