August 17, 2006 #2,665 Editor-Barry Block, DPM, JD

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Hultman Named to HealthSciences Institute's Advisory Board

Jon Hultman, DPM. MBA has been appointed to the HealthSciences Institute's Advisory Board (through its Chronic Care Group's division). HealthSciences Institute is a multidisciplinary collaborative founded in Minneapolis in 2003. The Institute is focused on improving the value of healthcare delivered to consumers and purchasers through evidence, partnership-building, and innovation. HealthSciences maintains an advisory board of subject-matter experts representing a number of healthcare disciplines, industries, and learning institutions.

Dr. Jon Hultman

Chronic Care Group, a division of HealthSciences Institute, helps health care organizations design and implement performance-based disease management solutions, build professional disease management competencies, drive evidence-based care, support consumer self-management – and deliver improved value to consumers and payers.

Hultman is presently Executive Director of the California Podiatric Medical Association and is a contributing editor and regular columnist for Podiatry Management Magazine.

Armstrong Receives APMSA’s Kenison Award

The American Podiatric Medical Association (APMA) Annual Scientific Symposium was the venue for this year's awarding of the Kenison Award, and David G. Armstrong, DPM, PhD, Professor of Surgery and Associate Dean at the Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science was its unanimous recipient. The award, selected by the American Podiatric Medical Students' Association leadership, is given to the person who has made the most outstanding contribution to the profession of Podiatric Medicine in that given year.

Dr. David Armstrong

Armstrong noted, "I am humbled by this award, as it represents exactly what many of us strive to do-- that is mentor the next generation of leaders in podiatric medicine specifically, and medicine in general. I look forward to the day when many of the students who are coming up experience the singular thrill of watching one of their students succeed. It is the development of professional progeny that will, beyond scholarship or legislation, most successfully advance this wonderful profession."

Hospital Prices Up 0.8%, Doc Prices Hold Steady: PPI

Wholesale prices for acute-care hospitals climbed 0.8% in July after two consecutive months of 0.1% increases, according to the preliminary Producer Price Index from the Bureau of Labor Statistics. The hospital PPI hasn't recorded so high a one-month increase since January. For the 12 months ended in July, the hospital PPI was up 4.7%. Physician office prices remained unchanged after three consecutive months of declines. For the 12-month period, the physician PPI rose 0.6%. The PPI measures the average change over time in the selling prices received by producers of goods and services.

Source: Cinda Becker, ModernHealthcare, [8/15/06]

Query: Reception Room Educational Video

Has anyone come upon a company or source of a podiatry production on CD that could be used in the reception room as educational for patients to watch on a flat panel on continuous play. It should run for about 30 minutes to be effective so that the patient doesn't have to see the same one over and over. The discs could have different topics mixed so that the patients who come back weekly for treatment aren't bored. If no one is doing it, maybe I will produce it.

Marc Hudes, DPM, Monticello, NY, mhudes@footcaregroup.com

Editor’s comment: Over the years, PM News has received several similar requests. We believe that a professionally-made video including topics such as common foot and ankle conditions, orthotics, and surgery would be well-received by the profession.

Query: Physical Therapy Evaluations

I have just gotten off the phone with the physical therapy board of my state (Arizona) and have been informed that a physical therapist can and does perform a "physical therapy" evaluation on a wound care patient. These are patients that have already been seen and evaluated by a treating physician within the facility (a hospital based outpatient wound center). A plan of care has been formulated by the physician for the entire center staff.

Correct me if I am wrong, but would this not be considered "double dipping" for the same service?

The physicians (MD/Vascular and/or DPM) perform a comprehensive examination, order appropriate diagnostic testing to determine underlying cause(s) and associated diseases/complicatons and direct care to a multidisciplinary team.

What possibly could a "re-evaulation" by a physical therapist provide, other than added (and quite possibly inappropriate) reimbursement for this department?

Name Witheld by Moderator

Response: Physical therapy evaluations, like nursing evaluations, are not duplicative of physician evaluations or double dipping. They are undertaken for different reasons, and assess different aspects of the patient's care.

Physical therapy evaluations are required by Medicare (and possibly by some states) at the onset of treatment for a number of reasons--including to provide a baseline for setting goals for the physical therapist's treatment, and against which to assess the patient's response to physical therapy treatments.

Stacey Hernandez, CCS-P, Placentia, CA

Codingline subscription information can be found at http://www.codingline.com/subscribe.htm

RE: Hospital Admission by CA Podiatrist Constitutes Violation
From: Philip E. Larkins, DPM

This is simply not accurate as printed. The business and professions code has been modified by the state to allow podiatrists to do H&P's as long as it is not against some federal rule, ie, Medicare COP's. And this too shall change very shortly!

Philip E. Larkins, DPM, San Marcos, CA, larko33139@yahoo.com

RE: Anodyne Therapy National Coverage Decision (Ken Malkin, DPM)
From: Elliot Udell, DPM, Jeffrey Kass, DPM

I fully understand where Dr. Malkin is coming from regarding re-reimbursement for Anodyne. I use this modality in my office. It is part of the armamentarium of treatments we use for the treatment of diabetic neuropathy. I lecture about the treatments for PN. We have found that the reimbursement is much less than ten dollars in most cases and we treat many people pro bono whose insurance companies have no coverage for anodyne therapy and the patients cannot afford to pay for the therapy.

The reason why we go out of our way to give patients free 30 minute treatments is because the therapy is extremely effective in the management of certain forms of diabetic neuropathy. I have not only seen patients who were suffering with pain become asymptomatic after a series of treatments but I have used it effectively to treat recalcitrant ulcerations secondary to diabetic neuropathy coupled with localized peripheral vascular disease. I would love to get paid for this work. I deserve to be paid for this service. In our office we are stand for the pedal and emotional health of our patients and we will continue to treat patients irrespective of their abilities to afford effective therapy.

Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

I agree with Dr. Malkin's observation on Anodyne. I was considering purchasing a unit for the office after reading about it. However, once I did the math it was a losing proposition. Physical therapists offer the treatment as an adjunct service because they can bill out for various assessments, gait training, and a few other codes. These codes that they are able to bill out were not allowed by physicians last time I checked with Medicare.

If DMERC now does not want to dispense a home unit - the patient will have the option of purchasing one themselves or they will continue to go to the doctor for the treatments much the same way a patient goes 3x a week for dialysis. In the end, from a financial standpoint it may be more advantageous for the podiatrist.

The real question remains in my mind is whether or not the treatment works. Various published data shows conflicting outcomes. Maybe we can get some feedback from those Pods that are utilizing the treatment.

Jeffrey Kass, DPM, Forest Hills, NY, Jeffckass@aol.com

RE: Source For Women's Combination Last Shoes (Mel Cheskin MBS.,C.Ped).
From: Lloyd Smith, DPM

I cannot imagine anyone recommending Foot Solutions for shoes, unless they have a vested interest in that company. The employees of Foot Solutions often diagnose and treat foot complaints without a license or any training. They are "shoe dogs," a term used to describe shoe salesmen in the 50s..I know the term well. My father was one.

They also often prescribe a "custom orthotic" for about $250. A customer would be much better served buying any old running shoe and using a pre-fab insert and seeing a legitimate podiatrist.

Lloyd Smith, DPM, Newton Center, MA, Lloydpod@yahoo.com

RE: Aetna (Dale Smith, DPM)
From: Marc Katz, DPM

Here in Tampa, FL, a podiatry group sold out long ago to Aetna. This gives Aetna the message that podiatrists are pushovers and back stabbers. It is unfortunate that they know the truth.

Some day podiatrists will work together and help each other. My advice is to drop them. Out-of-network benefits and cash are far superior to being a provider for Aetna, I know first hand. Stand up or be stood upon!!

Marc Katz, DPM, Tampa, FL, dr_mkatz@yahoo.com

EQUIPMENT FOR SALE - PODIATRIC CHAIR

Midmark 416 podiatry exam chair. Lincoln Park Chicago, IL. Great chair. I moved office and no longer need it. Must sell. Blue color (will e-mail photo on request). 773-871-3338

HOUSE CALL PRACTICE FOR SALE – SOUTHERN CALIFORNIA

House Call practice for sale which includes approx. 400 patients and continued referrals. Perfect for solo practitioner. Extremely easy and profitable practice to run. Yearly gross of over $200K. Current DPM is retiring. Financials will also be provided. Please contact ccipinc@ccipinc.net

ASSOCIATE POSITION - NEW JERSEY

Seeking associate for practice in Ocean County area. Seeking a hardworking, ethical, energetic and well trained (PSR 24/36) individual. MUST be willing to do all aspects of podiatry! Competitive salary and benefits package. E-mail CV to NJFEET@aol.com

ASSOCIATE POSITION - GULFCOAST OF FLORIDA

Great opportunity in rapidly growing practice for a PSR- 24/36 BE/BC podiatrist with strong surgical skills. Hospital privileges available at 548-bed hospital system, new hospital is being built and multiple surgical centers. Candidate should perform rearfoot & ankle surgery, including Charcot reconstruction. Candidate needs to be ethical and motivated and must have a current Florida license. Established practitioner or new practitioner OK. Salary + percentage + benefits including insurance and 401K. Fax CV to (239) 566-8778.

ASSOCIATE POSITION- KANSAS CITY, MO

Excellent opportunity for a hard working, ethical podiatrist to join a vibrant, successful and growing podiatric medical and surgical practice. Dedicated, supportive staff with strong marketing and medical knowledge. Must be board eligible/certified. PSR/24. Partnership opportunity. Competitive salary, bonus structure, benefits. Wonderful place to raise a family. Fax CV to 816-455-8901

ASSOCIATE POSITION - NEW ENGLAND

Terrific Opportunity Now Available in growing New England practice. Well established and respected practice with new, large office space, latest technology, very helpful staff, loyal patients and solid referral base. Close proximity to hospitals with modern surgical suites. Opportunity for shared ownership. Prefer 24 month PSR with clinical practice experience or an experienced doctor looking to improve their situation. E-mail CV and particulars to NEAFC3@aol.com

HOUSE CALL PRACTICE OPPORTUNITY- CHICAGO / NORTHWEST INDIANA

Chicago-Home Physicians specializes in house calls to the elderly homebound. Full and part-time positions available in Chicago/Northwest IN. Competitive Compensation, including malpractice. Contact Scott Schneider. Phone-773-292-4800. Fax-773-486-3548. E-mail sschneider@homephysicians.com www.homephysicians.com

Seeking an experienced podiatrist versed in all aspects of podiatry with current AZ License. The right person will join as a salary associate leading to partial ownership in the group practice. Podiatry practice is well established over 25 years, successful and a large volume in the Phoenix metro area. Position available immediately. Email CV and inquiries to:pprac4sl@cox.net

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