The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

August 20, 2009 #3,627 Publisher-Barry Block, DPM, JD

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Congratulations to Jacqeline Chen, DPM of Waynesville, MO, winner of a TempTouch® Value $99.99)..

We encourage you to participate in this important survey at www.podiatrym.com/survey Completing this anonymous survey provides us with valuable data, which we will publish in the February 2010 issue of PM. It also makes you eligible to win thousands of dollars of valuable prizes. Enter by sending Question #43 (no answer necessary) to bblock@podiatrym.com along with your name and address.

Foot and Ankle Radiology

This week's prize is a copy of Foot and Ankle Radiology by Robert A. Christman, DPM  (Value $230) .

This is also your opportunity to vote for the next DPM and Non-DPM inductees into the PM Podiatry Hall of Fame. 

TX Podiatrist Warns of Flip-Flop Dangers

They're so easy, convenient, and comfortable, plus they're just fun to wear! However, disease could be right on your heels when you are wearing flip flops. "You tend to have to crunch your toes up more and when you crunch your toes up for extended periods of time, it creates a deformity called a hammertoe, which eventually will need surgical correction," said podiatrist Dr. Clint Warren.

Dr. Clint Warren

Warren said there's about the same amount of bacteria in flip-flops as closed toed shoes, but because your feet are out in the open, you are more susceptible to infection. "Drying of the skin, fissuring around the skin is what I typically see around the heels," Warren explained. "What people don't realize is that it dries the skin out because you don't wear an enclosed shoe that keeps it warm and moist."

Source: Holley Nees, KLTV [8/18/09]

APMA Corrects Obama's Misstatement on Foot Amputation Costs

According to a study published in 2007 in The Journal of the American Podiatric Medical Association (JAPMA), the overall estimated cost of a lower-leg amputation can range from $30,000 to $40,000, which includes fees for hospital stays, medical specialists, post-operative care, and physician reimbursement. While making a case for healthcare reform last week, President Obama inaccurately attributed that cost solely to physician reimbursement. The actual physician reimbursement fee for a leg or foot amputation, on average, is far less; and according to Medicare ranges from nearly $750 to close to $1,000.

Dr. Ronald Jensen

The JAPMA article cites that the actual physician reimbursement for the amputation is a small fraction of the projected $12 billion price tag paid by the nation's healthcare system to cover overall costs of treating lower-leg amputations annually. "When a patient's foot or leg has to be amputated, it usually means all other treatment options have been exhausted," said APMA President Ronald D. Jensen, DPM. "Nothing is more devastating than performing an amputation, knowing that perhaps it could have been prevented."

Studies have shown that as many as 85 percent of non-traumatic, diabetic leg and foot amputations could have been prevented with early detection and treatment. Podiatrists are an integral part of a diabetes management team, and regular preventive foot and ankle care by podiatrists for people with and at risk for the disease translates into fewer amputations.

Source: WESQ.com [8/18/09]
 

Physicians Seeking Licensing Increasingly Find a Standard Application

More state medical boards are adopting a uniform application as a way to simplify the licensing process, particularly for physicians seeking licenses in more than one state.

Seventeen medical boards are either using the standard licensing application or are in the process of adopting it, according to the Federation of State Medical Boards. The federation developed the form as part of its license portability demonstration project, which is funded by a grant from the federal Office of the Advancement of Telehealth.

Part of the project's goal is to cut licensing paperwork that needs to be filed by physicians who move frequently or treat patients in several states, said Lisa Robin, FSMB senior vice president of member services. Doctors may train as a resident in one state and get a fellowship in another, and a license is needed in each state, she said.

Source: Susan J. Landers, AMNews [8/17/09]

Query: Employee Background Check

I want to check up on a new potential employee before I offer her a job. Do you have any advice on how to best obtain background information including credit, criminal and civil activity? I was hoping that there was an online or national service that could run this kind of check with minimal effort and expense.
 
Mark Lambert, DPM, Pensacola, FL
 

RE: Patient With Foot/Ankle Swelling (Theresa Hughes, DPM)
From: Stanton C. Southward, DPM

I would advise more time and compression, e.g., knee-high support socks and/or an elastic adjustable ankle wrap and daily foot soaks. Be sure to rule out DVT and a stress fracture. Also, consider an injection of Celestone Soluspan, pending her  progress.

Stanton C. Southward, DPM, Colorado Springs, CO,  sbsouthie@comcast.net

RE: User-Friendly EMR (Judith E. Rubin, DPM)
From: Marc Garfield, DPM

If you have not heard the terms SQL, MySQL, ASP, SaaS, HL7, X-Link/Middleware, PQRI, Surescripts Gold, batch eligibility, claim scrubbing, and billing module vs. practice management module, then you are not yet ready to make an EMR decision. Making a decision just on charting ease might lead you to neglect important features such as e-prescribing, order sets, check out, patient instructions, claim scrubbing, code capture, and chart review. 

Establish your billing and PM software before making (or with) the EMR decision. Then, review The American Academy of Family Practitioners yearly user’s surveys and KLAS rankings.

Although, the final requirements for Hi-tech are not out yet, CCHIT seems to be the likely baseline and products that have CCHIT now, will be most likely to adapt to upcoming changes. Consider a site visit with some of the more popular products such as eMDs and eClinical Works, and download the freebees such as Amazing chart’s 3-month trial and Practice Fusion ad-supported EMR to see what might go with your workflow before making a decision.  
 
Marc Garfield, DPM, Williamsburg, VA, mgarfield1@cox.net
 

RE: Care Credit
From: Dan Klein, DPM

I believe that this is used by many dental offices, especially if there is going to be a lot of money involved to fix teeth e.g., root canals, crowns amounting to thousands of dollars. Care credit allows you to pay for this over the course of one year without any interest applied as long as you pay off the bill in one year. The dental office pays a fee to the GE credit company for this service and the dental office gets their money up front. This is good for cash flow and not a bad way to go for the patient to avoid interest on a large bill. In essence, it's a promissory note to GE Credit, signed by the patient.
 
Dan Klein, DPM, Fort Smith, AR, toefixer@aol.com
 

RE: IME Doctor Liable Despite No Patient Relationship
From: Steven N. Solomon, DPM, JD

This issue has been recently addressed by the Court of Appeals in New York (the state's highest court). In the case before the Court, the plaintiff claimed to have been injured during an IME examination. They needed to decide if this alleged injury fell under medical malpractice or a general personal injury action. If a medical malpractice action, the plaintiff would have 2 1/2 years to start a law suit, however, if the incident was a general personal injury action, the plaintiff would have 3 years to start a law suit. The plaintiff argued that there was no doctor- patient relationship so as to get the additional 6 months, while the doctor claimed that there was a limited doctor relationship.  In a 4-3 decision, the court ruled that there is a limited doctor-patient relationship which means that any lawsuit needs to be started within 2 1/2 years. To read the full decision, click here.

Steven N. Solomon, DPM, JD, New York, NY, legalfoot@yahoo.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.

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

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.

ASSOCIATE POSITION - FREDERICK, MD

Well-established and growing 2 office state-of-the-art practice located in medical/professional buildings. EMR, Digital X-ray, Ultrasound, DME provider, etc. Competitive Base Salary plus bonus, malpractice, health insurance, etc. PSR 24 minimum/Board Qualified or Certified with ability and desire to take ER call. If interested, forward CV to DOCSBNB@aol.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

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 – SOUTH CENTRAL FLORIDA

Multiple offices, in Jupiter, Ft Pierce. Looking for associate who is surgically trained PSR24, willing to travel between offices. Competitive Salary base plus percentage. Position available immediately. Send CV and questions to alfootdoctor@yahoo.com

ASSOCIATE POSITION - MARYLAND

Full time, hard-working, happy and personable Foot Surgeon needed for busy and growing practice in Frederick and Hagerstown Maryland. PM&S-36 or more required. We have a well-rounded, high tech practice with all types of pathology encountered in our two offices and in two local hospitals as well as our on-site accredited and certified ASC. Very competitive compensation. Please send your CV to drmichaels@rfainstitute.com

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

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

ASSOCIATE POSITION - BOSTON, MA

Associate wanted, Full-time or part-time, for busy long time, well established, and well-rounded practice. Good mix of general podiatry and surgery. Office will generate approximately 100+ surgical cases per year. Must have surgical background, ABPS Qualified minimum needed to obtain hospital privileges. Associate position is open for partnership or purchase. Contact robert.nunberg@comcast.net

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