The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

August 29, 2012 #4,551 Publisher-Barry Block, DPM, JD

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End of Summer Foot Problems Need Treatment: IL Podiatrist

If you’ve developed warts on your soles, hard calluses on your heels, or a fungus under your toenails from a summer spent wearing flip-flops and sandals or going barefoot in public places, you should take steps to relieve these painful pressure points. And do it before it’s time to switch to heavier and more restrictive shoes and boots.

Dr. Ada Paolucci

That’s the advice of Dr. Ada Paolucci, president of the Illinois Podiatric Medical Association. “Most of these conditions will respond to over-the-counter medications. But some of these sore spots such as callused heels that crack and develop deep fissures that become infected can be especially dangerous for people with diabetes or compromised immune systems,” she said.

Source: Jean Guarino, Chicago Sun Times [8/28/12]

WI Discusses Prevention of Children's Sports Injury

"A potential negative of sports is the possibility of injury. Your child can minimize that small risk by remembering to stretch and do warm-up exercises before beginning the activity. Warming up helps loosen muscles and prevents injuries in athletes of all ages. In addition, it’s extremely important to wear the correct shoes for the sport and to choose shoes that are sport-specific," says podiatrist Dr. Amy Jaeger.

Dr. Amy Jaeger

"Every child matures physically at his or her own rate and has a different degree of athletic ability. No amount of training can improve a child’s natural athletic ability, but training helps improve coordination and, therefore, performance. Parents should encourage their children to participate in sports, but never forget that competition should be fun," says Jaeger.

Source: Wisconsin Rapids Tribune [8/27/12]

Multidisciplinary Team Could Reduce Amputations: Aussie Podiatrist

The number of lower limb amputations in Australian diabetes patients with foot disease could be halved with better access to multidisciplinary foot team services, podiatry experts say. About a third of the 10,000 annual hospital admissions for diabetes-related foot ulcers result in amputation, representing a 30% rise over the past decade, according to a recent article in the Medical Journal of Australia.

Pete Lazzarini

Lead author of the published Brisbane study, Pete Lazzarini, senior research fellow at the School of Clinical Sciences, Queensland University of Technology, said feet were a “forgotten area” of diabetes. “We believe the number of amputations could fall by 50% if there were 10 times the existing 20 multidisciplinary foot teams in the country. However, the majority of these strategies have been based in tertiary hospital settings, rather than community settings where the majority of people with diabetic foot complications present.

Source: Neil Bramwell, The Observer [8/28/12]

Lower Walking Speed May Mean Arthritis: UK Podiatrist

Do you zip to the shops faster than Road Runner? It’s a sign your body is functioning well, says Dr. Tony Redmond, academic podiatrist at the University of Leeds and senior research fellow at Arthritis UK. "Someone who is young, fit and healthy will, on average, walk between 1.2 and 1.4 metres per second."

Dr. Tony Redmond

"But even if you have relatively mild arthritis or other aches and pains, walking speed will start to fall off. Those with arthritis tend to be below one meter a second, or if very bad, 50cm a second."

Source: Anna Hodgekiss, Daily Mail [8/28/12]

Query: Hammertoe Pain in a Smoker

A 50 year old active female presented to the office two months ago with a chief complaint of a painful callus beneath her 5th metatarsal head. She stated that she had surgery on it in 2009, but "it never improved it, but made it worse." Urea 40 cream and a gel metatarsal sleeve were prescribed on the first visit with mild relief. She has palpable pulses, CFT within normal limits. She is a pack-a-day smoker. Clinically, the right 5th digit is in a fixed contracted position with a diffuse callus noted submetatarsal 5th right foot. Radiographically, the 5th MTPJ is dislocated dorsally.

A-P X-Ray

She is interested in surgical intervention, so I told her she would have to dramatically decrease or quit smoking for at least 6 weeks to increase the likelihood of unremarkable healing after surgery. I think an arthroplasty with extensor tenotomy/lengthening with MTPJ capsulotomy would work. I'm against a metatarsal head resection, but considered a Weil. What are your thoughts?

Phillip Graham, DPM,  NY, NY

Query: Checking Medicare Pending Claims
 
Our office would like to know what other doctors and billing managers are now using to find out what is pending to be paid concerning Medicare claims. There used to be an 800 number that one could call to find out this information, but Medicare has discontinued that service. Any ideas or alternatives as to how to find this information would be appreciated.
 
Margaret Portela, DPM, Union City, NJ

Query: Bullying in Podiatry School?

I read an interesting article in the NY Times: The Bullying Culture of Medical School. I wonder how that relates to our current students in podiatry school. Back when I was in school (30 years ago), I remember a few teachers/clinicians who took pleasure in unnecessarily torturing the students - trying as hard as possible to increase our stress levels for no apparent reason. However, most professors and clinicians were  nice and helped us to succeed. How are things today in the school? Do any current students care to comment? Keep it anonymous - no names of teachers.

Name Withheld (NY)

Query: Coding a Second Opinion

Can anyone tell me what the correct CPT code would be for a second opinion performed in our office?

Joseph Fanara, DPM, Rockford, IL

Response: The CPT 9927x series of confirmatory consultation codes (for second and third opinions) were deleted from CPT in 2006.

You will need to use the appropriate outpatient E/M code (CPT 9920x) or E/M consultation code (CPT 9924x) depending on what type of service you provided, and who initiated the request for the service - the patient or another physician.

Paul Kinberg, DPM, Dallas, TX

Codingline subscription information can be found here
APMA Members: Click here for your free Codingline Silver subscription

RE: Recurring Forefoot Pain in a Cyclist (Mark Aldrich, DPM)
From: Jon Purdy, DPM

My guess is pressure-induced sciatica from the seat, not the cleat.  Have him go for a leisurely bike ride without putting significant pressure on the pedals. If the same thing happens, there is your answer. 

Jon Purdy, DPM, New Iberia, LA, jpurdy@mindspring.com

RE: Compensation in a Wound Care Center (Ed Dosremedios, DPM)
From: Phil Organ, DPM

At a hospital wound center, one can be a salaried employee or an independent contractor. The independent contractor bills for services just like in private practice and indicates the hospital center as the place of service. If the podiatrist is salaried, the hospital bills and collects all fees. As for HBO - the physician can bill for monitoring the dive, but the diagnosis for the dive would have to be in scope.

Phil Organ, DPM, Naples, FL, Philorgan@gmail.com

RE: Prospects for US Trained Podiatrist in the UK
From: Andrew Franklin

As an English citizen, I knew that when I began a new career path in podiatry here in the United States, it would mean a real commitment to this country - a commitment I am more than happy to embrace. However, now as a third-year student at KSUCPM and as my future as a podiatrist appears more attainable, I have become very interested in my additional prospects within the profession back in the UK. I would love to speak to anyone who has trained in the States and has then gone on to practice or indeed has any occupational role and/or professional links within the UK.

Andrew Franklin, Cleveland, OH, afrankl9@kent.edu 

RE: When Realitiy First Hits Home 

Source: Submitted by Dr. Joseph Borreggine

PRACTICE FOR SALE - BALTIMORE, MARYLAND

Established 40+ year old well-rounded practice of both surgical and non-surgical care with special emphasis on sports medicine. Medicare and BS/private insurance base, no Medical assistance. Needs to transition to a confident well trained individual. Purchase can include building. Contact: podiatrypracticesale@gmail.com

PRACTICE FOR SALE - NEW YORK

Located in New York, Capital District (Albany, Schenectady, Troy). Grossing 500k+ consistently with less than 10% surgery. 100% EHR Compliant and steady growth. Great opportunity for a doctor or doctors. Will help in the transition process, long-term lease is available. Please email serious inquiries to: PodiatristDoctor@gmail.com

PRACTICE FOR SALE - NEW ROCHELLE, NY

Flexible terms. Stable location, medical co-op, 24 year practice with a stable established patient base. Great opportunity for a self motivated podiatrist wanting immediate income and future stability. Call 551-574-0776 for details.

SPACE AVAILABLE - NYC & LI

Office to sublet and share - East 60th Manhattan, and Plainview, Long Island. access to an MRI, Joint Commission certified operating rooms, digital x-ray, diagnostic ultrasound, and access to a multi-specialty ambulatory surgical center. Also availability E 22nd between 2nd and 3rd and E 70th off 3rd. Turn-key operation - no investment needed PODO2345@AOL.COM 516 476-1815

ASSOCIATE POSITION - SOUTHERN CALIFORNIA

A busy practice with three offices in Huntington Park, Ontario and San Bernardino is looking to expand and bring on a part-time or full-time podiatrist. Spanish speaking is helpful, but not imperative. For full-time position, a six figured starting salary with benefits and bonuses is offered. Primarily office work. NO NURSING HOMES, HOWEVER! If interested, please send CV to scpodgroup@gmail.com

ASSOCIATE POSITION - LOWER HUDSON VALLEY, NY

Full-time associate position in well-established multi-office practice. Modern facilities, fully equipped with fluoroscopy, ultrasound, digital x-rays, and vascular testing. Great salary. Must have flexibility with schedule and be comfortable with all aspects of foot care. Fax CV to (919) 435-6091.

ASSOCIATE POSITION - KANSAS CITY

Kansas City may be the perfect move for you and your family. I am looking for an entrepreneurial minded associate who wants to grow and then own part of an already successful practice. If you are the right candidate for this associate position, you will enjoy a competitive compensation package and you will be working with a doctor who is as committed to your success as he is to his own. Go to: www.YourFutureInPodiatry.com for full details.

ASSOCIATE POSITION – NEW YORK
 
Great opportunity to share “state-of-the-art” offices and equipment in mid-town Manhattan and White Plains with Board Certified podiatrist. Out-of-network or participating providers welcome. Please call 212-704-4310 for additional information and fax your CV to 212-704-4311

ASSOCIATE POSITION - NASSAU COUNTY, NEW YORK

Exciting Opportunity! Associate position. Must be Board Qualified. Joining all Board Certified Doctors in foot surgery and reconstructive rear-foot and ankle surgery. Respond to: Podiatryoffice@doctor.com

ASSOCIATE POSITION - NORTHERN, NJ

Part-time or-full time. This position can and will lead to purchase of practice if so desired. Well-equipped modern office. Digital x-ray, ultrasound, etc. Individual must be well-trained and be ABPS Qualified/Certified. Must be competent in general foot care and be able to do routine foot surgery without help. Call: 201-986-1900.

ASSOCIATE POSITION - CHARLOTTE, NC

Charlotte, NC practice with excellent reputation and patient base seeks to hire a podiatric surgeon. Looking for an associate with partnership potential to join our team serving 5 offices located in Charlotte metro area. Please send resume to Charpodiatry@gmail.com.

ASSOCIATE POSITION - OHIO

Ohio practice with excellent reputation and patient base seeks to hire a Podiatric Surgeon. The offices are state of the art including Digital X-Ray, EMR, Diagnostic ultrasound, Padnet Vascular Testing, CO-2 Lasers all aspects of DME. The base salary is $120,000 with a bonus structure and benefits also would like to have this individual buy into the practice eventually. Please send CV to: Ohiopodiatrist@aol.com

ASSOCIATE POSITION – NORTHERN CALIFORNIA/BAY AREA

We’re looking for someone entrepreneurial who can help grow our practice. Must have great people skills, clinical/surgical skills, and positive demeanor. California license required. Send your CV and cover letter to cvpodiatrist@gmail.com

ASSOCIATE POSITION - NEW YORK CITY & QUEENS

High Income Potential. One of the fastest growing podiatry practices in New York City and Queens seeks a hard-working podiatrist who participates with HealthFirst, Fidelis, and other Medicaid plans. Contact me at: podocare123@gmail.com

ASSOCIATE POSITION – NEW YORK

Great opportunity to share “state-of-the-art” offices and equipment in mid-town Manhattan and White Plains with Board Certified podiatrist. Out-of-network or participating providers welcome. Please call 212-704-4310 for additional information and fax your CV to 212-704-4311 or email to: ifanelli.hms@verizon.net.

ASSOCIATE POSITION - NORTHWEST IOWA

A well-established, midwest multi-physician practice with strong hospital affiliations seeking FT podiatrist. Applicant should be well trained surgical physician, completed a 12/24 month residency, & board eligible. Practice offers high surgical volume, advanced wound care and good mix of general podiatry. Competitive salary, excellent benefits. Fax resume: 712-258-9977. 

ASSOCIATE POSITION - SACRAMENTO, CA

Associate position available immediately. Full or Part time. Opportunity for buy-in and full partnership. Full scope of practice with hospital and surgical privileges available. Please call 310.854.0203 or fax 916.732.2280.

EQUIPMENT FOR SALE: MIDMARK MODEL 646 PODIATRY CHAIR

This blue chair is in excellent condition. Purchased only 14 months ago. Foot pedal is included. Pictures upon request. This chair sells new for around $5,200 (retails for $7,500) Asking $2,900. Seller to pay shipping or local pick-up. Jack Ressler DPM Lauderhill, FL.  (954) 650-8637 redwingcrzy@aol.com

EQUIPMENT FOR SALE

Retiring from practice. Equipment For sale. Mini x-ray. One year old Ultrasound with MS arterial/venous X-ray plates. Great condition Ritter chairs. Drills, surgical tools. So much. Just ask, I probably have it: Footcare@comcast.net

EQUIPMENT FOR SALE - PINPOINTE LASER

PinPointe Laser for sale. All accessories included. In service since 2008. Service policy in place, fully transferable. $35,000. tatarb@verizon.net.

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