The Voice of Podiatrists

September 05, 2006 #2,681 Editor-Barry Block, DPM, JD

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NY Podiatrist Organizes Community Compliance Watch

Tired of leaning fences, untamed weeds and broken-down buildings around town. "The Watchful Eyes," a group of business owners in the Village of Monticello and the Town of Thompson, have organized an unusual neighborhood watch. They're prodding local governments to toughen building codes, strictly enforce violations and revamp outdated laws. And they're set to patrol the area, identifying eyesores and trouble spots over the next few weeks.

Dr. Marc Hudes

"I certainly am not proud of this community, and I dare anybody to get up and say that they are," said Dr. Marc Hudes, the podiatrist who organized the group, at a meeting in his office this week. "We've had years and years of non-compliance, lack of code enforcement."

Joining Hudes are an electrician, an ice cream store owner, a wholesaler, two dentists (one retired), a retired rug importer and some politicians.

Source: Simon Shifrin, Times-Herald Record [9/2/06]

CT Podiatrist Introduces Scouts to Model Airplanes

"We decided to bring some scouts for a fly-in," said Carmen Luciano, club president. Introducing youth to the model planes helps assure a future for the hobby and is also a form of community service for the club, he said. Luciano is a podiatrist and got in touch with the scouts through one of his patients.

Luciano got involved in RC planes as a father and son activity 11 years ago. He and his then 11-year-old son got an Avistar trainer and learned to fly it. "He learned to fly in three months, but it took me a year," said Luciano.

Now his son is grown and living in Florida. However, Luciano is more involved with the hobby than ever. As an editor for "Model Airplane News," he has a chance to assemble new airplane models before they hit the market and evaluate them for the readers. His collection includes about 10 craft. The largest is a 1/5th scale WWII Corsair, and the smallest is a tiny electric-powered plane.

Source: Jon Wason, Huntington Herald [8/31/06]

NJ Podiatrist Asks for Change in Venue

Ronald Sollitto, the podiatrist charged with manipulating an elderly Spring Lake widow into leaving him her fortune, has requested his criminal trial be conducted outside Monmouth County, where a poll indicates many potential jurors already have formed opinions on the case.

Citing the "extensive coverage" by the Asbury Park Press of the civil battle between Sollitto and the Spring Lake First Aid Squad over the multimillion-dollar estate of Madeleine Stockdale, Sollitto's attorney has asked for a venue change "to protect Dr. Sollitto's Sixth Amendment right to a fair trial by an impartial jury."

Sollitto, 55, was indicted in November 2004 and charged with nine criminal counts, including the second-degree counts of conspiracy to commit theft by deception and theft by deception. Other charges include forgery, record-tampering and neglect of an elderly person. A lesser charge was dismissed in May. If convicted of all charges, Sollitto would face a potential combined prison sentence of 45 years and fines totaling $400,000.

Source: Bob Cullinane, Asbury Park Press [9/2/06]

Query: Available Malpractice Carriers

I am going back in practice after a few years off and would like to see which carriers are available.

Maurice R. Gardner, DPM, MGar444392@aol.com, Lewiston, ME

Editor’s comment: PM News does not provide legal advice. Each state has its own rules as to which companies are admitted carriers. It’s a good idea to sign up with an admitted carrier because in the event the company goes belly-up, the state will generally pick up the coverage.

We suggest that you contact the Maine Podiatric Medical Association for a list of admitted carriers.

RE: Sclerosing Injection Protocol (Teresa J. Burtoft, DPM)
From: G. Dock Dockery, DPM, Elliot Udell, DPM

It is my opinion that the 4% alcohol chemical neurolysis injections may be repeated in a case like that described by Dr. Burtoft. However, first one should try to decide why the injections did not fully work the first time. Was the diagnosis correct? Was the injection series performed in such a manner as to relieve 100% of the original symptoms, or were there still some symptoms remaining after the first set of injections was performed? Were the injections performed proximal to the neuroma site or were they performed into the neuroma? Were the injections given close enough together and of sufficient numbers the first time?

By making sure that the injections contain a minimum concentration of 4% ethyl alcohol; the volume consists of a minimum of 0.5-cc of the solution; the injection is performed deep enough and proximal to the point of maximum tenderness; the injections are spaced from 5 to 10 days apart; and that up to 7 (or more) weekly injections are performed, then the results should be better.

I have several patients over the last 25 years that have undergone 3 or 4 series of injections. I usually wait at least 3 months between injection series before starting another and each time I expect better results than the last time. I always recommend stopping the treatment program if there are no signs of improvement and if there are any complications noted.

G. Dock Dockery, DPM, Seattle, WA, gdockdockery@aol.com

I have patients who come back from time to time for additional sclerosing injections. Some come back every 3 months for an injection. Others come every six months and some have not come back since I initially treated them. Every case is different I have had tremendous success with Dr Dockery's treatment protocol for neuromas and intend to keep this as a major part of my armamentarium for treatment of interdigital neuromas.

Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: Time For EMR? (James M. Petko, DPM, David E. Gurvis, DPM)
From: Larry Kosova, DPM

To answer both of you I think the time for an EMR is now! Many doctors have successfully added this technology into their offices whether a small one doctor office or a 15-doctor office with multiple locations. With the Hl7 interfaces most programs can "talk" to each other. For paper you can scan in lab reports, patient reports or those from other doctors into the patient accounts. The speed and ease of these systems is really great.

If you look into the August Podiatry Management, I am quoted about saying that you need to pick separate systems (like separate billing and EMR) and have them "linked" together to work with each other. I find these systems work better than the "all-in-one "systems since the billing portion might be great, but the EMR system might not be.

Also you should be able to "customize" your templates in the advanced programs. I would stay away from systems which you personally can not change the templates to.

Larry Kosova, DPM, Chicago, IL, lkosova@yahoo.com

RE: Time to Drop Out of Insurance Plans (Bob Kornfeld, DPM)
From: Samuel S. Mendicino, DPM

Regardless of how much we vent, how many people will actually resign from a major plan? In the age where we must depend on referring physicians we have to keep it simple or risk losing referrals. Those who send us patients don’t want to think about I’ll send Sam patients from this plan and Dr. Jones referrals from this plan. They search for one doctor who is competent who can see them all. This is why we still participate in lower paying plans including Medicaid. I’ll admit there are some who only refer those patients in poor paying plans to me and send the others to the local orthopedist.

The real problem is the disparity in payment. Most plans have a separate fee schedule for DPMs and DCs. These fees are significantly lower than MDs/DOs for the same service. This is not just for surgery but for office visits, and x-rays. I have colleagues who believe this is illegal and doesn’t exist. Unless your state has equal pay legislation it is permissible. Then you are sent a fee schedule and you either sign it or refuse to be in the plan. Negotiation works but you never get to the MD schedule. If we have equal pay then we benefit from the efforts of the larger MD/DO organizations when they fight to increase reimbursements. We need equal pay legislation nationally or we need to finally listen to Dr. Block and progress to a MD/DO degree.

Samuel S. Mendicino, DPM, Houston, TX, DrSMendo@aol.com

"Something is dreadfully wrong with this Picture" as quoted by Dr. Bob Kornfeld is an understatement. In the eight short years I have been practicing in this grand profession, I have watched reimbursements spiral downward to pitiful levels. I am sure it is not over yet. I find this ridiculous and cannot imagine what practitioners practicing longer than I must be thinking.

Over the last 3 years I have been quietly muttering to myself "I should've become a dentist." We have been duped by the divide and conquer technique of the insurance companies started in the mid 90's. A combination of fear and greed has gotten us physicians (DPM & MD alike) into our current quagmire. Dentists however, were either initially not included in the original plan of insurance companies, or managed to stick together and watch what happened to their allopathic partners. Several years later, dentists still enjoy practicing with minimal exposure to insurance plan shell games.

I asked my dentist if he still increases his rates every year. He looked at me, rather confused at my query, and said "well yeah, and patients pay it every year." I told him that our practice has not increased rates in 10 years. He exclaimed "What?". They come in to see their dentist with check or credit card in hand. Nobody pulls out an insurance card and states "if it’s not covered by my plan, I don't want it," What a wonderful concept!

We as DPM's need to somehow turn back the hands of time and oust these insurance companies from our practice. No one provides the type of quality foot care that we do. We either band together or hope for socialized healthcare as the answer.

Jose' M. Concha, DPM, St. Augustine, FL, fungus@pol.net

ASSOCIATE POSITION – NEW ENGLAND

Opportunity in growing New England practice. Well established and respected practice with large office and surgicenter, latest technology, great staff, loyal patients and solid referral base. Close proximity to hospitals, full scope practice. Opportunity for partnership. Prefer 24 month PSR with clinical practice experience or an experienced doctor looking to improve their situation. E-mail CV and contact info to: footdoc@usa.net

DOCTOR’S OFFICE LARGE ROOM FOR RENT NY (FLATIRON) $2000

Medical office space available to share in a great building in the Flatiron District of NYC. Amenities include: 24-hour doorman and elevator access. Room is large, recently renovated, has a sink with working plumbing, central air (CAC), and audio with volume control. Space is also available at the reception bay. Rent- $2000/month if full-time; less if part-time. All utilities except phone included. Dr. Christopher Anselmi 212-475-8104 anselmic@hss.edu

INDEPENDENT CONTRACTOR POSITION AVAILABLE- GREATER ST. LOUIS MISSOURI AREA

Immediate full-time position available in the long term care field. One of the largest providers of long term care servicein the midwest. Corporate support with 10+ years in the business. Competitive compensation and assistant provided. Fax resumes to (636)281-1808.

ASSOCIATE POSITION -ARIZONA

Seeking an experienced podiatrist versed in all aspects of podiatry with current AZ License. The right person will join as a salary associate leading to partial ownership in a group practice. Podiatry practice is well established over 25 years, successful and a large volume in the Phoenix metro area. Position available immediately. Email CV and inquiries to: pprac4sl@cox.net

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 WANTED – SOUTH FLORIDA

Miami-Dade and SW Ft. Lauderdale, well established surgical practice needs part-time podiatrists to assist in surgical cases and patient volume. Email response to podfootdocs@aol.com

PRACTICE FOR SALE – SOUTH FLORIDA

Miami-Dade and SW Ft. Lauderdale, well established surgical practice for sale. This one has everything. Surgery, Orthopedics, Pediatrics, Trauma, ER, General Podiatry. Participates in all local and national managed care plans. $850,000 but will discount depending on amount up front. Mature, serious inquires with business experience preferred. Email response to podfootdocs@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

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