The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

August 11, 2009 #3,619 Publisher-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2009- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

Hear PM News Editor Interviewed Tuesday Night

Have you ever wanted to ask PM News editor Barry Block, DPM, JD a question in real time? On Tuesday night at 9 PM (EDT), you'll get your chance. Dr. Block is being interviewed by Bret Ribotsky, DPM as part of the "Meet the Masters" telephone call -in series. Block will discuss tips on building a practice during hard economic times.   

You can register for this free event at www.PodiatricSuccess.com 

MA Podiatrist Prevents Amputation in Diabetic

A 43-year-old Iraq war veteran with diabetes is living in Texas with his wife and four young children when he is told that he must prepare for the amputation of one of his legs. The spreading, non-healing wounds and their complications make the amputation necessary to save not just his limb, but his life, his doctors tell him. But he refuses to proceed with the amputation surgery.

Dr. Vicki Driver

Instead, he searches the Web until he finds a research study on limb preservation and wound healing advances. The study is led by a former military doctor now at Boston Medical Center, a podiatrist and podiatric surgeon by the name of Dr. Vicki Driver. The man gets in his truck and drives 1,500 miles to see her. She agrees to work with him, enlisting the help of a team of vascular, cardiac, and other specialists, and in the end, she saves his leg. Later, when he develops wound ulcers in the other leg, she and her team of specialists manage to heal and save that one, too.

The good news for people with diabetes is that this story, although perhaps more dramatic than most, is not at all unusual.

Source: Dennis McGrath, Diabetes Health [8/10/09]

OCPM Provides Foot Aid Station at 2009 Rite Aid Cleveland Marathon

Kathy J. Siesel, DPM, Class of 1989 and associate professor in biomechanics, supervised evaluation and treatment of 46 runners at the recent Rite Aid Cleveland Marathon, Half Marathon and 10K. She was joined by 16 students from all class years currently enrolled at the Ohio College of Podiatric Medicine. Dr. Siesel has been the  coordinator for the OCPM Foot Aid Station for the Cleveland Marathon since 2004.

OCPM First Aid Station

The OCPM Foot Aid Station was located near the finish line. The students participated in the evaluation, treatment and basic charting for the runners who sought our assistance. The conditions treated included blisters, plantar fasciitis, Achilles tendinitis, and peroneal tendinitis.  It was a very busy day at the Foot Aid Station and numerous referrals were given to the participants. Many of the referrals were to the Cleveland Foot and Ankle Institute when the runner was local and did not currently have a podiatrist.

Source: Footsteps (OCPM) [July, 2009]
 

HHS Announces Shift in HIPAA Rules Authority

HHS is consolidating authority for both security- and privacy-rule enforcement under the Health Insurance Portability and Accountability Act of 1996 with the Civil Rights Office at HHS.

It shifted the duties of security rule enforcement from the CMS to the Civil Rights Office, which originally had only the role of enforcing the HIPAA privacy rule. According to Lisa Gallagher, senior director of privacy and security at the Healthcare Information and Management Systems Society, the aim of realignment is “to consolidate at least part of what they are doing in one area. Let's have enforcement in one place so we can properly resource it so we can be more efficient.”

The announcement that HHS is consolidating both healthcare information privacy and security rule enforcement responsibilities under one office is a signal that the federal government is going to step up enforcement in these areas, according to those familiar with the healthcare regulatory scene.

Source: Joseph Conn, Modern Healthcare

Query: Tingling and Burning of Toes Under Bedcovers

I had a 56-year-old healthy female in the office today with a complaint of tingling and burning in her toes only in bed when her feet are under her bedcovers. As soon as she removes her bedcovers, the discomfort immediately resolves. She has no discomfort whatsoever at any other time of the day. She can participate in any activity and wear any desired footgear without problems. This problem has been going on for several years and is not worsening. She is not taking any medications, essentially has no related family history, and her surgical history is not very remarkable either. Her neurologic and vascular exams are completely normal. Does she need any check-up from the neck up?

Bob Hatcher, DPM, Raleigh, NC

Query: Duty to Disclose Audit?

I was wondering if anyone had a comment on whether a practitioner who is selling a practice has a duty to disclose a previous Medicare audit. The practice I purchased was audited by Medicare about 4 years prior to the purchase, with significant findings by the audit.
 
Name Withheld

RE: Oral Lamisil Use in Children (Bruce N. Block, DPM)
From: Multiple Respondents

I have had great results using 1/2 the adult dose for the same length of time. The patient's caregiver needs to split the 250 mg pill in two. 125mg PO everyay for 3 months. 
 
Fausto J. Ramos, DPM, Perth Amboy, NJ, drfaustoramos@hotmail.com

Lamisil is also provided in granule form. With pediatrician approval, you may consider its use. The granules are small enough for young children. The granules are sprinkled onto a spoonful of pudding or other soft, non-acidic food; do not use with applesauce or fruit-based foods.
                                                           
Dosage by Body Weight
< 25 kg = 125 mg/day
25-35 kg = 187.5 mg/day
> 35 kg = 250 mg/day

Lamisil Oral Granules are supplied in cartons containing 14 packets. Each packet contains approximately either 30 (125mg) or 45 (187.5mg) granules.
 
Chris Majewski, DPM, Germantown, MD, christofeet@yahoo.com

Lamisil in a 12 year old is clearly off-label. Even with a waiver from the parent, I would not use it for someone this age. It's cut and dry for me. 

Brian Kashan, DPM, Baltimore, MD, drbkas@worldnet.att.net

RE: Yellow Pages Parity (Frank DiPalma, DPM)
From: Multiple Respondents

While, I am very proud of "our" profession and have seen enormous strides it has taken, I think it is wrong to claim podiatrists have more expertise "than an orthopod with a one-year fellowship in surgery." Having said that, - Dr. DiPalma actually states what the real problem is: 1) He is upset an orthopedist is advertising in "his" podiatry section. 2) He is upset that he is fixing the orthopod’s surgical errors. I’m not sure you can do much about the guy advertising in the podiatry section. With regard to fixing his errors, it is too bad he has so many. Athens, GA is lucky you are there to fix them. Some things in life you just can't control. 
 
Jeffrey Kass, DPM , Forest Hills, NY, Jeffckass@aol.com

I had a similar, funny situation but somewhat opposite yours. Our phone book has an "MD Specialty Section" with different categories, one of which is "Foot & Ankle Surgery." We advertised in that section for several years before an orthopedist got upset and demanded we stop, since it was an "MD Section" and we weren't MD's -- we even got a letter from the State Medical Board (we are not under them - we have our own board). 

Our phone book representative wasn't worried about it and pointed out that in the entire MD Specialty section, there were many other health care specialists listed such as physical therapists, social workers, psychologists, etc.  He asked us, "Are those people MD's ?"  We sent a letter to the medical board with photocopies of all the ads for the "other" healthcare providers who weren't MD's. We didn't worry about it. When the next year’s phone book came out, we were NOT listed in the Foot & Ankle Surgery section. We inquired to our rep who politely told us his boss made him take it out. He gave us no further explanation. 

R. Alex Dellinger, DPM, Little Rock, AR, raddpm@yahoo.com

While you may not be able to inform every medical practitioner of the orthopod’s lack of training, you should consider reporting him to your state board of podiatry. He is not allowed to pretend he is a podiatrist. He does not hold a podiatry license and by advertising in the podiatry section, he is implying he is one. In the state of PA, we have fined pedorthists who placed ads in newspapers implying they were able to cure neuropathy; therefore, practicing podiatry without a license. At the very least, the podiatry board should investigate this, and it might be enough to make him stop placing the ads.

Mary E. Loftus, DPM, Bethlehem, PA, loftusdpm@aol.com
 

RE: Flip Flops with Built-in Can Opener

These shoes have not received the APMA Seal of Acceptance

We don't know if you've ever tried to open a beer with your typical flip-flop, but it isn't pretty. That's a problem no more, because the fine folks at Reef have developed sandals with a bottle opener built right in, so you can pop the top on your beer or soda and barely break stride.

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 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 - MARYLAND

Harford County, Bel Air, est. 1991, seeking PSR24/36, strong ethics, friendly demeanor. Associate or partnership opportunity for the right applicant. We provide onsite ambulatory surgical center, patient base, strong referral resources, billing, scheduling, and many technologies. Visit our website. e-mail your CV to drhoward@hlsfootcare.com.

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

FOR SALE: MICROVASC UNIT

Excellent Condition, Never Used, New 14K, BEST OFFER. All-Pro 2010 X-Ray processor, used, great condition, Includes cassettes BEST OFFER
NYCPodiatry@gmail.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.

ASSOCIATE POSITION - SUBURBAN DETROIT AREA

Home care doctor needed immediately for growing home care practice in the suburban areas of Detroit. Must have own vehicle and good driving record. Excellent opportunity for the right individual! email cv to: metrohomefootcare@gmail.com

PRACTICE FOR SALE-VIRGINIA (SOUTHEAST)

Very busy office near Williamsburg. Currently, a satellite office 2 days a week. Great opportunity to make office full-time. Grosses approx. 130,000/year. The office has everything needed to start practicing. All included. Must sell. If interested, e-mail totalfootcareva@hotmail.com

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 - NEW JERSEY

Established successful practice in Central New Jersey seeking PT/FT Associate. PSR 24/36. Please forward CV to rpg145@gmail.com or fax 908 753-0199.

PM News Classified Ads Reach over 11,500 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 11,500 DPM's. Write to  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.