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PM News |
The Voice of Podiatrists
Serving Over 11,000 Podiatrists Daily
August 22, 2009 #3,629 Publisher-Barry Block, DPM, JD
A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 3009- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.
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Educate your patients about all your services! With The CaerVision Podiatry Network.
You perform surgeries and treat many conditions … but few patients know. Why not tell them while they wait? For only 30 cent/hour ($50/month)*, you can educate your patients on all the services you offer … AND get referrals. Grow your business with the most cost effective practice building tool – The CaerVision Podiatry Network. info@caervision.net or call us at 888-841-2237. Online: www.caervision.com *Internet and equipment required. (Mention Code #PMN0730)
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ANNUAL SURVEY NOW ONLINE - WIN VALUABLE PRIZES |
Congratulations to Chris Browning, DPM of Nederland, TX, winner of a copy of Foot and Ankle Radiology by Robert A. Christman, DPM (Value $230)
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.
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Insight Scale |
This week's prize is an Insight scale (Value $79.95).
This is also your opportunity to vote for the next DPM and Non-DPM inductees into the PM Podiatry Hall of Fame.
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PODIATRIST IN THE NEWS |
Flip-Flops/Sandals a Major Cause of Plantar Fasciitis: TX Podiatrist
Most flip-flops offer little to no support for the arch of the foot, and their lack of structure can cause long-term damage - some of which can require surgery. "Flip-flops will keep me in business for the rest of my career," said Dr. Damien Dauphinée, a podiatrist at Complete Foot and Ankle Care in Denton, TX.
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Dr. Damien Dauphinée |
"A lot of the time, plantar fasciitis occurs with women who wear sandals all the time," Dauphinée said. "There are sandals with arch support and if you have good foot structure then they're probably OK; but if you continue to wear them even after you start feeling pain, you're going to have problems."
Source: Heather Jackson, North Texas Daily [8/14/09]
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"…You are geniuses of shoe design. Your shoes have changed my life. For years I searched for shoes that would fit my wide toe area and narrow heel. As soon as I tried on Orthofeet it was love at first fit. At age 60 plus I can out-walk everyone I know, even those a third my age." Vivian Imperiale.
Improve your patients’ care, and at the same time, your profit center too:
Shoes - $42 to $52; Prefab Inserts - $8.95; Toe-Filler - $75.00;
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www.orthofeet.com 800-524-2845
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HEALTHCARE LEGISLATION |
Senate Negotiators Push Forward with Focus on Cost
A team of three Republicans and three Democrats on the Senate Finance Committee has made progress in talks on bipartisan healthcare reform, Committee Chairman Max Baucus (D-MT) announced. Baucus, along with ranking member Chuck Grassley (R-IA) and members Jeff Bingaman (D-NM), Kent Conrad (D-ND), Olympia Snowe (R-ME) and Mike Enzi (R-WY) participated in a teleconference to hammer out remaining differences on the path to reform and potentially avoid steps to push a bill forward without broad Republican support.
Discussions involved “an increased emphasis on affordability and reducing costs, and our efforts moving forward will reflect that focus," Baucus said in a written statement. "We have come a long way, will continue our work throughout August and plan to meet again before the Senate returns in September.”
Source: Jennifer Lubell, Modern Healthcare [8/21/09]
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PRACTICE MANAGEMENT TIP OF THE DAY |
Zip Your Lip When …
As a professional, you need to keep your cool at work, no matter what. And the best way to keep strong emotions such as anger under control is to keep your mouth closed just a little while. Waiting even a few seconds to respond can give you enough time to formulate a more measured response.
The next time you feel angry, buy some time to deliver a constructive response instead of a knee-jerk reaction. Say “Wow, I need to let that sink in, and then I will come and find you so that we can discuss it further” or “I don’t want to overreact to your statement. When I can focus again on our common goals, we need to talk about our plans.”
Source: Adapted from Coaching Made Easy, Mike Leibling and Robin Prior, Kogan Page via Communication Briefings
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QUERIES (NON-CLINICAL) |
Query: Faxed Requests from Pharmacies to Refill Prescriptions
Lately, my office has received an inordinate number of faxes from local pharmacies requesting prescription refills. We contact the patients to see if they initiated this request and most times they did not, and they do not need a refill. Needless to say, it takes time to process this information and to fax the pharmacy that the prescription is not to be refilled. Any idea as to why this is happening and what to do? The majority of these are prescription creams: anti-fungals, etc.
Richard A. Simmons, DPM, Rockledge, FL
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CODINGLINE CORNER |
Query: Orthotic Allowance Reduction
I recently received two EOBs from an insurance company reflecting a 60% reduction in the approved reimbursement for orthotics. These reductions follow a contract renewal year beginning July 1st. Do I have any recourse? The reimbursement now barely covers the lab fee, and certainly not the fee AND my time for follow-up and possible adjustments. I can't charge a cash fee for a covered service, so what do I do? Do I refuse to make them?
Neil Levin, DPM, Sycamore, IL
Response: If you have a contract with a payer, and that contract includes a foot orthotic benefit with fee schedule, you may be in serious violation of your contract if you "privately" bypass your agreement to balance bill the patient - even a willing patient - the differences between the fee schedule maximum allowance and your regular fees.
I would suggest you contact a healthcare attorney to review your contracts to see if you, as a participating provider, have an option allowing you to ignore the terms of your managed care contract or if your contracts permit you to balance bill patients.
If your contract does not permit you to balance bill or privately contract payments with patients, you can:
1) Write the prescription for the patient to get their DME elsewhere; or
2) Try to negotiate a better fee or balance billing clause; or
3) Terminate the contract; or
4) Dispense the custom foot orthotics at break even or at a loss (not really an option).
The thing you can't do is ignore your agreements. Trust me, even a willing patient will have a wife or son that will complain to the insurance company (Murphy's Law)...
Harry Goldsmith, DPM , Cerritos, CA
Codingline subscription information can be found at:
http://www.codingline.com/subscribe.htm
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CALL 1-877-270-3518 OR EMAIL INFO@DOXEMR.COM
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RESPONSES / COMMENTS (CLINICAL) |
RE: Protocol NaOH Matricectomy (Irwin S. Linker, DPM)
From: Multiple Respondents
I have been using the following protocol for chemical matrixectomies for over 27 years. I use 3 five-second application of 10% NaOH for partials; and for total nails, I use 4 to 5 five-second applications depending on matrix thickness and dystrophy. Flushing is with acetic acid (white vinegar), for approximately 10 seconds.
Angelo J. Bigelli, DPM, North Providence, RI toedocri@aol.com
After years of using phenol, I decided to try sodium hydroxide this year. After reviewing several protocols I settled on two ten second applications. The inflammatory reaction to sodium hydroxide is much greater than that of phenol. It absolutely must be neutralized with vinegar. I do not agree that healing time is quicker with sodium hydroxide. In fact I've noticed the opposite... healing time is longer!
Philbert Kuo, DPM, Chesapeake, VA, philbear@pol.net
I have used NaOH during my entire career of nearly 30 years. The strength is 10%. It is applied using a tourniquet to ensure a completely dry field. It is applied for 60 seconds using a small pointed q-tip. I blot away any excess immediately after application. It is flushed with plain vinegar. This flushes it out and chemically neutralizes the NaOH. The area is thoroughly curetted to remove coagulated tissue and cleaned. This is effective and safe.
While it is always possible to over or under treat, with experience, I believe you will find this method to be superior in time and results to the more frequently used phenol technique. Pain is generally mild. I almost never prescribe narcotic analgesics. I recommend very loose shoes or sandals for about 2 weeks to allow healing without shoe irritation. Results have been consistent and effective. Recurrence rate is very low. Infection rate is very low. I prefer gentle soap and water cleansing with flush using a syringe vs. soaking for care. This can be completed in less time with greater compliance and efficacy.
Timothy Bernard, DPM, Woodland, CA, tbdpm@aol.com
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The University of Texas Health Science Center at San Antonio
Reconstructive Foot and Ankle Surgery Fellowship
This fellowship is a one-year experience during which the Fellow will develop a rational approach to revisional and reconstructive foot and ankle surgery. The Fellow will function as a clinical instructor and participate in the teaching of Podiatric medical students and residents, and have ample opportunity to be involved in clinical and basic research projects. The fellowship will provide the candidate, further expertise in Charcot reconstruction, soft tissue coverage, trauma and deformity correction. The fellow is expected to complete two clinical or basic research projects during the year.
Duration: 1 year (July 1, 2010 - June 30, 2011) Deadline: November 20, 2009 Interviews: 12/1/2009 – 12/31/2009 Stipend: $44,100
Requirements: Completion of 3-year residency; a commitment to a part-time/full-time academic career in Podiatric Medicine and Surgery. Texas License eligible (Test date April 19, 2010, Application Deadline: February 19, 2010). ABPS Qualification eligible in Foot & Rearfoot / Ankle Surgery (Test dates TBD).
Application Deadline: February 19, 2010). ABPS Qualification eligible in Foot & Rearfoot / Ankle Surgery (Test dates TBD).
The University of Texas Health Science Center at San Antonio is an equal opportunity/affirmative action employer. All faculty appointments are designated as security sensitive positions.
Submit a CV and letter of interest to: Thomas Zgonis, DPM, FACFAS, Associate Professor & Chief, Division of Podiatric Medicine & Surgery, Director of Fellowship Programs, University of Texas Health Science Center At San Antonio, 7703 Floyd Curl Drive (MSC 7776) San Antonio, Texas 78229-3900, Email: Zgonis@uthscsa.edu Fax: (210)567-5153
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RESPONSES / COMMENTS (NEWS STORIES) |
Re: IME Doctor Liable Despite No Patient Relationship (Steven Solomon, DPM, JD)
From: Paul Kesselman, DPM
Does the New York decision discussed by Dr. Solomon mandate that the malpractice carriers in NYS, e.g. PICA, etc. are now obligated to cover us for professional liability resulting from allegations of injuries resulting from an IME? If so, what is the best method by which to inform PICA, etc. that they are now legally obligated to cover us (if they are)? What implications does this decision have for physicians practicing in other states? Will this adversely affect the premiums of those who conduct IME's and provide an advantage to those who do not?
Paul Kesselman, DPM, Woodside, NY, pkesselman@pol.net
Editor's comment: PM News does not provide legal advice. We posed this question to Jerry Brant, DPM of PICA who informed us that PICA covers incidents "according to state statute" and that as long as the area examined during the IME was within the scope of practice, it would likely be a covered incident. Brant stated, "PICA reserves the right to review any case, but in 30 years, PICA has never denied coverage for this type of case."
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MEETING NOTICES
• DESERT FOOT CONFERENCE 2009 •
6th Annual High Risk Diabetic Foot VA Conference
For podiatrists, nurses, wound care specialists - All welcomed
Weds, Nov 18 - Fri, Nov 20, 2009
The Buttes, a Marriott Hotel, in Tempe, AZ
14 hours state of the art CME from Frykberg, Armstrong, Robbins, Joseph, Wukich, Andersen, Halpern and more
Co-Chairmen • Robert Frykberg, DPM, MPH and Jeffrey Robbins, DPM
• Building interdisciplinary diabetic foot care teams • Improving self-management via educational interventions • Maintaining max functional potential after amputation • Review latest limb salvage research • Bring the family • programs for the kids • Escape your office routine to learn
Free for VA podiatrists, residents and other VA personnel. $150 for non VA podiatrists
LEARN MORE and REGISTER here or contact Nadine Taylor at 800-538-3375
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LEARN and EARN
• SUPERBONES 2010 Conference January 14-17, 2010 •
• Atlantis, Paradise Island, Nassau, Bahamas • 20 hours CME •
• Over 25 Featured Speakers including: Kalish, Steinberg, Zelen, Armstrong, Schoenhaus, Harkless, Jacobs, Block •
• Practical Skills Workshops • Medical and Surgical Advances in the Lower Extremity •
• Intense AM Learning Sessions •
• Join us for this dynamic and growing annual conference •
View FREE SAMPLE LECTURE from prior year’s Superbones program.
To register online, click here or phone 800.966.9056
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NEW ! ADVANCED PERIPHERAL NERVE 3 DAY WORKSHOP + SYMPOSIUM
Looking for something different for CME? Enhance your practice with peripheral nerve treatment.
September 23-27, 2009 - Omni Hotel, Ft. Worth, Texas
Sponsored by the Association of Extremity Nerve Surgeons.
Up to 37 ACCME Credits provided by approved provider New Hampshire Medical Society.
Includes:
Sept. 23- 25 = 3 day Hands-On Advanced Workshop with cadaver, didactic and live surgery (5 spaces left)
Sept. 25-27 = Annual Symposium with graft/ conduit lab, lectures, legal & research updates, round tables.
Location: 30 minutes from DFW airport in the heart of historic downtown & stockyards.
Go to www.aens.us to download brochure or call 512-494-1125 info@aens.us
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CLASSIFIED ADS |
WANTED – ASSOCIATE POSITION – CHICAGO, IL
Hard working and Ethical Podiatric Surgeon looking for Associate/Partnership position in the Chicagoland area. Please contact A773K@aol.com or cell phone (713) 992-6113.
ASSOCIATE POSITION - DALLAS/FORT WORTH AREA
Seeking well-trained ABPS board certified/qualified foot surgeon for surgical practice with national foot/hand/orthopedic surgery group. Excellent salary/benefits. E-mail CV and cover letter to: slb99@pdq.net
ASSOCIATE POSITION - CHICAGO AREA
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 – NORTH CAROLINA
Very busy practice in Western North Carolina, seeking Full-time Associate with hospital and surgical training. If interested please fax resume to 828-252-2272 or e-mail to mfas828@aol.com
EQIPMENT FOR SALE - ORTHOTIC FABRICATION SYSTEM
Amfit Orthotic Insole Fabrication System with Footfax SL Contact digitizer- For Sale Machine, Laptop, rolling bag, small inventory of shoes, insoles, all cords, parts and hardware Asking $10k.OBO! Please contact Jeff at Jhunt@psbank.net for further information, pictures.
WANTED: PRACTICE TO PURCHASE IN BERGEN COUNTY NJ
DPM interested in purchasing a practice in NNJ. If you are considering selling/retiring/slowing down etc let's talk and come to a mutually beneficial arrangement. Open to all situations/options. Contact: AdvancedFtCare@aol.com for quick deal.
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
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 - 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
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
PM News Classified Ads Reach over 11,500 DPM's and Students
Whether you have used equipment to sell or our offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 11,500 DPM's. Write to bblock@podiatrym.com or call (718) 897-9700 for details. THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451 Ext 110
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Disclaimers |
Acceptance and publication by this newsletter of an advertisement, news story, or letter does not imply endorsement or approval by Barry Block or Kane Communications of the company, product, content or ideas expressed in this newsletter. Podiatric Medical News does not represent the views, and is a separate entity from Podiatry Management Magazine and Podiatry Management Online. Any information pertaining to legal matters should not be considered to be legal advice, which can only be obtained via individual consultation with an attorney. Information about Medicare billing should be confirmed with your State CAC.
THIS MESSAGE IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR
ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS
PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE.
If the reader of this message is not the intended recipient or an
employee or agent responsible for delivering the message to the
intended recipient, you are hereby notified that any dissemination,
distribution, or copying of this communication is strictly
prohibited. If you have received this communication in error, please
immediately notify me and you are hereby instructed to delete all
electronic copies and destroy all printed copies.
DISCLAIMER: Internet communications cannot be guaranteed to be
either timely or free of viruses.
| Guidelines |
- To Post a message, send it to: bblock@podiatrym.com
- Notes should be original and may not be submitted to
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permission.
- Notes must be in the following form:
RE: (Topic)
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Body of letter. Be concise. Limit to 250 words or less). Use
Spellchecker
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- Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.
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