The Voice of Podiatrists

Serving Over 12,500 Podiatrists Daily

September 07, 2011 #4,253 Publisher-Barry Block, DPM, JD

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The photo of the 9-11 remembrance in yesterday's PM News should have listed the female podiatrist in the photo as Dr. Wilma Hunt-Watts.

By Dr. Peter Vannucchi

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Minimalist Shoes May Cause Overuse Injuries: NY Podiatrist

You see barefoot running shoes everywhere now. But could they be dangerous, or good for your feet? It’s the hottest new trend in sneakers. They feel like almost nothing. All the major manufacturers are making lightweight, minimalist shoes that mimic the feel of barefoot running, but promise to protect your feet. 

Dr. Christopher Ferguson

Some runners believe the movement is less jarring to the joints. But podiatrist Dr. Christopher Ferguson says the shoes may cause other problems. “Stress fractures, bunions, hammertoes, tendinitis, problems like that. Some people are even touting that it might even increase the impact in the forefoot. But we don’t know. There are no studies on it yet,” said Dr. Ferguson. That’s happening right now. Research is underway to compare injury rates between the new minimalist shoes and standard sneakers.

Source: Stephanie Stahl, KYW News radio [09/06/11]

OH Podiatrist Participates on a Medical Mission to Nicaragua

MedWish International is a non-profit organization committed to the recovery and recycling of donated medical supplies area healthcare providers must discard because they are expired. These life-saving supplies are made available to those providing medical care in developing countries throughout the world. 

Dr. Howard Kimmel in Nicaragua

Globally, the MedWish International program improves the quality of medical care available to the underserved around the world. On this mission, Dr. Howard Kimmel participated in the care of over 2,000 Nicaraguan local indigent patients, attending to their medical needs.

FL Podiatrist Arrested for Forging Narcotics Rxs

A podiatrist reportedly forged a fellow physician's signature to obtain oxycodone and other prescription medications at several pharmacies. Sarasota County Sheriff's Office investigators recently arrested Boyd Allen Robinson, 44 on six counts of fraud and one count of forgery.

Arrest and jail records state that Robinson is a podiatrist at The Foot & Ankle Clinics of Venice, Englewood, and Port Charlotte and the Surgery Center at St. Andrews. Detectives believe that, between June 4 and July 18, Robinson got forged prescriptions filled at Walgreens.
 
Source: Sarasota Herald-Tribune [9/6/11]

New NLRB Rule Requires Notification of Employee Rights to Organize

On August 25, 2011, the National Labor Relations Board (NLRB) issued a final rule that will require most private sector employers to post notices in their workplaces advising employees of their rights under the National Labor Relations Act (NLRA), regardless of whether the workplace is unionized or union-free. The NLRA, enacted in 1935, is the Federal statute that provides employees with the right to self-organization, to form, join, or assist labor organizations, to bargain collectively through representatives of their own choosing, and to engage in other concerted activities for the purpose of collective bargaining or other mutual aid or protection.

The rule appeared in the Federal Register on August 30, 2011, and will take effect 75 days after publication, on November 14, 2011. The NLRB has developed an 11-by-17 inch poster listing the NLRA rights, of which employees must be advised. Employers may download copies of the poster from the NLRB's website, nlrb.gov. The notice must be posted in conspicuous areas, including all places where other workplace notices are normally displayed. Employers must take steps to ensure that the notice is not altered, defaced, or covered with other material. Failure to post the notice is considered an "unfair labor practice" under the NLRA and can be reported to the NLRB by employees. Employers should maintain a record of when and where they posted the notice, including a digital photograph to serve as evidence of compliance with the notification requirement.

Source: Schwarzberg & Associates via Dr. Bret Ribotsky

Be Curious During Conflict

To resolve a conflict, approach the conversation with curiosity. Be ready to learn before you respond. As the other person talks, listen for answers to these questions:

•  What is the underlying cause of the conflict? Often what you begin discussing is only a triggering event. There’s more going on.
•  Why does this person view the situation that way? Understanding the other person’s viewpoint is key to working toward a resolution.
•  What does this person see that I don’t? Be willing to admit that you don’t know everything.
•  What do I know that this person doesn’t? Providing more information can sway the other person.

Source: Adapted from Conflict 101, Susan Shearouse, AMACOM via Communication Briefings

Query: NGS Medicare Request for Refund

I recently received two notices from National Government Services that I was overpaid for a service last year. NGC asked for the money back. It wasn't much money - about $16 and $60 - but they gave no explanation of what happened. They said I was supposed to know, that I didn't deserve it (their tone was that I somehow cheated them). They did not ask for more information - they just basically made the judgment that I was wrong. I sent in an appeal asking for the reason. Advice?

Name Withheld by Moderator

Response: You are correct, the way the letter is written, it puts the burden on YOU. If you are using ERAs to post your Medicare payments, the explanations are slim (in addition to the letter you received).

When I post Medicare payments from ERAs - I also print out the EDI report, so I have the complete explanation, not just part of it. Have your biller call the Provider Services line at the carrier, and get the full explanation - or search for the EOB report in full. This will provide the answer you need for the refund request.

Recently, I received a request for refund with the same evasive reason you received. I called the Provider Services line, and found out the following: "The patient was incarcerated at the time of service." Well, if you consider being in a nursing home "incarcerated", Medicare isn't due the refund, but this patient's status was never updated...and finding out WHO is supposed to do that is a big mystery.

Karen Hurley, CMM, CPC-I, Waldorf, MD

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RE: Hypersensitivity to Narcotics (Frank DiPalma, DPM)
From: Sloan Gordon, DPM
 
For your patient who is allergic to most narcotic analgestics, why not try a non-narcotic pain medication? There are several: Toradol, Celebrex, or Tordol intranasal (Sprix). This would be easier than allergy testing, etc. Have you conferred with a local allergist?
 
Sloan Gordon, DPM, Houston, TX, sgordnodoc@sbcglobal.net

RE: Cycling-specific Orthotics (Jeffrey A Petrinitz, DPM)
From: Sheila Wright, DPM, Robert S. Schwartz, CPed

I suggest having a look higher up. Request a digital x-ray of the pelvis and lower back through his PCP or a chiropractor. Rotation/ shifting of the pelvis or L4- L5 compression neuropathy may result during cycling.

Sheila Wright, DPM, Farmington Hills, MI, sheilawrightdpm@gmail.com

Even though your patient objected to your initial recommendations to wear wider cycling shoes, there is strong anecdotal evidence (ask any pedorthist) that tight-fitting shoes cause or exacerbate burning pain in the forefoot and numbness in the toes. Since all shoes are graded up in width as well as length with each increase in size, it is most appropriate to recommend longer shoes as a first solution. Objections are normal; rejection is not. Your patient’s feet will appreciate it. As far as orthoses, if the cycling shoe has a removable full length insole, replace it with a 3/4 length semi-rigid device (ending behind met heads), dancer’s pad included.

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

RE: APMA Nixes MD/DO Referendum
From: Michael M. Rosenblatt, DPM

Much will be written about APMA’s refusal to allow a general vote of the DPM/MD/DO issue. The reason for this is primarily parliamentary and has nothing to do with the actual issue. That said, it is important for APMA NOT to take what may appear as an obstructionist point of view. Appearances are always important. Most DPMs are dues-paying members and wish to continue. This issue is as primary as it gets for DPMs.

The DPM degree and range of practice, while certainly adequate for earning a living, forces podiatrists to squander precious political and practice management resources. On that, I think all DPMs agree. This is an historical problem that goes back to the very beginning of podiatry. Each generation is forced to play the same, exhausting and above all expensive educational effort with politicians, insurers, practice boards, hospitals, attorneys, judges and the courts.

Even more important, the new degree will benefit this country. There are about 15,000 DPMs. A widening of their practice scope will allow millions more Americans to actually be seen by American-trained physicians. Alternatively, we will have to import a large number of doctors from second and third world countries to fill this gap. This is a fact of life, no doubt recognized by the medical doctors of California, when they came to the same conclusion DPMs did.

Even if you don’t think you need to change your degree right now, please recognize the value this will bring to all of the parties involved, not the least all Americans who crave American-trained healthcare.

Michael M. Rosenblatt, DPM, San Jose, CA, Rosey1@prodigy.net

RE: You Mean I Have to Pay?

I was walking from my office to the hospital (across the street) when a guy in a new Camry stopped me and asked where should he park to visit the ER. I asked if he was visiting someone or a patient. He told me he broke his foot and needed to park close by. I told him how lucky he was that I was a podiatrist and could treat him. The guy told me, "I don't want to go somewhere where I have to pay."

Bret Ribotsky, DPM, Boca Raton, FL

 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.

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

FULL-TIME ASSOCIATE POSITION – NORTHEASTERN PENNSYLVANIA (LEHIGH VALLEY)
 
Well-established, rapidly growing practice with multiple offices. Motivated, ethical and personable with well-trained PSR-24/36. Modern office’s with complete EMR, digital radiography, diagnostic ultrasound, and laser. Competitive salary/benefits package with partnership opportunity. If interested please fax your CV, letter of intent and references to: 610-432-4887.

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 - 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 toddavidphawk@yahoo.com

SPACE AVAILABLE- NYC & LI

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

PM News Classified Ads Reach over 12,500 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 12,500 DPM's. Write tobblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $109 for a 50-word ad THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451.

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