August 24, 2006 #2,671 Editor-Barry Block, DPM, JD

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Education is Key to Prevention of Diabetic Foot Ulcers: Caporusso

Diabetic foot trauma has a wider reach than the Rio Grande Valley, said Joseph Caporusso, a McAllen podiatrist who also sits on the American Podiatric Medial Association Board of Trustees. Around the country, higher rates of diabetic complications exist in areas with higher percentages of minorities, he said. That spells trouble locally, as Hispanic-Americans run a high risk of developing the disease.

“People are not educated as much about diabetes and foot problems (in the Valley),” Caporusso said. “It becomes a problem that we pound on every day, what to do and what not to do, but sometimes it’s difficult to get that across.”

For patients with advanced diabetes, several conditions and ailments can develop over the years. The first of these disorders is peripheral arterial disease (PAD), or, put simply, bad circulation. Diabetics who don’t watch their diets, and even those who do, sometimes develop clogged or blocked arteries, which means blood has difficulty reaching the body’s extremities. The effect is like watering your garden with a knotted garden hose, Caporusso said. Without sufficient amounts of blood, parts of your body’s tissue die, leading to infection. The infections appear as open, infected sores called foot ulcers, which appear on the tops, bottoms or sides of feet.

Source: Kate Lohnes, The Monitor (TX) [8/21/06}

OH Podiatrist to Cycle Across Desert For Diabetic Kids

Doctor Irvin Lewin is going to bicycle across Death Valley to help kids with diabetes, two in particular, Molly and Ben. On Oct. 20, Lewin will join 22 other cyclists from Cincinnati and 300 from around the country in the Juvenile Diabetes Research Foundation (JDRF) Ride to Cure Diabetes. The ride is a grueling, one-day, 105-mile cycling challenge across the arduous terrain of Death Valley, CA. The riders' goal is to raise research money for a cure for Type 1 diabetes, the disease that affects more than 1,300,000 Americans.

Dr. Irvin Lewin with Ben Holub

Lewin is a Cincinnati podiatrist who daily treats the neurological and circulatory side-effects to the feet and legs caused by Type 1 diabetes (formerly called Juvenile Diabetes). He is also a long-distance cyclist who is using the intersection of his profession and his hobby to fulfill his charitable pursuits.

Source: Kathy Coogan, The Cincinnati Post, [8/22/06]

Federal Push For IT, Transparency Gets More Steam

President Bush signed an executive order today requiring HHS, three other federal agencies and their contractors to use interoperable health information technology and standard quality measures and to be more transparent about healthcare prices, the White House said. At deadline, a copy of the order wasn't available. Meanwhile, the CMS said it has posted on its Web site Medicare payment rates and facility costs for 61 procedures performed in ambulatory surgery centers. The CMS also said it is expanding the scope of a six-state pilot project to provide consumers as well as public programs with better cost and quality information. Final contracts for the project, announced in February, are being finalized.

Speaking to business leaders about the government's IT initiative this morning, HHS Secretary Mike Leavitt said he is asking the nation's largest employers to impose the same interoperability and transparency standards on healthcare companies with which they contract. "It's very important that the federal government isn't the only one doing this," Leavitt said. The executive order will apply to HHS, the Defense and Veterans Affairs departments and the U.S. Office of Personnel Management. –

Source: Matthew DoBias, Modern Healthcare [8/22/06]

Query: Non CPME- Approved Fellowship

Is a podiatrist allowed to be a fellow in a program that is Accreditation Council for Continuing Medical Education (ACCME) and/or Accreditation Council for Graduate Medical Education ACGME accredited and not Council on Podiatric Medical Education (CPME)? I have been offered a fellowship with these certifications which would be similar to a residency program and require me to go outside the podiatric scope of practice while being supervised.

Kyle Hoogendoorn, DPM, Westerville, OH, kyle_dpm@yahoo.com

Editor’s comment: PM News does not provide legal advice. There is no rule that prevents a podiatrist from participating in any fellowship, regardless of accreditation. The key issue is what you intend to use the training for. For example, CPME-approved residencies are the generally accepted pathways for board certification. So if that if you end goal, you would be wise to inquire to the board as to whether your training would be accepted for certification purposes.

Query: E/M Services - Hospital to Office

I was asked to consult on August 16, 2006 by a primary care physician on a patient in the hospital with a fractured metatarsal. I rendered my opinion and made suggestions on the patient's care. The patient was discharged, and the primary care physician referred the patient to my office for treatment on August 18, 2006.

How should the second encounter, this time in the office, be coded: as a new or established visit?

Bruce Freedman, DPM, Richlands, VA

Response: I would bill the hospital encounter as a consult E/M service, and I would bill the subsequent visit (office) as an established E/M encounter, not an initial visit. This determination is based on whether you have evaluated this patient or not and does not relate to place of service.

Tony Poggio, DPM, Alameda, CA

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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 - 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

SEEKING ASSOCIATE POSITION - NEW YORK

Hardworking, ethical and well trained PSR-24 trained podiatrist seeking a part-time associate position in Westchester county or surrounding areas. Please contact (206) 919-2832 or bbrick2@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

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