The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

September 03, 2011 #4,250 Publisher-Barry Block, DPM, JD

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Congratulations to Joseph Park, DPM of Burbank CA, winner of a two-night stay at the Pala Mesa Resort, including 2 rounds of golf (value $640.00).  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 2012 issue of Podiatry Management. It also makes you eligible to win thousands of dollars of valuable prizes. Enter by sending Question #43 (no answer is necessary) to bblock@podiatrym.com along with your name and address.

The Greenbrier, White Sulphur Springs, WV

This week's prize is a free registration to the 2012 Greenbrier Coding & Practice Management Workshop to be held August 20-22, 2012 (following the APMA Annual Meeting). This workshop is brought to you by Codingline and PM News in conjunction with the American Academy of Podiatric Practice Management  (Value $395).  

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

Charcot Foot Can be Successfully Treated in Early Stages: CA Podiatrist

An article in the September issue of the journal, Diabetes Care, describes Charcot foot and its treatment with a goal of educating medical professionals about this painful inflammation of the foot. The article is the product of an international task force of experts convened by the American Diabetes Association and the American Podiatric Medical Association in January to summarize available evidence on the pathophysiology, natural history, presentations, and treatment recommendations for Charcot foot syndrome. 

Dr. Lee C. Rogers

"Even though it was first described in 1883, the diagnosis and successful treatment of Charcot foot continue to be a challenge because this syndrome is not widely known or understood by the broader medical profession," said Lee C. Rogers, DPM, co-director of the Amputation Prevention Center at Valley Presbyterian Hospital in Van Nuys, CA, and lead author of the Diabetes Care article. "Charcot foot is now considered to be an inflammatory syndrome most often seen in patients with diabetes which can be successfully treated in its early stages."

Source: CNBC.com [9/1/11]

AZ Podiatrist Recommends Barefoot Exercising in Gym (Except for Pronators)

The latest craze is barefoot exercising in the gym. Some podiatrists even recommend it. "As we exercise barefoot, this allows us to stimulate the small muscles of the foot, called the intrinsics, which are vital for good function and to help prevent injury," says Dr. Thomas Hale.

Dr. Thomas Hale

Barefoot workouts, however, are not for everyone, says Hale. "People who pronate excessively could have problems, and should wear a supportive shoe."

Source: Kristen Anderson, KSAZ- Fox-TV [8/31/11]

Nearly All Physicians Must Revalidate Medicare Enrollment by 2013

Roughly 750,000 physicians in the Medicare program soon will be asked to revalidate their individual enrollment records during a massive anti-fraud effort required by the health system reform law. The Centers for Medicare & Medicaid Services hopes to weed out only the people who shouldn't have billing privileges, but physicians are concerned that legitimate health professionals could get caught up in the enrollment sweep by mistake.
 
CMS gradually will send revalidation requests by mail to more than 1.4 million health professionals -- more than half of whom are doctors -- between now and March 23, 2013, the agency announced on Aug. 10. Physicians who have enrolled since March 25, 2011, will not be required to revalidate, because their applications were scrutinized under new screening criteria, CMS said.

Source: Charles Fiegl, AMNews [8/29/11]

Alleged Lack of Informed Consent (NY)

Facts: On March 27, 2007, plaintiff Deene Kiefert, 64, a retired hospital records clerk, underwent podiatric surgery during which procedures were performed on two toes of her left foot. Kiefert later sued her operating podiatrist, Defendant, arguing that one of the procedures - a big-toe bunionectomy that involved removing the digit's joint - had left her in constant pain. Kiefert contended that Defendant had not properly informed her of the potential side-effects of the procedure prior to operating.

Kiefert, who had a history of bunion problems on the big toe of her left foot, claimed she...

Result: Verdict-Defendant Award Total: $0

Plaintiff's expert: Alfred A. Garofalo, DPM New York, NY

Defendant's expert : Mr. Gregory A. McNally; Handwriting Analysis; Spring Lake, NJ Thomas DeLauro, DPM; New York, NY

Editor's note: The full version of this jury verdict reporter can be read here.

Remove Yourself

Avoid sounding egotistical and self-centered when speaking to a group. Nix these three words: I, me, and my. Talk about your listeners, not yourself. Example: Instead of saying “I’m going to teach you,” say “Today you will learn …”

The exception: when you are taking responsibility, whether for something good or bad. Use first-person pronouns to emphasize that you are
accountable for the outcome.

Source: Adapted from “Executives Using Pronouns,” EMS Communications, Speaker’s Digest via Communication Briefings

Query: Revision for Repair of Hallux Varus

I recently performed revision of a right first metatarsal-phalangeal joint hemi-implant for post-operative hallux varus.

The revision consisted of removal of the hemi-implant, removal of additional bone from the base of the hallux to improve alignment (I did not remodel the 1st metatarsal head), and insertion of a new implant. I also did a lateral soft tissue tightening via a second incision made into the dorsal first web space. How should this be coded?

PM News Subscriber

Response: I would use the unlisted code, CPT 28899, for this procedure.

In my opinion, swapping out an implant with remodeling of the proximal phalangeal base would not qualify CPT 28293 (especially since you specified that you did not remodel the first metatarsal bone).

Tony Poggio, DPM, Alameda, CA

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

RE: Help Flood Victims
From: Paul Scollo, DPM

My town of Fairfield, NJ has been devastated by flooding from the Passaic River post-hurricane Irene. My family and I miraculously were untouched by the flooding. I usually run a highly successful sock drive for the homeless at holiday time. I am a member of a flood prevention committee in Fairfield. I got the idea to run a drive for waterproof rubber boots - Chest waders, hipwaders,knee-high rubber boots for those displaced by the flooding.

Many of my friends, neighbors, and patients had to leave their homes with the approaching waters. Some home foundations cracked due to water pressure and the word spread quickly that evacuees must open their windows to allow water into their homes to assure that the pressure was equalized. What a horrible thought that you had to allow caramel-colored riverwater into your home in order to save it!

I am in the process of acquiring gift cards from Dick's Sporting Goods, Cabela's, Sports Authority, etc. that I intend to give to people so they may purchase these boots. It is easier and cheaper than shipping boots, hip waders and chest waders to a central location for distribution. I encourage My fellow podiatrists to form a grassroots movement in their own flood ravaged communities to help those in need.

Paul Scollo, DPM, Fairfield, NJ, pscollo@aol.com

RE: Medicare Proposes No Podiatric Coverage For Pneumatic Compression Therapy (Allen Jacobs, DPM, Lloyd Smith, DPM)
From: Bret M. Ribotsky, DPM

After reading the comments on this problem from Dr. Jacobs and Dr. Smith, it seems that we are always playing catch-up to each of these federal programs. After decades of APMA's involvement in dealing with federal programs, it begs the question, "why are DPM's often left out or not included is some programs while no programs seem to be developed just for DPMs?"

What do we need to do to begin working on the result and stop focusing on the problem? We need everyone's suggestions. Can the DPM degree achieve the respect and the clout needed as we move forward into the future of healthcare delivery? This question has been asked to almost all the guests on Meet the Masters for over two years, but the answers differ widely. If our best of the best cannot agree on an answer, how can the federal government?

I suggest that we collectivity start working on the result we want or we will never get ahead and be dammed to always fight for inclusion. As APMA approaches100 years, the time is NOW to develop a consensus on what we want for the next decade.

Bret M. Ribotsky, DPM, Boca Raton, FL, ribotsky@yahoo.com

RE: Outrageous Shoe of the Day

Reverse Heel Shoes

Source: Submitted by Lloyd Nesbitt, DPM

SUB LEASING TIME on MRI (NYC)

.31 tesla extremity MRI in state-of-the-art midtown Manhattan office location. Lease time on magnet in compliance with the Stark laws. This magnet is the only one that will be accepted by Medicare and all other insurance as of 2012. Why not bill out for your own MRI's??? Email today dri@myfcny.com

EQUIPMENT FOR SALE - CLASS FOUR LASER

I have a class four pain laser for sale. Used for plantar fasciitis, Achilles tendonitis, neuroma, arthritic conditions and even fungus toe nails This laser is portable, re-chargable and can be move from room to room or office to office. This isn't the cold laser that you see. It is a 10 watt laser. We have used this laser on NFL sports players. For those that understand a good laser. E-mail David Zuckerman, DPM for Details and pricing. footcare@comcast.net

PRACTICE FOR SALE - NORTHERN NJ

Well established, part-time practice is for sale in Northern NJ. Digital X-rays, EMR, located in a medical condo building. Surgery 35%, Routine 30%, Average Gross is $130K on 2 half days per week. Asking $100K. Real estate available for purchase. Please call 800-983-4194, or  e-mail contactus@podiatrypracticeconsultants.com

PRACTICE FOR SALE - ARKANSAS

Busy, well established practice of 13 years grosses 160K/year for the past 5 years, while working 3.5 days/week. Nursing homes available. 50% Medicare, average of 15 new patients/week. Doctor retiring. Please call 800-983-4194 for more details, or  e-mail  contactus@podiatrypracticeconsultants.com

PRACTICE FOR SALE - SOUTHERN OH

Busy, well-established, full-time home visit practice. 100% referral-based. Wound care, pain management, routine care & DME’s. Excellent income, low overhead. DPM relocating out-of-state for family. Contact:  nanetter@zoomtown.com

PRACTICE FOR SALE - BOSTON AREA

8 miles north of Boston with sublease available in a modern medical building. Presently working 3 days/week, grossing $300,00 annually with easy potential for full-time. All office and podiatric equipment, instruments, digital x ray, furniture, etc. are included. Turn-key operation. Please e mail footdoc71@aol.com or call 781 279-2332.

ASSOCIATE POSITION - NORTH OF BOSTON

Seeking part-time podiatrist for both office and nursing home work. North Andover, MA (North of Boston) Could lead to possible partnership for the right person. jmclaughlin19@yahoo.com

ASSOCIATE POSITION - EAST TENNESSEE

30 year old practice with 5 offices in greater Knoxville area seeking ethical, personable, hardworking, team player. Extremely competitive base salary with bonus incentives and benefits. Knoxville is consistently ranked in top 5 places in U.S. Post-residency experience a plus. Please send resume to ddavidphawk@yahoo.com 

ASSOCIATE POSITION - SOUTH CENTRAL PA
 
Martin Foot and Ankle, largest provider of foot and ankle care in South Central Pennsylvania, is seeking a full-time associate interested in future partnership. Practice facilities and technologies include: Surgical Center, in-office Physical Therapy, six appointment locations, in-office MRI, digital x-ray, PSSD and PVR testing, diagnostic ultrasound, and Electronic Medical Records. We are looking to hire candidates with a minimum of a three-year surgical residency. Experience in rear foot and forefoot reconstruction, including complex nerve releases of the foot and leg, Charcot arthropathy, and arthrodesis is helpful.  E-mail CV to mfatrans@aol.com.

ASSOCIATE POSITION - OKLAHOMA

Looking for OK licensed podiatrist to take over half of a million dollar/year practice in Central Oklahoma. Transition for full takeover by Jan 1, 2012.  Will interview in OKC Saturday Sept 3rd and in Tulsa , Saturday, Sept 10th. Great opportunity. Call (918) 931-1425.

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. Preferably a Spanish-speaking podiatrist. Contact me at Podocare@aol.com

ASSOCIATE POSITION – IOWA CITY AREA

Established podiatric clinic looking for an associate to join our team, 4 offices located around the greater Seattle, WA area. Great base salary, benefits and friendly work environment. Please send resume to seattlefootdoctor@yahoo.com

ASSOCIATE NEEDED - SO. CAL

Position open for podiatry associate in Southern California. Applicant must be highly motivated and available for long term employment. This practice is extremely busy and requires a hard work ethic and desire to practice in a group practice environment. Excellent salary and benefit package offered. Please e-mail resume to footcare4all@aol.com

ASSOCIATE POSITION - NE GEORGIA

Immediate opening in established practice for PSR-36 or experienced doctor who is ABPS qualified or certified. Hosp./ASC privileges available. Excellent opportunity for partnership or purchase of practice. Contact dpm1942@hushmail.com

OFFICE TO SHARE - NYC (GRAMERCY)

Perfect for doctor looking to expand or to begin own practice. Terms are flexible. Beautiful, new fully supplied 1000 sq. foot. Two treatment rooms, lab, office and a large reception area. All equipment and X-ray on site.  Office is fully wired. Confidentiality upheld.  Please email: footpfc55@yahoo.com for further information.

SPACE AVAILABLE- NYC & LI

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