The Voice of Podiatrists

Serving Over 14,601 Podiatrists Daily

August 21, 2013 #4,854 Publisher-Barry Block, DPM, JD

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Simple Acts Can Save Feet of Diabetics: FL Podiatrist

When a person suffers from diabetes, the chance of developing foot problems increases, which makes visiting podiatrists such as Dr. Brandi Johnson, of Tampa, FL more important than ever before. "The feet are the area of the body that are most commonly prone to injury and infection if a person suffers from diabetes. Diabetic foot complications are usually the result of neuropathy, poor circulation, and a lower resistance to infection," says Johnson.

Dr. Brandi Johnson

"Some of the simplest acts can save a person's feet from damage. From shaking out your shoes and feeling inside them before wearing, to never walking barefoot or not smoking, it is important for people with diabetes to take every precaution available to ensure their health," said Dr. Johnson.

Two NYCPM Students Win Awards at AACA 2013 Meeting

A research poster created by two NYCPM students, Rene M. Kafka and Ian L. Aveytua, both Class of 2015, was recently presented at the American Association of Clinical Anatomists (AACA) 2013 meeting in Denver, CO. Ms. Kafka was the first author and Mr. Aveytua the second author. The poster, entitled “The Bifurcate Ligament of the Foot: An Anatomic, Histologic and Radiographic Study”, was presented the Sandy C. Marks, Jr. Student Poster Presentation Award for best clinical sciences research poster. 

Rene Kafka, NYCPM Class of 2015, presents poster she co-authored with Ian Aveytua.

Each poster is independently judged by three clinical anatomists, and then the mean scores are calculated. Judging criteria included the research design of the study, clinical implications, poster-design layout, and most importantly, the ability of the presenter to explain the science in a clear and logical manner, answer questions, and stay within a strict, 5-minute timeframe. The competition for the award is tough, and medical students from both within and outside the U.S. participate. The NYCPM group recently learned that it had received a grant to continue this study through the American Podiatric Medical Students’ Association.

UK Podiatrists Can Now Prescribe Drugs

The UK will now allow physiotherapists and podiatrists to prescribe drugs to their patients. New laws that come into force tomorrow mean trained practitioners will be able to give their patients medication such as painkillers and anti-inflammatories. Experts say that the "landmark" initiative will speed up patients' treatment and will also free up time for GPs. Under the new legislation, the "advanced practitioners" will no longer have to refer their patients back to another healthcare worker - such as a GP - if medication is needed.

Joanna Brown, chief executive of the College of Podiatry, said: "The new legislation will provide patients with more prompt and better access to treatment, helping to integrate care and reduce the pressure on other healthcare professionals. "Podiatrists play a key role in the management of conditions such as diabetes, arthritis of the foot and ankle, and dermatological conditions of the feet. The ability to independently prescribe will particularly benefit patients in these areas."

Source: Daily Record [8/19/13]

I am one of the 2013 graduates who unfortunately did not match due to the residency shortage. The last couple of months have been difficult, but I will never give up, and believe that by continuing to work hard, I will be successful in obtaining a residency program. I have been growing my knowledge and skills by attending multiple academic conferences and didactic sessions.

Dr. Vu Nguyen

I graduated from the University of California Irvine with a bachelor of science in biology, and Western University College of Podiatric Medicine. I have done multiple medical and non-medical research projects throughout the years. I am efficient and professional, as I have earned honors in many of my medical rotations. My philosophy for success includes the trio of patience, persistence, and perspiration. If given an opportunity, I am confident that my personal and professional values combined with my academic and clinical skills will make me an excellent addition to your residency program.

Vu Nguyen, DPM, Santa Ana, CA, vunguyen0107@yahoo.com

FL Podiatry Couple Balance Practice and Family

Finding time to be good parents and good doctors can be challenging. But Drs. Tim Henne and Michele McGowan are quite adept at juggling parental demands, bustling careers, and busy schedules. They also have three children: Lily,8; Abigail 7; and Emma, 2. "Tim and I make a good team, and he's the best teammate I've ever had," Dr. McGowan says.

Drs. Michele McGowan and Tim Henne

The couple met while attending medical school at Des Moines University. They married in 2000, and two years later, they opened the Center for Ankle and Foot Care in Clermont. For them, there has never been anything awkward about being business partners. "We still make it a point to have breakfast and dinner with the kids," Dr. Henne says.

Source: Style Magazine [August 2013] 

VA Podiatrist Offers Bike Safety Tips

If you do decide to ride your bike, always make sure your are practicing bike safety. Dr. Marc Platt, a Carilion Clinic podiatrist and avid cyclist shares some bike safety tips. "First and foremost, always wear a helmet and stay in the right hand lane (or bike lane, if there is one). Use hand signals when you do make a turn, and give plenty of notice because cars are going a lot faster than you are," says Platt.

Dr. Marc Platt

"Take some form of identification, take a cell phone, and have some sort of reflectors on the front and back of your bicycle," says Dr. Platt.

Source: Carillion Clinic Living

Query: Dermal Fillers
 
I am aware that more and more of our colleagues are using dermal fillers for everything from ball of foot pain to hammertoe "cushioning." I am curious as to results and patient satisfaction. Does anyone know if these fillers can be ordered by a DPM in New York, or if only an MD or DO can order them? 
 
Roger Hans, DPM, Queens, NY

Query: Code for Non-Covered Dispensed Products?

There seems to be discussion about an obligation to bill insurance, even when office supplies/products are not covered and the patient has been made aware of this. For example, I dispense Formula 3 and other antifungals (as well as other products) in my office. I make the patient aware that this/these items will not be covered by insurance (until now verbally). Do I really need to do something like an ABN for this? I will bill insurance anyway (currently using CPT 99070 [supplies and materials provided by the physician] with my current description in Medisoft listed as "non-included supplies").

Recently, I have been getting some insurance EOBs assigning a value (obviously arbitrarily based on my CPT description just mentioned) at less than what it costs me for the product. I have, until now, just been ignoring these because of their idiotic value assignments, since they have no basis in fact. What is the proper code to bill for non-covered products like this/these?

Ronald Van Vliet, DPM, Sugar Land, TX

Response: You must check with each payer/plan as they each have different rules/regulations as to whether you must submit the claim and whether the patient needs to sign an ABN. Some, such as UnitedHealthcare, actually announced they would be releasing their own ABN form.

As for general comments on Formula 3, which is an OTC product: These types of products are generally not covered by insurance carriers. However, the patient's health savings account (HSA) may reimburse for them. In general, I suggest that you continue to bill using CPT 99070 (supplies and materials provided by the physician), but add the NDC when billing OTC medications.

Paul Kesselman, DPM, Woodside, NY

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RE: Diagnostic Ultrasound (Michael Forman, DPM)
From: Neil H Hecht, DPM

The injections I give to the foot and ankle were taught to me without ultrasound because it didn’t exist during my training. While therefore anecdotal, it would seem that my technical competence is validated by the results of these injections. Local digital blocks and PT blocks yield obvious and verifiable anesthesia and vasomotor changes. Calcaneal nerve branch blocks yield heel anesthesia prior to “heel spur” injections. When done without branch blocks, medial approach and occasional plantar approach heel injections of corticosteroid/local combinations yield immediate pain relief from the field block and reported relief of plantar fasciitis of approximately 60-90%, on average, at most one week follow-up appointments. Intra-articular injections yield immediate verifiable results as well with relief of joint pain on the post-injection exam within minutes. Extra-articular injections such as anterior talo-fibular ligament or neuroma injections seem to be similar with virtually immediate pain relief on post-injection examination.
 
Casual discussions with peers reveal similar information. Perhaps this is because my peers have also been taught without the assistance of ultrasound guidance. Some of my peers do use ultrasound for diagnostic assistance and/or verification. I am curious if the training today, or in recent years, includes and/or mandates the use of ultrasound for injection guidance. Also, what do the podiatrists do in the operating room if they rely on ultrasound guidance in the office? I have not seen ultrasound imaging apparatus in any of the hospitals in which I perform surgery.
 
Neil H Hecht, DPM, Tarzana, CA, drhecht@drneilhecht.com

RE: Unmatched Graduate of the Day
From: Michael J. Schneider, DPM

Kudos to PM News for putting faces and personal stories/requests on this site with regard to the unmatched graduates. I believe that it will strike at the hearts of all podiatrists who read the stories and makes a solution to this issue more urgent than ever. Thank you.

Michael J. Schneider, DPM, Denver, CO, podiatristoncall@gmail.com

RE: Vet Charged With Treating Human; Patient Loses Toes
From: Robert Kornfeld, DPM

I don't see what's so wrong here. They call feet dogs, don't they?

Robert Kornfeld, DPM, Manhasset, NY, Holfoot153@aol.com

RE: Outrageous Shoe of The Day

The latest in Steel-Toed Shoes?

Source: Submitted by  Dr. Joseph Borreggine

BUSINESS FOR SALE - TOE-FOOD CHOCOLATES & CANDY

Toe-Food Chocolates & Candy (www.toefood.com ) is an established candy company specializing in creative foot-themed chocolates that has supported the podiatric community for over 30 years. Ideal opportunity for family member to run in house. Serious inquiries only please. Email:   MwolpaFootDoc@yahoo.com

ASSOCIATE POSITION - FLORIDA

Great opportunity for PSR- 24/36 BE/BC podiatrist with strong surgical skills to join multi-office practice. Hospital privileges available at 648 bed hospital system, 200 bed hospital system and multiple surgical centers. Florida has a great scope of practice law and we rotate for ER call at all 4 hospitals. Candidate needs to be ethical and motivated. Established practitioner or new practitioner OK. Base salary, percentage, benefits including 401K. Fax CV to (239)566-8778 or Email CV to Drgordon@gulfcoastfootcare.com.

ASSOCIATE POSITION - NYC and QUEENS, NY

We need a podiatrist (recent grads. welcome) for participation in NYC and Astoria Queens to learn and treat fungal nails with PinPointe laser. Perfect to pick up money in your spare time. Please respond to hansfeet@aol.com.

ASSOCIATE POSITION - CENTRAL FLORIDA

Associate position for busy practice in Central Florida. Competitive salary with complete benefit package available. Please send resume to cmedders@atlanticpodiatry.com

ASSOCIATE POSITION - CALIFORNIA

Associate wanted for multi-office, multi-doctor practice. Full Time, Self-motivated, highly skilled team player with surgical, wound care and palliative skills. Offices in Northern California Coast, CA License necessary, salary negotiable with possibility of partnership in future. Send CV and letter to:srfctysc@gmail.com

 ASSOCIATE POSITION - SOUTHEAST MICHIGAN (MI LICENSE REQUIRED)

Seeking a quality-oriented, patient-focused PSR trained associate for a fast paced, established group practice in Southeast Michigan. This is a secure, long-term position. Emphasis on diabetic foot and wound care.  Our outstanding staff allows you to concentrate on optimal patient care without the responsibilities of practice management. Partnership possibility for the right individual. If you are highly motivated, ethical and have good communication and clinical skill, please forward CV to:cfsdr@yahoo.com

ASSOCIATE POSITION - CENTRAL PA

Looking for an associate with 3-year surgical residency. The physician will provide all aspects of podiatric practice, including sports medicine, wound care, and foot and ankle surgery. Competitive compensation package. Partnership opportunity for right person. To apply, please email, letter of intent and CV to stringernyc@hotmail.com

ASSOCIATE NEEDED FULL TIME- MIAMI/DADE & BROWARD COUNTY FLORIDA

All phases podiatry, from major ankle surgery to routine care. Must take ER call. Salary plus benefits. Send CV to; footdoctormiami@gmail.com

ASSOCIATE POSITION - CENTRAL FLORIDA

Busy two doctor practice seeking the help of an ambitious associate to help handle the patient load. Position will lead to partnership for the right individual. Two office practice with hospital, surgery center and wound care center privileges. Good mix of surgery, wound care and general podiatry. Great salary with incentives, benefits, malpractice. Must have FL license. Suburban setting, close to attractions. Please send cover letter, CV and copy of surgical log to;  footpainbegone@gmail.com.

ASSOCIATE POSITION - DAYTON, OHIO

Join an established group practice in Dayton, Ohio excellent reputation, large referral base.  Base Salary$120,000, benefits and bonus structure. EMR;diagnostic ultrasound; Padnet; CO2 and Cutera Laser for nails, all aspects of DME. We need well trained personable PSR24/36 surgeon. Future Buy-in available. Please send CV to Ohiomedical@aol.com

ASSOCIATE POSITION - NYC METRO AREA

Must participate with HealthFirst, Affinity, Fidelis health plans (2 of 3 OK). Preferably on staff at Bronx or Manhattan hospitals or surgicenters. Excellent opportunity for quick partnership. email CV torrranch7@yahoo.com

ASSOCIATE POSITION - CONNECTICUT

Looking for an associate with 3-year residency training for a practice in Connecticut. Interested in all aspects of podiatry including  foot/ankle surgery and wound care. Hospital located close by with appointment to staff readily available. Will lead to partnership Please send CV to:dsharnoff@hotmail.com

EQUIPMENT FOR SALE - Q-CLEAR LASER (USED)

 The first high performance, portable, and truly affordable Dual Wavelength Q-Switched Nd:YAG Laser System for treating onychomycosis, tattoos, pigmented lesions, vascular lesions, leg & facial veins, skin resurfacing and other dermatological conditions. Price: $29,000 Email info@footsurgeon.com for inquiries.

EQUIPMENT FOR SALE - DIOWAVE 15 WATT, PORTABLE 980 LASER

This is a used multiple function laser, plantar fasciitis, Achilles tendonitis, joint pain. nerve pain, post surgical, warts, toenail  problems, two-year plus warranty, MSRP: $25,000. E mail Dr. Zuckerman at: footcare@comcast.net for questions and pricing.

EQUIPMENT FOR SALE - Q-CLEAR LASER

Brand new Light Age Q-Clear laser. This is a very unique one time opportunity. Recent special purchase permits sale of only a few units at the largest discount available. Rapid return on investment. Complete system with warranty and expert training included. Contact Dr. Holfinger at 216-390-9757.

PRACTICE FOR SALE - CONNECTICUT

Well-established, 35-year-old reputable practice/condo with approx 2,500 Square ft. Grossing approximately $450,000. Outside Hartford area. All phases of podiatry. Contact drsch52@hotmail.com

PRACTICE FOR SALE - MAINE

30 year, full service practice in Bangor, Maine. Cooperative and appreciative patients. A wonderful community to practice in and recreate during your free time. Owner is semi-retired, now ready to fully retire but will stay for transition. mainefootdoc@yahoo.com.

PRACTICE FOR SALE - QUEENS, NY

37 year practice.  7 years left on lease (transferable) - includes utilities. High traffic location, right near subway.  Selling practice as-is. 3 treatment rooms with chairs and x-ray equipment. Looking for quick sale. Price negotiable. Contact josh.block@gmail.com

PRACTICE FOR SALE - HUNTINGTON PARK, CA

46 years same location. Unsurpassed visibility on corner of major intersection. 3 fully equipped treatment rooms. Perfect opportunity to build a strong practice. Must retire due to age. Selling price $30,000 firm. (323) 588-1179 MTWF. evaonofre@hotmail.com

PRACTICE FOR SALE - SOUTHWEST FL

Multilocation multidoctor practice in beautiful Southwest Florida . Practice has grossed over seven figures consistently and currently shows 10-15% growth in revenues with increase in new patients and patient visits. EHR is already implemented with meaningful use criteria met. Practice has been professionally evaluated by Provider Resources. Only serious inquiries to this email address. This is a great practice in Paradise and a good opportunity for the right doctor or doctors. Email to:practiceforsaleswfla@gmail.com

PRACTICE FOR SALE - STAMFORD, CONNECTICUT

Well rounded general and surgical podiatry practice in beautiful Stamford, CT. 35 years. Walk to the hospital and OR. $350k gross / 4 days per week. May lease present office space. Super office manager. Practice offered @ $100k. jefre1@msn.com

ATTRACTIVE OPPORTUNITY IN NORTHERN CALIFORNIA

30 year old practice for sale, furnished office, hospital and physician referrals. Seeking conscientious, well trained DPM with wound care experience. Submit CV to dr.jeanturner@yahoo.com

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