The Voice of Podiatrists

Serving Over 12,000 Podiatrists Daily

August 19, 2010 #3,935 Publisher-Barry Block, DPM, JD

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We've just posted the article Understanding Porokeratosis by Bradley Bakotic, DPM, DO and Dennis Shavelson, DPM.

Intractable Plantar Keratosis

You can download this informative article by clicking here.  

IN Podiatrist Provides Back-to-School, Shoe-Buying Tips

The back-to-school weeks represent one of the peak times for children's shoe shopping, says Indianapolis podiatrist Dr. Richard Stanley. Parents need to keep in mind these tips from Stanley and the American Podiatric Medical Association as they peruse the shoe aisle for the young feet in the family:

Dr. Richard Stanley

Buy for fit, not size: Don't assume that because your child has grown out of one size that he or she needs the next size in the new pair of shoes, Stanley says. “The biggest mistake I see people make is buying a size instead of fit,” he said, adding that sizing may vary from brand to brand or even within a brand. So, make sure your child tries on both shoes, and that the shoes fit both feet. If one foot is larger than the other, as is frequently the case, make sure that the shoes fit both feet.

Source: Shari Rudavsky, The Indianapolis Star [8/13/10]

Canadian Podiatrist Volunteers to Aid Pakistani Flood Victims

As many as 10 Toronto-area doctors are placing their lucrative practices on hold to help victims in flood-ravaged Pakistan. The physicians will join frontline doctors in Islamabad and other cities in treating people suffering from rashes, diarrhea, cholera and waterborne diseases. They leave for Pakistan in about three weeks and will remain there for about 10 days.

Dr. Shahnaz Dar

"We will be out in the field treating people who are suffering," said podiatrist Dr. Shahnaz Dar. "I can stay here and make a whole lot of money or go there and make a difference."

Source: Tom Godfrey, Toronto Sun [7/16/10]

OH Podiatrist Faces Criminal Charges After Leaving 38 Animals Home Alone

The city of Solon, OH confiscated three birds, a rabbit and 33 dogs, puppies, cats and guinea pigs from their home and had all but a parakeet euthanized because they had fleas. Steven Friedman, 58, a podiatrist, and his wife, Heidi, 48, who abandoned the animals in their feces-filled home face criminal charges, city prosecutor Frank Gasper said.

According to the police report, the Friedmans' neighbor called police Friday to say the couple and their three children had gone on vacation Aug. 2, leaving the house closed up and the air conditioner off. Temperatures were in the high 80s.

Source: Donna J. Miller, Cleveland Plain Dealer [8/17/10]

Americans Likelier to Cut Back on Healthcare

Americans are more inclined to shun medical care during an economic downturn than those living in countries with government-backed health systems, according to a study. Researchers from Dartmouth College, Princeton, and Harvard universities found that Americans reduced their use of routine care because of a loss of money or job by 26.5%—much more than their counterparts living in Canada, Great Britain, France, and Germany.

In Great Britain and Canada, citizens sought 5.6% and 7.6% less care, while those living in France and Germany reduced their doctor visits by 12% and 10.3%, respectively. All of those countries have some level of government-backed healthcare. “We find strong evidence that the economic crisis—manifested in job and wealth losses—has led to reductions in the use of routine medical care,” according to the study. The survey, conducted in June and July of 2009, included 2,148 participants in the U.S., 1,001 in Great Britain, 1,132 in Canada, 1,097 in France, and 1,107 in Germany. 

Source: Matthew DoBias, Modern Healthcare [8/17/10] 

Legal Costs are Lower Under Openness Policy: Study

Despite fears of ballooning numbers of malpractice suits, the University of Michigan Health System's full-disclosure and compensation program for medical errors has coincided with fewer claims and lower liability costs, according to a study published in the Annals of Internal Medicine. Researchers examined data from 1995 to 2007—UMHS instituted its full disclosure policy in 2001—and noted decreases in the average monthly rate of new compensation claims, the average monthly rate of lawsuits, and in the average monthly liability costs after the protocols were implemented.

The authors acknowledged that those decreases may not have been the direct result of the health system's claims management program. But, they said, the 61% drop in legal defense spending by UMHS in the period after the policy was put in place suggests that patients respond favorably to prompt disclosure of errors.

Source: Maureen McKinney, Modern Healtcare [8/18/10] 

Query: Painful Venous Conformation

A 35-year old healthy professional drummer presented to me with a uniquely painful superficial mass on the bottom of the foot at the level of the proximal central plantar fascia. He states that it has been present for about 3-4 years, but has become much more painful recently, to the point that he can't bear weight. An MRI was performed which showed "a venous conformation with prominent veins."

Painful Venous Conformation

Of note, an MRI performed three years ago for a different issue showed a much smaller "confluence" at the same area. An ultrasound was performed which was read as "slow flow and/or thrombosis with a superficial vein in subcutaneous fat." The patient has not responded to warm compresses, NSAIDs, or off-loading. I would like to know if anyone has any experience with this type of phenomenon, and what treatments would be appropriate.

Robert Fridman, DPM, New York, NY

Query: Obtaining Patients’ Forwarding Addresses and HIPAA

While I was on vacation, a patient of mine saw a covering doctor for an emergent heel spur. Subsequently, upon my return, I completed her treatment. The patient was billed and her bill was returned as "unable to forward." Apparently, she had moved, and my office staff had not updated her address. I know it is permissible under HIPAA for doctors to share medical information for a common patient, but would I be in violation if I called the covering doctor and asked for the address she gave when they registered her?

Bruce N. Block, DPM, Kew Gardens, NY 

Editor’s comment: PM News does not provide legal advice. HIPAA allows treating doctors to share a patient’s PHI. This would include the patient’s subsequent address.

RE: Beechstreet (Ron Werter, DPM)
From: Multiple Respondents

Multiplan is a malignancy. Despite severing my participation with it years ago, every once in a while, I'll get a frenzy of faxes trying to seduce me into signing for a quick payment (less deductible and co-payment, etc.). Once you sign, you're back in! Just say no! Beechstreet is a scam that insurance companies use to reduce your payments. "Your payment has been "adjusted" because you are a member of Beechstreet." My advice is to get out of both as fast as you can. (From what I recall, Multiplan doesn't make it easy, but persevere for sanity sake!)

Over the years, I have gradually reduced participation in many plans. Just last week, The Empire Plan hit the "chopping block"...$13.00 for an x-ray?  Really? When you open the mail and see an EOB that makes you use profanity...that's the first one to go!!  I promise, you won't be sorry.

Janis R. D'Angelo, DPM, Staten Island, NY, janis@si.rr.com

Managed plans will be bought and sold as long as Wall Street can make money.

Our office has functioned best by getting out of all plans that do not provide proper reimbursement. This decision must be carefully orchestrated and plans must be evaluated and re-evaluated on a timely basis.

The most effective tool is to check patients' benefits when they call to make appointments. The staff making the appointment can usually assess probable fees by the chief complaint. Benefits may be checked online or by telephone. The patient is then advised, before coming to the office, of the approximate amount that will be covered, and the amount that will not be covered. They are advised they are expected to pay their portion (deductable, etc.) the day of the service and to bring a credit card, cash, or check with them.

Pete Harvey, DPM, Wichita Falls, TX, pmh@wffeet.com

I have had this happen to me several times; the most recent was two weeks ago.  I have not been participating in Cigna for three years. My recent EOB on a Cigna patient said that the Galaxy healthcare rate had been applied. Galaxy healthcare bought out another company and they had on file my signature on a contract from 1996. I sent a letter of resignation to Galaxy, ASAP. You cannot win in this situation. You are not in the provider’s network, so you don't get patients from their website or book. You also don't get full out-of-network benefits. As you become aware of these companies who contract with the insurance companies, drop them as fast as you can. This is an insurance company scam to deprive you of the fees you deserve. 

Larry Cohen, DPM, Clinton, NJ larrydpm2002@yahoo.com

ASSOCIATE POSITION - SW FLORIDA

Golf, Boating and Beaches - Great opportunity to join a well established Podiatry Practice. Excellent mix office/surgery, motivated experienced staff. Seeking full time Associate PSR 12-36. Excellent salary & benefits, early buy-in for the right hard-working, personable candidate. Email resume to capecoralpodiatry@live.com or fax to 239-573-9201

ASSOCIATE POSITION - FREDERICK, MARYLAND

Fredericks premier group practice is located only 45 minutes from both DC and Baltimore. Immediate opening for a minimum PSR 36 Podiatrist for full time position. We have it all: EMR, digital x-ray, ultrasound, ASC, etc. Excellent salary with bonus structure and benefits. Please email resume to docsbnb@aol.com

PODIATRY POSITION AVAILABLE – WISCONSIN

Affinity Medical Group, an integrated health care organization in East Central Wisconsin, is seeking a BC/BE Podiatrist for our Appleton location. This is a General Podiatric practice opportunity including routine care, sports medicine, and surgery. The Appleton area offers a unique quality of life, combining a family centered, university community with all season recreation, a nationally acclaimed educational system, and a diverse and growing economy and population. For information, contact or send your CV, to: Sara Roth, Affinity Medical Group, Physician Recruitment, Phone: 800-722-9989; Fax: 920-727-4350; E-mail: sroth@affinityhealth.org Visit our website at: www.affinityhealth.org EOE.

IMMEDIATELY AVAILABLE- ASSOCIATE POSITION -CT (FAIRFIELD AND NORTH HAVEN)

Great opportunity. Join one of the largest podiatric groups in Connecticut. Well-established and progressive offices. Electronic medical records, digital x-ray, diagnostic ultrasound, Padnet vascular studies, nerve conduction studies, pinpoint and CO2 lasers, electrical stimulation and ultrasound therapies. Seeking a well-trained, personable, and highly motivated individual. Please send resume and current photo to dr.kassaris@yahoo.com

ASSOCIATE POSITION - MANHATTAN

Associate needed in Upper West Side area one day a week for house calls. Earn reasonable income with virtually no overhead. Immediate employment available. Call me ASAP 201-491-2173 or email myfootdoctor2@aol.com

FULL-TIME ASSOCIATE NEEDED FREDERICK/HAGERSTOWN, MARYLAND

Reconstructive Foot & Ankle Institute, LLC needs full-time DPM at least PMS 36 to join premier group in Frederick/Hagerstown, MD. ASC, EMR, DR-digital radiography and ultrasound, Vascular/nerve testing, DME, retail store, strong hospital affiliations, salary, bonus and benefits. Respond to drmichaels@rfainstitute.com

ASSOCIATE POSITION – NEW YORK

Busy, well-established for 35 years, multi-site practice in upstate New York looking for licensed podiatrist who is ready for a thriving practice. Must be highly motivated, personable and great with patients. Competitive salary and benefit package. Send CV or letter of interest to associateinfoot@yahoo.com or fax 607-723-1567.

ASSOCIATE POSITION – LONG ISLAND, NY

Associate full-time. Well-established, busy, well-rounded podiatry practice looking for a motivated podiatrist. Suffolk Co. LI NY. Board eligible, Board certified PSR-24/36 trained. Fax resume to 631-581-0857.

EQUIPMENT FOR SALE

2 PDM electric chairs- Philips Oralix x-ray on mobile stand-- x-ray processor-Wall lights & mobile OR light assorted cabinets -- All in excellent shape- Immediate discount available before all gets placed in storage! NY-Tri State area, just above Westchester County respond to podassociate@aol.com for prices.

FELLOWSHIP OPPORTUNITY - OHIO

UH Richmond Medical Center is announcing a Podiatry Fellowship: INFECTIOUS DISEASE/WOUND CARE. Accepting applications now for the one year (9/1/10 to 8/31/11) fellowship. Fax a letter of intent and CV to 440-585-6141 attention Donna Ayres. Applicants must have completed a PM&S 36 or equivalent. Interviews are scheduled 8/20/10. This fellowship includes all aspects of a multidisciplinary faculty and clinical opportunities in medical and surgical wound management. Weekly schedule includes surgery, fellow’s clinic time as well as journal club and one research project. The Fellowship has been approved with provisional status by the Council on Podiatric Medical Education.

PRACTICE FOR SALE – MASSACHUSETTS

Solo Practice Grossing over $700K yearly 4 days a week. Mostly surgical with heavy emphasis on peripheral nerve patients and pediatrics. General bread and butter podiatry as well. No Medicaid very little Medicare. Very modern office. 30 minutes north of Boston. Modern new equipment (digital x-ray, ultrasound, computer network, etc.). Great referral network. Website included. Option to buy the condo 3500sq ft. Have PICA practice evaluation to show you. Call 978-944-7789 for details.

TN PRACTICE FOR SALE (LAWRENCE COUNTY)

Active, established practice includes office building and property ( appraised at 110k) with all equipment and shelf stock included. Great referral network with an excellent scope of practice. Patients on schedule 1 day/ week grossed over 250k last year. 125k OBO Call 931-446-5724 or email mchad500@gmail.com for more information.

PRACTICE FOR SALE - DALLAS, TX

Prestigious North Dallas location; 24 year old practice; excellent mix of hospital surgery, office surgery, orthotics, general podiatry, web site, electronic claim submission. Retiring owner will stay for transition. Owner financing available. dallasfootdr@yahoo.com

MEDICAL SPACE AVAILABLE- MANHATTAN

Multispecialty Medical Building with 24/7 doorman. Prime Luxury Building and Location, Gramercy, Stuyvesant, Peter Cooper Area. 305 Second Avenue (17th-18th). Prior tenants past 23 years; podiatrist, dentist (plumbing/electric intact), internist. Ideal for podiatry, co-share with dentist, MD, etc. (flexible lease terms). E-Mail; jbdrun@aol.com Phone; 480-951-2480.

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