The Voice of Podiatrists

September 06, 2006 #2,682 Editor-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2006- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

This week’s prize is a Silver Subscription to Codingline.com (Value $89) Codingline Silver is a listserv forum that allows, via email or through the Codingline site, registrants to participate in discussions on specific topics related to foot & ankle coding, reimbursement and practice management issues. Subscribers can submit questions they wish others to discuss, or offer comments to questions posed by others. Discussion participants may include Codingline Silver, Gold, and/or expert panelists. www.codingline.com

To enter, simply complete our practice survey at www.podiatrym.com and send your name, address, and question #45 from the survey to bblock@podiatrym.com. All entries are eligible for our grand prize of a one-week Windjammer Caribbean Cruise. Don’t forget to vote for next year’s inductee into the PM Podiatry Hall of Fame. This year, we’ve opened a new category for non-podiatrists.

FL Podiatrists Reports 80% Success Rate With Cryotherapy

Viera podiatrist Dr. Robert Tinsley is always on the lookout for treatments to reduce pain and suffering for his clients with foot injuries and ailments. In 2004, he became one of the first physicians in the area to purchase a CryoStar system for applications in what's known as cryo-analgesia, a specialized freezing technique for providing long-term pain relief for various podiatric conditions.

Dr. Robert Tinsley

"It is really an alternative to an excision procedure," Tinsley said. "Pain is sensed through the nerves, so we disable those nerves so that they can no longer transmit pain sensations." "We have treated about 90 patients," he said. "We are running about an 80 percent success rate. For patients that still have pain, we can try the procedure again or look into other options."

Tinsley said he chose to invest in the relatively expensive machine -- costing about $27,000 -- because it offered him a less invasive and more reliable tool. Tinsley said alternative treatments include excision procedures to remove nerves that require patients to miss a week of work and injection procedures that must be repeated. "I see many patients who have been treated using other methods that were time-consuming and had not produced a result for them," Tinsley noted.

When asked why more area doctors have not started offering the treatment, Tinsley said it could be a matter of money. "Some insurance companies don't cover the procedure," Tinsley said. "It is similar to the costs involved in laser treatments when they first came out, and now costs have come down." The procedure costs $550 for patients without insurance coverage. In-network co-payments vary by insurance carrier.

Source: Gayla Schaefer, Florida Today [9/5/06]

PA Podiatrist Honored for Long Service to Community

Among this year's recipients of Buhl Day honors was Dr. Leonard Pleban who received gifts and rode in the lead vehicle as part of a 11/2-mile-long parade. Pleban, a podiatrist for 56 years, was praised for offering free medical services and being team doctor for 50 years to Sharon High School's athletics department. Pleban, 86, practices in his Jefferson Avenue office and visits people at home, hospitals and nursing homes weekly.

Dr. Leonard Pleban

The Hermitage man, who was inducted into the Mercer County Hall of Fame in 1990, also was honored for his practice of making house calls and for offering his services to area nursing homes. "It's very humbling," he said of being selected. "Being picked is overwhelming."

Source: Sean Barron, Youngstown Vindicator (OH)[9/5/06], ], Courtney Anderson, The Herald [9/1/06]

E-Prescribing Holds Promise for Improving Rx Drug Adherence

Electronic prescribing has proven its ability to reduce medication errors and confusion that can result from doctors’ notoriously messy handwritten scripts. Plan medical directors say the technology also has the potential to improve another persistent healthcare problem: ensuring patients actually take their medications.

E-prescribing can let doctors know if their prescriptions are being filled — knowledge that allows physicians to intervene when necessary. A pilot project using an e-prescribing tool offered by Caremark, Inc. has cut by half non-adherence rates in two classes of drugs, according to medical directors involved in the initiative.

Prescription drug adherence — getting patients to finish their medications in the manner recommended by their doctors — “is a very real problem,” said Jan Berger, M.D., senior vice president and chief medical officer at Caremark. Poor adherence has a financial impact of $100 billion a year in direct health care costs and $50 billion in lost productivity.

Source: Drug Benefit News

Query: Autologous Platelet Gel Concentrate

Does anyone have experience using platelet gel in the treatment of plantar fasciitis? It is used to enhance wound healing. It is being looked at for treating tennis elbow.

Bruce Lebowitz, DPM. Baltimore, MD, blebowit@jhmi.edu

RE: Pedorthists: “Pharmacists of Shoes”
From: Robert S. Schwartz, C. Ped.

On behalf of the The International Alliance For the Advancement of Pedorthic Education (aka the Pedorthic Alliance) I would like to clarify a quote given in PM News #2,680. The Pedorthic Alliance is a coalition of pedorthic educators whose mission is to advance quality outcome-based pedorthic education and training globally to potential and practicing pedorthists, other allied healthcare professionals, retailers and the public.

In 2006, there was an increase in the curriculum requirements for individuals seeking to become a Board Certified Pedorthist. It is not linked to any Associates Degree Program. It remains a certification program with an increase in standards from prior years. It is now a compentency based educational program. The current curriculum is provided on-site in approximately a three to four week period. Currently educators must test the participant for competency before they sit for the BCP exam.

With pedorthists as members of the healthcare team, we as the pedorthic educators, are working to elevate the profession at the entry level as well as the practitioner level. We invite all healthcare professionals to join forces to upgrade the pedorthic profession. For more information on the International Alliance For the Advancement of Pedorthic Education (aka the Pedorthic Alliance) visit www.pedorthicalliance.org

Robert S. Schwartz, C. Ped., New York, NY, rss@eneslow.com

RE: Sclerosing Injection Protocol
From: G. Dock Dockery, DPM

I have received several E-mails from podiatrists from all around the country. Most of them say what a great addition the dilute alcohol injections has been to their treatment options. Many state that they haven't had to surgically treat a neuroma in one or two years because the injections are so successful. A few state that they are getting from 40 to 50% success following seven injection but most are having around 80 to 90 % success.

What bothers me, though, are the notes from doctors saying that we shouldn't be doing this treatment because they don't believe that the injections work; or, that the treatment is not really sclerosing the nerve; or, that some podiatrists are charging too much; or, that one of our own insurance coding experts advise against it; or, that insurance companies are going to start scrutinizing podiatrists more closely; or, that there are no good double-blind research papers comparing an equal amount of local anesthetic agent alone or and equal amount of local and cortisone.

I think that we should always embrace techniques that make our patients better and from my experience, and the feedback I receive from numerous podiatrists at every seminar I attend, the technique works and it works well when performed correctly on the proper patient. I don't call the injection technique "sclerosing injections" anymore but call them "chemical neurolysis injections" instead.

Finally, it is my understanding that there are at least two studies in current process that are trying to document the comparison of a dilute alcohol injection and cortisone injection. As you can imagine, this is very difficult because many patients don't have equal and symmetrical 3rd metatarsal space neuroma symptoms allowing a good comparative treatment in a blinded manner. Hopefully these studies will shed some light on the comparison and add a little more confidence in the technique.

I will continue to recommend this valuable treatment until someone can convince me that I am doing more harm than good.

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

ASSOCIATE POSITON - SOUTHEAST TENNESSEE/ NORTH GEORGIA

Immediate position available or will wait for the right individual. Unique practice opportunity in growing multi-physician/multi-office practice. Well established/cutting edge within the medical community. Close proximity to hospitals as well as opportunity to become involved with a free standing podiatric surgical center. Must be BQ/BC. Minimum PSR/24. Competitive salary, bonus structure and benefits. E-mail CV to afcjen@hotmail.com

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.

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

WEEKLY SPECIAL - One week of ads (6x) for only $75

PM Classified Ads Reach over 8,500 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 8,000 DPM's. Write bblock@podiatrym.com for details. Note: For commercial or display ads contact David Kagan at (800) 284-5451 dekagan@aol.com

• To Post a message, send it to:    bblock@podiatrym.com
• Notes should be original and may not be submitted to other publications or listservs without our express written permission.
• Notes must be in the following form:
  RE: (Topic)
  From: (your name, DPM)
  Body of letter. Be concise. Limit to 250 words or less). Use Spellchecker
  Your name, DPM City/State
• Subscribers are reminded that they have an ethical obligation to disclose any potential conflicts of interest when commenting on any product, procedure, or service.