The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

August 16, 2008 #3,325 Editor-Barry Block, DPM, JD

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PA Podiatrist Named Chief Medical Officer at Chestnut Hill Hospital

Dr. John Scanlon assumed the position of chief medical officer (CMO) of Chestnut Hill Hospital (CHH) in August. After 23 years as a member of the Hospital medical staff with a thriving podiatry practice, Scanlon chose to expand his role at the hospital in a capacity where he can improve the healthcare of his patients and the entire community.

Dr. John Scanlon

"We were excited that Dr. Scanlon was interested in representing the medical staff at CHH," says David Udis, M.D., medical staff president. "Dr. Scanlon received the full endorsement of the CHH medical staff and support of the University of Pennsylvania Health System chief medical officer, Patrick John Brennan, M.D. His passion and commitment for the Hospital has not wavered as we've undergone transitions in leadership and ownership in the last several years. He is an outspoken advocate for our more than 300 affiliated physicians and most importantly, our patients."

While on staff at the hospital, Scanlon developed a podiatric residency program. Students from across the country have benefited from the program since its inception in 2002. In 2003, Scanlon received the 2004 Service Excellence Award for going "above service expectations." Scanlon received a medical degree from Temple University School of Podiatric Medicine.

Source: RoxReview.com - Philadelphia, PA [8/14/08]

NY Podiatrist to Present Abstract at SICOT World Congress

Three oral scientific abstracts on pediatric foot deformities submitted by Azriel Benaroya, MD and Robert Fridman, DPM will be presented at the SICOT/SIROT 2008 XXIV Triennial World Congress on August 24th, 2008 in Hong Kong , China. The abstracts deal with complex pediatric foot deformities treated with surgery and differential distraction.

Dr. Robert Fridman

Dr. Benaroya is pediatric orthopedic surgeon at Mount Sinai Hospital- Elmhurst Medical Center in New York, and Dr. Fridman is a podiatric surgeon in the Department of Orthopaedic Surgery at Columbia University Medical Center, and Foot Associates of New York.

Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) is a global society of orthopedic surgeons with some 3,000 members from more than 100 countries around the world, and organizes a World Congress meeting every three years.

Health Plan Pays $100,000 to Settle Privacy Rules Violations

For the first time, a covered entity (CE) under the privacy and security rules has made a $100,000 payment to Uncle Sam and agreed to subject itself to three years of monitoring by HHS for losing unencrypted laptop computers and backup data more than two years ago.

Government officials, who announced the payment and corrective action plan (CAP) imposed on a Seattle-based health plan and home health agency on July 17, say the payment was not a "fine" and the organization did not admit any wrongdoing. But the news sent a chill through the privacy and security compliance community.

"This is a significant warning sign for covered entities, mainly a "heads up" that the government is getting more aggressive and [the CAP provides] a checklist of items that companies should be paying particular attention to in their security efforts," says Kirk Nahra, a partner with Washington, D.C.-based law firm Wiley Rein, LLP.

Source: Report on Patient Privacy [August 2008]

Double Your Brain Power - Part 2

You probably sometimes wish that you could think faster, grasp new information quicker and recall more of what you read and hear. You can with these tips:

• Plan for an upcoming learning event by selecting a reward you’ll give yourself afterward. Pick something you wouldn’t usually buy or do. Just before the learning event, picture yourself enjoying the reward. Repeat the process whenever you feel anxious about learning the information. Note: No matter how things turn out, give yourself the reward.

• Answer these questions after you read something that you want to remember: What is it about? What parts of it are most important? What opinions, if any, did it contain? What’s my opinion of it? What element makes it unique? Note: Do this mentally or in writing – whatever works best for you.

Source: Double Your Brain Power: Increase Your Memory by Using All Your Brain All the Time by Jean Marie Stine.

Query: Zinc Sulfate Intralesional Injections for Verruca

Does anyone have personal experience using Zinc Sulfate intralesional injections for verruca? We have read limited data and studies using it, and from the literature it seems effective. We have discussed doing a blind trial with several other practices in our area and combining data. We have found .5% (1/2%) solution, but have not been successful finding higher concentrations to dilute to a 2% solution. Does anyone have a source for the zinc sulfate for injection? If you have done this, was it helpful or any problems?

Paul Bishop, DPM, Yorkville, IL

Query: Internal Fixation Replacement

One of our doctors performed bunion surgery with internal fixation. The fixation didn't take, so the surgeon had to go back in a week later, remove the screw and replace it with K-wire.

Can he charge for the removal of the first fixation, and replacing it? If so, what code would be used?

Marc Maikon, DPM, Cedar Rapids, IA

Response: I don't think it would be reasonable to bill for both the removal of internal fixation and the replacement with new fixation. Bill for removal of the bone screw using CPT 20680, removal of internal fixation, deep. Do not bill for anything else.

Also, I suggest adding modifier "-78", indicating an unexpected return to the operating room for a related procedure during the post-operative period.

Howard Zlotoff, DPM, Camp Hill, PA

Codingline subscription information can be found here

RE: Use of Tourniquet with Sickle Cell Trait (William Sachs, DPM)
From: Susan Yeager, DPM

I have had numerous cases with sickle cell trait and used a tourniquet without incident. One must take into account the patient’s age, health status, circulation and procedure performed.

Susan Yeager, DPM, Jackson, MS, Susan.Yeager2@va.gov

RE: Residency as a License Requirement (Tip Sullivan, DPM)
From: Multiple Respondents

Many states use the PM Lexus exam as a substitute for residency requirements, when the podiatrist has already been practicing and is relocating.

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

We were under a similar Advisory Council to our Medical Board but now are an official voting member of the Medical Board in Oregon but the process is the same. An Administrative Rule can be written to explain the intent of the law which was NOT to exclude qualified doctors from practicing in your state but ensure qualified practitioners. This should be discussed informally first and then proposed once you know the answer to the question (Always know the answer to the question before you go before these state agencies.)

Be prepared with proper language to present to the Medical Board before you go to them. Legislative help would be in order such as that obtainable from APMA legal counsel or an attorney in your state familiar with your states rules and regs on this issue.

Gerald Peterson, DPM, Former Advisory Council Chair, Oregon, drp@ifixft.com

We seem to forget that residency training is only sheltered experience. A practitioner who has been in practice for a number of years has far greater experience that does the applicant who has just finished a one year residency program. Yet, we frequently see the new practitioner garner favor which is denied those who train him.

The Veterans Health Administration (VHA) has established a residency training equivalency standard that seems reasonable, and has been instrumental in convincing the credentialing committees of some hospitals and MCOs that experience counts. The VHA standard states, in part:
SECTION B. GRADE REQUIREMENTS. In addition to the basic requirements stated above, the following qualification criteria must be met in determining the appropriate grade assignment of candidates.
a. Associate Grade. None beyond the basic requirements.
b. Full Grade. Two years of podiatric practice or its equivalent. One year of approved residency training or its creditable equivalent acceptable to the Council on Podiatric Medical Education of the American Podiatric Medical Association is acceptable in lieu of the 2 years of practice.

APPENDIX G4. PODIATRIST QUALIFICATION STANDARD

The same language is repeated in Podiatrist Qualification Standard MP-5, Part II, Chapter 2, APPENDIX D. I can provide you with copies of these two documents, in Acrobat format, on request.

Howard L. Lazar, DPM, Bloomfield Hills, MI howardlazar@comcast.net

PRACTICE FOR SALE MN: PRIME LAKES AREA

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

ALL PRO 2010 X-RAY PROCESSOR FOR SALE

2 years old, excellent condition, monthly maintenance/cleaning done by NJ X-Ray. Includes processor, leveling base, chemical draining hoses, water hose, two 10x12 x-ray cassettes and 1 box of brand new x-ray film. Instruction manual and extra washers/parts also included. Asking price $2,500 + shipping costs. For inquiries, email nefootandankle@optonline.net

PRACTICE FOR SALE - TEXAS

10 year old Dallas practice for sale. All phases of podiatry including: surgery, routine care, orthotics, diabetic care, etc. grossing $185,000 on 3 days per week. Middle income area with hospital privileges available. please respond to: footdoc8390@yahoo.com

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