The Voice of Podiatrists

Serving Over 9,800 Podiatrists Daily

September 12, 2007 #3,038 Editor-Barry Block, DPM, JD

A service of Podiatry Management http://www.podiatrym.com
E-mail us by hitting the reply key.
COPYRIGHT 2007- No part of PM News can be reproduced without the
express written permission of Kane Communications, Inc.

“Barefoot is Best” for Infants: IL Podiatrist

When it comes to footwear for infants, “barefoot is best” That’s because the foot and its muscles develop through the preteen years. They do it best without restrictions, says Westmont podiatrist Marlene Reid, a spokeswoman for the American Podiatric Medical Association. Toes and soles also need a free range of motion for a baby to learn how to grip and balance.

Dr. Marlene Reid

“I’ll sometimes see 2-year-olds in sandals that don’t bend, and they have to lift their whole leg up to get the foot off the ground,” Reid said. “If their foot can’t bend, they’re going to be prone to injury. I sometimes actually stop moms in the park and tell them.” Many parents believe a child should be walking by 12 months and think the right shoes might help. But the average is between 12 and 15 months. And as a mother of two, Reid adds that it’s not a milestone to hurry.

Source: Wendy Donahue, Chicago Tribune [9/9/07]

Ultra Runs All Part Of CO Podiatrist’s Journey

Bikers from Thunder in the Rockies crossed paths with ultra runner Dr. Michael Thomas going up the Big Thompson Canyon between Drake and Lake Estes on Labor Day weekend. Running those 11 miles of U.S. Highway 34 was one of the hardest parts of the 106-mile journey Thomas, 45, took from his front door in southwest Fort Collins to the top of Longs Peak and back on Sept. 1 and 2. For the rest of the journey, Thomas was able to run on trails.

Dr. Michael Thomas

It was not his first ultra run. Thomas, who is a podiatrist at the Poudre Valley Foot & Ankle Clinic,. started what many would consider the extreme sport in 1993. Anything longer than a marathon (26.2 miles) is considered an ultra run. Twenty-one of the ultra runs Thomas completed were longer than 100 miles, but none of them placed him on top of a mountain that he can see from his hometown.

Ultra running requires putting yourself in the right place mentally, Thomas said. "I enjoy the fact that when you do it, everything funnels down into one thought process. The focus of your concentration gets very intense," Thomas said. "You could be in great shape, but if you don't put your body and mind in the right space - if you don't get past the hard times, you won't finish." Thomas said he starts his day with at least an hour-long run 6 days a week. When he's peaking toward a goal he runs 15 to 20 hours per week. "My running has been my best teacher," he said.

Source: Kelli Lackett, The Coloradoan [9/9/07]

IL Podiatrist Awes By Hair of His Chinny, Chin, Chin

His interview with BBC radio may have reached 400 million listeners worldwide, and Norwegian television followed him around watching him pile onions on a hot dog.Portuguese TV loved him, too, but maybe that's because David Powell — the imposing Evansville podiatrist who competed Sept. 1 in the World Beard and Mustache Contest in Brighton, England — told them Portuguese explorer Vasco de Gama was "much more of a real navigator than Christopher Columbus."

Dr. David Powell

"I had a blast," Powell said Friday of the biennial event, which drew more than 250 soup strainers and cookie dusters from 20 countries, including a Beard Team USA that had the heavily favored Germans scratching their chins. The Germans still won a majority of awards, "but we took a bite out of them. The American team won four firsts (out of 16) and five second and thirds," Powell boasted. And that doesn't count his fourth place finish in the Partial Beard Freestyle category.

"It was fun and I didn't trip on stage," he said of the experience which found him standing before several celebrity judges and a crowd of 2,300 at the seaside resort's convention hall. Onlookers each paid 10 pounds ($20) to watch, with money going to a children's charity. Powell, who has a salt-and-pepper mustache and two long tufts of chin hair that can reach his ears, plans to enter the event again when it comes to Anchorage, Alaska, in 2009.

Source: Rich Davis, Evansville Courier [9/8/07]

PAD Patients Need Timely Treatment: German Study

A recent German study on peripheral arterial disease, entitled getABI has recently been reported and published.

The study reported at the European Society of Cardiology concluded that PAD patients should no longer be treated as second-class atherothrombotic patients — whether they are asymptomatic or symptomatic, they die 10 years early. A huge number of lives could be saved if patients with atherosclerosis would be identified with ABI and treated timely. The study can be found at:

www.medscape.com/viewarticle/562571?sssdmh=dm1.300755&src=nldne

This study further confirms prior findings of the American Heart Association.

Source: Medscape via Paul Kesselman, DPM

Query: Unusual Presentation Of Diabetic Neuropathy

A 60 year old male had leg weakness in March. By April he couldn't walk. He was diagnosed with Type II DM, A1C 9+. He had no pain, burning, tingling or numb sensations. MRI, Ct scan plain films were all negative. Blood work neg for Lyme disease, etc. only showed Vit B12 level was a little low. He was given B12 injections now taking oral B12. NCS and EMG only showed neuropathy. He can now walk with a cane, but remains very weak.

The strength of extensors and calf muscles 1/5, tibialis posterior 2/5, peroneals 2/5. He has no pain, but he has intermittent tingling. LOPS, plantar right heel only. His PCP and endocrinologist don't believe the weakness is only from diabetic neuropathy. I am very skeptical as I have never seen diabetic neuropathy present with only paralysis and weakness. I have recommended a muscle and nerve biopsy Any other suggestions would be greatly appreciated.

Edward Orman, DPM, Perry Hall. MD

Query: Consumers Research

Has anyone heard of Consumers Research? This group selects the "leading podiatrists in America" among other groups. It has a website as well. www.consumersresearchcncl.org Check it out.

Lloyd S. Smith, DPM, Newton, MA

Query: Correct Use of T Modifiers

When we are performing bunionectomy procedures or tailor bunion correction procedures, can we use the "T" modifiers to describe location?

What about metatarsal surgery? Can a procedure done on the first or second metatarsal be coded with a "TA" or "T1" modifier, respectively, or are the "T" modifiers just for procedures performed on the actual toe? I use them, and have not had a problem yet, but I am looking for a more authoritative answer in responding back to someone.

Caroline McCravy, Tucker, GA

Response: "T" modifiers are for TOES only, not for metatarsals.

Use "LT" or "RT" modifiers to specify left versus right foot. If you perform surgery on multiple metatarsals on the same foot, you would append "-59" modifier to one CPT and the "LT" (or "RT") to the other. You need to consult to CCI to determine with procedure gets the "-59" modifier.

Mark Schilansky, DPM, Catskill, NY

Codingline subscription information can be found at:
http://www.codingline.com/subscribe.htm

RE: Disclosure of Gifts to Physicians
From: Charles Stillman, DPM

This adds a new definition to the meaning of chutzpah. Congress should demand this only if Congressmen disclose the "gifts" that they receive.

Charles Stillman, DPM, Palm Desert, CA, StillmanCP@aol.com

RE: Low Medicaid Payments (Gregory B. Nellis DPM)
From: Vito J.Rizzo, DPM

I can sense Dr. Nellis’ frustration. It is true the situation regarding fees, particularly those associated with the Medicaid system is terrible. However, Dr. Nellis incorrect in thinking that the NYSPMA is not paying attention, and is doing nothing. Issues such as this one get a great amount of air time at the meetings of the BOT and in committee discussions. The result is that we are working to change the status quo. Representatives of the NYSPMA and APMA meet with government officials and insurance groups to protect the interests of its members regularly. We are working with the representatives of MSSNY (it's an issue for their members as well) to correct these injustices.

What you need to realize is that our strategy of expanding the scope of practice and gaining recognition as physicians under Title 19 of Federal Medicaid Statutes needs to be accomplished to be able to create a position that will give us leverage to force a change for these issues.

Podiatrists should write letters and visit their elected representatives regularly explaining this and other issues affecting providers. I advocate that our patients do the same. Support NYSPMA and APMA. Be innovative in your practice business plan to optimize payment for the care that you render and continue providing quality care to patients that are in need.

Vito J.Rizzo, DPM, Trustee, NYSPMA, rizzo@optonline.net

ASSOCIATE POSITION - WISCONSIN

Our group practice is seeking caring DPM's for FT & PT opportunities available in the Eau Claire, Wausau, and Stevens Point regions. We offer an excellent compensation package and a family-friendly flexible schedule. Please fax or email resume to (920) 468-1235 or caringwi@healthdrive.com, or please call Dianna DeMond at (920) 366-6762.

ASSOCIATE POSITION- NORTH LOS ANGELES COUNTY

Full scope of podiatry. Requires usual skills in surgery, medicine and biomechanics. Must be self-starter and highly motivated. Two full days per week. May soon increase to three days per week. All billing and administrative aspects handled by staff. Can practice autonomously. footguy1@pacbell.net

ASSOCIATE POSITION - LOUISIANA

2-location (Baton Rouge / Villa Platte) Louisiana practice has an immediate opening for an associate with option to buy, written into the contract. Earn, learn and buy! We won't let you fail. Great pay with benefit package. Send CV to American Doctor Sales, fax 614-918-3001

NY/NJ METRO PRACTICE FOR SALE

Sellers motivated! Contact American Doctor Sales 614-918-3000 or email sell_my_practice@yahoo.com 10-year financing available with working capital loans - we can get'r'done!!!

PODIATRISTS NEEDED - CHICAGO --NORTHWEST INDIANA

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists. We are located in Chicago and Northwest Indiana. Full and part time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-292-4800. Fax 773-342-4201 -E-Mail sschneider@homephysicians.com -- www.homephysicians.com

IN-NETWORK PODIATRIST WANTED – MANHATTAN

Busy Manhattan Office (2 locations) needs IN-NETWORK PODIATRIST, Can start immediately-Do not reply unless you are in with all plans Plz respond to gelus07@yahoo.com

ASSOCIATE POSITION – LOUISVILLE, KY

Immediate opening for multi-office podiatric practice specializing in general podiatry, high volume orthotics, surgery, and advanced wound care. Looking for a motivated, surgically trained podiatrist. Partnership opportunity. Competitive starting salary, benefits, and pension. Please submit: CV, letter of intent and references to: jbroyles23@yahoo.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.